The American Journal of Bioethics, Volume 12, Issue 9, Page 51-53, September 2012.

One striking observation in the history of rational choice models is that those models have not only been used in economics but spread widely across the social and behavioral sciences. How do such model transfers proceed? By closely studying the early efforts to transfer such models by William Riker – a major protagonist in pushing the adoption of game theoretic models in political science – this article examines the transfer process as one of ‘translation’ by which abstract and mathematical rational (...) choice models were constructed and modified such that they applied to a specific target system in a new domain. In this paper, we argue that to overcome a set of challenges that hampered the straightforward transfer of game theoretic models into political science, Riker complemented theoretical and conceptual modifications of von Neumann and Morgenstern’s game schemes with the use of narratives to turn them into applicable and testable models. As such, those narratives played a crucial role in enabling their transfer and ultimately facilitated the applicability of game theoretic models in political science. (shrink)

English summary: Ideas of man and concepts of the body are closely linked, and are a key factor in defining anthropological theories and problems. In addition, they are closely connected to the social structure of each cultural region, which itself has a continuous influence on human actions and attitudes, but which at the same time is also the result of human actions and attitudes. Scholars from various disciplines used this as their basis to explore the subject in their own cultural (...) field, each of them taking the perspective of their own methodological approach. The studies incorporate both, text and image sources. It is the authors' common goal to provide a precise description of specific anthropological developments which are dependent on time and culture and to include a discussion of basic issues of the conditio humana. German description: Menschenbilder und Korperkonzepte gehoren eng zusammen und bestimmen massgeblich anthropologische Lehren und Fragestellungen. Sie sind zudem eng mit der Sozialstruktur des jeweiligen Kulturraums verflochten, wobei dieselbe zwar ununterbrochen konditionierenden Einfluss auf menschliche Handlungen und Haltungen hat, sie aber zugleich auch das Ergebnis menschlicher Handlungen und Haltungen ist. Auf diesen Grundlagen haben sich Wissenschaftler unterschiedlicher Disziplinen zusammengefunden, um aus der Perspektive ihres jeweiligen methodischen Ansatzes dem Thema in ihrem jeweiligen Kulturbereich nachzugehen. Dabei werden Textquellen ebenso in die Untersuchungen mit einbezogen wie Bildquellen. Gemeinsames Ziel ist, zeit- und kulturgebundene Spezialentwicklungen prazise zu profilieren und Grundfragen der conditio humana in den Blick zu nehmen. (shrink)

Recent research has brought to light substantial fragments in Egyptian demotic, Old Coptic and Greek of manuals of divination by means of drawing lots. Typically, the lots carry a number, and each is attributed to a particular deity. This article presents the documentation known today, including some strips of palm leaf which could have served as the actual lots. It also discusses the degree of variation between the different manuscripts, and possible specific links between the gods and the answers to (...) which they are linked. (shrink)

Sedfestritual und Königtum: Die Reliefdekoration am Torbau Osorkons II. im Tempel der Bastet von Bubastis. By Eva Lange-Athinodorou. Ägyptologische Abhandlungen, vol. 75. Wiesbaden: Harrassowit Verlag, 2019. Pp. ix + 503, illus. €148.

Studies on societal path dependencies tend to focus on mechanisms that anchor and stabilize national trajectories while paying less attention to transnational interactions and multilevel governance. This paper explores processes of path transformation in societies that are presumed to have the characteristics of open systems. Two pairs of case studies are presented and compared. The first illustrates institutional change through collision, when a national path meets with another. The second describes the emergence of transnational institutional paths and the impact of (...) that process on national institutions and their (potential) transformation. The results indicate that path transformation often stems from a gradual succession and combination of incremental steps and junctures – change is gradual but consequential. They also point to increasing co-evolutionary interaction between national path transformation and transnational path creation. This implies a need for analytical tools that are adapted to the analysis of multi-level, nested processes of institutionalization and de-institutionalization. The paper suggests that the concept of path generation allows for a better specification of the conditions for change in existing societal paths and for the emergence of new paths in the case of open systems than the concept of path dependency. (shrink)

