Over a 20-year period, the United States has developed a consensus of legal opinion concerning living wills and other advance directives. At the heart of this consensus are two interconnected principles. First, the state should minimally interfere with the wishes of patients and surrogates and the decisions of physicians about foregoing life-sustaining treatments. Second, state interference is permissible for the sake of protecting a compelling state interest. The overwhelming majority of states with advance directive laws have attained this balance of (...) minimal interference and compelling state interest in developing their laws. (shrink)

In The Structure of Scientific Inference, Mary Hesse has argued for a realist interpretation of science. Her realism, however, is not to be understood in the context of the traditional realist/instrumentalist debate within the philosophy of science. That debate focused on the question of whether or not science did anything other than systematize the empirical data given in our experience. The traditional realist answered “yes” and most frequently described the theoretical statements of science, not only as true, but also as (...) providing descriptions of the world. The instrumentalist on the other hand answered “no” and ascribed no descriptive force to the theoretical statements of science. However, according to Hesse, neither party in the contemporary realism debate assumes the notion of an empirical given. Consequently, the present dispute must be understood as taking place on a level which is logically prior to its predecessor. (shrink)

This article begins with a criticism of Mclntyre and Gorovitz's account of medical error. Their theory implies that error, at least sometimes, it a necessary consequence of the inductive character of medical inquiry. The counter intuitive consequences of this account suggest that the issues surrounding induction may not be the most fertile area for developing a coherent interpretation of medical error. Given these shortcomings, I develop a new theory which assumes that the best philosophical soil for constructing a theory of (...) medical trror is the problem of universals. I then explain the problem and how the medical universal functions within arguments concerning diagnosis and treatment. A Wittgensteinian solution to the problem is presented which emphasizes the "borderline" character of some, if not many, medical judgments. Next, an argument is offered to establish that questions of medical error are not purely professional questions. This is because the theories used to make such professional judgments permit borderline cases even under the best circumstances. Finally, while there are a number of legitimate responses to this situation, I recommend one which involves legislative action. CiteULike Connotea Del.icio.us What's this? (shrink)

This volume consists of fourteen chapters selected from papers presented at the conference 'Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics treated (...) are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines. (shrink)

Bas van Fraassen has formulated a semantical or model theoretic analysis of the structure of scientific theories. He contrasts his semantical approach with the syntactic approach of the logical positivists and argues that his theory is preferable on a number of grounds. The aims of this paper are threefold. First, a brief description of van Fraassen's approach is presented. Secondly, his theory is compared with that of the logical positivists and, in so doing, the virtues that van Fraassen believes recommend (...) his theory over the positivist theory are identified. Finally, an objection that is positivist in spirit is raised which suggests that, epistemically, his account is indistinguishable from classical historicism. (shrink)