Although many of the pioneers of present-day bioethics came from religious and theological backgrounds, the recent controversy about the role of religion in bioethics has elicited much attention. Timothy Murphy would ban religion from bioethics altogether. Much of the ado hinges on conflicting understandings of just what bioethics is and just what religion is. This paper attempts to make more explicit how the fields of bioethics and religion have been understood in this context, and how they should not be understood. (...) We begin by looking at bioethics as a field: its origins, purpose, scope, and its methods. We then examine the notion of religion, looking especially at its importance for bioethics. Humanity is not just Homo sapiens but also Homo religiosus. Religion is more than a code of ethics; it gives insight into many of the foundational matters of bioethics. (shrink)

This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.'' I argue that pathologists do not use ``disease'' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; pathology's goal is (...) to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease'' but also such terms as ``nerve'' and ``organ''are laden with conceptual values. (shrink)

Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that our bodies (...) should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation. (shrink)

Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to (...) offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers. (shrink)

This paper is a response to Christopher Boorse's recent defense of his Biostatistical Theory of health and disease. Boorse maintains that his concept of theoretical health and disease reflects the "considered usage of pathologists." I argue that pathologists do not use "disease" in the purely theoretical way that is required by the BST. Pathology does not draw a sharp distinction between theoretical and practical aspects of medicine.

“Geneticization” is a term used to describe the ways in which the science of genetics is influencing society at large and medicine in particular; it has important implications for the process of diagnostics. Because genetic diagnostics produces knowledge about genetic disease and predisposition to disease, it is essentially influenced by these innovations in the disease concept. In this paper, I argue that genetic diagnostics presents new ethical challenges not because the diagnostic process or method in genetic diagnostics is ethically different (...) in kind from traditional medical diagnostics, but because it relies on a neo-ontological concept of disease in a context of genetic reductionism. Geneticization has not produced a radically new concept of disease, however, but has introduced innovations into the classical ontological concept of disease. When this new concept of disease is held in tandem with genetic reductionism, we are led to the absurd conclusion that disease is the very essence of the human being. I argue that neither the neo-ontological concept of disease nor genetic reductionism is necessary for a proper understanding of genetic diagnostics. (shrink)

Patients increasingly see physicians not as humane caregivers but as unfeeling technicians. The study of philosophy in medical school has been proposed to foster critical thinking about one's assumptions, perspectives and biases, encourage greater tolerance toward the ideas of others, and cultivate empathy. I suggest that the study of ethics and philosophy by medical students has failed to produce the humane physicians we seek because of the way the subject matter is quarantined in American medical education. First, the liberal arts (...) are seen as the province of undergraduate education, and not medical school. Second, philosophy, when taught in medical school, is seen by students as just one subject to be mastered along with many other more important ones, and not as a way to foster critical thinking and empathy. What is needed is a new pedagogy that combines both cognitive and affective elements to implant and nourish the liberal arts in students. Removing the quarantine of philosophy from other facets of medical education is an important first step. (shrink)

William E. Stempsey, S.J.; Institutional Identity and Roman Catholic Hospitals, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 7, Issue.

This article is an introduction to a special issue of Theoretical Medicine and Bioethics on clinical reasoning. Clinical reasoning encompasses the gamut of thinking about clinical medical practice—the evaluation and management of patients’ medical problems. Theories of clinical reasoning may be normative or descriptive; that is, they may offer recommendations on how clinicians ought to think or they may simply attempt to describe how clinicians actually do think. This article briefly surveys these approaches in order to show the complexity of (...) clinical reasoning and the inadequacy of any one theory for capturing the full richness of clinical reasoning. The authors of this issue offer both normative and descriptive elements in their accounts. Topics discussed include the importance for clinical reasoning of tacit knowing, risk assessment, narrative and hermeneutics, wisdom, and virtue epistemology. (shrink)

In considering whether medical miracles occur, the limits of epistemology bring us to confront our metaphysical worldview of medicine and nature in general. This raises epistemological questions of a higher order. David Hume’s understanding of miracles as violations of the laws of nature assumes that nature is completely regular, whereas doctrines such as C. S. Peirce’s "tychism" hold that there is an element of absolute chance in the workings of the universe. Process philosophy gives yet another view of the working (...) of nature. Physicians have no epistemological grounds for declaring any cure to be miraculous. Miracles are theological (or philosophical) entities, and not medical entities. All physicians can do is to determine whether or not a cure is scientifically inexplicable according to the current epistemological standards of medical science. (edited). (shrink)

