Charles Bonnet began his career as a naturalist, from an early age establishing a reputation as a careful observer. It is for those youthful observations, as well as for some suggestive speculations proposed relative to this field, that he is best remembered in English-speaking countries: regarding the taxonomic de mands of natural history he refurbished the idea of a chain of beings; regarding the question of generation he marshaled evidence in support of preforma tion theory; and regarding the analysis of the physiology of the nervous system he advanced a theory that individual nerve fibers receive and retain specific sensations. Following his loss of eyesight in his mid-twenties Bonnet entered a more reflective period, turning to philosophy and pondering the nature of human understanding - considerations he had formerly disdained, but that now seemed a natural outgrowth of his reflections on nature. This essay focuses on the philosophical and psychological works of the later period, the period in which he wrote all his major books. By giving these writings a broader exposure it has been one of my hopes that Bonnet's audience would also be broadened, releasing him, so to speak, from the charge of historians of science so that he might fmd his way, in general books on the "Enlightenment," from scattered footnotes into the texts themselves."

Medical healing implies knowledge of the assumptions that underlie our understanding of "health," and, concomitantly, how we define well being and its opposites, illness and disease. Today, health, health care (business, wellness, recreation), and medicine (especially research-driven scientific medicine) have become separate entities with different institutions, budgets, marketing philosophies and "corporate cultures." Furthermore, healing is individual and subjective, yet at the same time also culturally determined. The present volume brings together papers on these topics in an unique interdisciplinary approach. The book provides an ethical framework for healthcare from a political perspective. It discusses definitions of the terminology of healing and health and their ethical and medical implications including their historical contexts. A separate section expands the theme of the cultural constructedness of healing by the concepts of traditional Chinese medicine and homeopathy. Modern medicine has a strong focus on acute care, which urgently needs to place greater emphasis on preventive medicine including the crucial importance of social factors on health and on the emergence of "public health." The point of view of Business Concepts, their potential and limitations are by no means neglected and the legal ramifications of genetic research and innovative medical strategies with regard to some of our most foundational notions are discussed.

In this remarkable book, Gary Wright focuses thirty years experience as a family physician, and his Ph.D. in philosophy, to address the nature of good medical reasoning. Wright folds cognitive science into a pragmatist framework developed by John Dewey; this alternative view of mind and medical judgment leads to a model of reasoning that offers realistic guidance for medical decisions, one that each of us would want our own physicians to adopt.

The question of whether there might be a duty to die was first raised by Margaret Battin in 1987 in her ground-breaking essay, "Age Distribution and the Just Distribution of Health Care: Is There a Duty to-Die?" In 1997 the issue was reprised when two new articles appeared on the topic written by John Hardwig and the other by former Colorado Governor Richard D. Lamm. Given the renewed interest in the topic, as well as its undeniable importance, Biomedical Ethics Re views sought to initiate an in-depth discussion of the issue by soliciting articles and issuing a general call for papers on the topic "Is There a Duty to Die?" The twelve articles in this volume represent the ultimate fruits of those initiatives. The first seven essays in this text are sympathetic to the claim that there is a duty to die. They argue either: (a) that some form of a duty to die exists, or (b) that arguments that might be offered against the existence of such a duty cannot be sustained. By way of contrast, the last five articles in the text are critical of duty-to-die claims: The authors of the first three of these five articles attempt to cast doubt on the existence of a duty to die, and the writers of the last two essays argue that if such a duty did exist, severe problems would arise when ever we attempted to implement it."

1. GENERAL The term "diagnostics" refers to the general theory of diagnosis, not to the study of specific diagnoses but to their general framework. It borrows from different sciences and from different philosophies. Traditionally, the general framework of diagnostics was not distinguished from the framework of medicine. It was not taught in special courses in any systematic way; it was not accorded special attention: students absorbed it intuitively. There is almost no comprehensive study of diagnostics. The instruction in diagnosis provided in medical schools is exclusively specific. Clinical instruction includes (in addition to vital background information, such as anatomy and physiology) specific instruction in nosology, the theory and classification of diseases, and this includes information on diagnoses and prognoses of diverse diseases. What is the cause of the neglect of diagnostics, and of its integrated teaching? The main cause may be the prevalence of the view of diagnostics as part-and parcel of nosology. In this book nosology is taken as a given, autonomous field of study, which invites almost no comments; we shall freely borrow from it a few important general theses and a few examples. We attempt to integrate here three studies: ll of the way nosology is used in the diagnostic process; of the diagnostic process as a branch of applied ethics; ~ of the diagnostic process as a branch of social science and social technology.

