The ordination of bioethicists as secular moral experts

Social Philosophy and Policy

Volumn 19, Issue 2, 2002, Pages 59-82

  Engelhardt, H Tristram ^a  

^a RICE UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTICAL APPROACH; ARTICLE; BIOETHICS; BIOETHICS AND PROFESSIONAL ETHICS; ETHICIST; MORALITY; PHILOSOPHICAL APPROACH; PHILOSOPHY; POLICY; POLITICAL SYSTEM; PROFESSIONAL STANDARD; SECULARISM;

ANALYTICAL APPROACH; BIOETHICS AND PROFESSIONAL ETHICS; PHILOSOPHICAL APPROACH;

BIOETHICS; DEMOCRACY; ETHICISTS; MORALS; PHILOSOPHY, MEDICAL; PROFESSIONAL ROLE; PUBLIC POLICY; SECULARISM;

EID: 0037514509     PISSN: 02650525     EISSN: None     Source Type: Journal    
DOI: 10.1017/S026505250219203X     Document Type: Article

References (125)

1. An example of the National Commission's establishing a basic moral framework for research ethics, and therefore establishing a bioethics, is found in National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research (Washington, DC: U.S. Government Printing Office, 1978). Three basic moral principles are enumerated: respect for persons, beneficence, and justice. As is acknowledged in the commentary addressing the principle of justice, radically different interpretations of principles like these are possible.
2. The Ethics Advisory Board of the Department of Health, Education, and Welfare addressed moral issues involved in the then-emerging technology of in vitro fertilization, and then issued concrete recommendations concerning that procedure. See Ethics Advisory Board, Department of Health, Education, and Welfare, HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer, 2 vols. (Washington, DC: U.S. Government Printing Office, 1979).
3. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
4. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
5. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
6. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
7. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
8. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
9. See the following works, all by the President's Commission: Compensating for Research Injuries (Washington, DC: U.S. Government Printing Office, 1982); Deciding to Forego LifeSustaining Treatment (Washington, DC: U.S. Government Printing Office, 1983); Defining Death (Washington, DC: U.S. Government Printing Office, 1981); Making Health Care Decisions (Washington, DC: U.S. Government Printing Office, 1982); Screening and Counseling for Genetic Conditions (Washington, DC: U.S. Government Printing Office, 1983); Securing Access to Health Care (Washington, DC: U.S. Government Printing Office, 1983); and Splicing Life (Washington, DC: U.S. Government Printing Office, 1982).
10. The National Bioethics Advisory Commission has continued the former National Commission's practice of studying a controversial bioethical issue and then providing publicpolicy guidance. See, for example, the following works by the Commission: Cloning Human Beings, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1997); Research Involving Persons with Mental Disorders that May Affect Decisionmaking Capacity, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1998-99); Research Involving Human Biological Materials, vol. 1 (Rockville, MD: National Bioethics Advisory Commission, 1999); and Ethical Issues in Human Stem Cell Research, 3 vols. (Rockville, MD: National Bioethics Advisory Commission, 1999-2000).
11. The National Bioethics Advisory Commission has continued the former National Commission's practice of studying a controversial bioethical issue and then providing publicpolicy guidance. See, for example, the following works by the Commission: Cloning Human Beings, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1997); Research Involving Persons with Mental Disorders that May Affect Decisionmaking Capacity, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1998-99); Research Involving Human Biological Materials, vol. 1 (Rockville, MD: National Bioethics Advisory Commission, 1999); and Ethical Issues in Human Stem Cell Research, 3 vols. (Rockville, MD: National Bioethics Advisory Commission, 1999-2000).
12. The National Bioethics Advisory Commission has continued the former National Commission's practice of studying a controversial bioethical issue and then providing publicpolicy guidance. See, for example, the following works by the Commission: Cloning Human Beings, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1997); Research Involving Persons with Mental Disorders that May Affect Decisionmaking Capacity, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1998-99); Research Involving Human Biological Materials, vol. 1 (Rockville, MD: National Bioethics Advisory Commission, 1999); and Ethical Issues in Human Stem Cell Research, 3 vols. (Rockville, MD: National Bioethics Advisory Commission, 1999-2000).
13. The National Bioethics Advisory Commission has continued the former National Commission's practice of studying a controversial bioethical issue and then providing publicpolicy guidance. See, for example, the following works by the Commission: Cloning Human Beings, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1997); Research Involving Persons with Mental Disorders that May Affect Decisionmaking Capacity, 2 vols. (Rockville, MD: National Bioethics Advisory Commission, 1998-99); Research Involving Human Biological Materials, vol. 1 (Rockville, MD: National Bioethics Advisory Commission, 1999); and Ethical Issues in Human Stem Cell Research, 3 vols. (Rockville, MD: National Bioethics Advisory Commission, 1999-2000).
14. See Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M. Sheridan Smith (New York: Random House, 1973).
15. Ibid., 9.
16. Ibid., 10.
17. Ibid., 16.
18. For some of the debates regarding the meaning of consensus in bioethics, see Kurt Bayertz, ed., The Concept of Moral Consensus: The Case of Technological Interventions in Human Reproduction (Dordrecht, The Netherlands: Kluwer, 1994); and Henk A. M. J. ten Have and Hans-Martin Sass, eds., Consensus Formation in Healthcare Ethics (Dordrecht, The Netherlands: Kluwer, 1998).
19. For some of the debates regarding the meaning of consensus in bioethics, see Kurt Bayertz, ed., The Concept of Moral Consensus: The Case of Technological Interventions in Human Reproduction (Dordrecht, The Netherlands: Kluwer, 1994); and Henk A. M. J. ten Have and Hans-Martin Sass, eds., Consensus Formation in Healthcare Ethics (Dordrecht, The Netherlands: Kluwer, 1998).
