Abstract
Before the rise of the idea and reality of the physician, of the medicus, and partly alongside with it, we find the idea of the magician or ‘medicine man’, of the medically knowledgeable person. Three elements or factors chiefly1 characterize the physician and distinguish him from the medicine man and the medical practitioner who is not a physician:
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science (a scientific base of medical interventions),
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systematic technique or art of medicine, and
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an ethical dimension which involves both a personal moral commitment of the physician and a philosophical vision of man; this third element can also include a further religious dimension.2
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References
See Max Scheler, “Vom Wesen der Philosophie. Der philosophische Aufschwung und die moralischen Vorbedingungen,” in Max Scheler, Vom Ewigen im Menschen (Erkenntnislehre und Metaphysik), Schriften aus dem Nachlass Band II, herausgegeben mit einem Anhang von Manfred S. Frings (Bern: Francke Verlag, 1979), pp. 61–99.
Certainly, ‘pure physics’ is freer of pragmatically narrow points of view than applied physics, etc.; nevertheless, the whole science of physics does not purely look into the ultimate essence of its subject of investigation but looks into it not much farther than can be operated with.
See on such empirical methods for the exploration of a priori laws in mathematics, Gregory J. Chaitin, “Zahlen und Zufall—Algorithmische Informationstheorie. Neueste Resultate über die Grundlagen der Mathematik,” in H.-C. Reichel, E. Prat de la Riba (eds.), Naturwissenschaft und Weltbild (Wien: Hölder/Pichler/Tempsky, 1992), pp. 30–44.
See also, on a similar case in chess theory, the discussion and references presented in my Schachphilosophie (Darmstadt: Wissenschaftliche Buchgesellschaft, 1989).
We will return to this in chapter 5. See also the critique of non-cognitivist bioethics in Elio Sgreccia, Manuale di bioetica, I. Fondamenti ed etica biomedicale, II. Aspetti medico-sociali (Milano: Vita e Pensiero, 1988–1991; 2nd ed. 1994, 3rd ed. 2002), vol. I, pp. 75 ff.
See Claude Bernard, Introduction to the Study of Experimental Medicine (1865), (New York: Dover Publications, 1957), pp. 5 ff.
, especially p. 31: “Experimental reasoning is the only reasoning that naturalists and physicians can use seeking the truth and approaching it as nearly as possible.” Although he did not include it in his theory of medicine, Claude Bernard has a keen moral sense, thus admitting the importance of a non-experimental science of ethics for medicine, as can be seen, for example, from his discussion of vivisection in medical research, ibid., p. 101. Claude Bernard was born on July 12, 1813. He received a humanistic rather than a scientific education, writing some music and some drama. In 1834 Claude Bernard began to study medicine in Paris. The physiologist François Magendie was among his teachers. Bernard soon became one of the leading men of his time in science. A chair of general physiology was created for him at the Sorbonne (1854). In 1868, after the Emperor had a laboratory built for him at the Jardin des Plantes, Bernard left the Sorbonne and published the results of his scientific investigations in public lectures and writings (17 volumes). Among his publications are: Introduction to the Study of Experimental Medicine (1865) and General Physiology (1872). Bernard died in Paris on February 10, 1878, and had become so famous that he was accorded a State funeral, an honor never before bestowed by France on a man of science. See also Compton’s Interactive Encyclopedia (1996), article “Bernard, Claude.”
See on this Husserl’s distinction between Tatsachenwissenschaften and Wesenswissenschaften in his Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy, in Edmund Husserl, Collected Works, vol. III (Dordrecht/Boston/London: Kluwer Academic Publishers, 1989)
; and Adolf Reinach, Was ist Phänomenologie?, in Adolf Reinach, Sämtliche Werke. Kritische Ausgabe mit Kommentar. See likewise Dietrich von Hildebrand, What Is Philosophy?, ch. 4.
The role of ‘incomplete explanations’ was investigated carefully by Volker Gadenne, in his “Unvollständige Erklärungen,” in M. Sukale, ed., Sprache, Theorie und Wirklichkeit (Bern: P. Lang, 1990), pp. 263–287.
Certainly, medical explanations are necessarily incomplete inasmuch as this incomepleteness results from the limits of natural inductive science and of its formal object; but are they are also necessarily incomplete within the context of that science? Furthermore, is this incompleteness of the essence of medicine, or only imposed by the limits of each particular context of explanation? See also
Rudolf Grass and Markus Loeffler, Prinzipien der Medizin. Eine Übersicht ihrer Grundlagen und Methoden (Berlin/Heidelberg/New York, etc.: Springer 1998).
