The Philosophy of Medicine Reborn

Edmund D. Pellegrino

Description

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.

Sujets

• Philosophie
• Éthique et morale
• Medical
• Médecine
• Philosophy
• Ethics

Informations

• Publié par: University of Notre Dame Press
• Date de parution: 01 mars 2008
• Nombre de lectures: 0
• EAN13: 9780268161477
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

The Philosophy of Medicine Reborn
Notre Dame Studies in Medical Ethics
The Philosophy of Medicine Reborn
A Pellegrino Reader
EDMUND D. PELLEGRINO
Edited by H. Tristram Engelhardt, Jr., and Fabrice Jotterand
University of Notre Dame Press
Notre Dame, Indiana
University of Notre Dame Press
Apologia and Introduction 2008 by University of Notre Dame
Notre Dame, Indiana 46556
www.undpress.nd.edu
All Rights Reserved
Published in the United States of America
Reprinted in 2011
Designed by Wendy McMillen
Set in 10.3/14 Minion by EM Studio
Library of Congress Cataloging-in-Publication Data
Pellegrino, Edmund D., 1920-
The philosophy of medicine reborn : a Pellegrino reader / Edmund D. Pellegrino ; edited by H. Tristram Engelhardt, Jr., and Fabrice Jotterand.
p. ; cm. - (Notre Dame studies in medical ethics)
Includes bibliographical references and index.
ISBN -13: 978-0-268-03834-2 (pbk. : alk. paper)
ISBN -10: 0-268-03834-1 (pbk. : alk. paper)
1. Medicine-Philosophy. 2. Medical ethics. I. Engelhardt, H. Tristram (Hugo Tristram), 1941- II. Jotterand, Fabrice, 1967- III. Title. IV. Series. [DNLM: 1. Philosophy, Medical-Collected Works. 2. Ethics, Medica-Collected Works. W 61 P 386 P 2008]
R 723. P 3815 2008
174.2-dc22
2008000419
ISBN 9780268161477
This book printed on acid-free paper .
This e-Book was converted from the original source file by a third-party vendor. Readers who notice any formatting, textual, or readability issues are encouraged to contact the publisher at [e-mail] .
To Edmund D. Pellegrino,
Friend, Teacher, and Colleague
CONTENTS

Acknowledgments
Apologia for a Medical Truant Edmund D. Pellegrino
An Introduction: Edmund D. Pellegrino s Project H. Tristram Engelhardt, Jr., and Fabrice Jotterand
I
TOWARD A PHILOSOPHY OF MEDICINE
Philosophical Foundations of Medicine
1
What the Philosophy of Medicine Is
2
Philosophy of Medicine: Should It Be Teleologically or Socially Construed?
3
The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions
The Medical Profession
4
Humanistic Basis of Professional Ethics
5
The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic
6
Medicine Today: Its Identity, Its Role, and the Role of Physicians
7
From Medical Ethics to a Moral Philosophy of the Professions
II
PHYSICIAN-PATIENT RELATIONSHIP
The Healing Relationship
8
Moral Choice, the Good of the Patient, and the Patient s Good
9
The Four Principles and the Doctor-Patient Relationship: The Need for a Better Linkage
10
Patient and Physician Autonomy: Conflicting Rights and Obligations in the Physician-Patient Relationship
III
VIRTUE IN MEDICAL PRACTICE
The Physician as Moral Agent
11
Character, Virtue, and Self-Interest in the Ethics of the Professions
12
Toward a Virtue-Based Normative Ethics for the Health Professions
13
The Physician s Conscience, Conscience Clauses, and Religious Belief: A Catholic Perspective
IV
HUMANISM AND HIPPOCRATES: FACING THE FUTURE
Humanities in Medicine
14
The Most Humane of the Sciences, the Most Scientific of the Humanities
15
The Humanities in Medical Education: Entering the Post-Evangelical Era
16
Agape and Ethics: Some Reflections on Medical Morals from a Catholic Christian Perspective
17
Bioethics at Century s Turn: Can Normative Ethics Be Retrieved?
Hippocratic Tradition
18
Toward an Expanded Medical Ethics: The Hippocratic Ethic Revisited
19
Medical Ethics: Entering the Post-Hippocratic Era
Appendix: Biography of Edmund D. Pellegrino
Index
ACKNOWLEDGMENTS

