Philosophy of psychiatry is a philosophical discipline focused on fundamental theoretical and conceptual issues in contemporary psychiatry. One of such issues is the so-called demarcation problem, which can be understood as the question about the difference between mental illness and psychological functioning which is normal, or healthy. After a brief account of the standard criteria for such differentiation the dominant naturalistic understanding of psychiatry as well as the notion of mental illness proper to the latter are subjected to scrutiny. Then, (...) in turn, critical currents are investigated with their concept of psychiatry as a discipline of humanistic and normative character. Some of these currents, such as the antipsychiatry of Szasz, are of historical importance today. Still, however, many threads are discussed, especially in the context of the notion of mental disorder developed by the American Psychiatric Association. One may expect that such discussions will be fruitfully carried on, especially in those cases when particular disorders are philosophically investigated. (shrink)

Mit Beitragen von: Wolfgang U. Eckart, Christian Bonah, Wolfgang U. Eckart / Andreas Reuland, Alexander Neumann, Peter Steinkamp, Volker Roelcke, Anne ...

In fourteen scholarly yet delightfully readable essays, Ober solves some ancient mysteries and reveals the secret kinks and passions of famous and obscure historical figures.

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Innovative Interaction Between Medicine and the HumanitiesLaurence B. McCullough and Warren Thomas ReichThe past three decades have witnessed the emergence and remarkable success of the fields of bioethics and medical humanities. The intellectual landscape of medicine and that of the humanities have been remarkably altered in the process. Twenty-five to 30 years ago in the United States there existed but a (...) few courses in what came to be called “bioethics” in departments of philosophy, religious studies, and theology in colleges and universities, a handful of programs of teaching in medical schools such as the University of Texas Medical Branch at Galveston and Pennsylvania State University School of Medicine at Hershey, and but one independent research center (the Hastings Center) and one university-based research center (the Kennedy Institute of Ethics at Georgetown University). Articles on bioethics began to appear in the peer-reviewed medical, nursing, and humanities literature and some books were published. There was only one journal in bioethics, The Hastings Center Report (which consolidated two previously separate journals from the Hastings Center). Graduate programs in bioethics and medical humanities in colleges and universities and fellowship training in bioethics and medical humanities in medical schools did not exist. Very little existed in colleges, universities, and medical schools in other countries. Now, of course, everything is different.Teachers, scholars, and students of bioethics and medical humanities should not take these remarkable changes for granted, for they represent a sustained and innovative interaction between medicine and the humanities. We have chosen the metaphor of “laying medicine open” to characterize the history of bioethics and medical humanities of the past three decades. This surgical metaphor was used in eighteenth-century Britain by a number of writers who wanted to make medical science and practice more accessible to the sick and to the lay public more generally (Lawrence 1975). We use the metaphor to characterize the efforts of teachers and [End Page 1] scholars over the past three decades and more to make the value-laden dimensions of biomedical science and practice and of health care policy more accessible to patients and to the lay public more generally. The result of this laying open of medicine has gone a long way toward bringing closer together the two cultures of science and the humanities that had, as C. P. Snow famously described, become significantly isolated from each otherAlbert Jonsen (1998) has recently contributed the first book-length history of what he calls the “birth” of bioethics, adding to the work of other scholars such as Warren Reich (1994; 1995) and Robert Baker (1993) and, before them, Corrado Viafora (1990) and David Rothman (1991). The articles in this issue of the Kennedy Institute of Ethics Journal make additional contributions to the developing understanding of the history of the past thirty years of interaction between medicine and the humanities.Laurence McCullough provides an historical context for the three accounts of the recent laying open of medicine that follow. McCullough examines two times in the history of medicine when it has been laid open to accountability (in addition to its being laid open to and by bioethics and medical humanities). The first laying open occurred in the work of the eighteenth-century Scottish physician and philosopher John Gregory, who set out to create a profession of medicine in a true moral sense of a fiduciary profession by making medicine accountable for its scientific and moral quality. The second occurred in the late twentieth century in which the managed practice of medicine in general, and managed care in particular, have begun to lay medicine open to accountability for its scientific and moral quality, as well as its cost and, at least in the public sector, its accessibility. McCullough argues that, just as Gregory responded to the ethical challenges of medicine laid open more than two centuries ago, bioethics should respond to the ethical challenges in the current laying open of medicine.Warren Reich provides an account of André Hellegers, whose premature death left an enormous gap in the field that will never be filled. Reich claims that Hellegers was engaged substantially in much more than the laying open of medicine: he... (shrink)

