Philosophy of Medicine and Bioethics: A Twenty-Year Retrospective and Critical Appraisal (Philosophy and Medicine)

360 Pages·1997·1.85 MB·English

by  Ronald A. Carson

PHILOSOPHY OF MEDICINE AND BIOETHICS
Philosophy and Medicine
VOLUME 50
Editors
H. Tristram Engelhardt, Jr., Center for Ethics, Medicine, and Public Issues, Baylor
College of Medicine, Houston, Texas and Philosophy Department, Rice
University, Houston, Texas
Stuart F. Spicker, Center for Ethics, Medicine, and Public Issues, Baylor College of
Medicine, Houston, Texas
Associate Editor
Kevin W. Wildes, S.J., Department of Philosophy, Georgetown University,
Washington, D.C.
Editorial Board
George J. Agich, School of Medicine, Southern Illinois University, Springfield, Illinois
Edmund Erde, University of Medicine and Dentistry of New Jersey, Stratford, New
Jersey
E. Haavi Morreim, Department of Human Values and Ethics, College of Medicine,
University of Tennessee, Memphis, Tennessee
Becky White, Department of Philosophy, California State University, Chico,
California
PHILOSOPHY OF
MEDICINE AND BIOETHICS
A TWENTY-YEAR RETROSPECTIVE
AND CRITICAL APPRAISAL
Edited by
RONALD A. CARSON
Institute for the Medical Humanities,
University of Texas Medical Branch, Galveston, Texas, U.S.A.
CHESTER R. BURNS
Institute for the Medical Humanities,
University of Texas Medical Branch, Galveston, Texas, U.S.A.
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TABLE OF CONTENTS
RonaldA. Carson and ChesterR. Burns / Introduction ix
SECTION I HISTORY AND THEORY
EdmundD. Pellegrino / Bioethics as an Interdisciplinary Enterprise:
Where Does Ethics Fit in the Mosaic ofDisciplines? 1
K. DannerClouser / Humanities in the Service ofMedicine:
Three Models 25
Stephen Toulmin / The Primacy ofPractice: Medicine and
Postmodernism 41
Marx W. Wartofsky / WhatCan theEpistemologists Learn from the
Endocrinologists? OrIsthe PhilosophyofMedicine Based ona
Mistake? 55
Edmund D. Pellegrino/Praxis as a Keystone forthe Philosophy
andProfessional Ethics ofMedicine: TheNeed foranArch-Support:
Commentary onToulmin andWartofsky 69
H. TristramEngelhardt, Jr. / BioethicsandthePhilosophyof
MedicineReconsidered 85
Henk ten Have / FromSynthesis andSystemto Moralsand
Procedure: The Development ofPhilosophy ofMedicine 105
StuartF. Spicker / The Philosophy of Medicineand Bioethics:
Commentary ontenHaveandEngelhardt 125
v
vi TABLE OF CONTENTS
SECTION II PRACTICE AND THEORY
Larry R. Churchill / Bioethics in Social Context 137
Judith Andre / The Week of November Seventh: Bioethics as Practice 153
Thomas R. Cole / Toward a Humanist Bioethics: Commentary on
Churchill and Andre 173
Ronald A. Carson / Medical Ethics as Reflective Practice 181
Anne Hudson Jones / From Principles to Reflective Practice
or Narrative Ethics? Commentary on Carson 193
Carl Elliott / Hedgehogs and Hermaphrodites: Toward a More
Anthropological Bioethics 197
Gerald P. McKenny / An Anthropological Bioethics: Hermeneutical
or Critical? Commentary on Elliott 213
Loretta M. Kopelman / Medicine’s Challenge to Relativism: The
Case of Female Genital Mutilation 221
Grant Gillett / “We be of one blood, you and I”: Commentary
on Kopelman 239
Courtney S. Campbell / Must Patients Suffer? 247
David Barnard / Doctors and Their Suffering Patients:
Commentary on Campbell 265
SECTION III POLICY
Baruch Brody / Whatever Happened to Research Ethics? 275
Harold Y. Vanderpool / What’s Happening in Research Ethics?
Commentary on Brody 287
E. Haavi Morreim / At the Intersection of Medicine, Law, Economics,
and Ethics: Bioethics and the Art of Intellectual Cross-Dressing 299
William J. Winslade / Intellectual Cross-Dressing: An
Eccentricity or a Practical Necessity? Commentary on Morreim 327
Notes on Contributors 335
Index 337
IN MEMORIAM
MARX W. WARTOFSKY
1928 - 1997
With the death of Marx Wartofsky, American philosophy has
lost one of its most noble, generous, and energeticmembers.
The Philosophy and Medicine series would not have come
into existence without the support of Marx Wartofsky and
Robert Cohen, who, in 1974, approached D. Reidel Publishing
Company prior to the First Trans-Disciplinary Symposium
on Philosophy and Medicine.
The Editors are very fortunate to be able to publish Professor
Wartofsky’s contribution in this celebratory volume. The
philosophy of medicine has its character due to his creative
work. We deeply regret that he did not live to see its
publication.
He will be sorely missed.
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RONALD A. CARSON AND CHESTER R. BURNS
INTRODUCTION
The Institute for the Medical Humanities at the University of Texas Medical
Branch co-sponsored the first Trans-Disciplinary Symposium on Philosophy and
Medicine which was held in Galveston in May, 1974. The papers presented at
that meeting inaugurated a philosophy and medicine book series edited by H.
Tristram Engelhardt, Jr., and Stuart F. Spicker.
In their introduction to Volume 1 of this series, Engelhardt and Spicker
emphasized that there are “few, if any areas of social concerns so pervasive as
medicine and yet as underexamined by philosophy.”1 Participants in the first
symposium contributed historical and philosophical assessments of concepts of
health and disease, explorations of epistemological questions in the philosophy
of science and medicine, and phenomenological analyses of the relation of body
and self. There was also a lively exchange on “virtue ethics.” The editors envi-
sioned a continuing series of symposia that would provide opportunities for sus-
tained transdisciplinary dialogues about philosophy and medicine.
To help celebrate more than twenty years of extraordinary success with this
series, we convened another symposium in Galveston in February, 1995. We
asked the participants (some of whom had attended the first symposium) to ad-
dress the following questions: In what ways and to what ends have academic
humanists and medical scientists and practitioners become serious conversation
partners in recent decades? How have their dialogues been shaped by prevailing
social views, political philosophies, academic habits, professional mores, and
public pressures? What have been the key concepts and questions of these dia-
logues? Have they come and gone or remained with us, and why? Have the
dialogues made any appreciable intellectual or social differences? Have they
improved the care of the sick?
ix