An Introductory Philosophy of Medicine

Part III. Ethics

Ethics is the study of human actions and conduct, especially associated with moral rules and principles. It is derived from the Greek word, ethikos, which stands for character, and it is generally divided into descriptive, normative, and applied ethics. Descriptive ethics tells us how we act and is concerned with the details of actions and conduct, without evaluating them in terms of a moral code. It is "the factual description and explanation of moral behavior and beliefs" (Beauchamp and Walters, 1999, p. 2). It is also empirical in nature, observing the choices community members make under given conditions and situations. The result is usually the identification of a code of conduct or etiquette, without moralizing as to its rightness or wrongness.

A normative ethic, however, tells community members how they should act and is based on moral values held in common. It is generally concerned with ethical theories. Analysis of the foundations underlying the various normative ethical systems and their terms, like the good or the right, is called metaethics. Metaethics is also concerned "with metaphysical questions about the nature of ethical properties and epistemological questions about how claims to ethical knowledge are to be appraised" (Solomon, 2004, p. 813). Applied ethics is concerned with appropriating a specific form of normative ethics to a particular discipline like business or medicine.

In Part III, the first chapter is concerned with axiology and the values that are foundational to bioethics. In the next chapter, I discuss the development of bioethics, especially in the United States, and the different normative ethical theories, upon which contemporary bioethics is founded. In the proceeding chapter, the notion of principlism-the predominant ethical approach to bioethics-and the four principles that compose it are examined in detail, followed by a brief discussion of the future of bioethics. In the fourth chapter to this part, I discuss emotionally detached concern on the part of the biomedical practitioner and empathic care on the part of the humanistic or humane practitioner. In a final chapter, I explore the different types of patient-physician relationships. Ethics is critical for addressing the quality-of-care crisis, since it governs the relationship between the patient and physician. This crisis in modern medicine represents a breakdown of this foundational relationship, and its resolution can only be affected by repairing the relationship.

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