20. One might think in particular of such works in the Hippocratic corpus as "Ancient Medicine, " "The Art, " and "The Nature of Man." Hippocrates (ca. 460-377 B.C.) and the physicians of Greece were concerned to sustain a medical ethics that would sustain their profession. See Ludwig Edelstein, "The Professional Ethics of the Greek Physician, " in Owsei Temkin and C. Lillian Temkin, eds., Ancient Medicine: Selected Papers of Ludwig Edelstein (Baltimore, MD: Johns Hopkins University Press, 1967), 319-48.
21. It is interesting to note that reflections regarding the possibility of medicine as a science occupied both Sydenham and his practice partner, John Locke (1632-1704). See John Brown, Locke and Sydenham, with Other Occasional Papers, 2d ed. (Edinburgh, Scotland: Thomas Constable, 1859); Patrick Romanell, John Locke and Medicine: A New Key to Locke (Buffalo, NY: Prometheus, 1984); and Miguel Angel Sanchez Gonzalez, "La presencia de la medicina en la obra de John Locke" (doctoral dissertation, University of Madrid, 1987). These reflections became reality in the nineteenth century. See Rudolf Virchow, Disease, Life, and Man: Selected Essays, trans. Lelland J. Rather (Stanford, CA: Stanford University Press, 1958).
22. It is interesting to note that reflections regarding the possibility of medicine as a science occupied both Sydenham and his practice partner, John Locke (1632-1704). See John Brown, Locke and Sydenham, with Other Occasional Papers, 2d ed. (Edinburgh, Scotland: Thomas Constable, 1859); Patrick Romanell, John Locke and Medicine: A New Key to Locke (Buffalo, NY: Prometheus, 1984); and Miguel Angel Sanchez Gonzalez, "La presencia de la medicina en la obra de John Locke" (doctoral dissertation, University of Madrid, 1987). These reflections became reality in the nineteenth century. See Rudolf Virchow, Disease, Life, and Man: Selected Essays, trans. Lelland J. Rather (Stanford, CA: Stanford University Press, 1958).
23. It is interesting to note that reflections regarding the possibility of medicine as a science occupied both Sydenham and his practice partner, John Locke (1632-1704). See John Brown, Locke and Sydenham, with Other Occasional Papers, 2d ed. (Edinburgh, Scotland: Thomas Constable, 1859); Patrick Romanell, John Locke and Medicine: A New Key to Locke (Buffalo, NY: Prometheus, 1984); and Miguel Angel Sanchez Gonzalez, "La presencia de la medicina en la obra de John Locke" (doctoral dissertation, University of Madrid, 1987). These reflections became reality in the nineteenth century. See Rudolf Virchow, Disease, Life, and Man: Selected Essays, trans. Lelland J. Rather (Stanford, CA: Stanford University Press, 1958).
24. It is interesting to note that reflections regarding the possibility of medicine as a science occupied both Sydenham and his practice partner, John Locke (1632-1704). See John Brown, Locke and Sydenham, with Other Occasional Papers, 2d ed. (Edinburgh, Scotland: Thomas Constable, 1859); Patrick Romanell, John Locke and Medicine: A New Key to Locke (Buffalo, NY: Prometheus, 1984); and Miguel Angel Sanchez Gonzalez, "La presencia de la medicina en la obra de John Locke" (doctoral dissertation, University of Madrid, 1987). These reflections became reality in the nineteenth century. See Rudolf Virchow, Disease, Life, and Man: Selected Essays, trans. Lelland J. Rather (Stanford, CA: Stanford University Press, 1958).
25. In the seventeenth and eighteenth centuries there developed a clinical phenomenology of the world of clinical appearance. This endeavor led to the elaboration of reflections on the nature of nosologies and on the character of appropriate descriptions of illnesses. For one of the classic examples of a clinical nosology, see François Boissier de la Croix de Sauvages, Nosologia methodica sistens morborum classes juxta Sydenhami mentem et botanicorum ordinem, 5 vols. (Amsterdam, The Netherlands: Fratrum de Tournes, 1763); and the two-volume second edition of the same work (Amsterdam, The Netherlands: Fratrum de Tournes, 1768). See also Carolus Linnaeus, Genera morborum, in auditorum usum (Upsalae, Sweden: Steinert, 1763); as well as Jo. Bapt. Mich. Sagar, Systema morborum symptomaticum (Vienna, Austria: Joannis Pauli Kraus, 1776).
26. In the seventeenth and eighteenth centuries there developed a clinical phenomenology of the world of clinical appearance. This endeavor led to the elaboration of reflections on the nature of nosologies and on the character of appropriate descriptions of illnesses. For one of the classic examples of a clinical nosology, see François Boissier de la Croix de Sauvages, Nosologia methodica sistens morborum classes juxta Sydenhami mentem et botanicorum ordinem, 5 vols. (Amsterdam, The Netherlands: Fratrum de Tournes, 1763); and the two-volume second edition of the same work (Amsterdam, The Netherlands: Fratrum de Tournes, 1768). See also Carolus Linnaeus, Genera morborum, in auditorum usum (Upsalae, Sweden: Steinert, 1763); as well as Jo. Bapt. Mich. Sagar, Systema morborum symptomaticum (Vienna, Austria: Joannis Pauli Kraus, 1776).
27. In the seventeenth and eighteenth centuries there developed a clinical phenomenology of the world of clinical appearance. This endeavor led to the elaboration of reflections on the nature of nosologies and on the character of appropriate descriptions of illnesses. For one of the classic examples of a clinical nosology, see François Boissier de la Croix de Sauvages, Nosologia methodica sistens morborum classes juxta Sydenhami mentem et botanicorum ordinem, 5 vols. (Amsterdam, The Netherlands: Fratrum de Tournes, 1763); and the two-volume second edition of the same work (Amsterdam, The Netherlands: Fratrum de Tournes, 1768). See also Carolus Linnaeus, Genera morborum, in auditorum usum (Upsalae, Sweden: Steinert, 1763); as well as Jo. Bapt. Mich. Sagar, Systema morborum symptomaticum (Vienna, Austria: Joannis Pauli Kraus, 1776).