This paper explores the role of religious belief in public debate about physician-assisted dying and argues that the role is essential because any discussion about the way we die raises the deepest questions about the meaning of human life and death. For religious people, such questions are essentially religious ones, even when the religious elements are framed in secular political or philosophical language. The paper begins by reviewing some of the empirical data about religious belief and practice in the United (...) States and Europe. It then explores the question of the proper role of religion in public policy debate and concludes with a discussion of the importance of religion and religious practices in considerations of how we die. (shrink)

Popular visions of holistic health and holistic medicine are not so much reactions to perceived excesses of technological medicine as they are visions of the good life itself and how to attain it. This paper attempts to clarify some of the concepts associated with holistic health and medicine. The particular vision of holistic health presented here is well exemplified in the writings of Plato. First, I examine the scientific concept of holism and argue that, while medicine is inadequately characterized by (...) scientific reductionism, any plausible holistic medicine must make room for a limited scientific reductionism. Next, I analyze the complexity of Plato's usage of health and demonstrate some of the parallels between Plato's thought and popular and scientific visions of holistic health. Finally, I look at what Plato has to say about medical practice and the relation of medicine and philosophy as therapies for the whole person. (shrink)

It is common to talk of wise physicians, but not so common to talk of wise patients. "Patient" is a word derived from the Latin patior - "to suffer," but also "to let be." Suffering has been the universal lot of humanity, and medicine rightly tries to relieve suffering. Medical progress, like all technological progress, leads us more and more to hope that we can control our fate. However, we do well to ask whether our attempts to control our fate (...) are wise. Wisdom played a major role in the philosophy of the ancient Stoics, and so I propose putting these questions into the context of a new stoicism. For the Stoic, happiness consists in living in accord with nature. Stoics are sometimes portrayed as apathetic fatalists, silently accepting whatever misfortune might come their way, but this is a misunderstanding. The Stoic sage, like the common person, wants to preserve life and health. The difference is that the sage's wisdom brings knowledge about what actions are appropriate in the face of suffering. The sage sees suffering not as something that demands immediate control, but as something that might reasonably direct actions. Suffering brings turmoil to the common patient, who will take any possible steps to end the suffering. The wise patient possesses the knowledge that enables a correct assessment of the options in the face of the reality that we ultimately do not control our own fate. (shrink)

The distinction between killing and letting die has been a controversial element in arguments about the morality of euthanasia and physician-assisted suicide. The killing/letting die distinction is based on causation of death. However, a number of causal factors come into play in any death; it is impossible to state a complete cause of death. I argue that John Mackie’s analysis of causation in terms of ‘inus factors,’ insufficient but nonredundant parts of unnecessary but sufficient conditions, helps us to see that (...) moral responsibility for death cannot rest on causation alone. In specifying the cause of death, some factors can be considered alternatively as either causal factors or merely parts of the presupposed background conditions. If a factor is moved from the background field into the causal field, the result is a changed background field. Comparisons of cases of killing and letting die often do just this; hence, the cases depend on different presuppositions and the causation cannot be directly compared. Moral judgments determine how to apportion factors to the causal and background fields. (shrink)

Hans Jonas argued that death is both a blessing and a burden, basing his argument on an evolutionary viewpoint. He highlighted the paradox that life carries the burden of death within itself. Daniel Callahan responded that Jonas’s failure to fully appreciate the value of life shows the deficiency of using evolution to explain how death could be a blessing for individuals. Jazmine Gabriel now convincingly defends Jonas against Callahan’s charges, showing that Jonas’s commitment to fight against the Nazis, his attack (...) against nihilism, and his rejection of the metaphysical dualism that opposes valuing, purpose-seeking humans against a value-free, purposeless world all demonstrate Jonas’s commitment to honoring individual lives. This paper affirms Gabriel’s response and advances the dialectic by considering a further paradox. As life carries within itself death, so does the blessing of death carry within itself the burden of death and the burden of death carry within itself the blessing of death. (shrink)