Critiquing many areas of medical practice and research whilst making constructive suggestions about medical education, this book extends the scope of medical ethics beyond sole concern with regulation. Illustrating some humanistic ways of understanding patients, this volume explores the connections between medical ethics, healthcare and subjects, such as philosophy, literature, creative writing and medical history and how they can affect the attitudes of doctors towards patients and the perceptions of medicine, health and disease which have become part of contemporary (...) culture. The authors examine a range of ideas in medical practice and research, including: the idea that patient status or the doctor/patient relationship can be understood via quantitative scales the illusion fostered by medical ethics that doctors, unlike those in other professions, are uniquely beneficent and indeed altruistic. An excellent text for undergraduate and postgraduate students of law, medical ethics and medical healthcare law, Bioethics and the Humanities shows the real ethical achievements, problems and half-truths of contemporary medicine. (shrink)

Slowing the aging process would be one of the most dramatic and momentous ways of enhancing human beings. It is also one that mainstream science is on the brink of pursuing. The state of the science, together with its possible impact, make it an important example for how to think about research into all enhancement technologies.

Throughout history, the world has been concerned with progress in different areas, and Medicine has not been the exception. Nevertheless, has this progress been positive in the sense of entailing benefits? The question emerges considering that through this progress, human beings have been able to modify natural processes. Considering this, the research question is: What is the role that medicine—a human and scientific discipline—must play, and which is the concept of what a human being must have in a (...) world where utilitarianism prevails over non-material benefits? Also, what are the implications of that role and concept on the decision-making about health, notions about humanity and, areas which require responsibility? The rise of artificial procedures which generate life, simultaneously defying time leads to the main objective of this paper: To present ideas on the current perception about the medical practice; in terms of responsibility about the human side of the patient, related to artificial practices. A second objective is to approach a social topic that motivates to reflect on new and recurring practices in the medical field. This topic will be studied from a hermeneutical perspective to establish relations and an interpretative approach between them, through Thiebaut’s work and Tría’s Philosophy of the Limit, considering the concept of human being and considering that there are limits which should be respected. Afterwards, the focus will be on the medical praxis and its sense of responsibility regarding human beings. (shrink)

In the Western media, stories about China seem to fall into one of two categories: China’s astounding economic development or its human rights abuses. As human rights discourses follow increasingly hegemonic conventions, especially with regard to China, many of their key assumptions remain unexamined. This special issue—the second in a two-part series beginning with “Cosmologies of the Human”—critically investigates the relationship between China and the human as it plays out in law, politics, biopolitics, political economy, labor, medicine, and culture. (...) The contributors interrogate the evolving meanings of “China” and “the human,” both inside China and internationally. The issue tracks the ways in which global discourses treat China—still officially socialist—as similar to, different from, and alternative to Western capitalist modernities. Several essays probe the modern theoretical underpinnings of human rights abuses in China, including a crucial distinction between “the human” and “the people.” Others review the impact of Maoism on Marxist debates in China and in the West, as well as the specific influences of Mao’s writings on French politics and theory in the 1960s. A visual dossier compares eight contemporary Chinese artists, directors, and public image-makers in order to discuss the figure of the human from Tiananmen Square to the 2008 Beijing Olympics. While many contributors discuss China and the West comparatively, the issue interrogates the universalizing claims of both Western and Chinese norms of the human by privileging the local, particular, and eccentric. Contributors: Ackbar Abbas, Michael Dutton, David L. Eng, Doug Howland, Petrus Liu, Camille Robcis, Teemu Ruskola, Shuang Shen, Shu-mei Shih, Wang Xiaoming David L. Eng is Professor of English, Comparative Literature, and Asian American Studies at the University of Pennsylvania. He is the author of _The Feeling of Kinship: Queer Liberalism and the Racialization of Intimacy_ and _Racial Castration: Managing Masculinity in Asian America_, both also published by Duke University Press. Teemu Ruskola is Professor of Law at Emory University and Visiting Professor of Law at Georgetown University. Shuang Shen is Assistant Professor of Comparative Literature and Chinese at Pennsylvania State University. (shrink)

