Rosamond Rhodes makes a persuasive case for the view that medical ethics does not derive from common morality.1 Rhodes identifies the challenge that immediately arises and its corollary: Whence the origin of medical ethics? And, should we understand medical ethics as autonomous? From the perspective of professional ethics in medicine, the first question can now be restated: Whence the origin of the ethical concept of medicine as a profession, the basis of the ethical obligations of physicians in patient care, research, (...) medical education, and in advocacy and healthcare policy? The history of Western philosophy offers us two pathways to address this question. The first is the quest for certainty,2 a quest fulfilled by using methods designed to discover concepts that are independent of human thought and judgement and thus intellectually and morally authoritative for everyone. Such concepts are timeless and therefore transcultural, transreligious and transnational. Examples include Plato’s Forms,3 PF Stawson’s ‘our conceptual structure’,4 Edmund Pellegrino’s ‘fact of illness’ and the ‘act of profession’ in response to the vulnerability that illness creates,5 and common morality.6 Thought experiments, using what Rhodes characterises as ‘the hypethetico-deductive method’,1 aim to discover timeless concepts. Discovering timeless concepts must address their ontological and epistemological status. Plato’s ontology of Forms,2 for example, is not clear, as …. (shrink)

Despite its prominence in the abortion debate and in public policy, the discourse of ‘unborn patient’ has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of ‘unborn child.’ There is a long history of the descriptive use of ‘unborn child.’ Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion (...) want it to do, namely, to establish the independent moral status of fetuses and their rights, the right to life in particular. Third, we argue that the normative content of ‘unborn child’ should be dependent moral status, not independent moral status. We conclude that the ethical concept of the fetus as a patient should replace the discourse of “unborn child” when that phrase is used normatively. (shrink)

The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power—the legitimation of physicians’ power—a core concept of clinical ethics. In the absence of legitimation, the physician’s power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores (...) themes of physicians’ power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility. (shrink)