On the aims of medicine: Comments on ‘philosophy of medicine as the source for medical ethics’

Health defined as the psychophysiological capacity to act or respond appropriately in a wide variety of situations, is enhanced by many means other than preventing and treating disease and injury. Therefore no choice of a particular medical intervention is likely to maximize health for all people with (or at risk for) a given disease. As a result, if medical practitioners are to be fully competent in the sense of knowing not only how to perform procedures but when and when not to do so, they must be able to support patients (and those who know and care about them) in weighing all of the many factors which bear upon the decision as to which, if any, medical interventions are likely to improve the person's health.     

Living donation and cosmetic surgery: a double standard in medical ethics?

The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation.     

Can phronesis save the life of medical ethics?

There has been a growing interest in casuistry since the ground breaking work of Jonsen and Toulmin. Casuistry, in their view, offers the possibility of securing the moral agreement that policy makers desire but which has proved elusive to theory driven approaches to ethics. However, their account of casuistry is dependent upon the exercise of phronesis. As recent discussions of phronesis make clear, this requires attention not only to the particulars of the case, but also to the substantive goods at stake in the case. Without agreement on these goods attention to cases is unlikely to secure the productive consensus that Jonson and Toulmin seek.     

A baldrige process for ethics?

In this paper we describe and explore a management tool called the Caux Round Table Self-Assessment and Improvement Process (SAIP). Based upon the Caux Round Table Principles for Business — a stakeholder-based, transcultural statement of business values — the SAIP assists executives with the task of shaping their firm’s conscience through an organizational self-appraisal process. This process is modeled after the self-assessment methodology pioneered by the Malcolm Baldrige National Quality Award Program. After briefly describing the SAIP, we address three topics. First, we examine similarities and differences between the Baldrige approach to corporate self-assessment and the self-assessment process utilized within the SAIP. Second, we report initial findings from two beta tests of the tool. These illustrate both the SAIP’s ability to help organizations strengthen their commitment to ethically responsible conduct, and some of the tool’s limitations. Third, we briefly analyze various dimensions of the business scandals of 2001–2002 (Enron, WorldCom, Tyco, etc.) in light of the ethical requirements articulated with the SAIP. This analysis suggests that the SAIP can help link the current concerns of stakeholders — for example, investors and the general public — to organizational practice, by providing companies with a practical way to incorporate critical lessons from these unfortunate events. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Casuistry in medical ethics: Rehabilitated,or repeat offender?

For a number of reasons, casuistry has come into vogue in medical ethics. Despite the frequency with which it is avowed, the application of casuistry to issues in medical ethics has been given virtually no systematic defense in the ethics literature. That may be for good reason, since a close examination reveals that casuistry delivers much less than its advocates suppose, and that it shares some of the same weaknesses as the principle-based methods it would hope to supplant.     

Soames on ethics: A new vision for the future of analytic philosophy?

Philosophical Studies -     

Is ethics fundamental? Questioning Levinas on irresponsibility

Continental Philosophy Review - My title echoes Levinas' 1951 “Is ontology fundamental?” – a seminal piece that paved the way for his justly famous Totality and Infinity and...     

International federation for information processing’s framework for computer ethics

This paper reviews codes of ethics and codes of conduct from different countries. The differences and similarities between code content and between attitudes are considered. Distinction is drawn between a code of ethics and a code of conduct. Recommendations are made for establishing a common framework for IFIP (International Federation for Information Process) Member or Affiliate Societies.     

What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics

This extended essay seeks to unpack some of the key aspects of philosophy which are applicable to medical thought and practice. It proceeds via an analytical discussion of the contemporary debate in three key areas of medical ethics: euthanasia, concepts of health & disease and psychiatry.

The main claims are as follows:

1. 1.
   The case for legalising euthanasia is strong on philosophical grounds but there are numerous practical obstacles.
    
2. 2.
   Elements from the normative and naturalistic definitions of disease are necessary for a thorough definition that dodges common objections to either.
    
3. 3.
   Mental health cannot be subsumed under a purely physicalist model of health rendering it distinctly different from other fields in Medicine.
    

Through a detailed discussion of three salient issues in the philosophy of medicine, it is argued that the application of profound philosophical thought to medicine and its practices reveals a depth that necessitates exploration before simply following the aims of curing all. Philosophical rigour matched with modern medicine has the potential to engage patients and help them make independent, informed decisions and assist physicians to think more clearly, analytically and empathetically.     

Commentary on “six domains of research ethics”

This commentary on K.D. Pimple’s “Six Domains of Research Ethics”, focuses on the area of institutional integrity and looks at “relationships between researchers, their sponsoring institutions, funding agencies, and the government,” considering the implications of institutional demands and support for research, and, in turn, demands and support on research priorities and public education.     

Prayer is a positive activity for children—a report on recent research

This article reports on Australian research investigating the meaning and function of prayer for children. Semi‐structured interviews were conducted with 60 primary school participants selected from six different schools in Melbourne, reflecting some of the diverse philosophical and religious traditions found in the Australian society. The three sources of data were analysed qualitatively using the method of Grounded Theory. Considerable agreement was observed through the data. In the multicultural Australian community, prayer for these children has been shown as a valued aspect of life. All participants indicated that they prayed and all contributed ideas about prayer. All participants perceived prayer to function as an aid in life and it was used at significant moments in life. The words or thoughts in prayer helped to clarify and articulate deep feelings. This research presents recommendations for professionals engaged in religious education, child welfare and the nurture of children’s spirituality.     

Faking on a situational judgment test in a medical school selection setting: Effect of different scoring methods?

We examined the occurrence of faking on a rating situational judgment test (SJT) by comparing SJT scores and response styles of the same individuals across two naturally occurring situations. An SJT for medical school selection was administered twice to the same group of applicants (N = 317) under low‐stakes (T1) and high‐stakes (T2) circumstances. The SJT was scored using three different methods that were differentially affected by response tendencies. Applicants used significantly more extreme responding on T2 than T1. Faking (higher SJT score on T2) was only observed for scoring methods that controlled for response tendencies. Scoring methods that do not control for response tendencies introduce systematic error into the SJT score, which may lead to inaccurate conclusions about the existence of faking.     

Match or Mismatch? Attempting a Feminist Pedagogy for a Course on Biblical Criticisms

This paper reports on a project undertaken as part of a wider group exploration of feminist pedagogy. It reflects on the issues this raised in teaching a course on contemporary biblical criticisms, an area of biblical studies where questions of power and ideology are frequently asked of texts. The project therefore asked the question whether there was a match or mismatch between the teaching process and the content of the course. Of particular concern was the understanding of the role of the teacher, the lecturer's ‘what am I doing in this class?’ question. The move to open up the student space led to the matter of boundaries. Who decides upon and regulates the limits of what can be discussed? What allows trust in a class and how does one deal with feelings and emotions? This paper engages the class members on all these issues, drawing on their comments gained from the questionnaire that was part of the project design.