28. The character of disease-related language was refashioned early in the nineteenth century by work in anatomy and physiology. See, for example, Rudolf Virchow, Hundert Jahre allgemeiner Pathologie (Berlin: August Hirschwald, 1895); as well as Carl Wunderlich, "Einleitung, " Archiv für physiologische Heilkunde 1 (1842): 1-24. In particular, the physiologist François Broussais (1772-1838) was apparently responsible for drawing the distinction between ontological versus physiological accounts of disease. See F. J. V. Broussais, Examen des doctrines medicales et des systems de nosologie (Paris: Méquignon-Marvis, 1821), 2:646. Broussais's work appeared widely in English; see, for example, F. J. V. Broussais, Principles of Physiological Medicine, trans. Isaac Hays and R. Eglesfeld Griffith (Philadelphia: Carey and Lea, 1832).
29. The character of disease-related language was refashioned early in the nineteenth century by work in anatomy and physiology. See, for example, Rudolf Virchow, Hundert Jahre allgemeiner Pathologie (Berlin: August Hirschwald, 1895); as well as Carl Wunderlich, "Einleitung, " Archiv für physiologische Heilkunde 1 (1842): 1-24. In particular, the physiologist François Broussais (1772-1838) was apparently responsible for drawing the distinction between ontological versus physiological accounts of disease. See F. J. V. Broussais, Examen des doctrines medicales et des systems de nosologie (Paris: Méquignon-Marvis, 1821), 2:646. Broussais's work appeared widely in English; see, for example, F. J. V. Broussais, Principles of Physiological Medicine, trans. Isaac Hays and R. Eglesfeld Griffith (Philadelphia: Carey and Lea, 1832).
30. The character of disease-related language was refashioned early in the nineteenth century by work in anatomy and physiology. See, for example, Rudolf Virchow, Hundert Jahre allgemeiner Pathologie (Berlin: August Hirschwald, 1895); as well as Carl Wunderlich, "Einleitung, " Archiv für physiologische Heilkunde 1 (1842): 1-24. In particular, the physiologist François Broussais (1772-1838) was apparently responsible for drawing the distinction between ontological versus physiological accounts of disease. See F. J. V. Broussais, Examen des doctrines medicales et des systems de nosologie (Paris: Méquignon-Marvis, 1821), 2:646. Broussais's work appeared widely in English; see, for example, F. J. V. Broussais, Principles of Physiological Medicine, trans. Isaac Hays and R. Eglesfeld Griffith (Philadelphia: Carey and Lea, 1832).
31. The character of disease-related language was refashioned early in the nineteenth century by work in anatomy and physiology. See, for example, Rudolf Virchow, Hundert Jahre allgemeiner Pathologie (Berlin: August Hirschwald, 1895); as well as Carl Wunderlich, "Einleitung, " Archiv für physiologische Heilkunde 1 (1842): 1-24. In particular, the physiologist François Broussais (1772-1838) was apparently responsible for drawing the distinction between ontological versus physiological accounts of disease. See F. J. V. Broussais, Examen des doctrines medicales et des systems de nosologie (Paris: Méquignon-Marvis, 1821), 2:646. Broussais's work appeared widely in English; see, for example, F. J. V. Broussais, Principles of Physiological Medicine, trans. Isaac Hays and R. Eglesfeld Griffith (Philadelphia: Carey and Lea, 1832).
32. This term was first introduced in Abraham Flexner, Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching (New York: Carnegie Foundation for the Advancement of Teaching, 1910), 26.
33. An exemplar account of the reconceptualization of clinical descriptions in terms of underlying pathoanatomical explanations is found in the work of Xavier Bichat: It is well known into how many errors we have fallen, so long as we had confined ourselves to the simple observation of symptoms. Let us take for example consumption. It has been considered as an essential malady, before we had recourse to post-mortem examination; since, it has been shown that marasmus was only a consecutive symptomatic malady of the affection of an organ. Jaundice has been for a long time considered by practitioners as an essential malady; post-mortem examination has also proved that this affection, though primitive, was in reality only consecutive to diverse alterations of the liver, of which it is always the symptom. The same has happened with respect to dropsies, which although for a long time considered as essential affections, have never been other than the result of some organic disease. It is, then, ignorance of organic affections, resulting from a total neglect of post-mortem examination, which is the cause that has misled the ancient practitioners on most diseases; thus, [the nosographers William] Cullen and [François Boissier de] Sauvages have erred in their classifications. Xavier Bichat, "Preliminary Discourse, " in Bichat, Pathological Anatomy, trans. Joseph Togno (Philadelphia: John Grigg, 1827), reprinted in Arthur L. Caplan, H. Tristram Engelhardt, Jr., and James J. McCartney, eds., Concepts of Health and Disease (Reading, MA: Addison-Wesley, 1981), 167-68.
34. An exemplar account of the reconceptualization of clinical descriptions in terms of underlying pathoanatomical explanations is found in the work of Xavier Bichat: It is well known into how many errors we have fallen, so long as we had confined ourselves to the simple observation of symptoms. Let us take for example consumption. It has been considered as an essential malady, before we had recourse to post-mortem examination; since, it has been shown that marasmus was only a consecutive symptomatic malady of the affection of an organ. Jaundice has been for a long time considered by practitioners as an essential malady; post-mortem examination has also proved that this affection, though primitive, was in reality only consecutive to diverse alterations of the liver, of which it is always the symptom. The same has happened with respect to dropsies, which although for a long time considered as essential affections, have never been other than the result of some organic disease. It is, then, ignorance of organic affections, resulting from a total neglect of post-mortem examination, which is the cause that has misled the ancient practitioners on most diseases; thus, [the nosographers William] Cullen and [François Boissier de] Sauvages have erred in their classifications. Xavier Bichat, "Preliminary Discourse, " in Bichat, Pathological Anatomy, trans. Joseph Togno (Philadelphia: John Grigg, 1827), reprinted in Arthur L. Caplan, H. Tristram Engelhardt, Jr., and James J. McCartney, eds., Concepts of Health and Disease (Reading, MA: Addison-Wesley, 1981), 167-68.
