Philosophical Perspectives On Bioethics

The contributors to the volume discuss various approaches to bioethical thinking and the political and institutional contexts of bioethics, addressing underlying concerns about the purposes of its practice.

In general, the history of virtue theory is well-documented (Sherman, 1997; O’Neill, 1996). Its relationship to medicine is also recorded in our work and in that of others (Pellegrino and Thomasma, 1993b; 1996; Drane, 1994; Ellos, 1990). General publications stress the importance of training the young in virtuous practices. Still, the popularity of education in virtue is widely viewed as part of a conservative backlash to modern liberal society. Given the authorship of some of these works by professional conservatives like William Bennett (1993; 1995), this concern is authentic. One might correspondingly fear that greater adoption of virtue theory in medicine will be accompanied by a corresponding backward-looking social agenda. Worse yet, does reaffirmation of virtue theory lacquer over the many challenges of the postmodern world view as if these were not serious concerns? After all, recreating the past is the “retro” temptation of our times. Searching for greater certitude than we can now obtain preoccupies most thinkers today. One wishes for the old clarity and certitudes (Engelhardt, 1991). On the other hand, the same thinkers who yearn for the past, like Engelhardt sometimes seems to do, might stress the unyielding gulf between past and present that creates the postmodern reaction to all systems of Enlightenment thought (1996).

This title was first published in 2002: This volume discusses the subject of biomedical ethics. Various views, historical and contemporary, are discussed, with the editors using the contrasting concepts in the shift from paternalism to autonomy in 20th-century medicine as a heuristic tool for the critical study of ethics in medicine.As far as the evidence in this volume goes, paternalistic medical practices and patient autonomy had an uneasy relationship by the beginning of the 20th century. A hundred years later, full autonomy in decisions on medical treatment is still subject to numerous caveats. The text pays close attention to the interplay between various players, noting how factors such as social contexts, governmental organizations and the biotechnological industry influence and shape responses to the principle of bioethics.

This volume explores the different dimensions of how the contingency of life, and especially human life, is relevant for ethical discussions and the normative frameworks in bioethics. It explores the relevance of the notion contingency, needs and desires for moral argumentation and bioethics. The volume discusses those notions in a philosophical perspective. Additionally, the volume is a contribution to a deeper reflection on basic philosophical assumptions of bioethics.

The idea of reviewing the ethical concerns of ancient medicine with an eye as to how they might instruct us about the extremely lively disputes of our own contemporary medicine is such a natural one that it surprises us to real ize how very slow we have been to pursue it in a sustained way_ Ideologues have often seized on the very name of Hippocrates to close off debate about such matters as abortion and euthanasia - as if by appeal to a well-known and sacred authority that no informed person would care or dare to oppose_ And yet, beneath the polite fakery of such reference, we have deprived our selves of a familiarity with the genuinely 'unsimple' variety of Greek and Roman reflections on the great questions of medical ethics. The fascination of recovering those views surely depends on one stunning truism at least: humans sicken and die; they must be cared for by those who are socially endorsed to specialize in the task; and the changes in the rounds of human life are so much the same from ancient times to our own that the disputes and agreements of the past are remarkably similar to those of our own.

This book challenges the unchallenged methods in medicine, such as "evidence-based medicine," which claim to be, but often are not, scientific. It completes medical care by adding the comprehensive humanistic perspectives and philosophy of medicine. No specific or absolute recommendations are given regarding medical treatment, moral approaches, or legal advice. Given rather is discussion about each issue involved and the strongest arguments indicated. Each argument is subject to further critical analysis. This is the same position as with any philosophical, medical or scientific view. The argument that decision-making in medicine is inadequate unless grounded on a philosophy of medicine is not meant to include all of philosophy and every philosopher. On the contrary, it includes only sound, practical and humanistic philosophy and philosophers who are creative and critical thinkers and who have concerned themselves with the topics relevant to medicine. These would be those philosophers who engage in practical philosophy, such as the pragmatists, humanists, naturalists, and ordinary-language philosophers. A new definition of our own philosophy of life emerges and it is necessary to have one. Good lifestyle no longer means just abstaining from cigarettes, alcohol and getting exercise. It also means living a holistic life, which includes all of one's thinking, personality and actions. This book also includes new ways of thinking. In this regard the "Metaphorical Method" is explained, used, and exemplified in depth, for example in the chapters on care, egoism and altruism, letting die, etc.

The advances in molecular biology and genetics, medicine and neurosciences, in ethology and environmental studies have put the concept of the person firmly on the philosophical agenda. Whereas earlier times seemed to have a clear understanding about the moral implications of personhood and its boundaries, today there is little consensus on such matters. Whether a patient in the last stages of Alzheimer's disease is still a person, or whether a human embryo is already a person are highly contentious issues. This book tackles the issue of personhood and its moral implications head-on. The thirteen essays are representative of the major strands in the current bioethical debate and offer new insights into humanity's moral standing, its foundations, and its implications for social interaction. While most of the essays approach the issue by drawing on the rich intellectual tradition of the West, others offer a cross-cultural perspective and make available for ethical consideration the philosophical resources and the wisdom of the East. The contributors to this book are highly recognized philosophers, ethicists, theologians, and professionals in health care and medicine from East Asia (China, Japan), Europe, and North America. The first part of the book probes the foundations of personhood. Examining critically the main theories on personhood in contemporary philosophy, the authors offer alternatives that better respond to contemporary challenges and their implications for bioethics. The focus of the second part is firmly on the Confucian relational concept of the person and on the social constitution of personhood in traditional Japanese culture. While the essays challenge the individualistic features of personhood in the Western tradition, they lay the foundations for a richer concept that holds great promise for the resolution of moral dilemmas in modern medicine and health care. The third part of the book enters into a dialogue with the Christian tradition and draws on its spiritual heritage in the search for answers to the contemporary challenges to human dignity and value. Its focus is on the Catholic social thought and Lutheran theology. The fourth part addresses the moral status of persons in view of specific issues such as the effects of brain injury, gene therapy, and human cloning on personhood. It extends the scope of research beyond human beings and inquires also into the moral status of animals.

The contributions to this volume grew out of papers presented at an international conference Individual, Community & Society: Bioethics in the Third Millennium, held in Hong Kong, Special Administrative Region of the People's Republic of China, between 25-28 May 1999. The conference was organized by the Centre for Comparative Public Management and Social Policy, and Ethics in Contemporary China Research Group, in the Faculty of Humanities and Social Sciences at the City University of Hong Kong. The conference brought together scholars from east and west to investigate the challenges to caring and to traditional moral authorities that would confront bioethics in the third millennium. They explored the implications of moral loss and moral diversity in post-traditional and post-modern societies, and how these would shape the character of medical care and bioethics discourse in the new era. A proceedings volume under the same title of Individual, Community & Society: Bioethics in the Third Millennium, was published in May 1999 for the conference meeting.