Philosophy of Medicine provides a fresh and comprehensive treatment of the topic. It offers a novel theory of the nature of medicine, and proposes a new attitude to medicine, aimed at improving the quality of debates between medical traditions and facilitating medicine's decolonization.

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists (...) about the concepts of health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

A less analytic and more wholistic approach to philosophy, described as best overall fit or seeing how things all hang together, is defended in recent works by John Rawls and Richard Rorty and can usefully be applied to problems in philosophy of medicine. Looking at sickness and its impact upon the person as a central problem for philosophy of medicine, this approach discourages a search for necessary and sufficient conditions for being sick, and instead encourages (...) a listing of true and interesting observations about sickness which reflect the convergence of a number of different viewpoints. Among the relevant viewpoints are other humanities disciplines besides philosophy and the social sciences. Literature, in particular, provides insights into the meaning and the uniqueness of episodes of sickness in a way that philosophers may otherwise fail to grasp. (shrink)

Papers presented at a symposium on philosophy and medicine at the Institute for the Medical Humanities at the University of Texas Medical Branch in 1974 were published in the inaugural volume of this series.

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists (...) about the concepts of health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

What the philosophy of medicine is -- Philosophy of medicine: should it be teleologically or socially construed? -- The internal morality of clinical medicine: a paradigm for the ethics of the helping and healing professions -- Humanistic basis of professional ethics -- The commodification of medical and health care: the moral consequences of a paradigm shift from a professional to a market ethic -- Medicine today: its identity, its role, and the role of physicians (...) -- From medical ethics to a moral philosophy of the professions -- Moral choice, the good of the patient, and the patient's good -- The four principles and the doctor-patient relationship: the need for a better linkage -- Patient and physician autonomy: conflicting rights and obligations in the physician-patient relationship -- Character, virtue, and self-interest in the ethics of the professions -- Toward a virtue-based normative ethics for the health professions -- The physician's conscience, conscience clauses, and religious belief: a Catholic perspective -- The most humane of the sciences, the most scientific of the humanities -- The humanities in medical education: entering the post-evangelical era -- Agape and ethics: some reflections on medical morals from a catholic christian perspective -- Bioethics at century's turn: can normative ethics be retrieved? -- Hippocratic tradition -- Toward an expanded medical ethics: the Hippocratic ethic revisited -- Medical ethics: entering the post-Hippocratic era. (shrink)

In this introduction to a special subsection of Theoretical Medicine and Bioethics comprising separate reviews of the Springer Handbook of the Philosophy of Medicine, The Routledge Companion to Philosophy of Medicine, and The Bloomsbury Companion to Contemporary Philosophy of Medicine, I compare the three texts with respect to their overall organization and their approach to the relation between the science and the art of medicine. I then indicate two areas that merit more (...) explicit attention in developing a comprehensive philosophy of medicine going forward: health economics and systematic relations within the field as a whole. The reviews that follow speak for themselves. (shrink)

The Covid-19 pandemic was a world event on our intellectual doorstep. What were our duties to respond, and how well did we respond? We published papers, but we did not engage extensively or influentially in public debate. Perhaps we felt we were not experts. Yet in a health crisis, philosophers of medicine can offer not only “conceptual clarification,” but also domain-specific knowledge concerning structural properties of relevant sciences and their social-political uses. I set out three conditions for the kind (...) of contribution I felt was lacking: public, critical, and timely. And I call for us to do more of it. (shrink)

What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is ‘evidence-based’ medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology – questions that are central to philosophy as well as medicine. In this book Paul R. Thompson and Ross E. (...) G. Upshur introduce the fundamental issues in philosophy of medicine for those coming to the subject for the first time. They introduce and explain the following key topics: Understanding the physician-patient relationship: the phenomenology of the medical encounter. Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? The concept of evidence in medical research: what do we mean by ‘Evidence-based medicine?’ Should all medicine be based on evidence? Causation in medicine What do advances in neuroscience reveal about the relationship between mind and body? Defining health and disease: are explanations of disease objective or do they depend on values? Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies is made throughout the book. These include debates about smoking and cancer, the use of placebos in randomised controlled trials and controversies about research into the causes of HIV and autism. This is an indispendable introduction to those teaching philosophy of medicine and philosophy of science. (shrink)