35. Thomas Sydenham, Observationes medicae, 3d ed. (London: Gualteri Kettilby, 1676). Sydenham's work continued to be very influential after his death, with complete editions of his work appearing in the sixteenth and the seventeenth centuries in both English and Latin. See, for example, Thomas Sydenham, Opera omnia medica (Geneva, Switzerland: Fratres de Tournes, 1696); John Swan, ed. and trans., The Entire Works of Dr. Thomas Sydenham, 3d ed. (London: E. Cave, 1753); and Thomas Sydenham, Opera omnia, ed. William Alexander Greenhill (London: Sydenham Society, 1846).
36. Thomas Sydenham, Observationes medicae, 3d ed. (London: Gualteri Kettilby, 1676). Sydenham's work continued to be very influential after his death, with complete editions of his work appearing in the sixteenth and the seventeenth centuries in both English and Latin. See, for example, Thomas Sydenham, Opera omnia medica (Geneva, Switzerland: Fratres de Tournes, 1696); John Swan, ed. and trans., The Entire Works of Dr. Thomas Sydenham, 3d ed. (London: E. Cave, 1753); and Thomas Sydenham, Opera omnia, ed. William Alexander Greenhill (London: Sydenham Society, 1846).
37. Thomas Sydenham, Observationes medicae, 3d ed. (London: Gualteri Kettilby, 1676). Sydenham's work continued to be very influential after his death, with complete editions of his work appearing in the sixteenth and the seventeenth centuries in both English and Latin. See, for example, Thomas Sydenham, Opera omnia medica (Geneva, Switzerland: Fratres de Tournes, 1696); John Swan, ed. and trans., The Entire Works of Dr. Thomas Sydenham, 3d ed. (London: E. Cave, 1753); and Thomas Sydenham, Opera omnia, ed. William Alexander Greenhill (London: Sydenham Society, 1846).
38. Thomas Sydenham, Observationes medicae, 3d ed. (London: Gualteri Kettilby, 1676). Sydenham's work continued to be very influential after his death, with complete editions of his work appearing in the sixteenth and the seventeenth centuries in both English and Latin. See, for example, Thomas Sydenham, Opera omnia medica (Geneva, Switzerland: Fratres de Tournes, 1696); John Swan, ed. and trans., The Entire Works of Dr. Thomas Sydenham, 3d ed. (London: E. Cave, 1753); and Thomas Sydenham, Opera omnia, ed. William Alexander Greenhill (London: Sydenham Society, 1846).
39. Théophile Bonet, Sepulchretum sive anatomica practica ex cadaveribus morbo denatis (Geneva, Switzerland: L. Chouët, 1679).
40. Giovanni Morgagni, De sedibus et causis morborum per anatomen indagatis (Venice, Italy: Ex Typographia Remondiniana, 1761).
41. Bichat, "Preliminary Discourse, " 167-68.
42. Flourens not only engaged in the ablation of neural tissue in order to study neural function, but also argued against both the empiricism of the phrenologists and the rationalist claims of the Cartesians. See M. J. P. Flourens, Examen de la phrénologie, 2d ed. (Paris: Paulin, 1845).
43. Bernard's still widely read 1865 work An Introduction to the Study of Experimental Medicine may have been one of the books that most helped to frame the new notion of the biomedical scientist as being an active manipulator of nature. See Claude Bernard, An Introduction to the Study of Experimental Medicine, trans. Henry C. Green (New York: Dover, 1957).
44. It was recognized at this time that apparent cures, often attributed to specific therapeutic interventions, were instead due to the waxing and waning of clinical manifestations of particular maladies. See, for example, Jacob Bigelow, "On Self-Limited Diseases, " in Bigelow, Nature in Disease (Boston: Ticknor and Fields, 1854), 1-39.
45. P. C. A. Louis, Recherches sur les effets de la saignée dans quelques maladies inflammatoires (Paris: Baillière, 1835).
46. Jules Gavarret, Principes généraux de statistique médicale (Paris: Bechet jeune et Labé, 1840).
47. See, for example, John Snow, On the Mode of Communication of Cholera, 2d ed. (London: John Churchill, 1855).
48. In sections 16 and 17 of the preface to Sydenham, Observationes medicae, Sydenham laments the absence of a disciplined approach to assessing and determining which medications are effective. For another work of the time that discusses the need for an experimental method in medicine, see Richard Lower, Diatribae Thomae Willisii (London: Martyn and Allestry, 1665).
49. In sections 16 and 17 of the preface to Sydenham, Observationes medicae, Sydenham laments the absence of a disciplined approach to assessing and determining which medications are effective. For another work of the time that discusses the need for an experimental method in medicine, see Richard Lower, Diatribae Thomae Willisii (London: Martyn and Allestry, 1665).
50. Francesco Vaccà Berlinghieri, La filosofia della medicina (Lucca, Italy: published by the author, 1801).
51. Johann Christian August Grohmann, Philosophie der Medizin (Berlin: Schmidt, 1808).
52. Jean Baptiste Bouillaud, Essai sur la philosophie médicale et sur les généralités de la clinique médicale (Paris: Rouvier et le Bouvier, 1836).
53. Elisha Bartlett, An Essay on the Philosophy of Medical Science (Philadelphia: Lea and Blanchard, 1844). Also among the works influential in this genre was a series of publications that appeared under the rubric of "medical logic." See, for instance, Friedrich Oesterlen, Medical Logic, trans. George Whitley (London: Sydenham Society, 1855); Wladyslaw Bieganski, Logika medyzyny (Warazawa, Poland: Kowalewski, 1894); and Gilbert Blane, Elements of Medical Logick (London: Thomas and George Underwood, 1819).
