Abstract
The field of bio- or medical ethics continues to show serious distress, appearances to the contrary notwithstanding. Not that such news will, I dare say, cause many tremors in the landscape of medicine or health care. What with the upheavals brought on by the open shift to commercializing health care—and the threats to the autonomy long enjoyed by many health professionals, physicians in particular, now experiencing the real anguish implicit to functioning as gatekeepers (Pellegrino ED, J Contemp Health Law Policy 2:23–45, 1986)—there has been quite enough to preoccupy physicians, researchers and others in health care’s increasingly embattled demesne.
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Notes
- 1.
It is not insignificant to note that from meager beginnings in the early 1960s in the United States, this ‘field’ quickly became an international phenomenon of the first order: often required in some form or other by hospitals, physician groups, even governmental agencies, world-wide. A stunning development in the essentially socially conservative field of education alone, this development is all the more remarkable for its general acceptance in public arenas everywhere (Pellegrino and McElhiney 1981).
- 2.
Although not cited by him, one hears faint echoes of Alasdair MacIntyre’s analysis of the moral confusion of our times. (MacIntyre, After Virtue, 1981).
- 3.
Of course, even Scofield would have to make a list of exceptions to this typical sort of claim: no children, no one believed to be mentally disabled, etc., would be admitted into this charmed circle, not even by the most devout egalitarian. And, this lands him in the same paradoxes already familiar to most of us: how ‘to draw the line’ demarcating inclusion and exclusion? Scofield neither raises nor hints at how to handle the problem he himself presents.
- 4.
I presume, too, that this view implies that Jonsen is opposed to Fletcher’s proposal.
- 5.
Especially acceptance in the world of clinical and academic medicine. I recall being stopped in the hall by the Dean of Medicine at Vanderbilt, not for a question for so he could observe, somewhat slyly, that ‘ethics is the first new program at Vanderbilt in more than 36 years!’ To his subsequent wink and smile I could only respond, ‘What? I’m a ‘program’ and not just a professor?’
- 6.
Despite his disclaimer of the term, quite clearly Jonsen does regard himself as a “consultant”.
- 7.
It should be noted that just this seems in some instances the pathos of the illness experience: wanting to know while precisely that is just what may not be knowable. People living through terminal illness often display just this profound enigma: why is that I must die? Why does cancer kill—not just kill, but kill me? Sick people do want to know, but it may not be at all clear just what it is that they want, and need, to know.
- 8.
This might possibly even qualify as one of those elusive phenomena, a ‘principle’.
References
Beauchamp, Tom. 1982. What philosophers can offer. Hastings Center Report 12: 13–14.
Bliton, Mark J., and Stuart G. Finder. 1999. The eclipse of the individual in policy (Where is the place for justice?). Cambridge Quarterly of Healthcare Ethics. In Performance, talk, reflection: What is going on in clinical ethics consultation, ed. Richard M. Zaner. Dordrecht: Kluwer Academic Publishers.
Brody, Howard. 1994. My story is broken; can you help me fix it? Medical ethics and the joint construction of narrative. Literature and Medicine 13: 79–92.
Callahan, Daniel. 1975. The ethics backlash. Hastings Center Report 11: 1–14.
Charon, Rita. 2006. Narrative medicine: Honoring the stories of illness. New York: Oxford University Press.
Ethics Consultants and Ethics Consultations, Special Section. 1993. Cambridge Quarterly of Healthcare Ethics 2(4): 417–448.
Fleischman, A. 1981. Teaching medical ethics in a pediatric training program. Pediatric Annals 10: 51–53.
Fletcher, John C. 1993. Commentary: Constructiveness where it counts. Cambridge Quarterly of Healthcare Ethics 2: 426–434.
Hardy, Robert C. 1978. Sick: How people feel about being sick and what they think of those who care for them. Chicago: Teach ‘Em, Inc.
Ingelfinger, F.J. 1975. Editorial: Ethics and high blood pressure. New England Journal of Medicine 202: 43–44.
Jonas, Hans. 1974. Technology and responsibility: Reflections on the new tasks of ethics. In Philosophical essays: From ancient creed to technological man, ed. Jonas Hans. Chicago: University of Chicago Press.
Jonsen, Albert R. 1991. Casuistry as methodology in clinical ethics. Theoretical Medicine 12: 295–307.