The nature of health is one of the central topics in the philosophy of medicine. The concept of health is complex because it comprises multiple features and there is no consensus on which feature is most basic or even whether some particular feature has any importance at all. This paper focuses on how several basic elements play a role in the formation of the concept of health. My central claim is that the theory of emergence offers a way to construct (...) a theory of health that is sympathetic to both analytic and holistic perspectives. In one way, this emergent theory of health looks very much like a holistic theory in that it considers not only biological factors as fundamental to understanding health, but also psychological, and social factors. In another way, this theory looks very much like an analytic theory because it sees health as a phenomenon that emerges from more basic elements: biology, psychology, and sociology. This may seem ambiguous, but this kind of ambiguity might just be the biggest virtue of the theory. (shrink)

Religious voices were important in the early days of the contemporary field of bioethics but have now become decidedly less prominent. This is unfortunate because religious elements are essential parts of the most foundational aspects of bioethics. The problem is that there is an incommensurability between religious language and languages of public discourse such as the “public reason” of John Rawls. To eliminate what is unique in religious language is to lose something essential. This paper examines the reasons for the (...) marginalization of religion in bioethics, shows the limitations of Rawls’s notion of public reason, and argues for a more robust role for theology in articulating a new language for public discourse in bioethics. (shrink)

The question of whether the universe is expanding or contracting serves as a model for current questions facing the medical humanities. The medical humanities might aptly be described as a metamedical multiverse encompassing many separate universes of discourse, the most prominent of which is probably bioethics. Bioethics, however, is increasingly developing into a new interdisciplinary discipline, and threatens to engulf the other medical humanities, robbing them of their own distinctive contributions to metamedicine. The philosophy of medicine considered as a distinct (...) field of study has suffered as a result. Indeed, consensus on whether the philosophy of medicine even constitutes a legitimate field of study is lacking. This paper presents an argument for the importance of a broad conception of the philosophy of medicine and the central role it should play in organizing and interpreting the various fields of study that make up the metamedical multiverse. (shrink)

This paper is a criticalexamination of the development of thephilosophy of medicine as a discipline. Ithighlights two major themes in the contemporarydebate about the philosophy of medicine: thescope of the discipline and the relation of thediscipline to its cognate disciplines. A broadview of the philosophy of medicine is defendedand the philosophy of medicine is seen as aphilosophical sub-discipline. These viewsdepend in important ways on three factors: ageneral metaphysical world view, particularunderstandings of the cognate disciplines, andthe perspective from which one asks (...) thequestions about the nature of the discipline. It is proposed that the future of thephilosophy of medicine may follow thephilosophy of science in that philosophical,sociological and historical studies may combinein a mutually enriching way to form ‘‘medicinestudies.’‘. (shrink)

The Twentieth European Conference on Philosophy of Medicine and Health Care was held in Helsinki, Finland, in August 2006 and highlighted the theme “Medicine, Philosophy and the Humanities.” The four papers in this thematic section are developed from presentations made at that conference.They are the work of physicians and philosophers and present fundamentally philosophical reflections on the medical humanities. The authors show that philosophy offers both a substantial way of humanizing the theory and practice of medicine and a way to (...) orchestrate the contributions of all the medical humanities. (shrink)

Complexity, agency, and time -- The vicissitudes of experience -- Belief, spirituality, and time -- The human predicament -- Capital flows, sovereign decisions, and world resonance machines -- The theorist and the seer.

This chapter contains sections titled: Serial Killers, Real and Imagined Dexter Gacy Are Serial Killers Morally Responsible? Moral Responsibility: Emotions and Cognitive Frames.

1 Non-reductive physicalists deny that there is any explanation of mentality in purely physical terms, but do not deny that the mental is entirely determined by and constituted out of underlying physical structures. There are important issues about the stability of such a view which teeters on the edge of explanatory reductionism on the one side and dualism on the other (see Kim 1998). 2 Save perhaps for eliminative materialism (see Churchland 1981 for a classic exposition). In fact, however, while.

