Virtue And Medicine

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book with the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine.

Although modern medicine enjoys unprecedented success in providing excellent technical care, many patients are dissatisfied with the poor quality of care or the unprofessional manner in which physicians sometimes deliver it. Recently, this patient dissatisfaction has led to quality-of-care and professionalism crises in medicine. In this book, the author proposes a notion of virtuous physician to address these crises. He discusses the nature of the two crises and efforts by the medical profession to resolve them and then he briefly introduces the notion of virtuous physician and outlines its basic features. Further, virtue theory is discussed, along with virtue ethics and virtue epistemology, and specific virtues, especially as they relate to medicine. The author also explores the ontological priority of caring as the metaphysical virtue for grounding the notion of virtuous physician, and two essential ontic virtues—care and competence. In addition to this, he examines the transformation of competence into prudent wisdom and care into personal radical love to forge the compound virtue of prudent love, which is sufficient for defining the virtuous physician. Lastly, two clinical case stories are reconstructed which illustrate the various virtues associated with medical practice, and it is discussed how the notion of virtuous physician addresses the quality-of-care and professionalism crises.

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine.

How, in a secular world, should we resolve ethically controversial and troubling issues relating to health care? Should we, as some argue, make a clean sweep, getting rid of the Hippocratic ethic, such vestiges of it as remain? Jennifer Jackson seeks to answer these significant questions, establishing new foundations for a traditional and secular ethic which would not require a radical and problematic overhaul of the old. These new foundations rest on familiar observations of human nature and human needs. Jackson presents morality as a loose anatomy of constituent virtues that are related in different ways to how we fare in life, and suggests that in order to address problems in medical ethics, a virtues-based approach is needed. Throughout, attention is paid to the role of philosophy in medical ethics, and how it can be used to clarify key notions and distinctions that underlie current debates and controversial issues. By reinstating such concepts as justice, cardinal virtue, and moral duty, Jackson lays the groundwork for an ethics of health care that makes headway toward resolving seeming dilemmas in medical ethics today. This penetrating and accessible book will be invaluable to students of sociology and health care, as well as those who are interested in the ethical uncertainties faced by the medical world.

Although modern medicine enjoys unprecedented success in providing excellent technical care, many patients are dissatisfied with the poor quality of care or the unprofessional manner in which physicians sometimes deliver it. Recently, this patient dissatisfaction has led to quality-of-care and professionalism crises in medicine. In this book, the author proposes a notion of virtuous physician to address these crises. He discusses the nature of the two crises and efforts by the medical profession to resolve them and then he briefly introduces the notion of virtuous physician and outlines its basic features. Further, virtue theory is discussed, along with virtue ethics and virtue epistemology, and specific virtues, especially as they relate to medicine. The author also explores the ontological priority of caring as the metaphysical virtue for grounding the notion of virtuous physician, and two essential ontic virtues—care and competence. In addition to this, he examines the transformation of competence into prudent wisdom and care into personal radical love to forge the compound virtue of prudent love, which is sufficient for defining the virtuous physician. Lastly, two clinical case stories are reconstructed which illustrate the various virtues associated with medical practice, and it is discussed how the notion of virtuous physician addresses the quality-of-care and professionalism crises.

Interest in theories of virtue and the place of virtues in the moral life con tinues to grow. Nicolai Hartmann [7], George F. Thomas [20], G.E.M. Anscombe [1], and G.H. von Wright [21], for example, called to our atten tion decades ago that virtue had become a neglected topic in modem ethics. The challenge implicit in these sorts of reminders to rediscover the contribu tion that the notion of virtue can make to moral reasoning, moral character, and moral judgment has not gone unattended. Arthur Dyck [3], P.T. Geach [5], Josef Pieper (16], David Hamed [6], and, most notably, Stanley Hauerwas [8-11], in the theological community, have analyzed or utilized in their work virtue-based theories of morality. Philosophical probings have come from Lawrance Becker [2], Philippa Foot [4], Edmund Pincoffs [17], James Wallace [22], and most notably, Alasdair MacIntyre [12-14]. Draw ing upon and revising mainly ancient and medieval sources, these and other commentators have ignited what appears to be the beginning of a sustained examination of virtue.

An argument against the “lifeboat ethic” of contemporary bioethics that views medicine as a commodity rather than a tradition of care and caring. Bioethics emerged in the 1960s from a conviction that physicians and researchers needed the guidance of philosophers in handling the issues raised by technological advances in medicine. It blossomed as a response to the perceived doctor-knows-best paternalism of the traditional medical ethic and today plays a critical role in health policies and treatment decisions. Bioethics claimed to offer a set of generally applicable, universally accepted guidelines that would simplify complex situations. In Thieves of Virtue, Tom Koch contends that bioethics has failed to deliver on its promises. Instead, he argues, bioethics has promoted a view of medicine as a commodity whose delivery is predicated not on care but on economic efficiency. At the heart of bioethics, Koch writes, is a “lifeboat ethic” that assumes “scarcity” of medical resources is a natural condition rather than the result of prior economic, political, and social choices. The idea of natural scarcity requiring ethical triage signaled a shift in ethical emphasis from patient care and the physician's responsibility for it to neoliberal accountancies and the promotion of research as the preeminent good. The solution to the failure of bioethics is not a new set of simplistic principles. Koch points the way to a transformed medical ethics that is humanist, responsible, and defensible.

Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty. Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal balances theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions. Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient.