ABSTRACT
Anne Barnhill and Franklin Miller dispute my claim that the prescriptions of placebo treatments to patients are not typically deceptive, and do not typically violate the patients' informed consent. However, Barnhill and Miller seriously mischaracterise my position in two ways, as well as failing to show that the procedure I discuss requires a physician to act wrongfully in deceiving her patient. Accordingly, I find their argument unpersuasive.
Subject(s)
Disclosure , Personal Autonomy , Female , Humans , Informed Consent , Paternalism , Physician-Patient RelationsABSTRACT
It is widely supposed that the prescription of placebo treatments to patients for therapeutic purposes is ethically problematic on the grounds that the patient cannot give informed consent to the treatment, and is therefore deceived by the physician. This claim, I argue, rests on two confusions: one concerning the meaning of 'informed consent' and its relation to the information available to the patient, and another concerning the relation of body and mind. Taken together, these errors lead naturally to the conclusion that the prescription of placebos to unwitting patients is unethical. Once they are dispelled, I argue, we can see that providing 'full' information against a background of metaphysical confusion may make a patient less informed and that the 'therapeutic' goal of relieving the patient of such confusions is properly the duty of the philosopher rather than the physician. Therapeutic placebos therefore do not violate the patient's informed consent or the ethical duties of the doctor.
Subject(s)
Disclosure/ethics , Informed Consent/ethics , Physician-Patient Relations/ethics , Placebos , Ethical Theory , Humans , Informed Consent/psychology , Moral Obligations , Personal Autonomy , Placebos/therapeutic useABSTRACT
Politics and science, it is customarily and broadly assumed, should not mix. I investigate a purported "new mental illness" arising from psychological stress associated with environmental damage. Previous assessments have concluded that the diagnosis of "solastalgia", which is clearly intended to advance a political agenda, may thereby lack scientific validity. Building on work by Ian Hacking and Nelson Goodman, and drawing comparisons with the history of "political medicine"--in particular, the scientific study of Child Abuse and Sudden Infant Death Syndrome--I argue that the political consequences of such a diagnosis may plausibly help to justify it as a distinct objective scientific kind, by demarcating it from alternative classifications. That science should be objective, then, does not require that it be politically neutral.
Subject(s)
Child Abuse , Environmental Illness , Mental Disorders , Politics , Science , Stress, Psychological , Sudden Infant Death , Child , Environment , Humans , Infant, NewbornABSTRACT
In this paper, I explore the links between liberal political theory and the evaluative nature of medical classification, arguing for stronger recognition of those links in a liberal model of medical practice. All judgments of medical or psychiatric "dysfunction," I argue, are fundamentally evaluative, reflecting our collective willingness or reluctance to tolerate and/or accommodate the conditions in question. Illness, then, is "socially constructed." But the relativist worries that this loaded phrase evokes are unfounded; patients, doctors, and communities will agree in the vast majority of cases about what counts as illness. Where they cannot come to agreement, however, we are faced with precisely the sort of dispute about values and ways of life that the institutions of the liberal state are designed to accommodate. I accordingly sketch a model of medical practice, based loosely on Jürgen Habermas's political theories, designed to maximize both our awareness and our understanding of these disputes.
Subject(s)
Disease/classification , Judgment , Mental Disorders/classification , Politics , Social Environment , Deafness/diagnosis , Depression/diagnosis , Ethical Analysis , Homosexuality/classification , Humans , Paternalism , Philosophy, Medical , PrejudiceABSTRACT
Can biological facts explain human morality? Aristotelian 'virtue' ethics has traditionally assumed so. In recent years Alasdair MacIntyre has reintroduced a form of Aristotle's 'metaphysical biology' into his ethics. He argues that the ethological study of dependence and rationality in other species--dolphins in particular--sheds light on how those same traits in the typical lives of humans give rise to the moral virtues. However, some goal-oriented dolphin behaviour appears both dependent and rational in the precise manner which impresses MacIntyre, yet anything but ethically 'virtuous'. More damningly, dolphin ethologists consistently refuse to evaluate such behaviour in the manner MacIntyre claims is appropriate to moral judgement. In light of this, I argue that virtues--insofar as they name a biological or ethological category--do not name a morally significant one.