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition (...) to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities . We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. (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)

Untoward injuries are unacceptably common in medical treatment, at times with tragic consequences for patients. The phrases 'an epidemic of error' and 'the medical toll' have been coined to describe this problem of 'iatrogenic harm', which it has been suggested may have contributed to 98,000 deaths per year in the US. Some of these incidents are the result of negligence on the part of doctors, but more usually they are no more than inevitable concomitants of the complexity of modern healthcare. (...) This book is fundamentally about distinguishing the former from the latter. Although medicine is used as the book's primary example, the points made apply equally to aviation, industrial activities, and many other fields of human endeavour. The book advocates a more informed alternative to the blaming culture which has increasingly come to dominate our response to accidents, whether in the medical field or elsewhere. (shrink)

This book examines the relationship between law and scientific advancement, with a particular focus on the theory of evolution and medical innovation. Historically, the law has struggled to keep pace with modern medical advances. The authors demonstrate that the laws that govern human behaviour must evolve in response to such advances."--Provided by publisher.

Medicine at the Crossroads is a collection of essays based a column originally published in the Waco-Tribune Herald by renowned cardiologist Dr. Michael Attas of Baylor University. It touches on three perspectives - the physician, the patient, and the healthcare system - and addresses some of the most pressing questions in medicine today.

The contemporary philosophy of medicine may be characterized as a continuous struggle with the Cartesian heritage, in order to reach a more satisfying image of man. This paper outlines the influence of Cartesian dualism on the foundations of medicine.The notion of a real distinction between the mental and physical, particularly the mechanistic conception of the human body, made possible the development of the natural sciences as well as scientific medicine, not hampered any longer by the risk of (...) colliding with religion or Church. (shrink)

How to avoid disease, how to breed successfully, and how to live to a reasonable age are questions that have perplexed humankind throughout history. This book explores our progress in understanding these challenges, and the risks and rewards of devising solutions. A broad range of topics are covered, including reproduction, the development of human progeny from conception to adulthood, staying healthy, ageing, cancer, infection and the burden of our genetic legacy.

Is technology value-free or is it value-laden? How does technology affect human autonomy? These questions, viewed within the context of medicine, are the focus of attention in this article. The central argument is that we need neither to subscribe to the value-neutrality dictum nor to the all-encompassing value-ladenness thesis to explain the pertinent position of technology in medicine. Technology is constitutive of and strongly implicated in difficult questions of value. This, however, does not mean that technology is identical (...) to (or neutral to) these value-laden questions. Technology poses issues of value, but only some of these relate to technology qua technology. Hence, it makes a difference whether we discuss general questions of value posed by technology or whether we discuss the value-ladenness of technology. Admitting technological value-ladenness does not imply that we are subject to a technological imperative that reduces our autonomy, on the contrary, it explains how technology increases our responsibility. This is particularly prominent in medicine. (shrink)

A decade after the completion of the Human Genome Project, the widespread appeal of personalized genomic medicine's vision and potential virtues for health care remains compelling. Advocates argue that our current medical regime “is in crisis as it is expensive, reactive, inefficient, and focused largely on one size fits all treatments for events of late stage disease.” What is revolutionary about this kind of medicine, its advocates maintain, is that it promises to resolve that crisis by simultaneously increasing (...) the ability to be “personalized,” “predictive,” “preventive,” and “participatory.” Some call personalized genomic medicine “P4 Medicine,” inscribing these cardinal virtues into the movement's name. All of these putative virtues have interesting implications for the future of health care. In this essay, we are especially interested in the claims that personalized medicine will lead to a more “participatory” or “patient‐centered” approach to health care, in which patients are “empowered” to take more personal control over their care. The rhetoric of patient empowerment is nothing new in health care, but personalized medicine is an interesting case study because it portrays empowerment as one of its key virtues and as a mechanism for fixing the health care “crisis.”. (shrink)