The Perceptual Hypothesis is that we sometimes see, and thereby have non-inferential knowledge of, others' mental features. The Perceptual Hypothesis opposes Inferentialism, which is the view that our knowledge of others' mental features is always inferential. The claim that some mental features are embodied is the claim that some mental features are realised by states or processes that extend beyond the brain. The view I discuss here is that the Perceptual Hypothesis is plausible if, but only if, the mental features (...) it claims we see are suitably embodied. Call this Embodied Perception Theory. I argue that Embodied Perception Theory is false. It doesn't follow that the Perceptual Hypothesis is implausible. The considerations which serve to undermine Embodied Perception Theory serve equally to undermine the motivations for assuming that others' mental lives are always imperceptible. (shrink)

What the Church teaches and why on issues of euthanasia, invitro fertilization, genetic counseling, assisted suicide, living wills, persistent vegetative state, organ transplants, and more.

It is often assumed that when we see common opaque objects in standard light this is in virtue of seeing their facing surfaces. Here I argue that we should reject that claim. Either we don't see objects' facing surfaces, or—if we hold on to the claim that we do see such things—it is at least not in virtue of seeing them that we see common opaque objects. I end by showing how this conclusion squares both with our intuitions and with (...) the facts of vision science. (shrink)

Offers a vivid, nuanced, and chronological account of Buddhistreligion in Japan -- from its emergence in the sixth centuryright through to the present day.

A profound, valuable, scholarly study of theology from a cogent well- written Jewish perspective, exposing the arrogant disregard the "New Atheists" bring to the God-controversy by their collective neglect of the great variety of God- concepts embodied in the works of Jewish theologians.

In this foundational work in contemporary political theory, William Connolly makes a distinctive contribution to our understanding of the relationship between ...

We can know some things about each others' mental lives. The view that some of this knowledge is genuinely perceptual is getting traction. But the idea that we can see any of each others' mental states themselves - the Simple Perceptual Hypothesis - remains unpopular. Very often the view that we can perceptually know, for example, that James is angry, is thought to depend either on our awareness of James' expression or on the way James appears - versions of what (...) I call the Expressive Hypothesis. The Expressive Hypothesis is intuitive. But in this chapter I argue that it does not allow us to do away with the thought that we sometimes perceive people's mental states. I take my arguments to provide some tentative support for the Simple Perceptual Hypothesis. (shrink)

An impressive body of recent literature posits that traditional notions of civil disobedience prevent us from properly considering potentially legitimate types of ‘uncivil’ political lawbreaking. When might uncivil (covert, legally evasive, morally offensive and potentially violent) lawbreaking prove normatively acceptable? If justifiable, what conditions should its practitioners be reasonably expected to meet? Despite some important insights, defenders of uncivil disobedience rely on a narrow and sometimes misleading view of civil disobedience, as previously practiced and theorized. Notwithstanding legitimate skepticism about Rawlsian (...) notions of civil disobedience, they reproduce its troublesome binary or ‘all-or-nothing’ view of political lawbreaking. Uncivil disobedience’s proponents tend to group a vast array of distinctive types of lawbreaking under one amorphous categorical rubric, impeding the suitably complex, nuanced analysis we need. A superior approach would pay careful attention to uncivil disobedience’s ambivalent historical record, a record suggesting that UD is more likely to reproduce authoritarian populism’s disturbing political logic than counteract it. (shrink)

There has been recent interest in the hypothesis that we can directly perceive some of each other’s mental features. One popular strategy for defending that hypothesis is to claim that some mental features are embodied in a way that makes them available to perception. Here I argue that this view would imply a particular limit on the kinds of mental feature that would be perceptible (§2). I sketch reasons for thinking that the view is not yet well-motivated (§3). And I (...) present an alternative, epistemological strategy (§4). The epistemological strategy is to discern which features of our environment are perceptible by reflection on our capacity to identify them. If the epistemological strategy is accepted it becomes plausible that we sometimes directly perceive some of each other’s mental features. But it becomes implausible to suppose that our perceptual access is limited in the way the embodied view would imply. I end by sketching reasons to think that we sometimes directly perceive each other’s desires (§5). (shrink)

A representationalist-friendly introduction to representationalism which covers a number of central problems and objections.