See John Worrall, “What Evidence in Evidence-Based Medicine?” Philosophy of Science (2002), 69 (3 Supplement): 316–330.
It understands ‘evidence-based medicine’ (EBM) as a (relatively new) movement that seeks to put clinical medicine on a firmer scientific footing. The author argues that it is uncontroversial that medical practice should be based on the best evidence it can obtain but then discusses interesting questions concerning a more detailed understanding and application of this principle, moving towards a more coherent and unified account of best evidence in medicine, by exploring in particular the question of what ‘randomized controlled trials’ contribute to the evidence of medical knowledge. I would suggest that only if inductive empirical knowledge stands on firm grounds, evidence-based medicine in this epistemological sense can be defended.
See also Ross E. G. Upshur, “The Ethics of Alpha: Reflections on Statistics, Evidence and Values in Medicine,” Theoretical Medicine and Bioethics (2001), 22(6): 565–576.
See likewise H. Nederbragt, “The Biomedical Disciplines and the Structure of Biomedical and Clinical Knowledge,” Theoretical Medicine and Bioethics (2000), 21(6): 553–566.
The author argues that the structure of clinical knowledge involves knowledge of the patient who has a disease. Therefore, the notion of evidence-based medicine should realize that not only biomedical knowledge contributes to this knowledge but that it also entails knowledge regarding economic and social relations, ethics and personal experience. He argues that the interaction between each of the participating ‘knowledges’ in clinical knowledge is different from biomedical knowledge, and based on a competition and partial exclusion rather than on mutual dependency and accumulation of different arguments from each. The difference of the structure of biomedical knowledge from that of clinical knowledge is linked with a discussion of the place of technology, evidence-based medicine, and the gap between scientific and clinical knowledge. See also the application of Gadamer’s theory of hermeneutics in
R. E. G. Upshur, “Priors and Prejudice,” Theoretical Medicine and Bioethics (Aug 1999), 20(4): 319–327.
I will argue that the basis of medical evidence has to lie in certain ontological and not only in hermeneutical presuppositions which will easily lead to the types of scientific and ethical relativism and skepticism discussed in chapter 5. See also
Derrick K. S. Au, “Constructing Options for Health Care Reform in Hong Kong,” Journal of Medicine and Philosophy (D 1999), 24(6): 607–623.
This paper seeks to show that the Harvard Report, published in April 1999 for public consultation in Hong Kong, which proposes a fundamental restructuring in health care delivery and financing systems in Hong Kong, while it claims to be evidence-based in its approach and to rely on surveys, consultations and focus groups, the recommendations put forth express clear ideological preferences and contain questionable value assumptions.
Cf. Ross E. G. Upshur, Erica Zarkovich, “The Virtues of Evidence,” Theoretical Medicine and Bioethics (2002), 23(4-5): 403–412.
The authors proceed from a definition of evidence-based medicine as “the conscientious and judicious use of current best evidence in making clinical decisions.” The paper goes on to show that the terms ‘conscientious’ and ‘judicious’ represent terms derived from virtue ethics and virtue epistemology. The identification of explicit virtue components in the definition and conception of evidence-based medicine presents an important starting point in the connection between virtue theories and medicine.
Medical ethical codes and the law wisely require that such experiments be first performed on animals, although this should not be misconstrued as defending a license for ruthless experimentation and exploitation of animals without respect for the ethical requirements and conditions of such research. Cf. Julian Nida-Rümelin, Angewandte Ethik. Die Bereichsethiken und ihre theoretische Fundierung. Ein Handbuch herausgegeben von Julian Nida-Rümelin (Stuttgart: Alfred Kröner Verlag, 1996).