54. Elisha Bartlett, An Essay on the Philosophy of Medical Science (Philadelphia: Lea and Blanchard, 1844). Also among the works influential in this genre was a series of publications that appeared under the rubric of "medical logic." See, for instance, Friedrich Oesterlen, Medical Logic, trans. George Whitley (London: Sydenham Society, 1855); Wladyslaw Bieganski, Logika medyzyny (Warazawa, Poland: Kowalewski, 1894); and Gilbert Blane, Elements of Medical Logick (London: Thomas and George Underwood, 1819).
55. Elisha Bartlett, An Essay on the Philosophy of Medical Science (Philadelphia: Lea and Blanchard, 1844). Also among the works influential in this genre was a series of publications that appeared under the rubric of "medical logic." See, for instance, Friedrich Oesterlen, Medical Logic, trans. George Whitley (London: Sydenham Society, 1855); Wladyslaw Bieganski, Logika medyzyny (Warazawa, Poland: Kowalewski, 1894); and Gilbert Blane, Elements of Medical Logick (London: Thomas and George Underwood, 1819).
56. Elisha Bartlett, An Essay on the Philosophy of Medical Science (Philadelphia: Lea and Blanchard, 1844). Also among the works influential in this genre was a series of publications that appeared under the rubric of "medical logic." See, for instance, Friedrich Oesterlen, Medical Logic, trans. George Whitley (London: Sydenham Society, 1855); Wladyslaw Bieganski, Logika medyzyny (Warazawa, Poland: Kowalewski, 1894); and Gilbert Blane, Elements of Medical Logick (London: Thomas and George Underwood, 1819).
57. Allen Buchanan et al., From Chance to Choice: Genetics and Justice (New York: Cambridge University Press, 2000).
58. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
59. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
60. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
61. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
62. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
63. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
64. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
65. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
66. There is a considerable recent literature examining the value-laden and sociopolitically charged character of various concepts in medicine, including Scott DeVito, "On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again, " Journal of Medicine and Philosophy 25, no. 5 (2000): 539-67; Steven D. Edwards, "Dismantling the Disability-Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 589-606; Kateryna Fedoryka, "Health as Normative Concept, " Journal of Medicine and Philosophy 22, no. 2 (1997): 143-60; Eric T. Juengst, "Can Enhancement Be Distinguished from Prevention in Genetic Medicine?" Journal of Medicine and Philosophy 22, no. 2 (1997): 125-42; George Khushf, "Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and Disease, " Theoretical Medicine 18, no. 1-2 (1997): 145-63; Fernando Lolas, "Theoretical Medicine: A Proposal for Reconceptualizing Medicine as a Science of Actions, " Journal of Medicine and Philosophy 21, no. 6 (1996): 659-70; Lennart Nordenfelt, "The Importance of a Disability/Handicap Distinction, " Journal of Medicine and Philosophy 22, no. 6 (1997): 607-22; John Z. Sadler and George J. Agich, "Diseases, Functions, Values, and Psychiatric Classification, " Philosophy, Psychiatry, and Psychology 2, no. 3 (1995): 219-31; and Evert Van Leeuwen and Gerrit K. Kimsma, "Philosophy of Medical Practice: A Discursive Approach, " Theoretical Medicine 18, no. 1-2 (1997): 99-112. This selection from the literature identifies studies that focus on explanatory issues in medicine yet nevertheless remain tied to bioethical questions.
67. In Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985), Daniels claims that his account of that health care which must be provided within an egalitarian one-tier health-care system relies, with some modifications, on Boorse's attempt to ground concepts of disease in notions of species-typical levels of species-typical functions. For Boorse's work, see Christopher Boorse, "On the Distinction between Disease and Illness, " Philosophy and Public Affairs 5, no. 1 (1975): 61; and Christopher Boorse, "Health as a Theoretical Concept, " Philosophy of Science 44 (1977): 562-67.
68. In Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985), Daniels claims that his account of that health care which must be provided within an egalitarian one-tier health-care system relies, with some modifications, on Boorse's attempt to ground concepts of disease in notions of species-typical levels of species-typical functions. For Boorse's work, see Christopher Boorse, "On the Distinction between Disease and Illness, " Philosophy and Public Affairs 5, no. 1 (1975): 61; and Christopher Boorse, "Health as a Theoretical Concept, " Philosophy of Science 44 (1977): 562-67.
69. In Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985), Daniels claims that his account of that health care which must be provided within an egalitarian one-tier health-care system relies, with some modifications, on Boorse's attempt to ground concepts of disease in notions of species-typical levels of species-typical functions. For Boorse's work, see Christopher Boorse, "On the Distinction between Disease and Illness, " Philosophy and Public Affairs 5, no. 1 (1975): 61; and Christopher Boorse, "Health as a Theoretical Concept, " Philosophy of Science 44 (1977): 562-67.
70. My recasting here of Foucault's third spatialization of disease amounts to a radical reformulation of his recognition that medicine is embedded within the sociopolitical power structures that authorize and support it.
71. See Albert R. Jonsen, The Birth of Bioethics (New York: Oxford University Press, 1998). For a somewhat different account of the emergence of bioethics, see M. L. Tina Stevens, Bioethics in America: Origins and Cultural Politics (Baltimore, MD: Johns Hopkins University Press, 2000).
72. See Albert R. Jonsen, The Birth of Bioethics (New York: Oxford University Press, 1998). For a somewhat different account of the emergence of bioethics, see M. L. Tina Stevens, Bioethics in America: Origins and Cultural Politics (Baltimore, MD: Johns Hopkins University Press, 2000).
73. Katherine R. Levit, "National Health Expenditures, 1984, " Health Care Financing 7, no. 1 (1985): 3.
74. Edmund D. Pellegrino, Humanism and the Physician (Knoxville: University of Tennessee Press, 1979).
75. See, for example, Medical Association of North Eastern Kentucky, A System of Medical Etiquette (Maysville, KY: Maysville Eagle, 1839); Samuel A. Cartwright, "Synopsis of Medical Etiquette, " New Orleans Medical and Surgical Journal 1, no. 2 (1844): 101-4; and American Medical Association, Code of Medical Ethics (New York: H. Ludwig, 1848). For an overview of these developments, see Donald E. Konold, A History of American Medical Ethics, 1847-1912 (Madison: State Historical Society of Wisconsin, 1962).
