Is Rorty's neopragmatism the "real" foundation of medical ethics: a search for foundational principles. 2006

William T Branch
Emory University School of Medicine, 1525 Clifton Road, Atlanta, Georgia 30322, USA. William.branch@emoryhealthcare.org

Principlism, the predominate approach to bioethics, has no foundational principles. This absence of foundations reflects the general intellectual climate of postmodern relativism. Even America's foremost public philosopher, Richard Rorty, whose pragmatism might suggest a philosophy of commonsense, seems to be swimming in the postmodern swamp. Alternatively, principlism's architects, Beauchamp and Childress, suggest a constantly evolving reflective equilibrium with some basis in common morality as a workable framework for twenty-first century bioethics. The flaw in their approach is failure to conform to real doctors' and patients' experiences. Real doctors adopt a scientific paradigm that assumes an objective reality. Patients experience real suffering and seek effective cures, treatments, palliation and solace. The foundation of medical ethics should be that doctors altruistically respond to their patients' suffering using scientifically acceptable modalities. Compassion, caring, and respect for human dignity are needed as guides in addition to justice, beneficence, nonmaleficence and respect for autonomy.

UI MeSH Term Description Entries
D010686 Philosophy, Medical The underlying rationale or theoretical basis for the principles of MEDICINE. Medical Philosophy
D004992 Ethics, Medical The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families. Medical Ethics
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D049673 History, 20th Century Time period from 1901 through 2000 of the common era. 20th Century History,20th Cent. History (Medicine),20th Cent. History of Medicine,20th Cent. Medicine,Historical Events, 20th Century,History of Medicine, 20th Cent.,History, Twentieth Century,Medical History, 20th Cent.,Medicine, 20th Cent.,20th Cent. Histories (Medicine),20th Century Histories,Cent. Histories, 20th (Medicine),Cent. History, 20th (Medicine),Century Histories, 20th,Century Histories, Twentieth,Century History, 20th,Century History, Twentieth,Histories, 20th Cent. (Medicine),Histories, 20th Century,Histories, Twentieth Century,History, 20th Cent. (Medicine),Twentieth Century Histories,Twentieth Century History
D049674 History, 21st Century Time period from 2001 through 2100 of the common era. 21st Century History,21st Cent. History (Medicine),21st Cent. History of Medicine,21st Cent. Medicine,Historical Events, 21st Century,History of Medicine, 21st Cent.,History, Twenty-first Century,Medical History, 21st Cent.,Medicine, 21st Cent.,21st Cent. Histories (Medicine),21st Cent. Medicines,21st Century Histories,Cent. Histories, 21st (Medicine),Cent. History, 21st (Medicine),Cent. Medicine, 21st,Cent. Medicines, 21st,Century Histories, 21st,Century Histories, Twenty-first,Century History, 21st,Century History, Twenty-first,Histories, 21st Cent. (Medicine),Histories, 21st Century,Histories, Twenty-first Century,History, 21st Cent. (Medicine),History, Twenty first Century,Medicines, 21st Cent.,Twenty-first Century Histories,Twenty-first Century History
D028781 Ethical Relativism The philosophical view that conceptions of truth and moral values are not absolute but are relative to the persons or groups holding them. (from American Heritage Dictionary of the English Language, 4th ed) Relativism, Ethical

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