There is more to modern health than new scientific discoveries, the development of new technologies, or emerging or re‐emerging diseases. World events and experiences, such as the AIDS epidemic and the humanitarian emergencies in Bosnia and Rwanda, have made this evident by creating new relationships among medicine, public health, ethics, and human rights. Each domain has seeped into the other, making allies of public health and human rights, pressing the need for an ethics of public health, and revealing the (...) rights‐related responsibilities of physicians and other health care workers. (shrink)

A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the basic tenets of the Geneva Convention. Medical ethics differs (...) from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is ‘Witnesses in Uniform’ in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions. (shrink)

Comics has always had a critical engagement with socio-political and cultural issues and hence evolved into a medium with a subversive power to challenge the status quo. Staying true to the criticality of the medium, graphic medicine critiques the exploitative and unethical practices in the field of healthcare, thereby creating a critical consciousness in the reader. In close reading select graphic pathographies such as Gabby Schulz's Sick, Emily Steinberg's Broken Eggs, Ellen Forney's Marbles: Mania, Depression, Michelangelo & Me and (...) Marisa Marchetto's Cancer Vixen, the present article delineates how graphic medicine interrogates the larger than life forces in the field of healthcare. Drawing specific instances from the aforementioned graphic texts, the essay demonstrates that graphic medicine scrutinizes the political economy of health under capitalism. In so doing, the article illustrates how the pharmaceutical corporations, insurance companies, medical technology, and healthcare corporations marketize and commoditize health in the neoliberal era. Finally, the article attempts to theorize how graphic pathographies, mediating subjective experiences, generate a new critical literacy through the conflation of the personal and the political in the verbovisual medium of comics. (shrink)

The ArgumentThe status of the person is analyzed as represented by the life sciences under the influence of modern physico–chemical and molecular biology.At the same time the linguistic structure of reality as seen through formalized scientific discourse is not that of a language, but rather that of operational symbolisms, so that the judeo–Greek tradition of Verb as creating and Logos as procreating — which is probably at the origin of the surprising confidence in the possibility of dominating nature through words (...) and formulae — could be suc–cessful only through the depersonalization of language.Notwithstanding appearances, the phenomena of structural and functional self–organization do not really change this situation.In this context the question of the status of the person and of the intentional subject has to be dealt with pragmatically, giving up the notion of a unified scientific theory that would take into consideration at the same time the experi–mental sciences and the human sciences as linking subjectivity and intentionality. (shrink)

Medicine's crucial concern with health is perennial, but its reflection, concepts, means change with the advance of science and social life. We present here a fascinating panorama of current medical discussions with their philosophical underpinnings, and queries as they have evolved from the past. The role of Tymieniecka's phenomenology of life is brought forth as the system of philosophical reference.

Stephen Gaukroger presents an original account of the development of empirical science and the understanding of human behaviour from the mid-eighteenth century. During this period science was cut loose from the legitimating culture in which it had had a public rationale as a fruitful and worthwhile form of enquiry. An abrupt but fundamental shift in how the tasks of scientific enquiry were conceived is at the centre of this development, and at its core lies the naturalization of the human: attempts (...) to understand human behaviour and motivations no longer in theological and metaphysical terms, but in empirical terms. Gaukroger explores the variety of forms that this took, in anthropological medicine, philosophical anthropology, the 'natural history of man', and social arithmetic. Each of these disciplines re-formulated basic questions so that empirical investigation could be drawn upon in answering them, but the empirical dimension was conceived very differently in each case, with the result that the naturalization of the human took the form of competing, and in some respects mutually exclusive, projects. (shrink)

Jeffrey Bishop’s The Anticipatory Corpse exposes a functional metaphysics at the root of contemporary medical practice that gives rise to inhumane medicine, especially at the end of life. His critique of medicine argues for alternative spaces and practices in which the communal significance of the body, its telos, can be restored and the meaning of a “good death” enriched. This essay develops an alternative epistemology of the body, drawing from Christian theological accounts of the communal or Eucharistic body (...) and linking liturgical practices to the cultivation of solidarity. It argues for an epistemology of the body that makes visible the invisible bodies at medicine’s margins and illumines the disparate worlds of health care globally. (shrink)

