The book offers an introduction to the moral concepts and value of health care. It is written by a moral philosopher, a doctor and a nurse and contains questions, cases and exercises which are suitable for medical, nursing and all students and commentators on health care. Moral dilemmas include consent, confidentiality, the giving or withholding of information, and the economics of health care. The issues of artificial reproduction, terminal care and the research and testing of drugs are addressed.

The treatment decisions of competent adults, especially treatment refusals, are generally respected. In the case of minors something turns on their age, and older minors ought increasingly to make their own decisions. On the other hand, parents decide on behalf of infants and young children. Their right to do so can best be justified in terms of the importance of preserving intimate family relationships, rather than in terms of the child's best interests, although the child's best interests will most often (...) follow from this arrangement. Nevertheless, there are and ought to be legal, ethical, and financial constraints on parental decision making. (shrink)

In his paper ‘Collective Responsibility’ Mr. D. E. Cooper argues for the thesis that collectives can be held responsible in a sense not reducible to the individual responsibility of the members of the collective. And he uses this conclusion to support views of individual responsibility and of blame and punishment which he wishes to assert independently. Is hall argue that although there is a sense in which the actions and responsibility of a collective cannot be analysed in terms of the (...) actions and responsibilities of the individual persons who compose the collective, it is not moral responsibility which is involved. I shall then maintain that Cooper's account of collective responsibility does not support his account of individual responsibility; and that his account of individual responsibility is in any case false, if he means moral responsiblity. (shrink)

R S Downie; Professions and Professionalism, Journal of Philosophy of Education, Volume 24, Issue 2, 30 May 2006, Pages 147–159, https://doi.org/10.1111/j.1467-.

Some practical problems in the teaching of ethics to medical students are described. The definition of the objectives of the course remains the central aspect, and is more important than the specific content. The use of student projects, buzz groups, case histories and discussion points is described. There is a need for student assessment or examination at the end of the course. The teachers require a broad background in philosophy, clinical medicine and teaching skills. The learning of the teachers may (...) be as important as that of the students. (shrink)

There are various ways in which medicine and literature interact, but this paper concentrates on the contribution which literature can make to 'whole person understanding'. Scientific understanding is concerned with seeing events and actions in terms of patterns or similarities. But 'whole person understanding' is concerned with uniqueness or with what it is for a given person to have an illness. Literature can in various ways develop this kind of understanding.

R S Downie; Professions and Professionalism, Journal of Philosophy of Education, Volume 24, Issue 2, 30 May 2006, Pages 147–159, https://doi.org/10.1111/j.1467-.

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)

Supererogation can be distinguished from altruism, in that the former is located in the category of duty but exceeds the strict requirements of duty, whereas altruism belongs to a different moral category from duty. It follows that doctors do not act altruistically in their professional roles. Individual doctors may sometimes show supererogation, but supererogation is not a necessary feature of the medical profession. The aim of medicine is to act in the best interests of patients. This aim involves neither supererogation (...) nor even the moral quality of beneficence. It is simply a job description. Morality enters medicine through the quality of the individual doctor's work, not by the definition of that work. (shrink)

The difficulties of establishing a definition of torture are discussed, and a definition is suggested. It is then argued that, irrespective of general ethical questions, doctors in particular should never be involved because of their social role.

It is often said that human beings have the ability to plan and choose what to do, can think for themselves and have the freedom and the right to form their own opinions on moral questions. Such claims are sometimes expressed by saying that the human agent is autonomous. In this paper we shall try to disentangle various theses about the autonomy of the agent which the common claims do not always distinguish.

The concept of moral responsibility has many applications. We speak, for example, of a person's responsibilities, and mean his professional or domestic commitments. In this sense a person can be said to have too many responsibilities, or none at all, and he can be said to be responsible to or for another person. Again, we can speak of the person himself as being responsible or irresponsible, and mean that he is conscientious and trustworthy in the performance of his duties or (...) that he has a sense of responsibility. Finally, we can speak of a person as accepting responsibility for an action or another person. A thorough analysis of these complexities of usage would require the investigation of a number of background concepts, but in this paper I have the more limited object of classifying some of the usages. I propose to do this by constructing three analytical models based on the concept of a social role. (shrink)

The aim of the article is to distinguish for a medical readership different senses of and connections between the words 'ethics', 'morals', and 'moral philosophy'. 'ethics' and 'morals' can be used as synonyms to refer to first order morality; they can be used to distinguish different areas within morality; 'professional ethics' can be a specialized form of first order morality; or it can refer to codified procedures; 'ethics' can be a synonym for moral philosophy, which is the study of first-order (...) morality. (shrink)

First published in 1980, Caring and Curing is for all those involved in the 'caring professions' - medicine, social work, and the other health and welfare occupations. It is both an introduction to philosophy for the caring professions and a philosophy of those professions. The authors believe that the best way to introduce philosophy is to engage in it, to philosophize, and that the most exciting way to philosophize is to offer a reasoned but controversial point of view on matters (...) to which people are professionally committed. They argue, first, that there is an essential unity of the caring professions in that the concepts of health and welfare are different aspects of a single value judgement as to what sort of life a person should be enabled to live in his society. Secondly, they show the limits of scientific expertise in relation to human behaviour and argue that the education of medical and social workers should include broader humane disciplines to assist them in coping with the problems of ethics and values of all kinds in present-day society. Thus, the discussion introduces the main branches of philosophy and deals with many of the current moral dilemmas in medicine and social work. (shrink)

There is a widespread assumption that responsibility in health care is vested in the last resort in the individual doctor who is caring for a given patient. In the first section of this article I shall try to bring out the plausibility of this assumption, and examine the concept of collective responsibility which it allows. In the second and third sections I shall try to show the fatal weaknesses of the assumption in its unmodified form, and shall argue that if (...) we are to understand the nature of health care at the present time we must take the norm to be collective and not individual responsibility. I shall discuss the two relevant senses of collective responsibility and try to show how they can be reconciled with what is acceptable in the widespread assumption of individual responsibility. CiteULike Connotea Del.icio.us What's this? (shrink)