A novel photon-based proton model is developed. A proton’s ground state is assumed to be coherent to the degree that all of its mass-energy precipitates into a single uncharged spherical structure. A quantum vortex, initiated by the strong force, but sustained in the proton’s ground state by the circular Unruh effect and a spherical Rindler horizon, is proposed to confine the proton’s mass-energy in its ground state. A direct connection between the circular Unruh effect, the zitterbewegung effect, spin, and general (...) relativity is proposed. Such a structure acts as an uncharged zitterbewegung fermion, and may explain neutrino mass. A ground-state proton’s central zitterbewegung fermion is assumed to be surrounded by a halo of charge shells of both signs. Virtual photon standing waves are assumed to synchronize the inner shell with the central zitterbewegung fermion. The charge shells are proposed to be associated with isospin and proton g-factor. There are only two model inputs—proton mass and quantized electronic charge—and just one adjustable parameter. The adjustable parameter, reduced only by about 0.4% from an initial estimate, provides the proton’s experimentally determined magnetic moment to arbitrary precision. The resulting modeled proton charge radius agrees very well with the 2018 CODATA value. Magnetic moment and charge radius are calculated algebraically in a manner easily understood by undergraduate physics students. This proposed ground-state proton model could be considered a low-energy approximation to a full quantum chromodynamical proton model. (shrink)

After a crisis, broad and sweeping reforms are enacted to restore trust. Following the 2007-2008 Great Financial Crisis, the European Union has engaged in an ambitious overhaul of banking regulation. One of its centerpieces, the 2013 Fourth Capital Requirements Directive, tackles, amongst other things, the perceived pre-crisis failings in the governance of banks. We focus on the provisions that are aimed at reshaping bank boards’ composition, functioning, and their members’ liabilities, and argue that they are unlikely to improve bank boards’ (...) effectiveness or prevent excessive risk-taking. We criticize some of them for mandating solutions, like board diversity and the separation of chairman and CEO, that may be good for some banks but are bad for others, in the absence of any convincing argument that their overall effect is positive. We also criticize enhanced board liability by showing that it may increase the risk of herd behavior and lead to more serious harm in the event of managerial mistakes. We also highlight that the push towards unfriendly boards will negatively affect board dynamics and make boards as dysfunctional as when the CEO dominates them. We further argue that limits on directorships and diversity requirements will worsen the shortage of bank directors, while requirements for induction and training and board evaluation exercises will more likely lead to tick-the-box exercises than under the current situation in which they are just best practices. We conclude that European policymakers and supervisors should avoid using a heavy hand, respectively, when issuing rules implementing CRD IV provisions with regard to bank boards and when enforcing them. (shrink)

Are there any characteristics by which we can reliably identify and distinguish quackery from genuine medicine? A commonly offered criterion for the distinction between medicine and quackery is science: genuine medicine is scientific; quackery is non-scientific. But it proves to be the case that at the boundary of science and non-science, there is an entanglement of considerations. Two cases are considered: that of homoeopathy and that of the Quantum Booster. In the first case, the degree to which reported phenomena that (...) question established theory should be doubted arises; in the second case, the status of pleomorphism as a scientifically plausible doctrine is discussed. The application of the criterion of being scientific to these cases reveals something of the nature and density of the entanglement. (shrink)

Discerning adaptations from by-products is a defining feature of evolutionary science. Mehr, Krasnow, Bryant, and Hagen posit that music is an adaptation that evolved to function as a credible signal. We counter this claim, as we are not convinced they have dispelled the possibility that music is an elaboration of extant features of language.