Pellegrino and Thomasma have proposed a normative medical ethics founded on a conception of the end of medicine detached from any broader notion of the telos of human life. In this essay, I question whether such a narrow teleological account of medicine can be sustained, taking as a starting point Pellegrino and Thomasma’s own contention that the end of medicine projects itself onto the intermediate acts that aim at that end. In order to show how the final (...) end of human life similarly alters intermediate ends, such as the end of medicine, I describe Thomas Aquinas’s concept of pain and explain how his remedies for pain derive from his account of the telos of human life. In turn, this account has implications for the way in which physicians who accept such a telos would manage their patients’ pain. If a comprehensive telos for human life is necessary to make sense of even such a routine aspect of medical care, then medical ethicists may not be able to sidestep questions about the good life for human beings. (shrink)

The often-emphasized tension between the singularity of the patient and technical–scientific reproducibility in medicine cannot be resolved without a discussion of the epistemological and methodological status of the human sciences. On the one hand, the rules concerning human action are analogous to the scientific laws of nature. They are de facto sufficiently stable to allow predictions and explanations similar to those of experimental sciences. From this point of view, it is only a trivial truth, but still a methodological irrelevancy, (...) that the patient and the doctor–patient relationship represent an ontologically irreproducible reality. On the other hand, however, one can never exclude that one can fail in the application of "laws" of the human sciences to the individual patient, for such laws are by no means wholly separated from a patient's personal-hermeneutic mediation, and can at any time be revoked by becoming aware of them. This requires a synergistic collaboration of clinical and statistical methods, and shows a methodologically relevant sense in which one cannot disregard the singularity of the patient. The reason for the crucial role of the patient's singularity in medicine is every individual patient's capacity to revoke, in principle, routines and quasi-automatisms, even though the personal mediation by the patient's consciousness de facto changes them in such a small degree that predictions and explanations modeled in experimental science remain possible. (shrink)

This study sets out to examine the implications of Foucault's work for students and researchers in a wide selection of areas in the social and human sciences.

The Pneumatist school of medicine has the distinction of being the only medical school in antiquity named for a belief in a part of a human being. Unlike the Herophileans or the Asclepiadeans, their name does not pick out the founder of the school. Unlike the Dogmatists, Empiricists, or Methodists, their name does not pick out a specific approach to medicine. Instead, the name picks out a belief: the fact that pneuma is of paramount importance, both for explaining (...) health and disease, and for determining treatments for the healthy and sick. In this paper, we re-examine what our sources say about the pneuma of the Pneumatists in order to understand what these physicians thought it was and how it shaped their views on physiology, diagnosis and treatment. (shrink)

The traditional paradigm of medicine assumes that health is a natural given depending on a body's intrinsic teleology, and that medicine aims at restoring or preserving health, making a physician only an "assistant to nature." I argue that nowadays this paradigm is becoming obsolete, because the concept of health is no longer a "natural given" and interventions on the human body attempt not only to help nature's teleology, but also to change it whenever doing so can satisfy human (...) needs and wants. We should abandon the term "medicine" and adopt the term "health care" to mark such an epoch-making transition, analogous to that marking the passage from "alchemy" to "chemistry.". (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

This article provides an introduction to the articles in this theme issue. This collection examines epistemological, ontological, moral and political questions in medicine in light of the philosophical ideas of Charles Taylor. A synthesis of Taylor's relevant work is presented. Taylor has argued for a conception of the human sciences that regards human life as meaningful–deriving meaning from surrounding horizons of significance. An overview of the interdisciplinary articles in this issue is presented. This collection advances our thinking in the (...) philosophy of medicine as well as the philosophy of Charles Taylor. (shrink)