Pope John Paul II surprised much of the medical world in 2004 with his strongly worded statement insisting that patients in a persistent vegetative state should be provided with nutrition and hydration. This collection of essays featuring some of the most prominent Catholic bioethicists addresses the Pope s statements, the moral issues surrounding artificial feeding and hydration, the refusal of treatment, and the ethics of care for those at the end of life."

The idea for an anthology on personhood grew out of two things, viz., the work I did with Martin Benjamin during the Summer of 1982 at Michigan State University on the question, What is a person?, and the amount of time, effort, and expense required for serious research on the topic itself. The former experience taught me the importance of, among other things, attempting to get clear about what we are to mean by 'person, ' while the latter experience suggested a possible course of action whereby getting clear might be made more manage able simply by having relatively convenient access to some of the most insightful and stimulating writings on the topic. The problems of personhood addressed in this book are central to issues in ethics ranging from the treatment or termination of infants with birth defects to the question whether there can be rational suicide. But before questions on such issues as the morality of abortion, genetic engineering, infanticide, and so on, can be settled, the prob lems of personhood must be clarified and analyzed. Hence What Is a Person? has as its primary theme the examination of various proposed conditions of personhood."

Internationally recognized scientists, clinicians, and technologists review and explain the fundamental molecular and cellular biology that has been applied to the emerging field of transplant immunology and xenotransplantation, and what impact these advances might optimally have on medicine and science. The authoritative experts writing here-many of whom made the basic discoveries underlying the recent advances-examine the biological and immunological hurdles to xenotransplantation, illuminating how the immune system interacts with the xenograft and laying a practical foundation for the use of genetic engineering and animal transplants in the treatment of human disease.

Prominent bioethicists whose work is rooted in philosophy, religion, medicine, nursing, literature, history, and policy analysis join together to discuss their methods and professional insights, as well as to better define the field and its future development. Writing from the perspective of their own specialties, the authors: review just how their personal disciplines have contributed to bioethics, debate the current and future bioethical issues they face, and identify the most significant strengths and weaknesses in the current practice of bioethics. Seeking a sound foundation for the discipline, they also consider what basic knowledge and skills are necessary to be competent in bioethics, what methods and theoretical approaches are most promising for its future development, and what issues or perspectives have been neglected.

Any list of the most influential figures of the second half of the twentieth century would arguably have to begin with the name of Pope John Paul II. From 1978, when he was inaugurated, to the present, over a quarter of a century later, the Pope has been a dominant force in the world, both within the Catholic and Christian Church, and in the larger international community. Among the areas in which the Pope has been of signal importance to contemporary discussion, argument, and policy has been the field of bioethics. This collection brings together for the first time in an accessible and readable form a summary and assessment of John Paul II's contribution to bioethical issues and theories. It includes discussion of the Pope's views on the dignity of the person and the sanctity of human life, and the application of these views to various difficulties in medical ethics such as abortion and embryo research, the right to health care and the problem of suffering. Throughout, attention is paid to the way in which the Pope stands as a recognizably authentic voice for the Catholic faith in the medical arena.

In this book, developed by a group of collaborating scholars in bioethics from different European countries, an overview is given of the most salient themes in present-day bioethics. The themes are discussed in order to enable the reader to have an in-depth overview of the state of the art in bioethics. Introductory chapters will guide the reader through the relevant dimensions of a particular area, while subsequent case discussions will help the reader to apply the ethical theories to specific clinical problems and health policy queries. The book focuses on perspectives typical for the European context. This highlights not only particular bioethical themes such as social justice, choices in health care, and health policy (e.g., in post-communist countries), it also emphasizes specific approaches in ethical theory, in relation to Continental philosophies such as phenomenology and hermeneutics.
Because of its articulation of what is typical for the European health care setting as well as for bioethical debate, this book is unique in comparison to existing textbooks in bioethics.
The book is an introductory textbook acquainting the reader with the major issues in present-day health care as well as the various theoretical and practical approaches to clarify these issues.

