Medicine and Philosophy: The Coming Together of an Odd Couple

Abstract

Part of the history of bioethics involves the coming together of what can be described as an odd couple—the professions of clinical medicine and moral philosophy. During the late 1960s and early 1970s, the medical profession in the U.S. began reaching out to the academic disciplines of philosophy and the other humanities, seeking help in dealing with a number of serious problems facing medicine. These problems included the following: changes in the practice of medicine in the years after World War II had made interactions between physicians and their patients increasingly impersonal; there was widespread dissatisfaction with medical education and its apparent inability to restore the humanism that once had characterized American medicine; the rise of patient autonomy was calling into question traditional medical paternalism; abuses in medical research involving human subjects had come to light, raising concerns that medicine was unable to regulate itself; and advances in biomedical technology were creating new and difficult ethical issues for physicians. Looking back, it is ironic that medicine sought help from philosophy, given that moral philosophy in the English-speaking world during the previous decades had become more and more removed from “real world” problems. The thesis of this essay includes two main assertions: the coming together of medicine and moral philosophy changed both of these fields; and the characteristics that bioethics turned out to have were greatly influenced by the ways in which the interaction between clinical medicine and philosophy unfolded in the context of medical education. In developing this thesis, the author draws upon his own experience as a philosopher who was recruited to teach ethics to medical students and residents.