This paper represents a preliminary investigation relating Bernard Lonergan’s thought to health science and the healing arts. First, I provide background for basic elements of Lonergan’s theoretical terminology that I employ. As inquiry is the engine of Lonergan’s method, next I specify two questions that underlie medical insights and define several terms, including health, disease, and illness, in relation to these questions. Then I expand the frame of reference to include all disciplines involved in the cycle of clinical interaction under (...) the heading health science and the healing arts. Finally, I analyze the cycle of clinical interaction in terms of Lonergan’s cognitive theory. I compare and contrast my analysis, based on Lonergan, with that of Pellegrino, Thomasma and Sulmasy as I proceed. In closing, I comment briefly on the next stage of this project regarding Lonergan’s theory of the human good in relation to the practice of the healing arts. (shrink)
The essays collected in this volume to honor Ernest Nagel reflect his wide interest in all topics relating philosophy to the natural and social sciences. The essays, written by distinguished philosophers and scientists form a mixed bag, but most of them are very good. The first part, "Science and Inquiry" begins with notes taken by Patrick Suppes of Nagel's lectures on Dewey's logic delivered in 1947. It follows with essays on knowledge by Stuart Hampshire, on intensions and the law (...) of inverse variation by R. M. Martin, and four essays on problems of induction and confirmation which contribute markedly to this well-worn field. The eleven essays of the second part, "Structure of Science" range from discussions of physics and ontology, mechanism and evolution to essays on functionalism in anthropology and ethics and legal theory. In between there are very good essays by C. Hempel on reduction, S. Morgenbesser on the realist-instrumentalist controversy, essays on the identity thesis, extensive measurement, causation and action, philosophy of language, and the differences between the natural and social sciences. Part three contains six essays on the role of values in various settings, e.g., ethical theory, the social sciences, legal theory and existentialism. The fourth and final part contains a variety of historical studies: Clagett on the quadrature of lunes in medieval science, I. Bernard Cohen on Newton, A. Koslow on the law of inertia, Charles Parsons on Kant's philosophy of arithmetic, Philip Wiener on a Soviet view of Peirce's pragmatism and S. Diamond on John D. Rockefeller and the historians.--R. H. K. (shrink)
What constitutes clinical reasoning is a disputed subject regarding the processes underlying accurate diagnosis, the importance of patient‐specific versus population‐based data, and the relation between virtue and expertise in clinical practice. In this paper, I present a model of clinical reasoning that identifies and integrates the processes of diagnosis, prognosis, and therapeutic decision making. The model is based on the generalized empirical method of Bernard Lonergan, which approaches inquiry with equal attention to the subject who investigates and the object under (...) investigation. After identifying the structured operations of knowing and doing and relating these to a self‐correcting cycle of learning, I correlate levels of inquiry regarding what‐is‐going‐on and what‐to‐do to the practical and theoretical elements of clinical reasoning. I conclude that this model provides a methodical way to study questions regarding the operations of clinical reasoning as well as what constitute significant clinical data, clinical expertise, and virtuous health care practice. (shrink)
After considering two of Pellegrino’s papers that address the relation between philosophy of medicine and medical ethics, I identify several overarching problems in his account that revolve around his self-described essentialism and the lack of a systematic attempt to relate clinical medicine to biomedicine and public health. I address these from the critical realist position of Bernard Lonergan, who grounds both metaphysics and ethics on the normative structure of human inquiry and seeks to understand historical development, such as we are (...) witnessing in health science and health care, in terms of the dynamic structure of the human good. I conclude that Lonergan’s generalized empirical method and hierarchical account of world order provide a potentially dynamic framework on which to build a more comprehensive philosophy of medicine than one whose foundations rest primarily on a phenomenology of the clinical encounter and the telos of medicine. (shrink)
After a review of terminology, I identify—in addition to Margaret Battin’s list of five primary arguments for and against aid-in-dying—the argument from functional equivalence as another primary argument. I introduce a novel way to approach this argument based on Bernard Lonergan’s generalized empirical method. Then I proceed on the basis of GEM to distinguish palliative sedation, palliative sedation to unconsciousness when prognosis is less than two weeks, and foregoing life-sustaining treatment from aid-in-dying. I conclude that aid-in-dying must be justified on (...) its own merits and not on the basis of these well-established palliative care practices; and that societies must decide, in weighing the merits of aid-in-dying, whether or not to make the judgment that no life is better than life-like-this part of their operative value structure. (shrink)
Prior research has demonstrated that antisocial behavior, substance-use disorders, and personality dimensions of aggression and impulsivity are indicators of a highly heritable underlying dimension of risk, labeled externalizing. Other work has shown that individual trait constructs within this psychopathology spectrum are associated with reduced self-monitoring, as reflected by amplitude of the error-related negativity (ERN) brain response. In this study of undergraduate subjects, reduced ERN amplitude was associated with higher scores on a self-report measure of the broad externalizing construct that links (...) these various indicators. In addition, the ERN was associated with a response-locked increase in anterior theta (4–7 Hz) oscillation; like the ERN, this theta response to errors was reduced among high-externalizing individuals. These findings suggest that neurobiologically based deficits in endogenous action monitoring may underlie generalized risk for an array of impulse-control problems. (shrink)
Defining disease and delineating its boundaries is a contested area in contemporary philosophy of medicine. The leading naturalistic theory faces a new round of difficulties related to defining a normal environment alongside normal organismic functioning and to delineating a discrete boundary between risk factors and disease. Normative theories face ongoing and seemingly intractable difficulties related to value pluralism and the problematic relation between theory and practice. In this article, I argue for an integral—as opposed to a hybrid—philosophy of health based (...) on Bernard Lonergan’s notion of generalized empirical method that provides a way to settle these difficulties dynamically and comprehensively, both in theory, by orienting functional and statistical investigation toward an explanatory ecological viewpoint, and in practice, by framing critiques in relation to the normativity intrinsic to all human inquiry. (shrink)
Authors present a practical approach to developing health care trainees' native ability as moral agents to become responsible health care practitioners. Highly recommended. Full text available free online.
The unfinished nature of Beauchamp and Childress’s account of the common morality after 34 years and seven editions raises questions about what is lacking, specifically in the way they carry out their project, more generally in the presuppositions of the classical liberal tradition on which they rely. Their wide-ranging review of ethical theories has not provided a method by which to move beyond a hypothetical approach to justification or, on a practical level regarding values conflict, beyond a questionable appeal to (...) consensus. My major purpose in this paper is to introduce the thought of Bernard Lonergan as offering a way toward such a methodological breakthrough. In the first section, I consider Beauchamp and Childress’s defense of their theory of the common morality. In the second, I relate a persisting vacillation in their argument regarding the relative importance of reason and experience to a similar tension in classical liberal theory. In the third, I consider aspects of Lonergan’s generalized empirical method as a way to address problems that surface in the first two sections of the paper: (1) the structural relation of reason and experience in human action; and (2) the importance of theory for practice in terms of what Lonergan calls “common sense” and “general bias.”. (shrink)
At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.
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)
As J. Baird Callicott has argued, Adam Smith’s moral theory is a philosophical ancestor of recent work in environmental ethics. However, Smith’s “all important emotion of sympathy” (Callicott 2001: 209) seems incapable of extension to entities that lack emotions with which one can sympathize. Drawing on the distinctive account of sympathy developed in Smith’s Theory of Moral Sentiments , as well as his account of anthropomorphizing nature in “History of Astronomy and Physics,” I show that sympathy with non-sentient nature is (...) possible within a Smithian ethics. This provides the possibility of extending sympathy, and thereby benevolence and justice, to nature. (shrink)