Background Continued advances in human microbiome research and technologies raise a number of ethical, legal, and social challenges. These challenges are associated not only with the conduct of the research, but also with broader implications, such as the production and distribution of commercial products promising maintenance or restoration of good physical health and disease prevention. In this article, we document several ethical, legal, and social challenges associated with the commercialization of human microbiome research, focusing particularly on how this research is (...) mobilized within economic markets for new public health uses. Methods We conducted in-depth, semi-structured interviews (2009–2010) with 63 scientists, researchers, and National Institutes of Health project leaders (“investigators”) involved with human microbiome research. Interviews explored a range of ethical, legal, and social dimensions of human microbiome research, including investigators’ perspectives on commercialization. Using thematic content analysis, we identified and analyzed emergent themes and patterns. Results Investigators discussed the commercialization of human microbiome research in terms of (1) commercialization, probiotics, and issues of safety, (2) public awareness of the benefits and risks of dietary supplements, and (3) regulation. Conclusion The prevailing theme of ethical, legal, social concern focused on the need to find a balance between the marketplace, scientific research, and the public’s health. The themes we identified are intended to serve as points for discussions about the relationship between scientific research and the manufacture and distribution of over-the-counter dietary supplements in the United States. (shrink)

Separate from the question of whether our patients believe us as doctors is the question of whether we ourselves believe in our healing ‘performances’. Borrowing from Bernard Williams’ model of truth based on the two irreducible virtues of sincerity and accuracy, this article describes a spectrum of states of self-belief, from the quack who does not believe in his acts to the fanatic who does not ‘dis-believe’, with ranges of pious fraud and bad faith in between and on either (...) side of a variable range of justified self-belief. I describe how as practitioners we move and are moved up and down this range throughout our careers and as a result of the behaviors of others. The model provides the basis for a critique of the marketing efforts of industries related to medical practice. (shrink)

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)

Ägypten zwischen innerem Zwist und äußerem Druck: Die Zeit Ptolemaios’ VI. bis VIII. Edited by Andrea Jördens and Joachim Friedrich Quack. Philippika, vol. 45. Wiesbaden: Harrassowitz Verlag, 2011. Pp. ix + 338, illus. €58.

Following a recent trend in the field of the history of philosophy and medicine, this paper stresses the necessity of recognizing empiricism’s patent indebtedness to the sciences of the body. While the tribute paid to the Hippocratic method of observation in the work of Thomas Sydenham is well known, it seems necessary to take into account a trend more critical of ancient medicine developed by followers of chemical medicine who considered the doctrine of elements and humours to be a typical (...) example of the idols that hinder the improvement of medical knowledge and defend the necessity of experimentation. In light of the fact that modern discoveries resulted in a “new frame of human nature,” they developed a critical reading of ancient empiricism. As a consequence, we can distinguish between two distinct anti-speculative traditions in the genesis of philosophical empiricism. The first recommends an active investigation into nature and refers to the figure of Democritus, the ancient philosopher who devoted himself to the dissection of beasts. Defenders of this first tradition refuse point-blank to be called ‘empiricists’, a label which had a very negative meaning during the seventeenth century, when it was used to dismiss charlatans and quacks. The other tradition, stressing as it does the role of description and observation, is more sceptical of the ability of dissection or anatomy to give us access to causes of diseases. This later tradition comes closer to the definition of ancient empiricism and to the figure of Hippocrates. (shrink)

We think we know what healers do: they build on patients' irrational beliefs and treat them in a 'symbolic' way. If they get results, it's thanks to their capacity to listen, rather than any influence on a clinical level. At the same time, we also think we know what modern medicine is: a highly technical and rational process, but one that scarcely listens to patients at all. In this book, ethnopsychiatrist Tobie Nathan and philosopher Isabelle Stengers argue that this commonly (...) posed opposition between traditional and modern medicine is misleading. They show instead that healers are interesting precisely because they don't listen to patients, using techniques of 'divination' rather than 'diagnosis'. Healers construct genuine therapeutic strategies by identifying the origins of symptoms in external forces, outside of the mind of the sufferer, and in this regard African healers are virtuosos. Though it may claim otherwise, modern medicine, for its part, is characterised by empiricism rather than rationality. What appears to be the pursuit of rationality is ultimately only a means to dismiss and exclude other forms of treatment. Blurring the distinctions between traditional and modern practices and drawing on perspectives from across the globe, this ethnopsychiatric manifesto encourages us to think in radically new ways about illness, challenging accepted notions on the relationship between sufferer and symptom. It will be of great interest to those working in medicine and healthcare, as well as anthropologists, social scientists and those in the humanities more broadly. (shrink)