With gratitude it is acknowledged that the following has been reprinted with permission:
What the Philosophy of Medicine Is. Theoretical Medicine and Bioethics 19 (1998): 315-336. Kluwer Academic Publishers, with kind permission of Springer Science and Business Media.
Philosophy of Medicine: Should It Be Teleologically or Socially Construed? Kennedy Institute of Ethics Journal 11 (2001): 169-180. The Johns Hopkins University Press.
The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions. Journal of Medicine and Philosophy 26 (2001): 559-579. Swets Zeitlinger.
Humanistic Basis of Professional Ethics. In Humanism and the Physician , 117-129. Knoxville: University of Tennessee Press, 1979. Edmund D. Pellegrino.
The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic. Journal of Medicine and Philosophy 24 (1999): 243-266. Swets Zeitlinger.
Medicine Today: Its Identity, Its Role, and the Role of Physicians. Itinerarium 10 (2002): 57-79. Istituto Teologico S. Tommaso.
From Medical Ethics to a Moral Philosophy of the Professions. In The Story of Bioethics: From Seminal Works to Contemporary Explorations , ed. J. K. Walter and E. P. Klein, 3-15. Washington, DC: Georgetown University Press, 2003. Georgetown University Press.
Moral Choice, the Good of the Patient, and the Patient s Good. In Ethics and Critical Care Medicine , ed. J. C. Moskop and L. Kopelman, 117-138. Dordrecht: D. Reidel, 1985. D. Reidel Publishing Company, with kind permission of Springer Science and Business Media.
The Four Principles and the Doctor-Patient Relationship: The Need for a Better Linkage. In Principles of Health Care Ethics , ed. R. Gillon, 353-367. New York: John Wiley, 1994. John Wiley Sons Ltd.
Patient and Physician Autonomy: Conflicting Rights and Obligations in the Physician-Patient Relationship. Journal of Contemporary Health Law and Policy 10 (1994): 47-68. Catholic University of America Press.
Character, Virtue, and Self-Interest in the Ethics of the Professions. Journal of Contemporary Health Law and Policy 5 (1989): 53-73. Catholic University of America Press.
Toward a Virtue-Based Normative Ethics for the Health Professions. Kennedy Institute of Ethics Journal 5 (1995): 253-277. The Johns Hopkins University Press.
The Physician s Conscience, Conscience Clauses, and Religious Belief: A Catholic Perspective. Fordham Urban Law Journal 30 (2002): 221-244. Fordham University School of Law.
The Most Humane of the Sciences, the Most Scientific of the Humanities. In Humanism and the Physician , 16-37. Knoxville: University of Tennessee Press, 1979. University of Tennessee Press.
The Humanities in Medical Education: Entering the Post-Evangelical Era. Theoretical Medicine 5 (1984): 253-266. D. Reidel Publishing Company, with kind permission of Springer Science and Business Media.
Agape and Ethics: Some Reflections on Medical Morals from a Catholic Christian Perspective. In Catholic Perspectives on Medical Morals , ed. Edmund D. Pellegrino et al., 277-300. Dordrecht: Kluwer Academic Publishers, 1989. Kluwer Academic Publishers, with kind permission of Springer Science and Business Media.
Bioethics at Century s Turn: Can Normative Ethics Be Retrieved? Journal of Medicine and Philosophy 25 (2000): 655-675. Swets Zeitlinger.
Toward an Expanded Medical Ethics: The Hippocratic Ethic Revisited. In In Search of the Modern Hippocrates , ed. Roger J. Bulger, 45-64. Iowa City: University of Iowa Press, 1987. University of Iowa Press.
Medical Ethics: Entering the Post-Hippocratic Era. Journal of the American Board of Family Practice 1 (1988): 230-237. American Board of Family Practice.
APOLOGIA FOR A MEDICAL TRUANT
Edmund D. Pellegrino

The more our time seems to force us into an inherently confused relationship of doctor and patient, the more firmly must we recall what a true physician is like.
-Karl Jaspers, Philosophy and the World
I am grateful to the editors of this collection for their generous invitation to write a brief introduction to these readings. This gives me the opportunity to thank them for sifting assiduously through my writings for what might be significant. It is no small honor to be taken seriously by two bona fide philosophers-especially when one of them, Tristram Engelhardt, is a colleague whom I have admired for many years for his erudition and the vigor and rigor of his thought.
I would be remiss if I did not also express my gratitude to David Thomasma, my collaborator for 25 years. The marks of his philosophical scholarship are everywhere embedded in these readings (Pellegrino 2005). Finally, I thank, also, my colleagues at the Kennedy Institute of Ethics and the Department of Philosophy at Georgetown for their intellectual courtesy which permitted me to explore some of my thinking with them in collegial discourse.
These associations have special meaning for a philosophizing non-philosopher. There is no small disdain these days for physicians who transgress the perimeters of their clinical expertise. Like them, I have been a trespasser in the olive groves of Academia. This was not always the case. Physicians and philosophers were not easily distinguishable in ancient Greece. Hippocrates grossly overstated the case with his grandiose dictum: Iatros philosophus Iso Theos (The physician who is a philosopher is like a god). He was trying to say that good medical care needs more than its scientific orientation.
Grandiosity aside, it is worth remembering that medicine was one of the original nine liberal arts, until the fifth century AD, when it was banished by Martianus Capella. But even after its exile, university-trained physicians were well educated in the liberal arts from the Middle Ages through the Renaissance and up to the latter half of the twentieth century. They often wrote and spoke as members of a learned profession in fields beyond medicine.
This was still the case well into the twentieth century, when the enormous power and productivity of the physical and biological sciences made a scientific education more relevant for many. As medical specialization expanded, it became ever more difficult for physicians to wan