Pellegrino and Siegler have argued that medical ethics must be taught 'at the bedside', or clinically. This paper is an attempt to establish the need for clinical teaching of medical ethics both to medical students and to medical ethicists who are not physicians. Through a critique of six positions regarding the aims of medical ethics, four principles are established which are the basis of a philosophy of education for medical ethics. The need for a clinically-based educational programme in medical ethics (...) is thereby established, not on practical grounds, but on solid philosophical ones. The paper concludes with practical examples of a clinically-based medical ethics programme following from the four principles. (shrink)

The article offers an approach to inquiry about, the foundation of medical ethics by addressing three areas of conceptual presupposition basic to medical ethical theory. First, medical ethics must presuppose a view about the nature of medicine. it is argued that the view required by a cogent medical morality entails that medicine be seen both as a healing relationship and as a practical art. Three ways in which medicine inherently involves values and valuation are presented as important, i.e., in being (...) aimed at the good of health, in being a cognitive art evaluating towards that good, and as a manifestation of a virtuous disposition concerning that good. Finally, a value ontology drawn from these considerations is seen as necessarily underlying medical ethics. A set of three such basic values are promoted as crucial: the value of health; the value of the individual patient; and the value of altruism that mediates the class of potential patients. (shrink)

Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty. Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal (...) balances theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions. Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient. (shrink)

Exploring the moral foundations of the healing relationship, Edmund D. Pellegrino and David C. Thomasma offer the health care professional a highly readable Christian philosophy of medicine. This book examines the influence religious beliefs have on the kind of person the health professional should be, on the health care policies a society should adopt, and on what constitutes healing in its fullest sense. Helping and Healing looks at the ways a religious perspective shapes the healing relationship and the ethics (...) of that relationship. Pellegrino and Thomasma seek to clarify the role of religious belief in health care by providing a moral basis for such commitment as well as a balancing role for reason. This book establishes a common ground for believers and skeptics alike in their dedication to relieve suffering by showing that helping and healing require an involvement in the religious values of patients. It clearly argues that religion provides crucial insights into medical practice and morality that cannot be ignored, even in our morally heterogeneous society. Central to the authors' message is the concept of patients' vulnerabilities and the need to help them recover not only from the disease but also from an existential assault on their personhood. They then show how this understanding can move caregivers to view their professions as vocations and thereby change the nature of health care from a business to a community of healing. Physicians, nurses, administrators, clergy, theologians, and other health professionals and church leaders will find this volume helpful for their own reflections on the role of religion in the health care ministry and for making a religious commitment integral to their professional lives. (shrink)

Fifty years ago, 23 Nazi physicians were defendants before a military tribunal in Nuremberg, charged with crimes against humanity. During that trial, the world learned of their personal roles in human experimentation with political and military prisoners, mass eugenic sterilizations, state-ordered euthanasia of the and the program of genocide we now know as the Holocaust. These physicians, and their colleagues who did not stand trial, were universally condemned in the free world as ethical pariahs. The term became the paradigm for (...) total defection from the most rudimentary elements of medical morality. The caduceus literally became the instrument of the swastika. (shrink)

Book reviewed in this article: For the Patient's Good: The Restoration of Beneficence in Health Care. By Edmund D. Pellegrino and David C. Thomasma.

You wrote an editorial in JAMA giving a 30-year retrospective on bioethics. If you look ahead to the next 30 years, what are the issues you see facing bioethics in the future?

Pellegrino's philosophy of medicine is explored in categories such as the motivation in constructing a philosophy of medicine, the method, the starting point of the doctor-patient relationship, negotiation about values in this relationship, the goal of the relationship, the moral basis of medicine, and additional concerns in the relationship (concerns such as gatekeeping, philosophical anthropology, axiology, philosophy of the body, and the general disjunction between science and morals). A critique of this philosophy is presented in the following areas: methodology, relation (...) to ontology and sociology, the dynamic of individual and social concerns, and the new social condition of medicine. Finally, some suggestions for the future revitalization of philosophy of medicine are made based on Pellegrino's ideas. The focus throughout is on the moral basis and moral consequences of the philosophy of medicine, and not on other important themes. Keywords: doctor-patient relationship, goal of medicine, medical ethics, philosophical method, philosophy of medicine, philosophy of the body, values in medicine CiteULike Connotea Del.icio.us What's this? (shrink)

This paper argues that the concept and role of ‘institutional racism’ in contemporary discussions of race should be reconsidered. It starts by distinguishing between ‘intrinsic institutional racism’, which holds that institutions are racist in virtue of their constitutive features, and ‘extrinsic institutional racism’, which holds that institutions are racist in virtue of their negative effects. It accepts intrinsic institutional racism, but argues that a ‘disparate impact’ conception of extrinsic conception faces a number of objections, the most serious being that it (...) has no plausible account of what it is that makes extrinsically racist institutions racist. It also argues that claims about the explanatory indispensability of institutional racism are overstated (individual racism is at least as important), critiques structural approaches to racial inequality, and suggests that there is reason to doubt whether institutional reform can provide us with all that morality may require in the racial domain. (shrink)

