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PubMed2005

Respect for persons, autonomy and palliative care.

This paper explores some of the values that underpin health care and how these relate more specifically to the values and ethics of palliative care. The paper focuses on the concept of autonomy because autonomy has emerged as a foundational concept in contemporary health care ethics and because this is an opportunity to scratch the surface of this concept in order to reveal something of its complexity, a necessary precaution when applying the concept to the context of palliative care. The paper begins with a theoretical discussion of autonomy exploring an aspect of its contemporary meaning and relevance to health care. The second part of the paper focuses more closely on how the principle of respect for autonomy can be applied in the context of palliative care. In this section an ethical framework is employed to explore a practical application of this principle within a broader context of respect for persons.

Ethics, Medical↗
PubMed2004

Clinical medicine and the quest for certainty.

Orthodox medicine works in a scientific framework which often discounts knowledge arising outside biomedical models and the statistical means by which these are tested. Alternative medicine cannot meet these standards because it is holistic and individual in its orientations toward the understanding and treatment of human illness. But in fact the dominant model also has problems with surgery and other areas such as family practice as sub-disciplines where individualised caring solutions are important. These prominently include areas in which wider social and economic concerns directly impinge on health care so that we need a more liberal attitude to medical knowledge and discovery. I suggest that this wider conception is more in keeping with the Hippocratic ethos as a whole and with the idea of a healing praxis. Because our aim as doctors and health care professionals is to help people, and our knowledge is directed towards furthering this end, medicine is a practical science not able to stand apart and build theories in detached contemplation from within the ivory tower of the academy. However the practicality of medicine and the assurance needed to poison people or inflict grievous bodily harm in an effort to help them often puts a premium on certainties in our thinking about clinical medicine before the scientific basis for such certainty has been established. Therefore, hand in hand with the professional calling that is health care, goes the need for a certain style of belief in what one is doing and its ultimate rightness. This leads to an almost unique profile for medicine among the sciences.

Beneficence↗
PubMed1997

Ownership of genetic material and information.

As a result of the International Human Genome Project genetic information is rapidly multiplying. To avoid some of the problems regarding the availability and use of genetic information, it is sometimes suggested to apply the concept of ownership. This article focuses on the clarification of the status of genetic material and genetic information, obtained as a result of screening and counseling of individual patients. First, some philosophical theories of ownership are examined for a justification of the use of the concept of ownership with regard to the human body. Next, arguments with regard to ownership of the human body are examined. The results of this analysis are applied to genetic material and genetic information.

Ethics, Medical↗
PubMed1988

Aristotle's biopolitics: a defense of biological teleology against biological nihilism.

Modern Darwinian biology seems to promote nihilism, for it seems to teach that there is no rationally discoverable standard in nature for giving meaning to life. The purpose of this article is to argue for a revival of Aristotle's biological teleology as a reasonable alternative to biological nihilism. The article begins with Edward Wilson's vain struggle against nihilism. Then it is argued that a teleological understanding of nature is assumed in the practice of medicine, as illustrated by one case from Oliver Sacks' neurological practice. The article then considers the importance of biological teleology for Aristotle's moral and political philosophy, and attention is given to some points of agreement and disagreement with contemporary sociobiologists. The main part of the article is then devoted to a defense of Aristotle's biology against the five objections that might be made by a Darwinian biologist. Finally, the article illustrates the practical implications of this issue for bioethics by considering the recent work of Engelhardt.

Animals↗