See Ludwig von Bertalanffy, General Systems Theory (New York, 4th ed. 1972). See also Paulina Taboada, “Bedeutung der ‘allgemeinen Systemtheorie’ in der heutigen Debatte über den Gesundheitsbegriff.” The key notion of the influential “general systems theory,” namely the concept of an ‘organized whole’, or ‘organized totality’, has also much to do with entelechy although it rejects vehemently the notion of entelechy. One problem with this theory, which was shown by Conrad-Martius and Paulina Taboada to amount to a subtle reductionism, is that it fails to account for the inner finality, and above all to the dynamically self-forming character of this organization. Cf. Hedwig Conrad-Martius, “Präformismus in der Natur,” in H. Conrad-Martius, Schriften zur Philosophie, edited by Eberhard Avé-Lallement (Munich: Kösel, 1964), vol. 2, pp. 153–173.
p. 160: [Für] die nicht mehr fortzuleugnenden transphysischen Phänomene [bleibt] nur der mathematische Symbolismus übrig—wenn man nicht zu mechanistischen Analogien und Figmenten oder aber, was der Biologie näherliegt, zu psychologistischen greifen will. See also ibid., p. 159. This theory also fails to recognize the metaphysical necessity that only life itself and soul can explain the specific irreducible essence of the effects and activities of living organisms. See my What is Life?. This is very understandable given the origins of Bertalanffy’s thought (1952) in the circle of disciples of Moritz Schlick and of the Vienna Circle of Neopositivism to whose descendants he ascribes himself. See T. Purola, “A Systems Approach to Health and Health Policy,” Medical Care, 10:5 (1972). Other names of contemporary defenders of some version of general systems theory today include H. Noack, R. Anderson, and A. Kaplun.
See Karl R. Popper/ John C. Eccles, The Self and Its Brain (Berlin/Heidelberg/London/New York: Springer-Verlag International, 1977
; corrected printing 1981).
Cf. Sir John Eccles, The Human Psyche. The Gifford Lectures, University of Edinburgh, 1978–1979 (New York/Heidelberg/Berlin Springer Verlag International, 1980), pp. 22 ff., 31 ff, 44 ff, 85 ff, 98 ff, 147 ff., 153-155.
See also Karl R. Popper/John C. Eccles, The Self and Its Brain
Sir John Eccles, Facing Reality; The Human Mystery. The Gifford Lectures, University of Edinburgh, 1977–1978 (Berlin/Heidelberg/New York: Springer Verlag International, 1979).
Sir John Eccles and D. N. Robinson, The Wonder of Being Human. Our Brain and Our Mind (New York/London, 1984).
Since medicine uses far less ‘paradigms’ and is a stricter experimental science than, for example, physics, I do not think it is necessary here to deal with the ultimately skeptical theory of science propounded by Thomas Kuhn with which I am dealing elsewhere.
Thomas S. Kuhn, The Structure of Scientific Revolutions, 3rd ed. (Chicago & London: The University of Cicago Press, 1964).
See also Thomas S. Kuhn, The Essential Tension. Selected Studies in Scientific Tradition and Change (Chicago & London: The University of Chicago Press, 1977).
For a critique of Thomas S. Kuhn’s theory see my “Nachwort des Herausgebers”, in Giovanni Reale, Zu einer neuen Interpretation Piatons. Eine Auslegung der Metaphysik der großen Dialoge im Lichte der “ungeschriebenen Lehren, ” übers, v. L. Hölscher, mit einer Einleitung von H. Krämer, hrsg. und mit einem Nachwort von J. Seifert (Paderborn: Schöningh, 1993), pp. 541-558; and my “Wissen und Wahrheit in Naturwissenschaften, Philosophie und Glauben”, in Naturwissenschaft und Weltbild (Hrsg. H.-C. Reichel, E. Prat de la Riba), (Wien: Hölder-Pichler-Tempsky, 1992).
We refer the reader to a more detailed defense of the method of induction against Popper’s well-known critique of it, offered elsewhere. Cf. Josef Seifert, “Objektivismus in der Wissenschaft und Grundlagen philosophischer Rationalität. Kritische Überlegungen zu Karl Poppers Wissenschafts-, Erkenntnis-und Wahrheitstheorie,” in N. Leser, J. Seifert, K. Plitzner (eds.), Die Gedankenwelt Sir Karl Poppers: Kritischer Rationalismus im Dialog (Heidelberg: Universitätsverlag C. Winter, 1991), pp. 31–74.
and “Diskussion,” ibid., pp. 75-82.
See on this question a paper that argues that in regard to the empirical science of the observable Bernard was a realist, but with respect to the apriori or in general to the unobservable a nominalist: Luiz Henrique Dutra, “O Realismo Cientifico de Claude Bernard,” Cad Hist Filosof Cie 6(1), (1996): 29–44.
With respect to his conception of the empirical methods of medicine, he could also be regarded as a forerunner of Popperian fallibilism, as is argued in J. F. Malherbe, “Karl Popper et Claude Bernard,” Dialectica 35, (1981): 373–388.