76. See, for example, Medical Association of North Eastern Kentucky, A System of Medical Etiquette (Maysville, KY: Maysville Eagle, 1839); Samuel A. Cartwright, "Synopsis of Medical Etiquette, " New Orleans Medical and Surgical Journal 1, no. 2 (1844): 101-4; and American Medical Association, Code of Medical Ethics (New York: H. Ludwig, 1848). For an overview of these developments, see Donald E. Konold, A History of American Medical Ethics, 1847-1912 (Madison: State Historical Society of Wisconsin, 1962).
77. See, for example, Medical Association of North Eastern Kentucky, A System of Medical Etiquette (Maysville, KY: Maysville Eagle, 1839); Samuel A. Cartwright, "Synopsis of Medical Etiquette, " New Orleans Medical and Surgical Journal 1, no. 2 (1844): 101-4; and American Medical Association, Code of Medical Ethics (New York: H. Ludwig, 1848). For an overview of these developments, see Donald E. Konold, A History of American Medical Ethics, 1847-1912 (Madison: State Historical Society of Wisconsin, 1962).
78. See, for example, Medical Association of North Eastern Kentucky, A System of Medical Etiquette (Maysville, KY: Maysville Eagle, 1839); Samuel A. Cartwright, "Synopsis of Medical Etiquette, " New Orleans Medical and Surgical Journal 1, no. 2 (1844): 101-4; and American Medical Association, Code of Medical Ethics (New York: H. Ludwig, 1848). For an overview of these developments, see Donald E. Konold, A History of American Medical Ethics, 1847-1912 (Madison: State Historical Society of Wisconsin, 1962).
79. See, for example, Laurence B. McCullough, John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine (Dordrecht, The Netherlands: Kluwer, 1998); and Benjamin Rush, Observations on the Duties of a Physician and Methods of Improving Medicine (Philadelphia: Prichard and Hall, 1789).
80. See, for example, Laurence B. McCullough, John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine (Dordrecht, The Netherlands: Kluwer, 1998); and Benjamin Rush, Observations on the Duties of a Physician and Methods of Improving Medicine (Philadelphia: Prichard and Hall, 1789).
81. For example, in American Medical Association v. United States, 317 U.S. 519 (1943), the U.S. Supreme Court held that organized medicine could not act to prevent the influence of insurance organizations such as Blue Cross and Blue Shield; in American Medical Association v. Federal Trade Commission, 638 F.2d 443 (2d Cir. 1980), an appellate court stripped the medical profession of the authority to control the character of physicians' advertisements.
82. From the eighteenth century onward, English law recognized the importance of getting patient consent prior to providing nonemergency medical care; see Slater v. Baker and Stapleton, 95 Eng. Rep. 860 (K.B. 1767). American courts at the beginning of the twentieth century further emphasized the importance of getting consent prior to medical interventions; see Mohr v. Williams, 104 N.W. 12 (Minn. 1905); Pratt v. Davis, 79 N.E. 562 (Ill. 1906); Rolater v. Strain, 137 P. 96 (Okla. 1913); and Schloendorff v. Society of New York Hospitals, 105 N.E. 92 (N.Y. 1914). The twentieth-century move in American medicine from acceptance of a professionally based disclosure standard to acceptance of a so-called reasonable person or objective standard can be seen by comparing Natanson v. Kline, 350 P.2d 1093 (Kan. 1960), with Canterbury v. Spence, 464 F.2d 772 (D.C. Cir. 1972). Some jurisdictions even established a subjective standard; see Scott v. Bradford, 606 P.2d 554 (Okla. 1980); and Spencer v. Seikel, 742 P.2d 1126 (Okla. 1987).
83. For an excellent account of this social reshaping of medicine, see Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982).
84. "Evidence that Protestant Christianity [was] the functional common religion of [American] society would overwhelm us if we sought it out." John Wilson, "Common Religion in American Society, " in Leroy S. Rouner, ed., Civil Religion and Political Theology (Notre Dame, IN: University of Notre Dame Press, 1986), 113.
85. See, for example, Church of the Holy Trinity v. United States, 143 U.S. 457 (1892); and United States v. Macintosh, 283 U.S. 605 (1931).
86. The secularization or de-Christianization of American law and public policy took place as the Bill of Rights of the compact styled the Constitution of the United States was applied to the states. See, for example, Everson v. Board of Education 330 U.S. 1 (1947). The result was the gradual disestablishment of Christianity through a number of important Supreme Court holdings. See, for example, Zorach v. Clauson, 343 U.S. 306 (1952); Torcaso v. Watkins, 367 U.S. 488 (1961); and Abington School District v. Schempp, 374 U.S. 203 (1963). The thrust of these holdings was eventually expressed in Supreme Court decisions that had a radical impact on health law and policy. One might think in particular of the holdings in Griswold v. Connecticut, 381 U.S. 479 (1965); Eisenstadt v. Baird, 405 U.S. 438 (1972); and Roe v. Wade, 410 U.S. 113 (1973).
87. John Berkman, "How Important Is the Doctrine of Double Effect for Moral Theology? Contextualizing the Controversy, " Christian Bioethics 3, no. 2 (1997): 91.