The articles assembled here demonstrate the impact of Lacan's thought on epistemology, anthropology, feminist studies, and literature. The focus of Leupin's introduction and of the first chapters by Jean-Claude Milner and Francois Regnault is Lacan's linking of the social sciences and science. Leupin writes that while Freud drew upon "medicine and biology to ensure... scientific consistency", in Lacan these are replaced by mathematics and topology. Lacan argued that the social or human sciences should be renamed the "conjectural sciences"--that they (...) are susceptible of an exact calculation in terms of probability. (shrink)

The ends of medicine are sometimes construed simply as promotion of health, treatment and prevention of disease, and alleviation of pain. Practitioners might agree that this simple formulation captures much of what medical practice is about. But while the ends of medicine may seem simple or even obvious, the essays in this issue demonstrate the wide variety of philosophical questions and issues associated with the ends of medicine. They raise questions about how to characterize terms like “health” (...) and “disease”; whether medicine’s goals should be extended to include enhancement beyond normal human function; and whether the ends of medicine are binding on those involved in health care outside of professional medicine, such as pharmaceutical companies. They also give philosophical attention to patient experiences, and so raise questions about whether current practices achieve the ends of medicine from the perspective of the patient. Together these essays demonstrate the important role played by a conception of medicine’s ends in a wide variety of issues and problems in the philosophy and ethics of medicine. (shrink)

Pellegrino and Thomasma have proposed a normative medical ethics founded on a conception of the end of medicine detached from any broader notion of the telos of human life. In this essay, I question whether such a narrow teleological account of medicine can be sustained, taking as a starting point Pellegrino and Thomasma’s own contention that the end of medicine projects itself onto the intermediate acts that aim at that end. In order to show how the final (...) end of human life similarly alters intermediate ends, such as the end of medicine, I describe Thomas Aquinas’s concept of pain and explain how his remedies for pain derive from his account of the telos of human life. In turn, this account has implications for the way in which physicians who accept such a telos would manage their patients’ pain. If a comprehensive telos for human life is necessary to make sense of even such a routine aspect of medical care, then medical ethicists may not be able to sidestep questions about the good life for human beings. (shrink)

The articles assembled here demonstrate the impact of Lacan's thought on epistemology, anthropology, feminist studies, and literature. The focus of Leupin's introduction and of the first chapters by Jean-Claude Milner and Francois Regnault is Lacan's linking of the social sciences and science. Leupin writes that while Freud drew upon "medicine and biology to ensure... scientific consistency", in Lacan these are replaced by mathematics and topology. Lacan argued that the social or human sciences should be renamed the "conjectural sciences"--that they (...) are susceptible of an exact calculation in terms of probability. (shrink)

This special issue examines the diverse realities created by the intersection of emerging technologies, new scientific knowledge, and the human being. It engages with two key questions: how is the human being shaped and constructed in new ways through advances in science and technology? and how might these new ways of imagining the subject shape present and future human rights law and practice? The papers examine a variety of scientific technologies—personalized medicine and organ transplant, mitochondrial DNA replacement, and scaffolds (...) and regenerative medicine—and their implications for our conceptualization of the human subject. Each is then followed by a commentary that both brings to light new dimensions of the original paper and presents a new theoretical take on the topic. Together these papers offer a serious challenge to the vision of the human subject at the root of human rights law. Instead of the autonomous, rational, unique, and physically discrete individual who owns herself and her body, the subject that emerges from the human technology assemblage has physically porous boundaries and a relational self. This depiction of the human being as a relational subject enmeshed in her technoscientific environment requires that we reconceptualize human rights law and practice. (shrink)

Why on earth should literary skills, or even a love of literature, make for a better doctor? Gribble (1992) has argued that encouraging literary critical skills sharpens those specific skills but has no benefits that flow into other cognitive areas. Nussbaum (1995), per contra, has claimed that literature does indeed allow imaginative participation in situations that are ethically challenging and therefore encourages the development of phronesis, or practical wisdom. Robin Downie (1994) taught an immensely popular course on medicine and (...) the arts in Glasgow. Osler (1948) listed the great works that every medical student should read. And so it goes, one authority after another telling us that education in the humanities makes for better ethics, communication, empathy, humanity, understanding, and so on in medical practitioners, while in the background is a small voice saying that such things as literary skills promote only literary skills.Behind the propaganda that underpins humane medic. (shrink)