Several recent publications have suggested that hermeneutics, the method of literary criticism, might prove to be useful in medicine. In this essay I consider this thesis with particular attention to the claim that medicine is hermeneutics all the way down. After examining an anti-positivist critique of positivist medicine and arguing that hermeneutic interpretation involves a more radical critique of modern medicine, I examine the supposed consequences of hermeneutical universalism:relativism, skepticism andantirealism which further evaluation reveals to be only potential consequences of (...) hermeneutics. A brief discussion ofphronesis and of the possible texts of medicine concludes the article. (shrink)

The purpose of this essay is to argue for the necessity of an ethics of the practice of the specialist-technologist in medicine. In the first part I sketch three stages of medical ethics, each with a particular viewpoint regarding the technology of medicine. I focus on Brody's consideration of the physician's power as a example of contemporary medical ethics which explicitly excludes the specialist-technologist as a locus of development of medical ethics. Next, the philosophy of Heidegger is examined to suggest (...) an approach to the problem, and, finally, some of Levinas' contributions regarding the other are introduced to suggest a preliminary approach to a medical ethics of the specialist-technologist. (shrink)

Ulf Schmidt, writing on “Medical Ethics and Nazism” in the recently published Cambridge World History of Medical Ethics, states:In 1920, the lawyer Karl Binding and the psychiatrist Alfred Hoche published their tract Permission for the Destruction of Life Unworthy of Life. … Their positivistic theory was a combination of legal norms and medical arguments that granted the state fundamental rights while overriding the rights of individuals. The traditional moral belief system that advocated care and compassion for the weak and unproductive (...) was radically called into question. The book was written in the wake of World War I; readers were asked to compare the “battlefields littered with.. (shrink)

Because physicians use scientific inference for the generalizations of individual observations and the application of general knowledge to particular situations, the Bayesian probability solution to the problem of induction has been proposed and frequently utilized. Several problems with the Bayesian approach are introduced and discussed. These include: subjectivity, the favoring of a weak hypothesis, the problem of the false hypothesis, the old evidence/new theory problem and the observation that physicians are not currently Bayesians. To the complaint that the prior probability (...) is subjective, Bayesians reply that there will be ultimate convergence, but the rebuttal to this is that there will not be uniform convergence. Secondly, since the Bayesian scheme favors a weak hypothesis, theories turn out to be a gratuitous risk. The problem with the false hypothesis comes out in the denominator of the theorem, revealing that a factor which is not a theory at all is being considered in the reasoning. On the old evidence/new theory problem old evidence cannot confirm a new theory so that the posterior probability will equal the prior probability. Finally, empiric studies have shown that current physicians are not Bayesians. But on consideration of Bayesian inference as a system of inference, it can be reasoned that physicians should be Bayesians. However, the problem of physicians' and patients' own subjectivity continue to plague this system of medical decision making. (shrink)