The spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of (...) basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge. (shrink)

In his writings, Edmund Pellegrino analyzes four deficiencies in the humanity of those who fall ill: the loss of (1) freedom of action, (2) freedom to make rational choices, (3) freedom from the power of others, and (4) a sense of the integrity of the self. Since Pellegrino's analysis and commitment to virtuebased ethics preceded much of the attention later given by philosophers to the importance of the moral principle of autonomy (in contrast to beneficence) in patient care, it is (...) helpful to trace the source of his commitment to virtue-based ethics and his account of freedom to Aristotle's analysis of the human soul, as an entelechy of an intact and healthy living organism that, unimpeded by illness, moves itself to act, to actualize its intellectual potential in the form of making rational choices, and to free itself from the power of others by remaining independent and without need of continuous assistance, while at the same time retaining the integrity of a unified self that can act, think, and choose for itself autonomously. (shrink)

The concept 'health' is ambiguous [18,9, 11]. The concept 'mental health' is even more so. 'Health' compasses senses of well-being, wholeness, and sound ness that mean more than the simple freedom from illness - a fact appreci ated in the World Health Organization's definition of health as more than the absence of disease or infirmity [7]. The wide range of viewpoints of the con tributors to this volume attests to the scope of issues placed under the rubric 'mental health. ' (...) These papers, presented at the Fourth Symposium on Philos ophy and Medicine, were written and discussed within a broad context of interests concerning mental health. Moreover, in their diversity these papers point to the many descriptive, evaluative, and, in fact, performative functions of statements concerning mental health. Before introducing the substance of these papers in any detail, I want to indicate the profound commerce between philosophical and psychological ideas in theories of mental health and disease. This will be done in part by a consideration of some conceptual developments in the history of psychiatry, as well as through an analysis of some of the functions of the notions of mental illness and health. 'Mental health' lays a special stress on the wholeness of human intuition, emotion, thought, and action. (shrink)

Proceedings of the second trans-disciplinary symposium on philosophy and medicine held at Farmington, Connecticut, May 15-17, 1975.

in a scientific way, and takes the patient and his family into his confidence. Thus he learns something from the sufferer, and at the same time instructs the invalid to the best of his power. He does not give his prescriptions until he has won the patient's support, and when he has done so, he steadilY aims at producing complete restoration to health by persuading the sufferer in to compliance (Laws 4. 720 b-e, [28]). This passage shows the perennial nature (...) of the problems of treating the patient as a person. It shows as well the historical'depth of philosophical interest in medicine. The history of philosophy includes more reflections upon medical ethics than the casual reader might suspect. Many of these reflections are pertinent to contemporary issues such as abortion and population control. Plato, for example, recommends abortion in cases of incest (Republic 5. 461c); and Aristotle argues for letting seriously deformed children die, while forbidding infanticide as a means of popUlation control, suggesting instead the use of early abortions. 'As to the exposure in rearing of children, let there be a law that no deformed child shall live, but that on the ground of an excess in the number of children... let abortion be procured before sense and life have begun; what mayor may not be lawfully done in these cases depends on the question of life and sensation' (Politics VII, 16,335 b20-26, [4]). (shrink)

Proceedings of the eighth trans-disciplinary symposium on philosophy and medicine held at Farmington, Connecticut, November 9-11,1978.