For generations following the first American Medical Association Code of Ethics in 1847, the relationship between doctors and advertising remained unambiguous—advertising was forbidden. In 1975, however, the Federal Trade Commission accused the profession of “restraint of trade” and legally persuaded doctors to permit advertising amongst their clan. As the 1970s witnessed the relentless burgeoning of healthcare expenditure, physicians accepted the blame for immuring themselves from the natural forces of economics. American physicians were bullied to embrace advertising under the delusion that (...) doctoring—like any trade—would become better and cheaper if incited by competition. Today most American physicians engage in some form of paid advertising, yet it is doubtful that physician advertising has either augmented the quality or diminished the cost of health care. Advertisement has eroded medical professionalism by denying doctors the right to enforce ethical boundaries between themselves and the “let the buyer beware” world of business. And more is at stake than professional status, for the doctor/patient relationship, the cornerstone of medicine, is endangered as physicians continue to cast forth the self interested lure of advertisement.To assume that for over 130 years physicians anathematised advertising for purely ethical reasons would be naive. Sociologist Paul Starr explains that in the early 19th century, no group “embraced the ways of the market as actively as did popularisers, alternative healers, and quacks”.1 Advertisement was perhaps the most successful implement of empirical medicine. So it is no surprise that professional licensed doctors in America grew up with a “distaste and discomfort for advertising”.2 Medical advertisements were especially potent in the self reliant Jacksonian era, which touted health as a do it yourself venture commodified into tonics and one time procedures. To distinguish themselves from the circus of healthcare providers, physicians not only instituted higher educational standards and licensure …. (shrink)

An epistemic agent A is a false epistemic authority for others iff they falsely believe A to be in a position to help them accomplish their epistemic ends. A major divide exists between what I call "epistemic quacks", who falsely believe themselves to be relevantly competent, and "epistemic charlatans", i.e., false authorities who believe or even know that they are incompetent. Both types of false authority do not cover what Lackey (2021) calls "predatory experts": experts who systematically misuse their social-epistemic (...) status as a cover for predatory behavior. Qua experts, predatory experts are competent and thus could (and maybe sometimes do) help their clients. But should we count them as genuine epistemic authorities? No, I argue, they are false epistemic authorities because, in addition to their practical and moral misconduct, such experts systematically deceive their clients, thereby thwarting the clients’ epistemic ends. (shrink)

In 1738, Jacques Vaucanson unveiled his masterpiece before the court of Louis XV: a gilded copper duck that ate, drank, quacked, flapped its wings, splashed about, and, most astonishing of all, digested its food and excreted the remains. The imitation of life by technology fascinated Vaucanson's contemporaries. Today our technology is more powerful, but our fascination is tempered with apprehension. Artificial intelligence and genetic engineering, to name just two areas, raise profoundly disturbing ethical issues that undermine our most fundamental beliefs (...) about what it means to be human. In The Vital Machine, David Channell examines the history of our relationship with technology and argues that, while the resolution of these issues may not be imminent, a philosophical framework for dealing with them is already in place. The source of our fears, he suggests, lies in an outmoded distinction between organic life and machines, a distinction rooted in the two world-views that have defined and guided Western civilization: the mechanical and the organic. The mechanical view holds that the universe is basically a machine--we can understand it by breaking it down into its smallest components. Even organisms are machines. The organic view claims that there is something more, some vital, directive force. The whole is more than just the sum of its parts. Even machines are organisms. Channell presents these polar views in a fascinating chronicle of human thought and achievement, ranging over the discoveries of Galileo, Copernicus, Newton, and Einstein, the philosophies of Plato, Descartes, Kant, and Marx, the fields of alchemy, physics, astrology, and biology. We see not only how the two views progressed independently, but also how they influenced each other, not only how they persisted, but also how they changed. Most fascinating of all, we follow the emergence of a third, all-embracing world view as developments in genetics, relativity, quantum mechanics, and computer intelligence force both science and philosophy to come to a more complex understanding of the universe. As a central metaphor for this third view Channell proposes "the vital machine." And in this stimulating work by the same name, he reveals how this new metaphor may provide us with the philosophical understanding we need to address the ethical issues our science has created. (shrink)

