Over a period of a year, the symposium on clinical judgment has taken shape as a volume devoted to the analysis of how knowledge claims are framed in medicine and how choices of treatment are made. We hope it will afford the reader, whether layman, physician or philosopher, a useful perspective on the process of knowing what occurs in medicine; and that the results of the dis cussions at the Fifth Symposium on Philosophy and Medicine will lead to a better understanding of how philosophy and medicine can usefully challenge each other. As the interchange between physicians, philosophers, nurses and psychologists recorded in the major papers, the commentaries and the round table discussion shows, these issues are truly interdisciplinary. In particular, they have shown that members of the health care professions have much to learn about themselves from philosophers as well as much of interest to engage philosophers. By making the structure of medical reasoning more apparent to its users, philosophers can show health care practitioners how better to master clinical judgment and how better to focus it towards the goods and values medicine wishes to pursue. Becoming clearer about the process of knowing can in short teach us how to know better and how to learn more efficiently. The result can be more than (though it surely would be enough ) a powerful intellectual insight into a major cultural endeavor, medicine."

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically.

This volume, which has developed from the Fourteenth Trans Disciplinary Symposium on Philosophy and Medicine, September 5-8, 1982, at Tel Aviv University, Israel, contains the contributions of a group of distinguished scholars who together examine the ethical issues raised by the advance of biomedical science and technology. We are, of course, still at the beginning of a revolution in our understanding of human biology; scientific medicine and clinical research are scarcely one hundred years old. Both the sciences and the technology of medicine until ten or fifteen years ago had the feeling of the 19th century about them; we sense that they belonged to an older time; that era is ending. The next twenty-five to fifty years of investigative work belong to neurobiology, genetics, and reproductive biology. The technologies of information processing and imaging will make diagnosis and treatment almost incomprehensible by my generation of physicians. Our science and technology will become so powerful that we shall require all of the art and wisdom we can muster to be sure that they remain dedicated, as Francis Bacon hoped four centuries ago, "to the uses of life." It is well that, as philosophers and physicians, we grapple with the issues now when they are relatively simple, and while the pace of change is relatively slow. We require a strategy for the future; that strategy must be worked out by scientists, philosophers, physicians, lawyers, theologians, and, I should like to add, artists and poets."

This book examines the factors influencing women's choices of obstetrical care in a Bariba community in the People's Republic of Benin, West Africa. When selecting a research topic, I decided to investigate health care among the Bariba for several reasons. First, I had served as a Peace Corps Volunteer in northern Benin (then Dahomey) and had established a network of contacts in the region. In addition, I had worked for a year as assistant manager of a pharmacy in a northern town and had become interested in the pattern of utilization of health care services by urban residents. This three-year residence proved an invaluable asset in preparing and conducting research in the northern region. In particular, I was able to establish relationships with several indigenous midwives whose families I already knew both from prior research experience and mutual friend ships. These relationships enabled me to obtain detailed information regarding obstetrical practice and thus form the foundation of this book. The fieldwork upon which the book is directly based was conducted between June 1976 and December 1977 and sponsored by the F ord-Rockefeller Popula tion Policy Program, the Social Science Research Council, the National Science Foundation, and the FUlbright-Hays Doctoral Dissertation Research Program. The Ford-Rockefeller Population Policy Program funded the project as a collab oration between myself and Professor Eusebe Alihonou, Professor Agrege (Gynecologie-Obstetrique) at the National University of Benin."

Human existence is marked by pain, limitation, disability, disease, suffering, and death. These facts of life and of death give ample grounds for characterizing much of the human condition as unfortunate. A core philosophical question is whether the circumstances are in addition unfair or unjust in the sense of justifying claims on the resources, time, and abilities of others. The temptation to use the languages of rights and of justice is und- standable. Faced with pain, disability, and death, it seems natural to complain that "someone should do something," "this is unfair," or "it just isn't fight that people should suffer this way." Yet it is one thing to complain about the unfairness of another's actions, and another thing to complain about the unfairness of biological or physical processes. If no one is to blame for one's illness, disability, or death, in what sense are one's unfortunate circumstances unfair or unjust? How can claims against others for aid and support arise if no one has caused the unfortunate state of affairs? To justify the languages of fights to health care or justice in health care requires showing why particular unfortunate circumstances are also unfair, in the sense of demanding the labors of others. It requires understanding as well the limits of property claims. After all, claims regarding justice in health care or about fights to health care limit the property fights of those whose resources will be used to provide care.

The growth of knowledge and its effects on the practice of medicine have been issues of philosophical and ethical interest for several decades and will remain so for many years to come. The outline of the present volume was conceived nearly three years ago. In 1987, a conference on this theme was held in Maastricht, the Netherlands, on the occasion of the founding of the European Society for Philosophy of Medicine and Health Care (ESPMH). Most of the chapters of this book are derived from papers presented at that meeting, and for the purpose of editing the book Stuart Spicker, Ph. D. , joined two founding members of ESPMH, Henk ten Have and Gerrit Kimsma. The three of them successfully brought together a number of interesting contribu tions to the theme, and ESPMH is grateful and proud to have initiated the production of this volume. The Society intends that annual meetings be held in different European countries on a rotating basis and to publish volumes related to these meetings whenever feasible. In 1988, the second conference was held in Aarhus, Denmark on "Values in Medical Decision Making and Resource Allocation in Health Care". In 1989, a meeting was held in Czestochowa, Poland, on "European Traditions in Philosophy of Medicine. From Brentano to Bieganski". It is hoped that these conferences and the books to be derived from them, will initiate a new European tradition, lasting well into the 21 st century! P. J.