In this commentary on the article by Arthur L. Caplan [1] the philosophy of medicine is viewed from a medical perspective. Philosophical studies have a long tradition in medicine, especially during periods of paradigmatic unrest, and they serve the same goal as other medical activities: the prevention and treatment of disease. The medical profession needs the help of professional philosophers in much the same way as it needs the cooperation of basic scientists. Philosophy of medicine (...) may not deserve the status of a philosophical subspecialty or field, but it so closely linked to the main trends of contemporary medical thinking that it must be regarded as an emerging (or reemerging) medical subdiscipline. (shrink)

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough (...) to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field. (shrink)

SummaryThe congruence between medicine and philosophy which we find in the Protagoras and the Treatise on Ancient Medicine as well as the tensions symbolized in the dialectic between Eryximachus and Diotima will always be with us. The congruence and the divergence of these ancient disciplines are both important to human well-being. By opposing one another, medicine and philosophy can each balance the other's pretension to universality. By converging, they illumine some of the most important questions (...) of human existence. This essay has examined ways in which medicine and philosophy can converge in our times as philosophy and medicine, philosophy in medicine, and philosophy of medicine. The present moment in our intellectual history is particularly propitious for the nurture of the engagement of medicine and philosophy. The most fruitful form of that interaction may be in the philosophy of medicine, which is a definable discipline with a set of issues specific to it. If the obvious intellectual dangers can be avoided, those who practice medicine, those who think about it, and those who are served by it can gain deeper insight into the nature and the purpose of medicine as well as the nature of the profession and of man himself. Perhaps—positioned as it is, at the intersection of the sciences, the humanities, and technology—medicine can become “… a medium and the focus in which the problems of wisdom and science meet” (Buchanan 1938, p. 194). (shrink)

This response to Kevin WildesÕs article in the previous issue of the Kennedy Institute of Ethics Journal addresses several major points of disagreement between Pellegrino and Wildes regarding the nature and scope of a philosophy of medicine, in particular how it is derived and by what method of philosophical enquiry it is best pursued.

This volume covers a wide range of conceptual, epistemological and methodological issues in the philosophy of science raised by reflection upon medical science and practice.

This is a review of the literature in the philosophy of medicine published in China from 1930 to 1980. The topics dealt with include the relationship between medicine and philosophy, the basic concepts of medicine, etiology and causality, the bearing of psychology on physiology and pathology, epistemology in diagnostics, methodology of medical sciences, philosophical and methological problems in traditional Chinese medicine, philosophical problems in health policy, and medical ethics.

The celebration of thirty years of publication of The Journal of Medicine and Philosophy provides an opportunity to reflect on how medical ethics has evolved over that period. The reshaping of the field has occurred in no small part because of the impact of branches of philosophy other than ethics. These have included influences from Kantian theory of respect for persons, personal identity theory, philosophy of biology, linguistic analysis of the concepts of health and disease, personhood (...) theory, epistemology, and political philosophy. More critically, medicine itself has begun to be reshaped. The most fundamental restructuring of medicine is currently occurring - stemming, in part, from the application of contemporary philosophy of science to the medical field. There is no journal more central to these critical events of the past three decades than The Journal of Medicine and Philosophy. (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)

Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the moral (...) and metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time. -/- . (shrink)

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been (...) dedicated to showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

Obviously medicine should be evidence-based. The issues lie in the details: what exactly counts as evidence? Do certain kinds of evidence carry more weight than others? (And if so why?) And how exactly should medicine be based on evidence? When it comes to these details, the evidence-based medicine (EBM) movement has got itself into a mess – or so it will be argued. In order to start to resolve this mess, we need to go 'back to basics'; (...) and that means turning to the philosophy of science. The theory of evidence, or rather the logic of the interrelations between theory and evidence, has always been central to the philosophy of science – sometimes under the alias of the 'theory of confirmation'. When taken together with a little philosophical commonsense, this logic can help us move towards a position on evidence in medicine that is more sophisticated and defensible than anything that EBM has been able so far to supply. (shrink)