Jonsen, Albert R. 1993. Commentary: Scofield as Socrates. Cambridge Quarterly of Healthcare Ethics 2: 434–438.
Jonsen, Albert R., and Stephen E. Toulmin. 1988. The abuse of casuistry: A history of moral reasoning. Berkeley: University of California Press.
Kleinman, Arthur. 1988. The illness narratives: Suffering, healing and the human condition. New York: Basic Books.
Lilje, C. 1993. Commentary: Ethics consultation: A dangerous, antidemocratic charlatanry? Cambridge Quarterly of Healthcare Ethics 2: 438–442.
MacIntyre, Alasdair. 1981. After virtue. Notre Dame: University of Notre Dame Press.
Martin, Samuel P. 1972. The new healer. In Proceedings of the 1st session, Institute on human values in medicine, ed. Edmund D. Pellegrino, 5–27. New York: State University of New York.
Noble, C.N. 1982. Ethics and experts. Hastings Center Report 12: 7–9.
Pellegrino, Edmund D. 1986. Rationing health care: The ethics of medical gatekeeping. Journal of Contemporary Health Law and Policy 2: 23–45.
Pellegrino, Edmund D., and T.K. McElhiney. 1981. Teaching ethics, the humanities, and human values in medical schools: A ten-year overview. Washington, DC: Institute on Human Values in Medicine, Society for Health and Human Values.
Ross, J.W. 1993. Why clinical ethics consultants might not want to be educators. Cambridge Quarterly of Healthcare Ethics 2: 445–448.
Ruddick, William. 1981. Can doctors and philosophers work together? Hastings Center Report 11: 12–17.
Scofield, G.R. 1993. Ethics consultation: The least dangerous profession? Cambridge Quarterly of Healthcare Ethics 2: 417–426.
Scofield, G.S. 1995. Ethics consultation: The most dangerous profession: A reply to critics. Cambridge Quarterly of Healthcare Ethics 4: 225–228.
Self, Donnie J. 1993. Commentary: Is ethics consultation dangerous? Cambridge Quarterly of Healthcare Ethics 2: 442–445.
Siegler, Mark. 1979. Clinical ethics and clinical medicine. Archives of Internal Medicine 139: 914–915.
Wolff, Kurt. 1976. Surrender and catch: Experience and inquiry today. Boston/Dordrecht: D. Reidel Publishing Co.
Zaner, R.M. 1981. The context of self: A phenomenological inquiry using medicine as a guide. Athens: Ohio University Press.
Zaner, R.M. 1988/2002. Ethics and the clinical encounter. Lima: Academic Renewal Press (Reprinted from: (1988)). Englewood Cliffs: Prentice-Hall, Inc.
Zaner, R.M. 1990. Medicine and dialogue. In Edmund Pellegrino’s philosophy of medicine: An overview and an assessment, ed. H.T. Engelhardt. Special issue of The Journal of Medicine and Philosophy 15: 303–325.
Zaner, R.M. 1994. Troubled voices. Cleveland: Pilgrim Press.
Zaner, R.M. 1999. Performance, talk, reflection: What is going on in clinical ethics consultation. In R.M. Zaner (guest ed.), Special issue for Human Studies 22(1): 1–3, 99–116.
Zaner, R.M. 2004. Conversations on the edge: Narratives in ethics and illness. Washington, DC: Georgetown University Press.
Zaner, R.M. 2006a. It’s the body that matters. In The sociology of radical commitment: Kurt H Wolff’s existential turn, ed. Backhaus Gary and Psathas George, 155–170. Boston: Roman & Littlefield, Pubs, Inc.
Zaner, R.M. 2006b. A meditation on vulnerability and power. In Health and human flourishing: Religion, medicine, and moral anthropology, ed. Carol R. Taylor and Roberto Dell’oro, 141–158. Washington, DC: Georgetown University Press.
Zaner, R.M. 2012. At play in the field of possibles: An essay on free-phantasy method and the foundation of self. Bucharest: Zeta Books.
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Zaner, R.M. (2015). Responsibility in Clinical Ethics Consultation. In: A Critical Examination of Ethics in Health Care and Biomedical Research. International Library of Ethics, Law, and the New Medicine, vol 60. Springer, Cham. https://doi.org/10.1007/978-3-319-18332-9_7
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