On the general epistemological views of Claude Bernard cf. J. M. D. Olmsted, E. Harris Olmsted, Claude Bernard and the Experimental Method in Medicine (New York: Schuman, 1952).
Sir Karl Popper, Objective Knowledge. An Evolutionary Approach (Oxford, Clarendon Press, 1972), pp. 3 ff.
We do not study here the reasons why Popper disputes this eminently apt observation of Bertrand Russell. See Sir Karl Popper, ibid., p. 5 ff. Though he rejects Russell’s observation, Popper holds nonetheless, for somehow mysterious reasons, that there is an “isomorphy between logic and psychology” and a “principle of transference,” which says: “What has validity in logic, is also valid for psychology. ” See Sir Karl Popper, Objektive Erkenntnis. Ein evolutionärer Entwurf 3rd ed. (Zürich: Buchclub ex Libris, 1985).
German translation (of fourth English ed.), p. 6. I fail to see how this remark can make sense inside Popper’s theory.
Ibid., pp. 47 ff., 52 ff. See Karl R. Popper, “A Note on Tarski’s Definition of Truth”, Mind (1955), 64: 388–391.
See also Luis Fernandez Moreno, “Tarskian Truth and the Correspondence Theory”, Synthese, (2001) January; 126(1–2): 123–147.
See Karl R. Popper, Conjectures and Refutations The Growth of Scientific Knowledge (London: Routledge and Kegan Paul, 1963), pp. 16, 27.
A. Pfänder, Logik, 4th ed., edited by Mariano Crespo (Heidelberg: Universitätsverlag C. Winter, 2000), pp. 341 ff.
See P. Feyerabend, “In Defence of Aristotle: Comments on the Condition of Content Increase,” in G. Radnitzky and G. Andersson (eds.), Progress and Rationality in Science (Dordrecht: Reidel, 1978), pp. 143–180, esp. 174-175, note 8.
See Bertrand Russell, Principles of Mathematics, 2nd ed. (London, 1937); see also Josef Seifert, Überwindung des Skandals der reinen Vernunft. Die Widerspruchsfreiheit der Wirklichkeit—trotz Kant (Freiburg/München: Karl Alber, 2001).
See Martin Cajthaml, Kritik des Relativismus (Heidelberg: Universitätsverlag Winter, 2003).
see also John F. Crosby, “Refutation of Skepticism and General Relativism”, in D. von Hildebrand (ed.), Rehabilitierung der Philosophie (Regensburg, 1974), pp. 103-123.
G. E. Moore, Principia Ethica, 14th ed. (London: Oxford University Press, 1971).
See chapter 6, below. See also Sir David Ross, Foundations of Ethics, 4th ed. (Oxford: Oxford University Press, 1960).
See as well Dietrich and Alice von Hildebrand, Morality and Situation Ethics. With a Preface of Bernhard Häring and an Epilogue by Alice von Hildebrand (Chicago: Franciscan Herald Press, 1966).
See Roman Ingarden, Von der Verantwortung. Ihre ontischen Fundamente (Stuttgart: Philipp Reclam Jun., 1970).
Speaking later of a ‘third world’ and calling its structures ‘intelligibilia’, Popper might have moved later away from his radical anti-Platonist and anti-essentialist earlier standpoint of his The Logic of Scientific Discovery, 2nd ed. (New York: Harper & Row, 1968). See D. Jakowljewitsch, “Die Frage nach dem methodologischen Dualismus der Natur-und Sozialwissenschaften und der Standpunkt kritischer Rationalisten”, in K. Salamun (ed.), Karl R. Popper und die Philosophie des kritischen Rationalismus. Zum 85. Geburtstag v. Karl R. Popper (Amsterdam: Rodopi, 1989), pp. 116–117.
