Abstract

This critical notice argues for the existence of a new trend in bioethics, a complex and dynamic field of philosophical enquiry that goes beyond applied ethics and professional deontological codes. This trend supplements their traditionally “minimalist” ethics—and its concern with harm, rights or justice—with “inflationary” positions open to an integration of medicine with the humanities. By comparing and contrasting the views of two quite different philosophers, Diego Gracia and Alfred Tauber, and placing them within the theoretical background delineated by George Khushf, I argue that the main contribution of this “inflationary bioethics” is an understanding of health and disease as intrinsically normative concepts, which in turn brings about a blurring of the distinction between facts and values. By refusing to construe the distinction as a dichotomy, a post-positivist philosophy of medicine must become more epistemological in order to help us clarify concepts in which the evaluative and the factual are impossible to separate. As a result, the “language of principles” in standard bioethics is being substituted by a more encompassing “language of values”; health and disease are increasingly understood as biopsychosocial phenomena; and the field is open to a process of moralization that challenges traditional models of patient autonomy and physician responsibility.