Many potential therapeutic agents are discarded before they are tested in humans. These are not quack medications. They are drugs and other interventions that have been developed by responsible scientists in respectable companies or universities and are often backed up by publications in peer-reviewed journals. These possible treatments might ease suffering and prolong the lives of innumerable patients, yet they have been put aside. In this paper, we outline a novel mechanism—the Plutocratic Proposal—to revive such neglected research and fund (...) early phase clinical trials. The central idea of the Proposal is that any patient who rescues a potential therapeutic agent from neglect by funding early phase clinical trials should be offered a place on the trial. (shrink)

This essay uses the case of the fin-de-siècle Vienna embryologist Samuel Leopold Schenk to analyze the factors at play in allegations of misconduct. In 1898, Schenk published a book titled Theorie Schenk. Einfluss auf das Geschlechtsverhältnis. The book argued that, by changing their diet, women trying to conceive could influence egg maturation and consequently select the sex of their offspring. This cross between a scientific monograph and a popular advice book received enormous publicity but also spurred first the Vienna Medical (...) Association and then the Senate of the University of Vienna to accuse Schenk of poor science, self-advertisement, quack medical practice, and wrong publisher choice. Formal proceedings against Schenk ended in 1900 with the unusually harsh punishment of early retirement. Schenk died two years later. I examine the elements of the case, from the science of sex determination and selection, to the growth of print media and advertising within the changing demographic and political landscape of Vienna. I argue that the influence of the public, via the growing media, upon science was the main driver of the case against Schenk, but also that the case would have had a more limited impact were it not for the volatile political moment rife with anti-Semitism, nationalism, and xenophobia. I draw the attention to the importance of setting cases of misconduct in the broader political history and against the key social concerns of the moment. (shrink)

In its forty years of existence, Artificial Intelligence has suffered both from the exaggerated claims of those who saw it as the definitive solution of an ancestral dream — that of constructing an intelligent machine-and from its detractors, who described it as the latest fad worthy of quacks. Yet AI is still alive, well and blossoming, and has left a legacy of tools and applications almost unequalled by any other field-probably because, as the heir of Renaissance thought, it represents a (...) possible bridge between the humanities and the natural sciences, philosophy and neurophysiology, psychology and integrated circuits-including systems that today are taken for granted, such as the computer interface with mouse pointer and windows. This writing describes a few results of AI that have modified the scientific world, as well as the way a layman sees computers: thetechnology of programming languages, such asLISP-witness the unique excellence of academic departments that have contributed to them-thecomputing workstations-of which our modern PC is but a vulgarised descendant-theapplications to the educational field-e.g., the realisation of some ideas of genetic epistemology-and tointerdisciplinary philosophy-such as Hofstadter's associations between the arts and mathematics-and the use ofAI techniques in music and musicology. All this has led to a generalisation of AI towards Negrotti's overallTheory of the Artificial, which encompasses further specialisation such asartificial reality, artificial life, and applications ofneural networks among others. (shrink)