See the following famous texts of David Hume: I am first affrighted and confounded with that forlorn solitude in which I am plac’d in my philosophy, and fancy myself some strange uncouth monster, who, not being able to mingle and unite in society, has been expell’d all human commerce, and left utterly abandon’d and disconsolate. Fain wou’d I run into the crowd for shelter and warmth, but cannot prevail with myself to mix with such deformity. I call upon others to join me, in order to make a company apart; but no one will hearken to me. Every one keeps at a distance, and dreads that storm, which beats upon me from every side. I have expos’d myself to the enmity of all metaphysicians, logicians, mathematicians, and even theologians; and can I wonder at the insults I must suffer? I have declar’d my dis-approbation of their systems; and can I be surpriz’d, if they shou’d express a hatred of mine and of my person? When I look abroad, I foresee on every side, dispute, contradiction, anger, calumny, and detraction. When I turn my eye inward, I find nothing but doubt and ignorance. All the world conspires to oppose and contradict me; thou’ such is my weakness, that I feel all my opinions loosen and fall of themselves, when unsupported by the approbation of others. Every step I take is with hesitation, and every new reflection makes me dread an error and absurdity in my reasoning. (Hume: Treatise on Human Nature, bk. 1, pt. 4, sec. 7, p. 264-265) For with what confidence can I venture upon such bold enterprizes, when beside those numberless infirmities peculiar to myself, I find so many which are common to human nature? Can I be sure, that in leaving all establish’d opinions I am following truth; and by what criterion shall I distinguish her, even if fortune shou’d at last guide me on her foot-steps? After the most accurate and exact of my reasonings, I can give no reason why I shou’d assent to it; and feel nothing but a strong propensity to consider objects strongly in that view, under which they appear to me. Experience is a principle, which instructs me in the several conjunctions of objects for the past. Habit is another principle, which determines me to expect the same for the future; and both of them conspiring to operate upon the imagination, make me form certain ideas in a more intense and lively manner, than others, which are not attended with the same advantages. Without this quality, by which the mind enlivens some ideas beyond others (which seemingly is so trivial, and so little founded on reason), we cou’d never assent to any argument, nor carry our view beyond those few objects, which are present to our senses. Nay, even to these objects we cou’d never attribute any existence, but what was dependent on the senses; and must comprehend them entirely in that succession of perceptions, which constitutes our self or person. Nay farther, even with relation to that succession, we cou’d only admit of those perceptions, which are immediately present to our consciousness, nor cou’d those lively images, with which the memory presents us, be ever receiv’d as true pictures of past perceptions. The memory, senses, and understanding are, therefore, all of them founded on the imagination, or the vivacity of our ideas. (Hume: Treatise on Human Nature, bk. 1, pt. 4, sec. 7, p. 265) See also Wolfgang Stegmüller, Metaphysik, Skepsis, Wissenschaft (München: Piper, 1970).
Cf. Claudius Galenus, A Translation of Galen’ s Hygiene (De sanitate tuenda), edited by Robert Montraville Green MD, with an Introduction by Henry E. Sigerist MD (Springfield, Ill.: Charles C. Thomas Publisher, 1951).
See the interesting paper by Christopher Melley, “Medical Malpractice, the Hippocratic Oath, and the Code of Silence,” in European Philosophy of Medicine and Health Care (1996, 4:2): 6–17.
The author argues that the Hippocratic Oath forbids any negligence and malpractice but that the silence it imposes cannot and must not be applied to an alleged verdict of not speaking out against clear cases of malpractice and negligence observed in colleagues and hospitals. On the contrary, the gravity of consequences of malpractice for patients demands to ignore a false sense of ‘collegiality’ and imposes a duty for such honest speaking out.
One is reminded here of Marshall McLuhan’s idea of the global village which in recent years took on much more advanced and sometimes frightening forms. See for instance Josef Seifert, Rocco Buttiglione and Radim Palous, Die Verantwortung des Menschen in einem globalen Weltzeitalter (Heidelberg: Universitätsverlag C. Winter, 1996), pp. 28–73.
There are superb thoughts on this in Theophrastus Paracelsus’s Labyrynthus medicorum errantium, in Theophrastus Paracelsus, Werke, besorgt von W.-E. Peuckert. Bd. II, Medizinische Schriften, pp. 440–495 (Darmstadt: Wissenschaftliche Buchgesellschaft, 1965).
Cf. my “Moral Goodness and Mental Health,” in James M. DuBois (ed.), Moral Issues in Psychology. Personalist Contributions to Selected Problems (Lanham/New York/London: University of America Press, 1997), pp. 43–64.
This important point is quite well brought out in Paracelsus’s work. How important an adequate philosophy is for medicine, Theophrastus Paracelsus especially points out in his Philosophia sagax, or in the full title, Astronomia magna oder die ganze philosophia sagax der grossen und kleinen Welt 1537/38, in Werke, besorgt von W.-E. Peuckert. Bd. III, Philosophische Schriften (Darmstadt: Wissenschaftliche Buchgesellschaft, 1965), pp. 37–405.
See on this also Josef Seifert, Leib und Seele. Ein Beitrag zur philosophischen Anthropologie (Salzburg: A. Pustet, 1973).
