Ethics in Diagnosis: Bodily Integrity, Trust-Telling, and the Good Physician

  • Stuart F. Spicker
Part of the Philosophy and Medicine book series (PHME, volume 40)


In addition to the acquisition of differential knowledge on the part of a physician, medical diagnosis depends on the subtleties of the patient-physician encounter, the prevailing nosological and conceptual systems in which this encounter occurs, the current status of biomedical research, and the physician’s reliance on the accuracy, reliability, and validity of the available laboratory analyses. Indeed, one can also make the case that the process of medical diagnosis tacitly involves the normative presuppositions of the medical context, the uncertainties of questionable diagnoses that may lead to ill-effects (including the physician’s failure to obtain peer and family approval rooted in a lack of confidence in his or her diagnostic competence), the values of other health care practitioners involved in a patient’s case, the diagnostic modalities available in the clinical setting in which specific medical acts take place, and even postmortem procedures [8] (when no treatment is possible) as propaedeutic to future diagnoses that are often forgotten but critical to public health problems like today’s AIDS epidemic.


Multiple Sclerosis Ethical Issue Macular Degeneration Bodily Integrity Proton Nuclear Magnetic Resonance Spectroscopy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Albert, D. A., Munson, R., and Resnik, M.D.: 1988, Reasoning in Medicine: An Introduction to Clinical Inference (The Johns Hopkins Series in Contemporary Medicine and Public Health), Johns Hopkins University Press, Baltimore Maryland.Google Scholar
  2. 2.
    Burnfield, A.: 1984, ‘Doctor-Patient Dilemmas in Multiple Sclerosis’, Journal of Medical Ethics 10(1), 21–26.CrossRefGoogle Scholar
  3. 3.
    Engelhardt, H.T., Jr.,: 1980, ‘Ethical Issues in Diagnosis’, Metamedicine 1(1), 39–50.CrossRefGoogle Scholar
  4. 4.
    Fossel, E.T. et al.: 1986, ‘Detection of Malignant Tumors: Watersuppressed Proton Nuclear Magnetic Resonance Spectroscopy of Plasma’, New England Journal of Medicine 315, 1369–1376.CrossRefGoogle Scholar
  5. 5.
    Griffith, R.M.: 1970, ‘Anthropodology: Man A-Foot’, in The Philosophy of the Body, S.F. Spicker (ed.), Quadrangle Books, Chicago, Illinois, pp. 273–292.Google Scholar
  6. 6.
    Hurst, J. W. (ed.): 1989, Criteria for Diagnosis, Butterworths, Boston, Massachusetts.Google Scholar
  7. 7.
    Kassirer, J.: 1989, ‘Our Stubborn Quest for Diagnostic Certainty: A Cause of Excessive Testing’, New England Journal of Medicine 320(22), 1489–1491.CrossRefGoogle Scholar
  8. 8.
    Laor, N., and Agassi, J.: 1991, Diagnosis: Philosophical and Medical Perspectives, Kluwer Academic Publishers, Dordrecht, The Netherlands, especially Chapter IV, “The Ethics of Diagnostic Systems”, pp. 67–90.Google Scholar
  9. 9.
    Leder, D.: 1992, ‘The Experience of Pain and its Clinical Implications’, in this volume, pp. 95–105.Google Scholar
  10. 10.
    Love, S. M., Gelman, R.S., and Silen, W.: 1982, [Sounding Board] ‘Fibrocystic “Disease” of the Breast — A Nondisease?’, New England Journal of Medicine 307(16), 1010–1014.CrossRefGoogle Scholar
  11. 11.
    Mainetti, J.A.: 1992, ‘Embodiment, Pathology and Diagnosis’, in this volume, pp. 79–93.Google Scholar
  12. 12.
    McCullough, L. B., and Christianson, C.E.: 1981, ‘Ethical Dimensions of Diagnosis: A Case Study and Analysis’, Metamedicine 2(2), 129–143.CrossRefGoogle Scholar
  13. 13.
    Moskowitz, R.: 1983, ‘Vague, Long-Term Diagnosis: The “Nocebo” Effect’, Journal of the American Institute of Homeopathy 76, 26–28.Google Scholar
  14. 14.
    Murphy, E.A.: 1976, The Logic of Medicine, Johns Hopkins University Press, Baltimore, Maryland.Google Scholar
  15. 15.
    Nelkin, D., and Tancredi, L.: 1989, Dangerous Diagnostics: The Social Power of Biological Information, Basic Books, New York.Google Scholar
  16. 16.
    Rosenberg, M.: 1990, [Letter] ‘History and Examination Should Precede Tests’, Journal of the American Medical Association 263(12) 1632.CrossRefGoogle Scholar
  17. 17.
    Schaffner, K.F. (ed.): 1985, Logic of Discovery and Diagnosis in Medicine, University of California Press, Berkeley/Los Angeles, California.Google Scholar
  18. 18.
    Shaw, A.: 1987, ‘Ethical Dilemmas in the Early Detection of Malignancy by NMR Spectroscopy of Plasma’, New England Journal of Medicine, 317(21), 1353.Google Scholar
  19. 19.
    Sox, H. C., Blatt, M.A., Higgins, M.C., and Marton, K.I.: 1988, Medical Decision Making, Butterworths, Boston, Massachussetts.Google Scholar
  20. 20.
    Spicker, S.F. (ed.): 1970, The Philosophy of the Body, Quadrangle Books, Chicago, Illinois, (Intro.) pp. 3–23.Google Scholar
  21. 21.
    Spicker, S.F., and Raye, J.R.: 1981, ‘The Bearing of Prognosis on the Ethics of Medicine: Congenital Anomalies, the Social Context and the Law’, in S.F. Spicker, J.M. Healey, Jr., and H. T. Engelhardt, Jr. (eds.) The Law-Medicine Relation: A Philosophical Exploration, D. Reidel Publishing Co., Dordrecht, Holland / Boston, U.S.A., pp. 189–216.Google Scholar
  22. 22.
    Stetten, D.: 1981, ‘Sounding Board’, The New England Journal of Medicine 305(8), 458–460.CrossRefGoogle Scholar
  23. 23.
    Webster, B.D.: 1989, All of a Piece: A Life with Multiple Sclerosis, Johns Hopkins University Press, Baltimore, Maryland.Google Scholar
  24. 24.
    Wulff, H.R.: 1981, Rational Diagnosis and Treatment: An Introduction to Clinical Decision-Making, 2nd ed., Blackwell Scientific Publications, Oxford, England.Google Scholar
  25. 25.
    Zaner, R.M. (ed.): 1988, Death: Beyond Whole-Brain Criteria, (Vol. 31, Philosophy and Medicine series) Kluwer Academic Publishers, Dordrecht, The Netherlands.Google Scholar

Copyright information

© Kluwer Academic Publishers 1992

Authors and Affiliations

  • Stuart F. Spicker
    • 1
  1. 1.University of Connecticut School of MedicineFarmingtonUSA

Personalised recommendations