The book "Wer hat das Wissen in der Wissenschaft versteckt?" [Who had hidden knowledge in science?] is about the organisational character of science - "science" as understood in continental Europa as social & natural sciences. The reason for this interest is that, as it is the case with other things, human beings undertake scientific enquiries because they, as individuals, have certain interests related to the content of their activities, they want to know certain things. Then, when an activity is organised, (...) the organisation (or organisational structure) itself develops own interests and imposes them on the individuals. Soon, the individuals do not follow anymore (so much) their own interests but the interests of the organisation. This phenomenon is exemplarified by an analysis of the foreword of Wilhelm Schmid's book: "Philosophie der Lebenskunst" (1998) [Philosophy of the art of living], his habilitation at the University of Erfurt: The analysis shows how Schmid in this foreword is trying hard to present the art of living (which is first and foremost useful for the individual human person) as something which is useful for society because this is what science, represented by the academic environment in which we are socialized requires. In total, the book comprises 12 individual studies of which the analysis of the foreword of Schmid's "Philosophie der Lebenskunst" is one. The other 11 studies analyse texts by: Jeanne Marie Gagnebin, Sandra Beaufays, andreas Hütig, Carl Djerassi, Monika Wogrolly, Friedericke Hassauer, Michel Foucault, John Stuart Mill, Erich Visotschnig & Siegfried Schrotta, Gordon A. Frutschnigg, and Oliver Sacks. One important aspect of the book is the relationship between philosophy and science, analysed e.g. with the help of Gordon A. Frutschnigg's diploma theses on the diploma theses completed at the Institute of Philosophy of the University of Vienna between 2005 and 2007: Can philosophy, which primarily serves for the orientation of the individual in life be scientific in the sense of the organisational character of science (which tries to exclude individual interests as best as it can for they are deemed to bring subjectivity into science striving for objective truth). The choice of the books/texts which are analyzed in this study was partly (admittedly) random; however, they bear a common characteristic which is: these are texts which show/make visible the organisational character of science. The character of the studies in this book is phenomenological because they provide a close look at 12 texts/books and their use of language, supported by extensive quotes. (shrink)

By considering the nature of the relationship between patient and healer, The Healing Bond explores the responsibilities of both, with a special emphasis on the therapeutic responsibility. The editors and contributors examine both orthodox and unorthodox forms of healing practice and apply a variety of professional and analytic perspectives to the medical profession as a whole. They look at specific areas of health such as midwifery, psychoanalysis, naturopathy, the relations between medicine and state, and the appeal of "quacks." Particular issues (...) of current concern are also discussed, including medical litigation, codes of ethics among complementary practitioners and cooperation between orthodox and complementary medicine practitioners. Contributors: Mary Douglas, Calliope Farsides, David Peters, Roy Porter, Richenda Power, Margaret Stacey, Robert Sumerling, and Gillian Vanhegan. (shrink)

Kendler and Schaffner have written an exemplary case study of the rise of the dopamine hypothesis and, if not its fall, at least its stagnation and transmutation. They bring out well both the state of the science and the opportunities offered by the theory to consider some famous philosophical theories of scientific progress. So well, in fact, have they done this, that I do not have a lot to say about it. I will just mention one or two points that (...) I found interesting, and then say a little about what looks to me like an omission from the story that the two Kens recount.One point they raise is the importance of competitor theories: now, there is supposed to be an old story about a quack who was apprehended during .. (shrink)

Summary This article discusses the intersection of science and culture in the marketplace and explores the ways in which radium quack and medicinal products were packaged and labelled in the early twentieth century US. Although there is an interesting growing body of literature by art historians on package design, historians of science and medicine have paid little to no attention to the ways scientific and medical objects that were turned into commodities were packaged and commercialized. Thinking about packages not (...) as mere containers but as multifunctional tools adds to historical accounts of science as a sociocultural enterprise and reminds us that science has always been part of consumer culture. This paper suggests that far from being receptacles that preserve their content and facilitate their transportation, bottles and boxes that contained radium products functioned as commercial and epistemic devices. It was the 1906 Pure Food and Drug Act that enforced such functions. Packages worked as commercial devices in the sense that they were used to boost sales. In addition, ‘epistemic’ points to the fact that the package is an artefact that ascribes meaning to and shapes its content while at the same time working as a device for distinguishing between patent and orthodox medicines. (shrink)

