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.

Realizing that a world remade by techno-science and global capital stands in great need of practical wisdom as an antidote to various forms of modern hubris, scholars across the human sciences have taken a renewed interest in exploring how the classical virtue of prudence can be reformulated as a guide for postmodern practice. This volume brings together scholars in classics, political philosophy, and rhetoric to analyze prudence as a distinctive and vital form of political intelligence. Through case studies from each (...) of the major periods in the history of prudence, the authors identify neglected resources for political judgment in today's conditions of pluralism and interdependency. Three assumptions inform these essays: the many dimensions of prudence cannot be adequately represented in the lexicon of any single discipline; the Aristotelian focus on prudence as rational calculation needs to be balanced by the Ciceronian emphasis on prudence as discursive performance embedded in familiar social practices; and understanding prudence requires attention to how it operates through the communicative media and public discourses that constitute the political community. Contributors, besides the editor, are Stephen H. Browne, Robert W. Cape Jr., Maurice Charland, Peter J. Diamond, Eugene Garver, James Jasinski, John S. Nelson, and Christine L. Oravec. (shrink)

Rationality in medicine is frequently construed as hypotheticodeductive. This article argues that such a model gives a distorted view of the rational character of an enterprise that makes judgments about individual human well-being. Medicine as a science is a practical human science. Seen as such, its rational orientation is one that applies general knowledge to particular situations. It is argued that such an orientation is not deductive but interpretative. The Aristotelian concept of practical wisdom (‘phron sis’) is used as a (...) model of the rational orientation of clinical judgment. Keywords: clinical judgment, rationality, human sciences CiteULike Connotea Del.icio.us What's this? (shrink)

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)

The moral authority for professional ethics in medicine customarily rests in some source external to medicine, i.e., a pre-existing philosophical system of ethics or some form of social construction, like consensus or dialogue. Rather, internal morality is grounded in the phenomena of medicine, i.e., in the nature of the clinical encounter between physician and patient. From this, a philosophy of medicine is derived which gives moral force to the duties, virtues and obligations of physicians qua physicians. Similarly, an ethic specific (...) to the other healing professions, law, teaching or ministry, can be derived from the specific ends to telos of each of these professions, which like medicine, are focused on a special type of human relationship. (shrink)

A basic question of medical ethics is whether the norms governing medical practice should be understood as the application of principles and rules of the common morality to medicine or whether some of these norms are internal or proper to medicine. In this article we describe and defend an evolutionary perspective on the internal morality of medicine that is defined in terms of the goals of clinical medicine and a set of duties that constrain medical practice in pursuit of these (...) goals. This perspective is developed by means of a critical examination of the essentialist conception of the internal morality of medicine advocated by Edmund Pellegrino and the critique of internal morality approaches by Robert Veatch and Tom Beauchamp. (shrink)

Some ethical issues facing contemporary medicine cannot be fully understood without addressing medicine's internal morality. Medicine as a profession is characterized by certain moral goals and morally acceptable means for achieving those goals. The list of appropriate goals and means allows some medical actions to be classified as clear violations of the internal morality, and others as borderline or controversial cases. Replies are available for common objections, including the superfluity of internal morality for ethical analysis, the argument that internal morality (...) is merely an apology for medicine's traditional power and authority, and the claim that there is no single, "core" internal morality. The value of addressing the internal morality of medicine may be illustrated by a detailed investigation of ethical issues posed by managed care. Managed care poses some fundamental challenges for medicine's internal morality, but also calls for thoughtful reflection and reconsideration of some traditionally held moral views on patient fidelity in particular. (shrink)

In this comprehensive anthology, twenty-seven outstanding scholars from North America and Europe address every major aspect of Thomas Aquinas's understanding of morality and comment on his remarkable legacy. The opening chapters of The Ethics of Aquinas introduce readers to the sources, methods, and major themes of Aquinas's ethics. Part II of the book provides an extended discussion of ideas in the Second Part of the Summa Theologiae, in which contributors present cogent interpretations of the structure, major arguments, and themes of (...) each of the treatises. The third and final part examines the legacy of Thomistic ethics for the twentieth century and today. These essays reflect a diverse group of scholars representing a variety of intellectual perspectives. Contributors span numerous fields of study, including intellectual history, medieval studies, moral philosophy, religious ethics, and moral theology. This remarkable variety underscores how interpretations of Thomas's ethics continue to develop and evolve -- and stimulate fervent discussion within the academy and the church. Book jacket. (shrink)

This paper explores the practical consequences that Enlightenment ideals had on morality as it applies to clinical practice, using Alisdair MacIntyre's conceptualization and critique of the Enlightenment as its reference point. Taking the perspective of a practicing clinician, I critically examine the historical origins of ideas that made shared decision making (SDM) a necessary and ideal model of clinician-patient relationship. I then build on MacIntyre's critique of Enlightenment thought and examine its implications for conceptions of shared decision-making that use an (...) Enlightenment justification, as well as examining contemporary threats to SDM that the Enlightenment made possible. I conclude by offering an alternative framing of SDM that fits with the clinician's duty to act on behalf of and along with patients but that avoids the tenuous Enlightenment assumptions that MacIntyre's work so vocally critiques. (shrink)

The article offers an approach to inquiry about, the foundation of medical ethics by addressing three areas of conceptual presupposition basic to medical ethical theory. First, medical ethics must presuppose a view about the nature of medicine. it is argued that the view required by a cogent medical morality entails that medicine be seen both as a healing relationship and as a practical art. Three ways in which medicine inherently involves values and valuation are presented as important, i.e., in being (...) aimed at the good of health, in being a cognitive art evaluating towards that good, and as a manifestation of a virtuous disposition concerning that good. Finally, a value ontology drawn from these considerations is seen as necessarily underlying medical ethics. A set of three such basic values are promoted as crucial: the value of health; the value of the individual patient; and the value of altruism that mediates the class of potential patients. (shrink)