In this open access book, Angela K. Martin thoroughly addresses what human and animal vulnerability are, how and why they matter from a moral point of view, and how they compare to each other. By first defining universal and situational human vulnerability, Martin lays the groundwork for investigating whether sentient nonhuman animals can also qualify as vulnerable beings. She then takes a closer look at three different contexts of animal vulnerability: animals used as a source of food, animals used in research, and the fate of wild animals. 

- Natural scientists, social scientists and humanists to assess if (or how) we may begin to coexist harmoniously with the mosquito. - Chapters assess polarizing arguments for conserving and preserving mosquitoes, as well as for controlling and killing them, elaborating on possible consequences of both strategies. - This book provides informed answers to the dual question: could we eliminate mosquitoes, and should we? Offering insights spanning the technical to the philosophical, this is the 'go to' book for exploring humanity's many relationships with the mosquito-which becomes a journey to finding better ways to inhabit the natural world.

Offering new ways of understanding the nature of disease, and exploring the idea that health and illness have a special interdependence, The Meaning of Illness shows the positive side of illness and its value in human experience.

This timely collection examines representations of medicine and medical practices in international period drama television. A preoccupation with medical plots and settings can be found across a range of important historical series, including Outlander, Poldark, The Knick, Call the Midwife, La Peste and A Place to Call Home. Such shows offer a critique of medical history while demonstrating how contemporary viewers access and understand the past. Topics covered in this collection include the innovations and horrors of surgery; the intersection of gender, class, race and medicine on the American frontier; psychiatry and the trauma of war; and the connections between past and present pandemics. Featuring original chapters on period television from the UK, the US, Spain and Australia, Diagnosing history offers an accessible, global and multidisciplinary contribution to both televisual and medical history. -- .

This volume offers a collection of writings on ethical issues regarding retarded persons. Because this important subject has been generally omitted from formal discussions of ethics, there is a great deal which needs to be addressed in a theoretical and critical way. Of course, many people have been very concerned with practical matters concerning the care of retarded persons such as what liberties, entitlements or advocacy they should have. Interestingly, because so much practical attention has been given to issues which are not discussed by ethical theorists, they offer a rare opportunity to evaluate ethical theories themselves. That is, certain theories which appear convincing on other subjects seem implausible when they are applied to reasoned and com pelling views we hold concerning retarded individuals. Our subject, then, has both practical and conceptual dimensions. More over, because it is one where pertinent information comes from many sources, contributors to this volume represent many fields, including philosophy, religion, history, law and medicine. We regret that it was not possible to include more points of view, like those of psychologists, sociologists, nurses and families. There is however, a good and longstanding literature on mental retardation from these perspectives."

The book contains more than 250 photographs which are representative of the thousands that were studied. Each photograph is evaluated and interpreted in terms of the intended meaning and purpose of the images. . . . This book is a pleasure to read and represents the distillation of many hundreds of hours reviewing photographic materials. . . . The basic information regarding the interpretation of photographic conventions should be of great interest to both photographers and those with an interest in the cultural histories of Britain and the US. Journal of Biological Photography With a perspective shaped by recent work in art history and the sociology of knowledge, the authors encourage the reader to analyze photographs as complicated historical documents. They argue that, while photographs may appear to be literal depictions of reality, they actually pose profound problems of historical interpretation. The authors take as their subject matter the representation of medicine in photographs taken in Britain and the United States from 1840 through the present day. They have studied thousands of photographs, more than 250 of which are reprinted in this volume, in conjunction with other primary sources and historical accounts. The text explores the representations of medicine made by photographers and their employers, and the ways that audiences through the years have interpreted their messages.

The editors have incurred many debts in preparing this book, and both etiquette and ethics would be contravened if they were not discharged here. Above all, we wish to thank the contributors for so cheerfully complying with our suggestions for preparing their papers for publication and efficiently meeting our schedules. It is thanks to their cooperation that this volume has appeared speedily and painlessly; their revisions have helped to give it internal coherence. This volume has emerged from papers delivered at a conference on the History of Medical Ethics, held at the Wellcome Institute for the History of Medicine, London, 1 December, 1989. We are most grateful to the Wellcome Trust for having underwritten the costs of the conference, and to Frieda Houser and Stephen Emberton whose organizational skills contributed so much to making it a smoothly-run and enjoyable day. In addition to the papers delivered at the conference, we are delighted to have secured further contributions from David Harley and Johanna Geyer-Kordesch. Our thanks to them for their eager help. From start to finish, we have received splendid encouragement from all those connected with the Philosophy and Medicine series, especially Professor Stuart Spicker, and Martin Scrivener at Kluwer Academic Publishers. Their enthusiasm has lightened our load, and expedited the editorial process.

The idea of reviewing the ethical concerns of ancient medicine with an eye as to how they might instruct us about the extremely lively disputes of our own contemporary medicine is such a natural one that it surprises us to real ize how very slow we have been to pursue it in a sustained way_ Ideologues have often seized on the very name of Hippocrates to close off debate about such matters as abortion and euthanasia - as if by appeal to a well-known and sacred authority that no informed person would care or dare to oppose_ And yet, beneath the polite fakery of such reference, we have deprived our selves of a familiarity with the genuinely 'unsimple' variety of Greek and Roman reflections on the great questions of medical ethics. The fascination of recovering those views surely depends on one stunning truism at least: humans sicken and die; they must be cared for by those who are socially endorsed to specialize in the task; and the changes in the rounds of human life are so much the same from ancient times to our own that the disputes and agreements of the past are remarkably similar to those of our own."