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Medical Ethics: Professional or Universal?

Published online by Cambridge University Press:  10 June 2011

Robert M. Veatch
Robert M. Veatch
Affiliation:
Institute of Society, Ethics and the Life Sciences, Hastings on Hudson, New York 10706
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Extract

From the first, professional ethics has been a hybrid. The Hippocratic Oath exudes that ambiguity. The scientific enterprise, which basically has universalistic tendencies, created a group with special knowledge and interests; eventually it took on a separate identity as a profession. Concern for the ethical point of view, which has the universalizability of normative statements as its foundation, is particularized by focusing on a specialized body of knowledge of a restricted professional group.

Type
Research Article
Information
Harvard Theological Review , Volume 65 , Issue 4 , October 1972 , pp. 531 - 559
Copyright
Copyright © President and Fellows of Harvard College 1972

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References

1 Hippocrates, , The Sacred Disease, Jones, W. H. S., ed., II (London: Heineman, 1923–1931), 139.Google Scholar

2 Edelstein, Ludwig, The Hippocratic Oath: Text, Translation and Interpretation, in Ancient Medicine (Baltimore: Johns Hopkins Press, 1967), 17–20.Google Scholar

3 Weber, Max, Science as a Vocation, in Gerth, H. H. and Mills, C. Wright, eds., From Max Weber (New York: Oxford Press, 1958), 129–56.Google Scholar

4 Paul Ellwood, quoted in The Health Maintenance Concept in a Nutshell, Medical World News, Nov. 6, 1970, p. 32E.

5 For a fuller discussion see Robert M. Veatch, Value Freedom in Science and Technology (unpublished dissertation, Harvard University, 1971), especially 173–87.

6 I am not suggesting that the philosophical debate over the nature of the “system of evaluation” is closed. One very important and plausible position, known as philosophical empiricism or naturalism, holds that the system of evaluation itself may have an empirical basis, being rooted in “moral facts.” See Perry, Ralph Barton, The General Theory of Value (Cambridge, Mass.: Harvard University Press, 1926)Google Scholar ; Broad, C. O., Is Goodness the Name of a Simple, Non-Natural Quality, Proceedings of the Aristotelian Society, 34 (1933–34), 249–68CrossRefGoogle Scholar; and Firth, Roderick, Ethical Absolutism and the Ideal Observer, Philosophy and Phenomenological Research, 12 (1952), 317–45, for various examples.CrossRefGoogle Scholar

7 There are empirical data suggesting that physicians as a group show more anxiety about death than their patients do. See Feifel, Herman, Hanson, Susan, Jones, Robert, and Edwards, Lauri, Physicians Consider Death,Proceedings, 75th Annual Convention, American Psychological Association(1967),201–02.Google Scholar

8 Euthanasia, Lord Brock, Proceedings of the Royal Society of Medicine, 63 (July, 1970), 662.Google Scholar

9 See Ross, W. D., The Right and the Good (Oxford: Clarendon Press, 1930), 21.Google Scholar

10 Parsons, Talcott, The Social System (Glencoe: The Free Press, 1951), 434Google Scholar. In Parsons' rather obscure language a universalistic pattern of values is one in which “the standard is derived from the validity of a set of existential ideas, on the generality of a normative rule,” while particularistic standards are characterized prinby the “particularity of the cathectic significance of an object or the status of the object in a relational system” (p. 62).

11 Sumner, William Graham, Folkways (New York: Dover, 1959 [1906]).Google Scholar

12 Parsons, Talcott, Research with Human Subjects and the “Professional Complex,” in Daedalus (Spring, 1969), 329.Google Scholar

13 Goldzieher, Joseph W., et al. , A Placebo-Controlled Double-Blind Crossover Investigation of the Side Effects Attributed to Oral Contraceptives, Fertility and Sterility, 22 (September, 1971), 609–23.CrossRefGoogle ScholarPubMed

14 Veatch, Robert M., “Experimental” Pregnancy, Hastings Center Report, I (June, 1971), 2.CrossRefGoogle Scholar

15 Gaylin, Willard, What's an FBI Poster Doing in a Nice Journal Like That? Hastings Center Report, II (April, 1972), 1–3.Google Scholar

16 A review of the entire case has been published by Cain, Leonard D. Jr., The AMA and the Gerontologists: Uses and Abuses of “A Profile of the Aging: U.S.A.,” in Ethics, Politics, and Social Research, Sjoberg, Gideon, ed. (Cambridge, Mass.: Schenkman Publishing Company, Inc., 1967), 78–114Google Scholar. The account given here is based on this article. The paper was published as A Profile of the Aging: U.S.A., Geriatrics (July, 1961), 336–42.

17 A new code of ethics and rules of procedure has recently been developed for the American Sociological Association. The rules took effect Sept. 1, 1971. Their effect remains to be determined.

18 See Langer, Elinor, Human Experimentation: Cancer Studies at Sloan-Kettering Stir Public Debate on Medical Ethics, Science, 143 (1964), 551–53CrossRefGoogle ScholarPubMed; and Human Experimentation, New York Verdict Affirms Patient's Rights, Science, 151 (1966), 663–66.CrossRefGoogle Scholar

19 Langer, Human Experimentation, New York Verdict, 663.

20 Chester M. Southam, Alice E. Moore, and Cornelius P. Rhoads, Science (Jan. 25, 1957), 158–60. To my knowledge the ethical implications of experimenting with prisoners even with consent based on a high degree of information was not an issue. On the subject see Beecher, Henry K., Research and the Individual: Human Studies (Boston: Little, Brown and Company, 1970), especially 69–78.Google Scholar

21 General Medical Council: Disciplinary Committee, British Medical Journal (March 13, 1971), 73; (March 20, 1971), 75–80; (March 27, 1971), 81–82; (April 3, 1971), 4–6.

22 Ibid., (March 20, 1971), 80.

23 The mechanisms discussed here are taken from a list presented by Talcott Parsons in Research with Human Subjects and the “Professional Complex,” Daedalus (Spring, 1969), 325–60.