Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict

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Where should physicians get their ethics? Professional codes such as the Hippocratic Oath claim moral authority for those in a particular field, yet according to medical ethicist Robert Veatch, these codes have little or nothing to do with how members of a guild should understand morality or make ethical decisions. While the Hippocratic Oath continues to be cited by a wide array of professional associations, scholars, and medical students, Veatch contends that the pledge is such an offensive code of ethics that it should be summarily excised from the profession. What, then, should serve as a basis for medical morality?

Building on his recent contribution to the prestigious Gifford Lectures, Veatch challenges the presumption that professional groups have the authority to declare codes of ethics for their members. To the contrary, he contends that role-specific duties must be derived from ethical norms having their foundations outside the profession, in religious and secular convictions. Further, these ethical norms must be comprehensible to lay people and patients. Veatch argues that there are some moral norms shared by most human beings that reflect a common morality, and ultimately it is these generally agreed-upon religious and secular ways of knowing -- thus far best exemplified by the 2005 Universal Declaration on Bioethics and Human Rights -- that should underpin the morality of all patient-professional relations in the field of medicine.

Hippocratic, Religious, and Secular Medical Ethics is the magnum opus of one of the most distinguished medical ethicists of his generation.

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Editorial Reviews

Doody's Review Service
Reviewer: Shahram Ahmadi Nasab Emran, MD, MA, MPH (Saint Louis University)
Description: In this work, which is based on his Gifford Lectures, the author offers a critical reflection on the sources of ethical norms for the practice of medicine.
Purpose: The purpose is to indicate the existence of fundamental points of conflict between professionally generated medical ethics, including Hippocratic ethics, on the one hand, and the religious and philosophical sources of medical morality, on the other hand. One prominent theme is to challenge the authority of medical professionals as the source of knowledge and articulation of the moral norms of medicine.
Audience: The author, a leading figure in the development of the field of bioethics, meticulously examines different positions and provides an original contribution to the field. The book will appeal both to medical practitioners in general and to those interested in philosophy of medicine in particular.
Features: Through a review of the various professional sources of medical morality, the author challenges the tradition of professional organizations developing binding codes of medical ethics. In contrast, the author considers religious and philosophical traditions as the two main legitimate sources of morality for practitioners of medicine. After a review of the eight contemporary philosophical and religious approaches to bioethics, including those developed by Engelhardt, Beauchamp and Childress, Brody, and himself, the author concludes that the normative theories are convergent in some major respects, and that these points of convergence ought to be normative for professional medical ethics.
Assessment: Though an interesting read, there are a few problems with the author's argument. A main problem in the author's method is the comparison of professional organizations with religion and philosophy as alternative sources of morality. The question of who should articulate the codes of medical ethics seems to be different from the question of sources for the codes. A related problem is the author's insufficient attention to the notion of a profession, which implies a set of shared standards of practice that have both technical and ethical sides. The technical side of the standards, which is the reason for the almost universal tradition of the professional articulation of the codes in different professions, seems to be missed by the author.
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Product Details

  • ISBN-13: 9781589019461
  • Publisher: Georgetown University Press
  • Publication date: 10/15/2012
  • Pages: 256
  • Product dimensions: 5.90 (w) x 9.00 (h) x 0.80 (d)

Meet the Author

Robert M. Veatch is a professor of medical ethics at Georgetown University's Kennedy Institute of Ethics. He is the recipient of a Lifetime Achievement Award from the American Society for Bioethics and the Humanities and a former member of the editorial board of the Journal of the American Medical Association. He is the author or editor of over forty books, including The Basics of Bioethics, Transplantation Ethics, and Patient, Heal Thyself.

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Table of Contents


Introduction: The Hippocratic ProblemEndnotes for Introduction

1. The Hippocratic Oath and the Ethic of HippocratismThe Normative Peculiarities of the Oath The Peculiar Oath of Initiation The Peculiar Code of Ethics Giving Deadly Drugs Abortive Remedies The Virtues of Purity and Holiness The Prohibition on Surgery Abstaining from Sexual Relations with Patients and Patients' Family Members Confidentiality The Concluding BargainThe Metaethical Peculiarities of the Hippocratic Oath The Claim of a Professional Moral Ontology The Claim of a Professional EpistemologyThe Hippocratic Ethic: A Bizarre Ethical TheoryEndnotes for Chapter 1

