Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty. Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal balances (...) theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions. Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient. (shrink)

Paul Ricoeur has been hailed as one of the most important thinkers of the century. Oneself as Another, the clearest account of his "philosophical ethics," substantiates this position and lays the groundwork for a metaphysics of morals.

This classic and controversial book examines the roots of the idea of virtue, diagnoses the reasons for its absence in modern life, and proposes a path for its recovery.

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life determinations, (...) the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient 's values. In order to act in the patient 's best interests, or the patient 's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient 's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient 's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician- patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today. (shrink)

A dialogue between virtue and care ethics is formed as a step towards meeting Pellegrino's challenge to create a more comprehensive moral philosophy. It is also a dialogue between nursing and medicine since each practice draws on the Greek Virtue Tradition and the Judeo-Christian Tradition of care differently. In the Greek Virtue Tradition, the point of scrutiny lies in the inner character of the actor, whereas in the Judeo-Christian Tradition the focus is relational, i.e. how virtues are lived out in (...) specific relationships, particularly unequal relationships where vulnerability of one of the members is an issue. In a care ethic relational qualities such as attunement rather than inner qualities are the point of scrutiny. A dialogue between these two traditions makes it possible to consider the relational virtues and skills of openness and responsiveness that are required for a respectful meeting of the other. (shrink)

What is the good for human persons? If I am trying to lead the best possible life I could lead, not the morally best life, but the life that is best for me, what exactly am I seeking?This phrasing of the question I will be pursuing may sound tendentious, so some explanation is needed. What is good for one person, we ordinarily suppose, can conflict with what is good for other persons and with what is required by morality. A prudent (...) person seeks her own good efficiently; she selects the best available means to her good. If we call the value that a person seeks when she is being prudent “prudential value,” then an alternative rendering of the question to be addressed in this essay is “What is prudential value?” We can also say that an individual flourishes or has a life high in well-being when her life is high in prudential value. Of course, these common-sense appearances that the good for an individual, the good for other persons, and the requirements of morality often are in conflict might be deceiving. For all that I have said here, the correct theory of individual good might yield the result that sacrificing oneself for the sake of other people or for the sake of a morally worthy cause can never occur, because helping others and being moral always maximize one's own good. But this would be the surprising result of a theory, not something we should presuppose at the start of inquiry. When a friend has a baby and I express a conventional wish that the child have a good life, I mean a life that is good for the child, not a life that merely helps others or merely respects the constraints of morality. After all, a life that is altruistic and perfectly moral, we suppose, could be a life that is pure hell for the person who lives it—a succession of horrible headaches marked by no achievements or attainments of anything worthwhile and ending in agonizing death at a young age. So the question remains, what constitutes a life that is good for the person who is living it? (shrink)

The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that satisfying one's preferences, (...) or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)

Originally published in 1991, this book focuses on the concept of virtue, and in particular on the virtue of wisdom or knowledge, as it is found in the epic poems of Homer, some tragedies of Sophocles, selected writings of Plato, Aristotle, and the Stoic and Epicurean philosophers. The key questions discussed are the nature of the virtues, their relation to each other, and the relation between the virtues and happiness or well-being. This book provides the background and interpretative framework to (...) make classical works on Ethics, such as Plato’s _Republic_ and Aristotle’s _Nicomachean Ethics_, accessible to readers with no training in the classics. (shrink)

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject him- or (...) herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)