GESTIÓN EN SALUD PÚBLICA: Does medicine have a telos?

domingo, 22 de julio de 2018

Does medicine have a telos? | BioEdge

Does medicine have a telos?

by Xavier Symons | 21 Jul 2018 |

Medical practice has changed rapidly in recent decades. Debates challenging essentialist conceptions of medical practice have proliferated in light of changing attitudes toward of euthanasia and suicide, transgenderism, assisted reproduction and other ethically contentious medical practices. A new edition of the Journal of Medicine and Philosophy attempts to grapple with these changes -- and the entrenchment of pluralism in Western liberal democracies -- by developing novel concepts of health, illness and disease that make no reference to the goals of medical practice.

Guest editor Adam Omelianchuk goes to great lengths to emphasise just how obsolete he believes the “old-fashioned” Aristotelian conception of health and disease have become:

The old-fashioned idea of health as being part of the fulfillment of human nature and constitutive of human flourishing is increasingly out of place in a world where individual selves are empowered to contract with others so as to satisfy their desires. Or in other, perhaps less tendentious words, a single unified concept of health is not at home within a pluralistic society with its competing visions of the good life.

In lieu of this outmoded account of medical practice, the authors propose a variety of accounts of health and illness that are unified by their mutual resistance toward some objective account of the ends of medicine. Bioethicists Mary Jean Walker (Monash) and Wendy Rogers (Macquarie), for example, argue against those who defend a rigid conception of disease, suggesting that “disease” cannot be classically defined in terms of a set of necessary and sufficient conditions. And De Paul University sociologist Black Hawk Hancock argues that Michel Foucault is essential for conceptualizing medicalization in our contemporary society.

Yet while the opponents of a traditional philosophy of medicine are becoming increasingly prominent in the literature, defenders of a teleological account of medical practice are attempting to consider how a concept of the good of the patient might be preserved in pluralist, 21st democracies. The journal Philosophy, Ethics, and Humanities in Medicine recently released a call for papers for an upcoming edition that will deal with this question and others.

Sunday, July 22, 2018

We’re back! Holidays are over and BioEdge has resumed publication. Now, while we’re still fresh and enthusiastic, is the time for our readers to make suggestions for improving our coverage.

This week the lead story focuses on a report from the Nuffield Council on Bioethics in Britain which has given an in-principle endorsement to germline modification. While the report is purely advisory, most of its recommendations on similar topics have eventually become law in the UK. For this reason, its advice to the British government is bound to have a world-wide impact.

Most people, including members of Parliament, will only read newspaper articles about this radical development in genetics. But it is fundamentally a philosophical, not a scientific question: what makes us human?

The Nuffield report fails to answer this, but the full report is scathingly critical of what it calls “genomic essentialism”: we are not our genes. Instead, as I read it, it has framed the question as a consumer rights issue: provided that the technology is safe, don’t couples have a right to have the kind of children they want?

What do you think?