The Identity and Structure of Medicine in Edmund Daniel Pellegrino’s Philosophy of Medicine
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2022-06-30
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Abstract
This work analyses, reconstructs, and presents Edmund Daniel Pellegrino’s comprehensive philosophy of medicine as a model of medical morality for contemporary medicine. The entire research revolves around those three fundamental questions that Pellegrino refers to as the central dilemmas of modern medicine – What is it? What is it for? What knowledge does it need? The dissertation is motivated by a series of issues concerning the nature and essence of medicine and the need for adequate moral guidance in medical practice. The complexity of the modern world and the fast advancements in science and technology have led to the increasing witness in the erosion of ethical and professional values in medical practice. The most fundamental and urgent need in today’s pluralistic society where ethical standards are fast eroding is the need for an informed conscience and coherent moral philosophy that is peculiar to the nature of medicine.
The need for moral guidance in the medical profession is inevitable as we are facing several kinds of vexing medical issues that previous generations never had to encounter. Biotechnological breakthroughs force upon us and create new moral and clinical medical issues, such as, should cloning of humans be allowed? Alternatively, to what extent should we permit fetal tissue research? To what extent and for what purposes should we permit the manipulation of human genetic materials? The field of medicine faces more professional, ethical dilemmas than any other profession in the world. Most medical issues that make the headlines are, typically, abortion, euthanasia, physician-assisted suicides, surrogate motherhood, stem-cell research, and genetic engineering. Other subtle ethical issues in medicine deal with autonomy–paternalism, the physician-patient relationship, consent, disclosure, and issues concerning privacy or confidentiality, diagnosis-related issues, malpractice crisis, and so on.
It is against the above background Pellegrino sees the growing demand for a philosophy of medicine that will clarify the ethical dimensions of professional roles in our age where medicine and health care have been commodified, commercialized, and politicized by social constructs. He describes a philosophy of medicine as inevitable and indispensable for the medical profession. This interdisciplinary research seeks to consider and situate the outcome and the relevance and to locate the significance, consequences, and implications of the philosophical and theological groundings and contributions of Pellegrino’s moral discourse on ontemporary medical ethics. In other words, we intend to demonstrate that Pellegrino’s view and proposals respond adequately and proffer solutions to the philosophical problems and medical dilemmas in contemporary society. Pellegrino sees the need for a revamping and re-instating of classical teleological and virtue ethics and proposes a medical morality that is rooted in the very nature and end of medicine as adequate and solid for the medical profession. An extension of the thesis of this dissertation reflects on the inevitability and indispensability of virtues in medical practice. He strongly believed that a virtue-based ethic was a tenable tool for solving the problems in contemporary medicine. The dissertation is composed of two parts. The first part, which contains chapters one and two, explores the philosophical basis of the structure and identity of medicine in Pellegrino. The second part, which contains the third, the fourth, and the fifth chapters, concentrates on Pellegrino’s humanistic ethics for medicine and the inevitability and indispensability of virtues in medical practice. The first chapter provided a philosophical background and foundation for understanding the identity of medicine. It focused on the intimate relationship, and the inevitable dialogue, between philosophy and medicine. It depicts the interdisciplinary nature of this investigation. The second chapter presents a phenomenology of the clinical encounter and all its constitutive elements as the true and ideal structure and identity of medicine. This chapter advocates for the rejuvenation of the personalist morality in medical practice as a viable antidote to the conceptual and practical challenges in modern medicine. The third chapter presented a history of virtues. The fourth chapter presents Pellegrino’s virtue-based and humanistic ethics as a vital and tenable tool for curbing the medical challenges and dilemmas in modern medicine. The fifth chapter presents the relevance of Pellegrino’s theory of medicine for renewing the face of contemporary medicine.
This study is significant to bioethicists, philosophers, and public health policy-making organizations and agencies, potential and professional medical workers, the government, and the public. We hope that this study affords the reader a helpful perspective on the process of knowing what occurs in medical practice at a more profound and critical level. This interdisciplinary research is a tiny window that indicates further research possibilities. It stimulates and provokes further inquiry and application of philosophical theories into other branches of healthcare and professional roles in medicine, such as nursing, pharmacology, and a host of others. It is also applicable to social welfare and other forms of human professional enterprises such as engineering, business, architecture, priesthood, law, politics, and so on.
Description
Wydział Filozofii, Instytut Filozofii; promotor: ks. dr hab. Alfred Wierzbicki