Efforts to evaluate the clinical encounter in terms of autonomous agents governed by rationally justified moral principles continue to be criticised. These essays, written by physicians, ethicists, theologians and philosophers, examine various models of the clinical encounter emerging out of these criticisms and explore the prospects they offer for theological and religious discourse. Individual essays focus on the reformulation of covenant models; revisions of principles approaches; and topics such as power, authority, narrative, rhetoric, dialogue, and alterity. The essays display a range of conclusions about whether theology articulates generally accessible religious insights or is a tradition-specific discipline. Hence the volume reflects current debates in theology while analysing current models of the clinical encounter. Students, professionals, and scholars who find themselves at the intersection of theology and medicine will welcome these voices in an ongoing conversation.

In the second half of the 20th century, the body has become a central theme of intellectual debate. How should we perceive the human body? Is it best understood biologically, experientially, culturally? How do social institutions exercise power over the body and determine norms of health and behavior? The answers arrived at by phenomenologists, social theorists, and feminists have radically challenged our cenventional notions of the body dating back to 17th century Cartesian thought. This is the first volume to systematically explore the range of contemporary thought concerning the body and draw out its crucial implications for medicine. Its authors suggest that many of the problems often found in modern medicine -- dehumanized treatment, overspecialization, neglect of the mind's healing resources -- are directly traceable to medicine's outmoded concepts of the body. New and exciting alternatives are proposed by some of the foremost physicians and philosophers working in the medical humanities today.

Religion is a dominant force in the lives of many Americans. It animates, challenges, directs and shapes, as well, the legal, political, and scientific agendas of the new Age of Biotechnology. In a very real way, religion, biomedical technology and law are - epistemologically - different. Yet, they are equal vectors of force in defining reality and approaching an understanding of it. Indeed, all three share a synergetic relationship, for they seek to understand and improve the human condition.

This book strikes a rich balance between thorough analysis (in the body), anchored in sound references to religion, law and medical scientific analysis, and a strong scholarly direction in the end notes. It presents new insights into the decision-making processes of the new Age of Biotechnology and shows how religion, law and medical science interact in shaping, directing and informing the political processes.

This volume will be of interest to both scholars and practitioners in the fields of religion and theology, philosophy, ethics, (family) law, science, medicine, political science and public policy, and gender studies. It will serve as a reference source and can be used in graduate and undergraduate courses in law, medicine and religion.

Section I examines historical philosophical understandings of expertise in order to situate the current institution of bioethics. Section II focuses on philosophical analyses of the concept of expertise, asking, among other things, how it should be understood, how it can be acquired, and what such expertise warrants. Finally, section III addresses topics in bioethics and how ethics expertise should or should not be brought to bear in these areas, including expertise in the court room, in the hospital room, in the media, and in making policy. 2. A GUIDED HISTORICAL TOUR As Scott LaBarge points out, Plato's dialogues can be viewed as an extended treatment of the concept of moral expertise, so it is fitting to begin the volume with an examination of "Socrates and Moral Expertise." Given Socrates' protestations (the Oracle at Delphi notwithstanding) that he knows nothing, LaBarge observes that it would be interesting to determine both what a Socratic theory of moral expertise might be and whether Socrates qualified as such an expert. Plato's model of moral expertise is what LaBarge calls "demonstrable expertise," which is concerned mainly with the ability to attain a goal and to explain how one did it. The problem with this account is that when one tries to solve the various problems in the model - for example, allowing that moral expertise is not an all-or-nothing skill - then one is immediately faced with the "credentials problem." As LaBarge puts it, ." . .