Josef Seifert, Das Leib-Seele Problem und die gegenwärtige philosophische Diskussion. Eine kritisch-systematische Analyse, 2nd ed. (Darmstadt: Wissenschaftliche Buchgesellschaft, 1989).
and J. Seifert, What is Life?.
See Edmund Husserl, Logische Untersuchungen. Text der ersten und zweiten Auflage, Bd. I: Prolegomena zu einer reinen Logik, hrsg. v. E. Holenstein, Husserliana, Bd. XVIII (Den Haag: M. Nijhoff, 1975)
Bd. II, 1: Untersuchungen zur Phänomenologie und Theorie der Erkenntnis, 1. Teil, Bd. II, 2: Untersuchungen zur Phänomenologie und Erkenntnis, 2. Teil, hrsg. v. U. Panzer, Husserliana, Bd. xix, 1 und Bd. xix, 2 (Den Haag: Nijhoff, 1984).
See M. Grabenwöger, M. Ehrlich, D. Hutschala, A. Rajek, S. Thurnher, J. Lammer, E. Wolner, “Die Chirurgie der Aorta descendens bei Dissektionen, Aneurysmen und Rupturen,” in J Kardiol 2001; 8: 30–33.
The article reports on this technique of operating on the aorta descendens at the AKH Vienna (in the Department directed by Univ. Prof. Dr. Ernst Wolner). Prior to the surgery the blood of the patient is taken out of the body of the patient, whose body is cooled to a temperature of 18° Celsius so that a deep hypothermia and arrest of blood circulation can be induced without lethal consequences; during the arrest of heart-beat the blood of the patient is collected in a heart-lung-machine so that the surgical intervention (bypass operation) and potential replacement of parts of the aorta through artificial parts of the aorta can be performed in a ‘dry operating field’. The use of oxyen sinks by 5% per each Celsius degree of cooling the body temperature. The EEG in such patients during the arrest of the circulatory activity and the external collection of blood equals that of a dead patient. Up to 50 minutes remaining of patients in this state is tolerated by brain cells and other parts of the nervous system. Professor of Psychology Dr. Giselher Guttmann (University of Vienna) and his team examined the patients who underwent this surgery three times: before, shortly after, and three months after the operation. After three months they found considerably improved cognitive functions in the patients who had undergone and survived this surgery.
The development of a personalistic concept of human health was the theme of a two-year research project at the International Academy of Philosophy in the Principality of Liechtenstein, supported by the Swiss National Science Foundation (Schweizerischer Nationalfonds zur Förderung wissenschaftlicher Forschung), which I directed. See some of the results in publications: Kateryna Fedoryka, “Health as a Normative Concept: Towards a New Conceptual Framework,” Journal of Medicine and Philosophy (22)2: 143–160, Ap 1997.
Kateryna Fedoryka, “Über die Möglichkeit einer objektiven Grundlage in einer subjektbezogenen Medizin,” in Imago Hominis, Bd. IV, Nr. 2 (1997), pp. 125–132.
Kateryna Fedoryka-Cuddeback, with Patricia Donohue-White, “The Good of Health: An Argument for an Objectivist Understanding,” in Paulina Taboada, Kateryna Fedoryka-Cuddeback, and Patricia Donohue-White (eds.), Person, Society and Value: Towards a Personalistic Conception of Health (Dordrecht/Boston/London: Kluwer 2001).
See also Paulina Taboada, Kateryna Fedoryka-Cuddeback, and Patricia Donohue-White (eds.), Person, Society and Value: Towards a Personalistic Concept of Health, symposium proceedings. See likewise Patricia Donohue-White, “Situating the Value of Health in the Hierarchy of Values. Reflections from the value philosophy of Max Scheler,” in James M. DuBois (ed.), Phenomenology and Value Realism, in review with Kluwer. See also Josef Seifert, “What is Human Health? Towards Understanding its Personalistic Dimensions,” in Person, Society, and Value: Towards a Personalistic Conception of Health; the same author, “Moral Goodness and Mental Health.”.
See on this the ethics for physicians, Deontologia médica segun el derecho natural, by Payen, S.J. (Barcelona: Rambla, 1944).
In this regard, recent findings are very interesting. See Robert D. Orr, Norman Pang, Edmund D. Pellegrino (& others), “Use of the Hippocratic Oath: A Review of Twentieth Century Practice and a Content Analysis of Oaths Administered in Medical Schools in the U.S. and Canada in 1993,” J Clin Ethics (Wint 1997), 8(4): 377–388.