88. Gerald Kelly, Medico-Moral Problems (St. Louis, MO: Catholic Hospital Association, 1958), 34.
89. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing
90. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
91. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
92. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
93. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
94. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
95. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
96. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
97. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
98. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
99. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
100. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
101. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
102. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
103. The tradition acquired this name because for over three hundred years Roman Catholics produced manuals aimed at guiding moral decisions. Between the end of the nine-teenth century and the middle of the twentieth, the Roman Catholic manualist tradition produced a wealth of literature addressing medical-moral issues. For English-language examples, see Alphonsus Bonnar, The Catholic Doctor, 3d ed. (London: Burns, Oates, and Washbourne, 1944); Timothy Lincoln Bouscaren, Ethics of Ectopic Operations (Chicago: Loyola University Press, 1933); Carl Franz Nicolaus Capellmann, Pastoral Medicine, trans. William Dassel (New York: F. Pustet, 1882); Charles Coppens, Moral Principles and Medical Practice, 3d ed. (New York: Benziger Brothers, 1897); Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery (Westminster, MD: Newman Press, 1951); Patrick A. Finney, Moral Problems in Hospital Practice, 2d ed. (St. Louis, MO: B. Herder, 1922); Peter Flood, ed., New Problems in Medical Ethics, 2 vols., trans. Malachy Gerard Carroll (Westminster, MD: Newman Press, 1953-54); Edward J. Hayes, Paul J. Hayes, and Dorothy Ellen Kelly, Moral Principles of Nursing (New York: Macmillan, 1964); Edwin F. Healy, Medical Ethics (Chicago: Loyola University Press, 1956); John P. Kenny, Principles of Medical Ethics (Westminster, MD: Newman Press, 1952); Stanislas A. Larochelle and Charles T. Fink, Handbook of Medical Ethics for Nurses, Physicians, and Priests, trans. M. E. Poupore (Westminster, MD: Newman Book Shop, 1944); Charles J. McFadden, Medical Ethics (Philadelphia: Davis, 1946); Charles J. McFadden, Medical Ethics for Nurses (Philadelphia: Davis, 1946); Thomas J. O'Donnell, Morals in Medicine (Westminster, MD: Newman Press, 1956); and Alexander Sanford, Pastoral Medicine: A Handbook for the Catholic Clergy (New York: Joseph Wagner, 1905).
104. Richard McCormick conveys a sense of the crisis that marked Roman Catholic moral theology in the 1970s: The Second Vatican Council, after speaking of the renewal of theological disciplines through livelier contact with the mystery of Christ and the history of salvation, remarked simply: "special attention needs to be given to the development of moral theology." During the past six or seven years moral theology has experienced this special attention so unremittingly, some would say, that the Christianity has been crushed right out of it. Richard A. McCormick, Notes on Moral Theology, 1965 through 1980 (Washington, DC: University Press of America, 1981), 423.
105. This emphasis on the contemporary social role of the philosophy of medicine is not to deny the rich history of previous reflections on the social and political significance of medicine. See, for example, Rodericus Castro, Medicus-politicus: sive de officiis medico-politicis tractatus (Hamburg, Germany: Frobeniano, 1614); Wolfgang Thomas Rau, Gedanken von dem Nutzen und der Nothwendigkeit einer medicinischen Policeyordnung in einem Staat (Ulm, Germany: Stettin, 1764); and Johann Frank, A System of Complete Medical Policy, trans. E. Wilim (Baltimore, MD: Johns Hopkins University Press, 1976).
106. This emphasis on the contemporary social role of the philosophy of medicine is not to deny the rich history of previous reflections on the social and political significance of medicine. See, for example, Rodericus Castro, Medicus-politicus: sive de officiis medico-politicis tractatus (Hamburg, Germany: Frobeniano, 1614); Wolfgang Thomas Rau, Gedanken von dem Nutzen und der Nothwendigkeit einer medicinischen Policeyordnung in einem Staat (Ulm, Germany: Stettin, 1764); and Johann Frank, A System of Complete Medical Policy, trans. E. Wilim (Baltimore, MD: Johns Hopkins University Press, 1976).
107. This emphasis on the contemporary social role of the philosophy of medicine is not to deny the rich history of previous reflections on the social and political significance of medicine. See, for example, Rodericus Castro, Medicus-politicus: sive de officiis medico-politicis tractatus (Hamburg, Germany: Frobeniano, 1614); Wolfgang Thomas Rau, Gedanken von dem Nutzen und der Nothwendigkeit einer medicinischen Policeyordnung in einem Staat (Ulm, Germany: Stettin, 1764); and Johann Frank, A System of Complete Medical Policy, trans. E. Wilim (Baltimore, MD: Johns Hopkins University Press, 1976).
108. Such internal professional norms had themselves assumed importance at the end of the Enlightenment, as medicine was being transformed by the growth of the laboratory or basic sciences and the medical profession was rapidly evolving as a consequence. See John Gregory, Observations on the Duties and Offices of a Physician (London: Strahan, 1770); Thomas Percival, Medical Ethics (Manchester, UK: Russell, 1803); and Jacqueline Jenkinson, Scottish Medical Societies, 1731-1939 (Edinburgh, Scotland: Edinburgh University Press, 1993).
109. Such internal professional norms had themselves assumed importance at the end of the Enlightenment, as medicine was being transformed by the growth of the laboratory or basic sciences and the medical profession was rapidly evolving as a consequence. See John Gregory, Observations on the Duties and Offices of a Physician (London: Strahan, 1770); Thomas Percival, Medical Ethics (Manchester, UK: Russell, 1803); and Jacqueline Jenkinson, Scottish Medical Societies, 1731-1939 (Edinburgh, Scotland: Edinburgh University Press, 1993).
110. Such internal professional norms had themselves assumed importance at the end of the Enlightenment, as medicine was being transformed by the growth of the laboratory or basic sciences and the medical profession was rapidly evolving as a consequence. See John Gregory, Observations on the Duties and Offices of a Physician (London: Strahan, 1770); Thomas Percival, Medical Ethics (Manchester, UK: Russell, 1803); and Jacqueline Jenkinson, Scottish Medical Societies, 1731-1939 (Edinburgh, Scotland: Edinburgh University Press, 1993).
111. For an overview of the search for a single content-rich moral vision, as opposed to accepting the existence of a plurality of consensual moral understandings, see H. Tristram Engelhardt, Jr., Bioethics and Secular Humanism (Philadelphia: Trinity Press International, 1991).