Some problems that arise in the account given by Thomasma and Pellegrino [6] of the foundations of medical ethics in a philosophy of medicine are addressed, in particular questions of a conceptual character about treating therelatum of medicine as health. Which concept of health is appropriate and which will bear the burden of the position thomasma and Pellegrino advance? It is argued that the proper relationship of medicine is one between a healer and developing embodied minds. (...) As a consequence, the project of providing a univocal account of the nature of medicine fails. Instead, pluralism infects philosophy and medicine, resulting in different philosophies of medicine. From these philosophies of medicine will follow not a single medical ethics but a variety. (shrink)

The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what (...) we call the “epistemological turn” in recent work in the philosophy of medicine; the third part addresses new developments in medical research that raise interesting questions for philosophy of medicine; the fourth part is a discussion of philosophical issues within the practice of diagnosis; the fifth part focuses on the recent developments in psychiatric classification and scientific and ethical issues therein, and the final part focuses on the objectivity of medical research. (shrink)

_The_ _Routledge Companion to Philosophy of Medicine _is a comprehensive guide to topics in the fields of epistemology and metaphysics of medicine. It examines traditional topics such as the concept of disease, causality in medicine, the epistemology of the randomized controlled trial, the biopsychosocial model, explanation, clinical judgment and phenomenology of medicine and emerging topics, such as philosophy of epidemiology, measuring harms, the concept of disability, nursing perspectives, race and gender, the metaphysics of Chinese (...) medicine, and narrative medicine. Each of the 48 chapters is written especially for this volume and with a student audience in mind. For pedagogy and clarity, each chapter contains an extended example illustrating the ideas discussed. This text is intended for use as a reference for students in courses in philosophy of medicine and philosophy of science, and pairs well with _The_ _Routledge Companion to Bioethics_ for use in medical humanities and social science courses. (shrink)

The development of the philosophy of medicine in the Federal Republic of Germany since 1945 is presented in a thematic form. The first two decades were characterized by the evolution of an anthropological school of thought that aimed at relating physician and patient in a more personal and existential form than had hitherto been the case. In the last years, this tendency to demand deeper psychic and broader social involvement with medical problems had increased. Somatic disorders were considered (...) to be fundamentally caused by socially induced mental stress. After a brief period during which the theme of organisms in general and phenomenologically grasped living-body of human beings in particular were discussed, there followed since the mid-seventies an essential preoccupation with the methodology and epistemology of medicine. According to this trend, medicine is to be analyzed in terms of the theory of action, with its conceptual and strategic orientation towards practice and not, as generally believed, towards the standards of scientific truth. The concepts of disease, diagnosis and therapy are therefore relative and their validity is dependent on time, persons and circumstances involved. Thus, the highest criteria of utility for medical actions cannot but be the affected patient and society. (shrink)

In the late 1720s and early 1730s, Christian Wolff writes a series of short treatises on general medical concepts such as health, disease, cause of disease, symptom, etc. The paper makes the claim that these texts should be considered as a pioneering attempt at developing a systematic philosophy of medicine based on metaphysical and epistemological investigations on medical concepts, doctrines, and practices. The main focus is on Wolff’s analysis of the concepts of health and disease in functional terms (...) and its connection to his teleological characterization of both natural and artificial machines. This also explains Wolff’s use of the normatively loaded concepts of fitness and nature to clarify the distinction between health as good functioning and disease as dysfunction. The conclusion is that Wolff’s mechanist view of living bodies and his realism about biological functions are just one side of the coin; the other is his commitment to a normative view of the human body’s nature and purposes. (shrink)

This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ (...) transplantation, abortion, euthanasia, experiments on living subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

This article presents a brief general view of the recent literature and the scholarly activity in the field of philosophy of medicine in Scandinavia. The focus of attention is not on medical ethics, but on studies on topics like decision theory, medical classification, causality, causal explanations, concept formation, and on analyses of different ideals of medical science and clinical practice. A few principal works on medical ethics are mentioned by way of introduction and a brief account of a (...) highly topical debate on the legislation on artificial insemination in Sweden is given at the end. (shrink)

Two challenges face European philosophy of medicine. The first is to counterbalance what is seen as an overemphasis on social analysis of medicine with greater attention to its personal and individual dimensions. The second, related challenge, is to more fully understand the clinical realities of modern medicine, which in turn, give rise to the scope and limits of physician duties, patient obligations, and social concerns.