ArgumentThis article highlights the epistemic concerns that have permeated the historical discourse around charlatanism. In it, I study the term “charlatan” as a multivalent actor’s category without a stable referent. Instead of defining or identifying “the charlatan,” I analyze how the concept of the charlatan was used to make epistemic interventions about what constituted credible knowledge in two interconnected controversies. Focusing on these controversies allows me to thematize how the concept of “the charlatan” expanded beyond medical contexts and to bring (...) a history of knowledge perspective to the history of medicine.The title of the article, “Charlatan Epistemology,” indicates a historical epistemological approach to charlatanism as well as the existence of a charlatan’s embodied epistemology. On the one hand, I historicize the epistemic characteristics of charlatanism, focusing on virtues as well as vices, knowledge as well as ignorance, by addressing the historical and contextual specificities of two case studies and the larger epistemic concerns at play. On the other hand, I show how references to charlatanism implied the existence of specific embodied knowledges, special skills and techniques to manipulate either natural secrets or the human psyche, and I explore the similarities and differences between charlatan epistemology and artisanal epistemology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine by Laurence B. McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine ed. by Laurence B. McCullough, Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush by Lisbeth HaakonssenHeiner F. KlemmeLaurence B. McCullough. John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine. Dordrecht, (...) Boston, London: Kluwer Academic Publishers, 1998. Pp. xv + 347. Cloth, $140.00.Laurence B. McCullough, editor. John Gregory’s Writings on Medical Ethics and Philosophy of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xi + 254. Cloth, $105.00.Lisbeth Haakonssen. Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush. Amsterdam, Atlanta: Rodopi, 1997. Pp. x + 247. Paper, $20.50.The Scottish Enlightenment is widely appreciated for its contributions to philosophy, economics, sociology, law, chemistry, and medicine. The ideas and theories advanced by Hume, Smith, Millar, and Ferguson are still widely debated. John Gregory (1724–1773), important in his own time, is not as well known as some of his friends and colleagues. He was professor of medicine at the University of Edinburgh from 1766 to 1773, where he taught introductory lectures on the theory and practice of medicine. A set of extensive student notes from these lectures, entitled Observations on the Duties and Offices of a Physician, appeared anonymously in 1770. Two years later, Gregory himself published a revised version of his lectures under the title Lectures on the Duties and Qualifications of a Physician. These two books are said to mark the beginnings of professional medical ethics in the English-speaking world. They are also sometimes characterized as having anticipated bioethics.McCullough’s comprehensive John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine is the first modern intellectual biography of Gregory. Based on extensive research into eighteenth-century institutional context and the study of hitherto unknown manuscripts, he gives a full account of Gregory’s education at Edinburgh and Leiden, and his practice and teaching of medicine at Aberdeen, London, and Edinburgh. He stresses the importance of Gregory’s membership in the Aberdeen Philosophical Society and his close contact with Mrs. Montagu and her Circle for the understanding of his medical ethics. McCullough also shows that Bacon’s experimental method had a decisive influence on Gregory. Gregory took over Bacon’s three offices or ends of medicine: preservation of health, prolonging of life, and curing of diseases. In 1772, perhaps anticipating his premature death from hereditary gout, he added a fourth office, namely easing the pain of dying. Gregory referred mainly to Bacon (and Reid) in his Lectures to make clear how we can enlarge our medical knowledge by the method of experience and observation, pointing out that the progress of medicine had been seriously retarded by the way in which it was taught since Hippocrates. He also thought it was handicapped by the view that only professionals [End Page 535] should practice it, and claimed that even quacks have their advantages because their interest and reputation seldom suffer from the failure of the experiments necessary for the improvement of the medical profession.Gregory also argued that we should regard medicine not as a trade but as an art. In this context the principle of sympathy (or humanity) became important for him. Sympathy was the basis of the central duties in his Lectures. In a time of extreme instability of manners, when medicine was regarded more as a trade than an art, there was no physician-patient relationship based on the epistemological and moral authority of the physician. According to McCullough, it was Gregory who created “the physician-patient relationship as fiduciary. The virtues of the physician as fiduciary—openness to conviction, tenderness, and steadiness—provided for him the moral causes that would gather physicians together into a group worthy of the name, ‘profession,’ in its intellectual and moral senses” (265). The physician should no longer view his patients as moral strangers.McCullough claims that Gregory’s medical ethics is not just of historical interest, providing bioethics with its own history. It is also of... (shrink)