PERSONHOOD AND HEALTH CARE This book arose as a result of a pre-conference devoted to the topic held June 28, 1999 in Paris, France. The pre-conference preceded the Annual Congress of the International Academy ofLaw and Mental Health. Other chapters were solicited after the conference in order to more completely explore the relation of personhood to health care. The pre conference was held in honor of Yves Pelicier who led so many of our French colleagues in medicine, philosophy, and ethics as Christian Herve notes in his Tribute. As health care is aimed at healing persons, it is important to realize how difficult it is to construct a theory of personhood for health care, and thus, a theory of how healing in health care comes about or ought to occur. The book is divided into four parts, Concepts of the Person, Theories of Personhood in Relation to Health Care and Bioethics, Person and Identity, and Personhood and Hs Relations. Each section explores a critical arena in constructing the relation of personhood to health care. Although no exploration ofthis nature can be exhaustive, every effort was made to present both conflicting and complementary views of personhood from within similar and different philosophical and religious traditions. PART ONE: CONCEPTS OF THE PERSON Tracing the origins of the concept of person from antiquity through present day, Jean Delemeau provides an historical sketch of the development of a wide range of meanings."

Medicine Across Cultures: The History and Practice of Medicine in Non-Western Cultures consists of 19 essays dealing with the medical knowledge and beliefs of cultures outside of the United States and Europe. In addition to articles surveying Islamic, Chinese, Native American, Aboriginal Australian, Indian, Egyptian, and Tibetan medicine, the book includes essays on comparing Chinese and western medicine and religion and medicine. The essays address the connections between medicine and culture and relate the medical practices to the cultures which produced them. Each essay is well illustrated and contains an extensive bibliography. Because the geographic range is global, the book fills a gap in both the history of medicine and in cultural studies. It should find a place on the bookshelves of advanced undergraduate students, graduate students, and scholars, as well as in libraries serving those groups.

Debate regarding organ sales is largely innocent of the history of thought on the matter. This volume seeks to remedy this shortcoming. Positions for or against a market in human organs are nested within moral intuitions, ontological or political theoretical premises, or understandings of special moral concerns, such as permissible uses of the body, which have a long history of analysis. The essays compass the views of Plato, Aristotle, Aquinas, Locke, Kant, Hegel, Mill and Christianity, as well as particular methodological approaches, such as the phenomenology of the body, natural law theory, legal theory and libertarian critique of legal theory. These discussions cluster a number of conceptually independent philosophical concerns: (1) What is the appropriate understanding of the relationship between persons and their bodies? (2) What does it mean to own' an organ? (3) Do governments have moral authority to regulate how persons use their own body parts? (4) What are the costs and benefits of a market in human organs? Such questions are related by an urgent public health challenge: the considerable disparity between the number of patients who could significantly benefit from organ transplantation and the number of human organs available for transplantation. This volume explores the theoretical, normative, and historical foundations for alternative policies for procurement and transplantation of human organs.

Science, Technology, and the Art of Medicine contains papers by eminent scholars who discuss issues and concepts regarding the character of medicine. Special attention is given to the extent to which medicine is a science, art, and technology. Investigations are carried out with a particular focus on the nature of medical knowledge. Concepts of medical research, medical causality, intuition, and medical decision-making are examined in the light of medicine's revolutionary advances in the twentieth century. Past perspectives and present perplexities are also examined, bringing together a volume in the philosophy of medicine that treats a broad range of issues in medical epistemology and practise in a careful, critical fashion.

This collection of essays represents the work produced in the course of a three-year project funded by the Commission of the European Communities under the Biomed I programme, on the ethics of genetic screening, entitled 'Genetic screening: ethical and philosophical perspectives, with special reference to multifactorial diseases'. The short title of the project was Euroscreen, thereafter known as Euroscreen I, in the light of the fact that a second project on genetic screening was subsequently funded. The project was multinational and multidisciplinary, and had as its objectives to examine the nature and extent of genetic screening programmes in different European countries; to analyse the social policy response to these developments in different countries; and to explore the applicability of normative ethical frameworks to the issues. The project was led by a core group who had oversight of the project and members of which have acted as editors for this volume. Darren Shickle edited the first section; Henk ten Have the second; Ruth Chadwick and Urban Wiesing the third and final part. The volume opens with an overview of genetic screening and the principles available for addressing developments in the field, with special reference to the Wilson and Jungner principles on screening. The first of the three major sections thereafter includes papers on the state of the art in different countries, together with some analysis of social context and policy.