This article discusses the adequacy of Rawls’ theory of justice as a tool for racial justice. It is argued that critics like Charles W Mills fail to appreciate both the insights and limits of the Rawlsian framework. The article has two main parts spread out over several different sections. The first is concerned with whether the Rawlsian framework suffices to prevent racial injustice. It is argued that there are reasons to doubt whether it does. The second part is concerned with (...) whether a Rawlsian framework has the resources to rectify past racial injustice. It is argued that it has more resources to do this than Mills allows. This second part of the article centers on two Rawlsian ideas: ideal theory and the fair equality of opportunity principle. It is argued that ideal theory is essential for the kind of rectificatory work that Mills wants nonideal theory to do, and that where there is a socioeconomic legacy of past injustice, it is hard to see how FEO could be implemented if it did no rectificatory work, a result which means that there is less need to turn to nonideal theory at all. (shrink)

... the topic of 'meaning' is the one topic discussed in philosophy in which there is literally nothing but 'theory' - literally nothing that can be labelled or even ridiculed as the 'common sense view'. Putnam, 'The Meaning of Meaning' This book explores some truths behind the truism that experimentation is a hallmark of scientific activity. Scientists' descriptions of nature result from two sorts of encounter: they interact with each other and with nature. Philosophy of science has, by and large, (...) failed to give an account of either sort of interaction. Philosophers typically imagine that scientists observe, theorize and experiment in order to produce general knowledge of natural laws, knowledge which can be applied to generate new theories and technologies. This view bifurcates the scientist's world into an empirical world of pre-articulate experience and know how and another world of talk, thought and argument. Most received philosophies of science focus so exclusively on the literary world of representations that they cannot begin to address the philosophical problems arising from the interaction of these worlds: empirical access as a source of knowledge, meaning and reference, and of course, realism. This has placed the epistemological burden entirely on the predictive role of experiment because, it is argued, testing predictions is all that could show that scientists' theorizing is constrained by nature. Here a purely literary approach contributes to its own demise. The epistemological significance of experiment turns out to be a theoretical matter: cruciality depends on argument, not experiment. (shrink)

Mencius, who lived in the 4th century B.C., is second only to Confucius in importance in the Confucian tradition. The _Mencius_ consists of sayings of Mencius and conversations he had with his contemporaries. When read side by side with the _Analects_, the _Mencius_ throws a great deal of light on the teachings of ConfuciusMencius developed many of the ideas of Confucius and at the same time discussed problems not touched upon by Confucius. He drew out the implications of Confucius' moral (...) principles and reinterpreted them for the conditions of his time. As the fullest of the four great Confucian texts, the _Mencius_ has been the required reading amongst Chinese scholars for two thousand years, and it still throws considerable light on the character of the Chinese people. (shrink)

_Rhetoric_ is the sixth volume in The New Hackett Aristotle series, a series featuring translations, with Introductions and Notes, by C. D. C. Reeve, Delta Kappa Epsilon Distinguished Professor of Philosophy at The University of North Carolina at Chapel Hill. The series will eventually include all of Aristotle's works.

A record of the words and teachings of Confucius, _The Analects_ is considered the most reliable expression of Confucian thought. However, the original meaning of Confucius's teachings have been filtered and interpreted by the commentaries of Confucianists of later ages, particularly the Neo-Confucianists of the Song dynasty, not altogether without distortion.In this monumental translation by Professor D. C. Lau, an attempt has been made to interpret the sayings as they stand. The corpus of the sayings is taken as an organic (...) whole and the final test of the interpretation rests on the internal consistency it exhibits. In other words, _The Analects_ is read in the light of _The Analects._This results in a truer understanding of Confucius' thought than the traditional interpretation and paves the way for a re-assessment of its importance in the history of Chinese thought and its relevance to the present day world.This volume also contains an introduction to the life and teachings of Confucius, and three appendices on the events in the life of Confucius, on his disciples, and on the composition of _The Analects._. (shrink)

This paper suggests that empirical educational research has not, on the whole, been treated well by philosophers of education. A variety of criticisms have been offered, ranging from triviality, conceptual confusion and the impossibility of empirically studying normative processes. Furthermore, many of those who criticise, or dismiss, empirical research do so without subjecting any specific examples to careful scholarly scrutiny. It is suggested that both philosophy of education, and the empirical research enterprise, stand to profit if philosophers pay more attention (...) to real cases—and this attention is especially important at present, when research funding is being based on spurious scientistic criteria such as the use of ‘gold standard’ randomised experimental research designs. (shrink)

This work provides an interesting, though sometimes rather sweeping, demonstration that the metaphysical problem of the same and the other is also the central problem of literature and literary criticism. The author defends the analogical imagination as the symbolic counterpart of participation in Platonic metaphysics.--D. C. B.

After an exceedingly short treatment of six theories of tragedy, the author concludes that while each has emphasized a necessary component of the tragic, none has really come to grips with its basic "paradox": the fact that while the art of tragedy attempts to explain the mystery of human suffering, such an attempt is doomed to failure.--D. C. B.

This paper suggests that empirical educational research has not, on the whole, been treated well by philosophers of education. A variety of criticisms have been offered, ranging from triviality, conceptual confusion and the impossibility of empirically studying normative processes. Furthermore, many of those who criticise, or dismiss, empirical research do so without subjecting any specific examples to careful scholarly scrutiny. It is suggested that both philosophy of education, and the empirical research enterprise, stand to profit if philosophers pay more attention (...) to real cases—and this attention is especially important at present, when research funding is being based on spurious scientistic criteria such as the use of ‘gold standard’ randomised experimental research designs. (shrink)