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

360 Pages·1997·1.85 MB·English
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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. KLUWER ACADEMIC PUBLISHERS NEW YORK,BOSTON, DORDRECHT, LONDON, MOSCOW eBookISBN: 0-306-48133-2 Print ISBN: 0-7923-3545-7 ©2002 Kluwer Academic Publishers NewYork, Boston, Dordrecht, London, Moscow Print ©1997 Kluwer Academic Publishers Dordrecht All rights reserved No part of this eBook maybe reproducedor transmitted inanyform or byanymeans,electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Kluwer Online at: http://kluweronline.com and Kluwer's eBookstore at: http://ebooks.kluweronline.com 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. This page intentionally left blank 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

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Papers presented at a symposium on philosophy and medicine at the Institute for the Medical Humanities at the University of Texas Medical Branch in 1974 were published in the inaugural volume of this series. To help celebrate more than 20 years of extraordinary success with the series, another sympo
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