2. The Hippocratic Tradition: A Sporadic RetreatThe Survival of the Hippocratic Tradition in Ancient and Medieval CultureThe Oath Insofar as a Christian May Swear ItThe Arabic Preservation of Hippocratic EthicsModern Hippocratic Ethics Early Modern Medical Ethics The Eighteenth Century Enlightenment The Rediscovery of Hippocrates in the Nineteenth Century The First American Professional Codes Kappa Lambda and the Discovery of the Hippocratic Oath as a Symbol Many Translations of Hippocrates in 19th century The American Medical Association, 1847 Primum Non Nocere: A Non-Hippocratic Alternative Hippocratism and Its Professional Alternatives in the Twentieth Century Revisions of the AMA Code The British Medical Association The WMA Declaration of Geneva The WMA Declaration of Helsinki, 1962 The Nuremberg CodeEndnotes for Chapter 2

3: The Cacophony of Codes in Medical Schools and Professional AssociationsProblems with Medical School Oath TakingThe Sporadic History of Oath Taking Oath Taking, 1928 Oath Taking, 1958 Oath Taking, 1977 Oath Taking, 1993 Oath Taking, Weill Cornell Medical College, 2005 A Survey of Students at St. George's University School of Medicine in GrenadaThe Implications of Medical School Oath-takingEndnotes for Chapter 3

4: The Limits of Professionally-Generated EthicsThe Strange Requirements of the OathAlternative Professionally-generated EthicsAn Internal Morality for Medicine Lay People Should Be Able to Contribute to a Discussion of What It Means to Heal Using the Medical Profession for Non-medical Purposes Determining What It Means to HealThe Example of Nutrition and HydrationThe Example of Capital PunishmentThe Example of Surrogate MotherhoodConclusionEndnotes for Chapter 4

5. Religious Medical Ethics: Revealed and Natural AlternativesRevealed Religious Truths: An Alternative to Hippocratic Revelation Karl Barth Barth's Defense of His Lectures: "Partner in the Conversation" All Theological Knowledge Is Revealed and Not Natural Knowledge of Ethics Is Theological Knowledge Available Only Through Revelation Examples of Barth's Ethics Applied to Medicine The Isolation of Revealed Ethics Stanley Hauerwas Hauerwas's Reconstruction of Natural Theology Hauerwas's Reliance on Revealed Morality in His Medical Ethics Oral Roberts The Lutheran Tradtion Judaism The Complex Case of Tristram Engelhardt The Implications of Religiously Revealed EthicsNatural Theology and Religious Moral Knowledge Roman Catholic Medical Ethics Philipp Melancthon John Calvin John WesleyEndnotes for Chapter 5

6. Secular Ethics and Professional EthicsThe Role of Reason Immanuel Kant John RawlsExperience and Sense Theories The Scottish Enlightenment Ralph Barton Perry Roderick FirthCommon Morality The Dartmouth Group: Gert, Culver, and Clouser The Kennedy Institute Group National Commission for the Protection of Human SubjectsEndnotes for Chapter 6

7. Fallibilism and the Convergence HypothesisThe Convergence HypothesisFallibilismConvergence Illustrated in Principle-based and Similar Normative Theories Beauchamp/Childress and Gillon Compared with the Belmont Report: Four Principles or Three? Utilitarianism, Libertarianism, and Hippocratic Theory: Single Principle Theories 261 Utilitarianism Libertarianism Edmund Pellegrino's Beneficence-in-Trust Hippocratic Beneficence Tristram Engelhardt's Two-principle Theory Baruch Brody's Five Conflicting Appeals W.D. Ross's Six Prima Facie Duties My Seven- (or Nine-) Principle Theory Unpacking Respect for Persons Differentiating Hippocratic and Social Utility Possibly Two More Principles Gert's Ten Rules: A Single Principle in Disguise? The Criteria for an Acceptable Public Ethic for the ProfessionsThe Council on Europe Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineUniversal Declaration on Human Rights and Its Application to Bioethics The Universal Declaration of Human Rights Universal Declaration on Bioethics and Human Rights The UDBHR Principles Endnotes for Chapter 7

Appendix: Universal Declaration on Bioethics and Human Rights

BibliographyThe Gifford Lectures: History and Previous LecturesThe History of Professional EthicsMedical School Oath-takingReligiously-based Medical Ethics Secular and Philosophical Medical Ethics

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