112. Middle-level principles, moral principles lying between theoretical foundational understandings and particular rules governing particular decisions, supposedly offered the basis on which actions could accord with a common morality even in the face of moral-theoretical disagreements. See, for example, Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (New York: Oxford University Press, 1979).
113. For an account of the development of the Kennedy Center for Bioethics and its influence on the field, see Jonsen, The Birth of Bioethics, 22-24.
114. For an account of the character of fundamental moral disagreements, see H. Tristram Engelhardt, Jr., The Foundations of Bioethics, 2d ed. (New York: Oxford University Press, 1996), especially chaps. 1-3.
115. The conflation of society and community assumes a strong commitment to the view that sound rational arguments will disclose a univocal understanding of morality and proper social structures. This assumption has roots in the Western Christian commitment to the powers of reason. H. Tristram Engelhardt, Jr., The Foundations of Christian Bioethics (Lisse, The Netherlands: Swets and Zeitlinger, 2000), chaps. 1 and 2.
116. The history of the invention and then the reapplication of the term "bioethics" (or perhaps its multiple invention) is complex and beset by controversy. One thing seems clear: Potter was the first to use the term. He coined it to identify an environmentally conscious way of life that could balance resources with population. See, for example, Van Rensselaer Potter, "Bioethics, the Science of Survival, " Perspectives in Biology and Medicine 14, no. 1 (1970): 127-53; Van Rensselaer Potter, "Biocybernetics and Survival, " Zygon 5 (1970): 229-46; and Van Rensselaer Potter, Bioethics, Bridge to the Future (Englewood Cliffs, NJ: Prentice-Hall, 1971). For an overview of some of the controversies in the term's history, see Warren Reich, "The Word 'Bioethics': Its Birth and the Legacies of Those Who Shaped It, " Kennedy Institute of Ethics Journal 4, no. 4 (1994): 319-36.
117. The history of the invention and then the reapplication of the term "bioethics" (or perhaps its multiple invention) is complex and beset by controversy. One thing seems clear: Potter was the first to use the term. He coined it to identify an environmentally conscious way of life that could balance resources with population. See, for example, Van Rensselaer Potter, "Bioethics, the Science of Survival, " Perspectives in Biology and Medicine 14, no. 1 (1970): 127-53; Van Rensselaer Potter, "Biocybernetics and Survival, " Zygon 5 (1970): 229-46; and Van Rensselaer Potter, Bioethics, Bridge to the Future (Englewood Cliffs, NJ: Prentice-Hall, 1971). For an overview of some of the controversies in the term's history, see Warren Reich, "The Word 'Bioethics': Its Birth and the Legacies of Those Who Shaped It, " Kennedy Institute of Ethics Journal 4, no. 4 (1994): 319-36.
118. The history of the invention and then the reapplication of the term "bioethics" (or perhaps its multiple invention) is complex and beset by controversy. One thing seems clear: Potter was the first to use the term. He coined it to identify an environmentally conscious way of life that could balance resources with population. See, for example, Van Rensselaer Potter, "Bioethics, the Science of Survival, " Perspectives in Biology and Medicine 14, no. 1 (1970): 127-53; Van Rensselaer Potter, "Biocybernetics and Survival, " Zygon 5 (1970): 229-46; and Van Rensselaer Potter, Bioethics, Bridge to the Future (Englewood Cliffs, NJ: Prentice-Hall, 1971). For an overview of some of the controversies in the term's history, see Warren Reich, "The Word 'Bioethics': Its Birth and the Legacies of Those Who Shaped It, " Kennedy Institute of Ethics Journal 4, no. 4 (1994): 319-36.
119. The history of the invention and then the reapplication of the term "bioethics" (or perhaps its multiple invention) is complex and beset by controversy. One thing seems clear: Potter was the first to use the term. He coined it to identify an environmentally conscious way of life that could balance resources with population. See, for example, Van Rensselaer Potter, "Bioethics, the Science of Survival, " Perspectives in Biology and Medicine 14, no. 1 (1970): 127-53; Van Rensselaer Potter, "Biocybernetics and Survival, " Zygon 5 (1970): 229-46; and Van Rensselaer Potter, Bioethics, Bridge to the Future (Englewood Cliffs, NJ: Prentice-Hall, 1971). For an overview of some of the controversies in the term's history, see Warren Reich, "The Word 'Bioethics': Its Birth and the Legacies of Those Who Shaped It, " Kennedy Institute of Ethics Journal 4, no. 4 (1994): 319-36.
120. Sargent Shriver, letter to author, January 26, 2001. Shriver, the founder of the Peace Corps, a one-time Democratic vice-presidential nominee, and the husband of Eunice Kennedy Shriver, was a major influence on the formation of the Kennedy Institute of Ethics, of which the Kennedy Center for Bioethics was a part.
121. Here my account contrasts in interpretative character with the account given in Jonsen, The Birth of Bioethics.
122. What is remarkable is how quickly the field was established. By 1978, the Kennedy Center had already produced Warren T. Reich, ed., The Encyclopedia of Bioethics (New York: Macmillan Free Press, 1978).
123. For a critical assessment of the role of bioethicists and philosophers of medicine as recognized experts before courts of law, see Kevin Wm. Wildes, "Healthy Skepticism: The Emperor Has Very Few Clothes, " Journal of Medicine and Philosophy 22, no. 4 (1997): 365-71; and Kenneth Kipnis, "Confessions of an Expert Ethics Witness, " Journal of Medicine and Philosophy 22, no. 4 (1997): 325-43.
124. For a critical assessment of the role of bioethicists and philosophers of medicine as recognized experts before courts of law, see Kevin Wm. Wildes, "Healthy Skepticism: The Emperor Has Very Few Clothes, " Journal of Medicine and Philosophy 22, no. 4 (1997): 365-71; and Kenneth Kipnis, "Confessions of an Expert Ethics Witness, " Journal of Medicine and Philosophy 22, no. 4 (1997): 325-43.
125. Karl Marx and Friedrich Engels, The German Ideology (New York: International Publishers, 1967), 40.