This paper contains a survey of all medical schools in North America to see what oaths were used in 1993. A comparison of similar data to surveys from 1928, 1958, 1978, and 1989, and a comparison of the content of current oaths with the classical Hippocratic Oath led to interesting results. There has been a considerable quantitative increase (24% to 98%) in the use of professional oaths in medical schools in the U.S. and Canada this century. At the same time there has been a steady decrease in several content items (invoking deity-11%; abjuring sexual impropriety towards patients-3%, abortion-8%, and euthanasia-14%) from the classical Hippocratic Oath.
Consequentialist ethics which entered also large numbers of books and papers of Christian moral theologians, was criticized in many philosophical books and papers by the earlier Karl Rahner, by Dietrich von Hildebrand, Karol Wojtyìa, Tadeusz Styczeî, Andrzej Szostek, John Finnis, Germain Grisez, William May, Andreas Laun, Martin Rhonheimer, Robert Spaemann, John Crosby, Elizabeth Anscombe, Julian Nida-Rümelin, Rocco Buttiglione, myself, and many others. This position was also sharply criticized in the Encyclicals Veritatis Splendor and Evangelium Vitae. See, for example, Andreas Laun, “Das Gewissen—sein Gesetz und seine Freiheit. Anmerkungen zur heutigen Diskussion,” in Aktuelle Probleme der Moraltheologie (Wien: Herder & Co., 1991), pp. 31–64.
See on this, e.g., Robert Spaemann, “Über die Unmöglichkeit einer rein teleologischen Begründung der Ethik,” Philosophisches Jahrbuch, 88. Jg. I. Halbband (1981), pp. 70-89; the same author, “Autonome Ethik und Ethik mit einem christlichen ‘Proprium’ als methodologisches Problem,” in D. Mieth and F. Compagnoni (eds.), Ethik im Kontext des Glaubens. Probleme — Grundsätze — Methoden (Freiburg/B. and Freiburg/Switzerland 1978), pp. 75-100; Julian Nida-Rümelin, Kritik des Konsequentialismus (München, 1993); Stephen Schwarz, The Moral Question of Abortion (Chicago: Loyola University Press, 1990).
Until recently, homosexuality and homosexual inclinations have been listed in the Handbook of the American Psychiatric Association as sexual abnormality, but during the last years not only homosexuality but other forms of abnormal sexual behavior are one after the other stricken from that list. See Richard Cohen, Coming Out Straight. Understanding and Healing Homosexuality (Winchester, Virginia: Oakhill Press, 2000).
This question was subject of a two-year research project directed by Professor T. H. Engelhardt, Jr. See my contribution to this project, “Toward a Personalistic Ethics of Limiting Access to Medical Treatment: Philosophical and Catholic Positions”, in H. Tristram Engelhardt, Jr. and Mark J. Cherry (eds.), Limiting Access to Medical Treatment in the Age of Medical Progress: A Roman Catholic Perspective (Dordrecht/Boston: Kluwer Academic Publishers, 2001), pp. 96–124.
This was adopted on October 10, 1975 by the 29th World Medical Assembly, and deals in §§ 1-4 and 6 with torture [World Medical Association, “Declaration of Tokyo,” Bull. Am. College of Physicians 17(6); 15, 1976].
See the beautiful short story of Turgenev, “The District Doctor,” in Thomas Seltzer (ed.), Best Russian Short Stories, pp. 82–95 (New York: The Modern Library, Inc., 1925).
which not only is a very moving love story but also illustrates the great task of physicians to accompany and comfort the dying.
See on this Gregorio Maranon, La Medicina y los Medicos (Madrid: Espasa-Calpe, 1962), pp. 138, 182, 188.
Most of Viktor Frankl’s work as a psychiatrist and as a theoretician is dedicated to this great goal.
See Viktor E. Frankl,... trotzdem Ja zum Leben sagen. Ein Psychologe erlebt das Konzentrationslager, 19th ed. (München: Kösel-Verlag and dtv, 2000).
Viktor E. Frankl, Man’s Search for Meaning. An Introduction to Logotherapy (a revised edition of From Death-Camp to Existentialism) (Boston: Beacon Press, 1963–2000).
Cf. also Viktor E. Frankl, Logotherapie und Existenzanalyse. Texte aus sechs Jahrzehnten, 2nd ed. (Berlin/München: Quintessenz Verlag, 1994).