Of central concern to the philosophy of medicine is an understanding of the relationship that arises between science and ethics when decisions involve human beings. To examine this relationship, we must consider the status of claims to medical knowledge and whether there exists within medical practice a style of collecting and analyzing data and mak- ing therapeutic decisions that is properly called science. Since ideally, in medicine, knowledge guides practice, to a significant extent our factual claims will (...) legislate our behavior toward our fellowman. Clearly, other considerations compete with science for influence over medical deci- sions—for example, law, custom, patient preferences, convenience. However, without a "science of clinical medicine" and without a clear understanding of how we distinguish between valid and invalid factual claims, medical opinion loses much of its moral force. (shrink)

The term `bioethics' was coined in 1971, just as interest in the medical humanities claimed a prominent place in medical education. Out of this interest, a substantial area of research and scholarship took shape: the philosophy of medicine. This field has been directed to the epistemological, ontological, and value-theoretical issues occasioned by medicine and the biomedical sciences. Bioethics is nested in this field and can only be fully understood in terms of the foundational issues it addresses. This (...) collection of essays in honor of Stuart F. Spicker, one of the individuals who gave shape to the philosophy of medicine, lays out the broad scope of concerns from the philosophy of embodiment, to issues of the role of ethics consultants, to concepts of disease, equity and the meaning of history. (shrink)

This report explores the relationship between philosophy and medicine in the Netherlands. In Section 1 we outline the ups and downs of medico-philosophical research in our country: pre-war flourishing, post-war decline, and modern renaissance. In Section 2 we review recent Dutch literature in the philosophy of medicine. The topics dealt with include methodology of medical science, alternative medicine, the basic concepts of medicine, anthropological medicine, medicalization, medicine and culture, and health care ethics.

It seems impossible to completely cover the field indicated by the title of this report because of the many contributions of individual physicians and non-physicians to problems of the philosophy of medicine in Austria, and to their solution. The main trends are rooted in historic developments and in the current problems of medicine and health care, which are similar world-wide. In Austria famous names like empress Maria Theresia or the physician Ignaz Semmelweis have to be mentioned in (...) connection with the development of the ideas of a philosophy of medicine. In recent times again influential and well-known persons in related fields of medicine and health care are Austrians. However, the main line of new developments goes mostly unseen by the public: activities in medical ethics with the goal to humanize health care, carried on by groups of young physicians, biomedical engineers and students. (shrink)

A definitive and authoritative guide to a vibrant and growing discipline in current philosophy, The Bloomsbury Companion to Contemporary Philosophy of Medicine presents an overview of the issues facing contemporary philosophy of medicine, the research methods required to understand them and a trajectory for the discipline's future. -/- Written by world leaders in the discipline, this companion addresses the ontological, epistemic, and methodological challenges facing philosophers of medicine today, from the debate between evidence-based and (...) person-centered medicine, medical humanism, and gender medicine, to traditional issues such as disease, health, and clinical reasoning and decision-making. Practical and forward-looking, it also includes a detailed guide to research sources, a glossary of key terms, and an annotated bibliography, as well as an introductory survey of research methods and discussion of new research directions emerging in response to the rapid changes in modern medicine. -/- “Philosophy needs medicine', Hillel Braude argues, 'to become more relevant'. By showing how modern medicine provides philosophers with a rich source of material for investigating issues facing contemporary society, The Bloomsbury Companion to Contemporary Philosophy of Medicine introduces the opportunities medicine offers philosophers together with the resources and skills required to contribute to contemporary debates and discussions. (shrink)