Methods in Medical Ethics

By Jeremy Sugarman; Daniel P. Sulmasy | Go to book overview

8
History

Darrel W. Amundsen

I shall begin this chapter by defining the most pertinent terms and delineating the parameters of the history of medical ethics. After briefly surveying the history of medical history with a view to discerning medical ethics' place in that field, I shall examine the nature of the historians craft and then suggest where the historically uninitiated may begin, providing some important caveats. I then give two examples of scholarship on issues of medical ethics. I end the chapter with some concluding observations and a description of useful resources.


DEFINING TERMS AND DELINEATING THE TERRAIN

In everyday usage the nouns “ethics” and “morality” and the adjectives “ethical” and “moral” are often employed interchangeably, although they are not, of course, precisely synonymous. These two word groups have specialized meanings in various disciplines, especially in philosophy. Even philosophers are not always in agreement about their exact definitions, but typically they use the word “ethics” to refer to the systematic and rigorous examination of moral norms.

Scholars who regard ethics as the systematic and rigorous examination of moral norms tend to distinguish historically between medical ethics and medical morality. When they speak of the genre of medical ethics as it existed prior to the mid-twentieth century, they may label it medical morality. By this they mean that it was nothing more than principles of etiquette and decorum informed by commonly held morality and circumscribed by religion and law. To such scholars medical ethics is a quite recent development, at which there had been only rare, spasmodic, and largely unnoticed earlier attempts. Thus understood, medical ethics, as a social and intellectual phenomenon, was initially but an adumbration of bioethics, of which it is now a subdivision.

A neologism datable to at least as early as 1971, bioethics has yet to achieve lexical stability. A quick and unsystematic survey of readily available dictionaries published between 1974 and the present reveals a wide range of nuances, but a primary emphasis on the ethical problems arising from advances in the biological sciences. Perhaps the much fuller definition given by Warren Reich in the revised edition of the Encyclopedia of Bioethics will influence lexicography: bioethics “can be defined as the systematic study of the moral di-

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Methods in Medical Ethics
Table of contents

Table of contents

  • Title Page i
  • Contents v
  • Preface vii
  • Acknowledgments xi
  • Contributors xiii
  • Part I - Overview 1
  • 1: The Many Methods of Medical Ethics (Or, Thirteen Ways of Looking at a Blackbird) 3
  • 2: A Decade of Empirical Research in Medical Ethics 19
  • Part II - Methods 29
  • 3: Philosophy 31
  • 4: Religion and Theology 47
  • 5: Professional Codes 70
  • 6: Legal Methods 88
  • 7: Casuistry 104
  • 8: History 126
  • 9: Qualitative Methods 146
  • 10: Ethnographic Methods 169
  • 11: Quantitative Surveys 1 192
  • 12: Experimental Methods 207
  • 13: Economics and Decision Science 227
  • Part III - Relationships and Applications 245
  • 14: Research in Medical Ethics: Physician-Assisted Suicide and Euthanasia 247
  • 15: Research in Medical Ethics: Genetic Diagnosis 1 267
  • 16: Reading the Medical Ethics Literature: a Discourse on Method 286
  • Index 298
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