Viktor E. Frankl, Sinn als anthropologische Kategorie. Meaning as an Anthropological Category (Heidelberg: Universitätsverlag C. Winter, 1996), pp. 19–29.
See Elisabeth Lukas, Lehrbuch der Logotherapie. Menschenbild und Methoden (München/Wien: Profil, 1997).
Such a metaphysics is proposed by Derek Parfit in his Reasons and Persons (Oxford: Oxford University Press, 1985).
See Blaise Pascal, Pensées, introduced by T. S. Eliot, translated by W. F. Trotter (New York: E. P. Dutton & Co., Inc., 1958), 347.
See Josef Seifert, “Meaning and Morality as Conditions of Mental Health: A Contribution towards a Theory of Counseling as a Specifically Personalistic Method of Providing Medical and Psychological Help to Persons,” Medicine, Mind, and Adolescence, 1996, vol. XI, no 2, pp. 59–76.
See also by the same author, “Moral Goodness and Mental Health.”.
By the syllogism that: (a) a good person does everything in her power to prevent evil; (b) an omnipotent person has the power to do whatever she likes; is incompatible with (c) evils exist. See on this Josef Seifert, Gott als Gottesbeweis. Eine phänomenologische Neubegründung des ontologischen Arguments (Heidelberg: Universitätsverlag C. Winter, 1996.
Erweiterte und verbesserte Auflage, mit einem Nachwort für die arabischen Leser, 2000); see also my “Zur Herkunft des Glaubens. Gründe und Hintergründe. Reflexionen über das Problem einer Theodizee angesichts der Leiden und Übel in der Welt,” in Glaube im Unglauben der Zeit (Augsburg: Dialogsekretariat, 1983).
See on this Robert Stern, Die Diskussion um das “Biogenetische Grundgesetz” in Bezug auf den Wert des menschlichen Lebens, aufgezeigt am Beispiel der Kindesabtreibung, Kindestötung und Euthanasie: Haeckel versus Blechschmidt (Universität Bern: unveröffentl. Dissertation: Medizinhistorisches Institut der Universität Bern, 1995).
especially the parallel texts in Hitler’s works and Haeckel on pp. 42 ff. See also Wanda Póitawska, Und ich fürchte meine Träume, a gripping description of her experiences in the Nazi-Camp of Ravensbrück, in which human persons were treated like animals for experimental purposes.
“The 17 Rules of Enjuin”, in Robert M. Veatch (ed.), Cross Cultural Perspectives in Medical Ethics: Readings (Boston: Jones and Bartlett, 1989), pp. 140.
Translated by Harry Friedenwald. Encyclopedia of Bioethics, edited by Warren T. Reich (New York: The Free Press, 1978).
René Cassin in John Warwick Montgomery, Human Rights and Human Dignity (Dallas: Probe Books, 1986), p. 30.
Peter Singer is not the first person to introduce an animal ethics. See on this Julian Nida-Rümelin, “Tierethik I: Zu den philosophischen und ethischen Grundlagen des Tierschutzes,” in Angewandte Ethik. Die Bereichsethiken und ihre theoretische Fundierung. Ein Handbuch herausgegeben von Julian Nida-Rümelin. (Stuttgart: Alfred Kröner Verlag, 1996), pp. 458–483.
see also Julian Nida-Rümelin und Dietmar v. d. Pfordten, “Tierethik II: Zu den philosophischen und ethischen Grundlagen des Tierschutzes,” in Angewandte Ethik, pp. 484-50. See likewise another Christian perspective on animal ethics in Andreas Laun, “Tierethik—Anmerkung zur aktuellen Diskussion,” in Kirche heute 10/Oktober (1996), pp. 13-31.
Cf. Bernard Gert, Charles M. Culver, K. Danner Clouser, “Common Morality versus Specified Principlism: Reply to Richardson,” Journal of Medicine and Philosophy, (2000 June), 25(3): 308–322.
Cf. Dietrich von Hildebrand, Moralia.
Gabriel Marcel, Les hommes contre l’humain (1951); in German, trans, by Herbert P. Schad, Die Erniedrigung des Menschen, 2nd ed. (Frankfurt: Knecht, 1964).
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Seifert, J. (2004). The Nature and the Seven Goals of Medicine as Objects of a Dramatic Free Choice of the Physician Today. In: The Philosophical Diseases of Medicine and their Cure. Philosophy and Medicine, vol 82. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2871-7_1
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