We have come to know that our ability to survive and grow as a nation to a very large degree depends upon our scientific progress. Moreover, it is not enough simply to keep 1 abreast of the rest of the world in scientific matters. We must maintain our leadership. President Harry Truman spoke those words in 1950, in the aftermath of World War II and in the midst of the Cold War. Indeed, the scientific and engineering leadership of the United States and its allies in the twentieth century played key roles in the successful outcomes of both World War II and the Cold War, sparing the world the twin horrors of fascism and totalitarian communism, and fueling the economic prosperity that followed. Today, as the United States and its allies once again find themselves at war, President Truman's words ring as true as they did a half-century ago. The goal set out in the Truman Administration of maintaining leadership in science has remained the policy of the U. S. Government to this day: Dr. John Marburger, the Director of the Office of Science and Technology (OSTP) in the Executive Office of the President, made remarks to that effect during his 2 confirmation hearings in October 2001. The United States needs metrics for measuring its success in meeting this goal of maintaining leadership in science and technology. That is one of the reasons that the National Science Foundation (NSF) and many other agencies of the U. S.

This volume is dedicated to the philosophy of medicine advanced by Edmund D. Pellegrino, a renowned physician educator and philosopher. Pellegrino's thinking about the philosophy of medicine centers on the importance of illness in the life of the patient, and the professional relationship established by promising to alleviate suffering. From this relationship norms are established that contribute to the staying power of medicine as a moral enterprise. Chapters are included from established thinkers and newcomers to the field, all of whom have been influenced by Pellegrino. Some chapters expand upon his thinking for primary care, managed care, and other delivery systems. Other chapters explain in more detail certain key concepts in Pellegrino's thought, like beneficence, doing no harm, and clinical phronesis or prudential decision making. Still others explore areas of difficulty like the reliance on role modeling and virtue ethics, the problem of pluralism and a loss of professional normative ethics, and the search for the foundations of the philosophy of medicine. Constructing a viable philosophy of medicine for the next century is an essential task for grounding the morality of medicine during enormous social and economic change. Pellegrino's thinking and the ideas of those he has influenced will contribute immensely to this challenge.

TERMINAL SEDATION DURING THE 1990s During the 1990s a discussion took place in scholarly journals concerning a measure within palliative care that had earlier attracted little attention, to wit, the sedation of dying patients. There seem to have been two main reasons why the practice came under debate. On the one hand, some people felt that, when palliative medicine had advanced and methods to control symptoms had improved, it was no longer justified to sedate the patients in a manner that had often been done in the past. The system of 1 terminal sedation had turned into 'euthanasia in disguise' or 'slow euthanasia'. On the other hand, there were people sympathetic to the recently established Dutch system of euthanasia, people who agreed that terminal sedation was euthanasia in disguise, but who felt that, if it is not objectionable to sedate dying patients at their request, then why should it not be permitted for doctors to kill dying patients at 2 request? From these two motives a discussion about terminal sedation gained momentum. The intention behind this anthology is to continue and deepen this discussion. The anthology starts off with a chapter where an influential article from the 1990s has been reprinted.

The potential of modern medicine in a pluralistic world leads to the potential for moral conflict. The most prevalent bioethical theories often either overestimate or underestimate the amount of shared moral belief that can be used to address those conflicts. This work presents a means for taking seriously the pluralism in the modern world while recognizing the likelihood of moral "acquaintance" between persons with differing views. It criticizes moral theories that overstate the extent of the problem of pluralism as well as those that imply too much agreement between reasonable moral persons, yet it locates a means for the resolution of many moral conflicts in moral acquaintanceship. Drawing from the work of H. Tristram Engelhardt, Jr., casuists and principle-based theorists, and Erich Loewy and Kevin W. Wildes's initial development of the concept of moral acquaintanceship, Moral Acquaintances and Moral Decisions is philosophically indepth work with direct applications for decisionmaking in real medical settings. A work in moral theory as well as a source of real world guidance, clinically oriented bioethics professionals as well as students of bioethical theory should find the theory of moral acquaintanceship provided here important to their work.