When I was asked to contribute an essay in honor of the 150th volume in the Philosophy and Medicine series, I asked myself, what could a philosopher and clinical ethicist who has spent most of her time teaching undergraduate biomedical ethics say that could contribute to discussions? Ah, herein is the start of an essay. In this essay, and in honor of the Philosophy and Medicine series’ 150th volume and 50th anniversary in publishing, I share what I say to my (...) students in the classroom: there is a need for continued dialogue on the mutual dependence of biomedical ethics and philosophy of medicine within a global context. In what follows, I illustrate this mutual dependence of philosophy of medicine and biomedical ethics that is heralded in volumes in the Philosophy and Medicine series. I then illustrate this mutual dependence in discussions of philosophy of disease, a focus of my work for over three-plus decades now. As we celebrate the contributions of the Philosophy and Medicine series, we are reminded of its deep roots and lasting legacy in the literature. (shrink)

This book explores the ethical implications of managing uncertainty in clinical decision-making during the COVID-19 pandemic. It develops an ethics of clinical uncertainty that brings together insights from the clinical and biomedical ethical literatures. The book sets out to recognize the central role uncertainty plays in clinical decision-making and to acknowledge the different levels, kinds, and dimensions of clinical uncertainty. It also aims to aid clinicians and patients in managing clinical uncertainty, and to recognize the ethical duty they have to (...) manage clinical uncertainty. The book addresses four ethical duties related to clinical uncertainty: (1) the duty to advance the welfare of those in clinical medicine, (2) to respect the rights of those in clinical medicine, (3) to promote just access to health care, and (4) to care for one another in clinical medicine. These duties took on select urgency during the COVID-19 pandemic because clinical risk assessments about COVID-19 were limited, we were asked to give informed consent in the context of limited and changing knowledge, the pandemic unearthed myriad problems about the distribution of health care, and the pandemic raised questions about how we care for each other in medicine. An Ethics of Clinical Uncertainty will appeal to scholars, advanced students, and medical professionals working in philosophy of medicine, biomedical ethics, clinical medicine, nursing, public health care, and gerontology. (shrink)

In this essay, and in his honor, I focus on two of physician-philosopher H. Tristram Engelhardt, Jr.’s many contributions, namely, his view that biomedical ethics cannot offer a singular content-driven theoretical approach and requires an appreciation of epistemologies of knowing in medicine. While these two positions remain controversial, because we all want definitive answers to our questions concerning what we ought to do in medicine and elsewhere, Dr. Engelhardt’s view makes possible discussion and debate in medicine to include diverse, defensible (...) ways of knowing. In the end, Dr. Engelhardt’s approach in biomedical ethics is one of shared decision making and negotiation. This is an important model if we take respect for patients seriously in the clinical setting. (shrink)

The classification of clinical problems, such as AIDS, requires choices. Choices are made on epistemic (i.e., knowledge-based) and non-epistemic (i.e., action-based) grounds. That is, the ways in which we classify clinical problems, such as AIDS, involve a balancing of different understandings of clinical reality and of clinical values among participants of the clinical community. On this view, the interplay between epistemic and non-epistemic interests occurs within the embrace of particular clinical contexts.The ways in which we classify AIDS is the topic (...) of this paper. We consider the extent to which we construct clinical reality; we examine a suggested classification of AIDS; and we conclude suggesting that the choice regarding how to classify AIDS is the result of negotiation among participants in the clinical community. (shrink)

Our understanding of gender carries significant bioethical implications. An errant account of gender-specific disease can lead to overgeneralizations, undergeneralizations, and misdiagnoses. It can also lead to problems in the structure of health-care delivery, the creation of policy, and the development of clinical curricula. In this volume, Cutter argues that gender-specific disease and related bioethical discourses are philosophically integrative. Gender-specific disease is integrative because the descriptive roles of gender, disease, and their relation are inextricably tied to their prescriptive roles within frames (...) of reference. An integrative account of gender-specific disease carries ethical implications because our understanding of gender-specific disease is evaluative, and our evaluations of gender-specific disease entail judgments concerning the praiseworthiness and blameworthiness of a clinical event. Cutter supports a "both/and" emphasis on context and integration in relation to gender-specific disease and bioethical analyses. While the text mainly focuses on gender-specific diseases that affect women, Cutter also includes examples involving men, children, and members of the LGBT community. (shrink)

Thinking Through Breast Cancer is a philosophical analysis of breast cancer inspired by the author's journey as a breast cancer patient. It sets out to show the relevancy of philosophical thinking in medicine today and shares advice about how to navigate the uncertainty of breast cancer diagnosis, treatment, and survival.

Ethical choices in Contemporary Medicine rejects the standard medical ethics model of "rights" language and shows that the bioethical problems that receive attention from the media and public are explicable in terms of the epistemological foundations of science and medicine... The authors examine present concerns about medicine in terms of cultural context and suggest that, given the conflicting frameworks, agendas, and attitudes, it may be necessary to go beyond rational, parochial, ethical dialogue. They show that two interrelated issues surface in (...) evaluations of medicine: on the one hand, there is a strong critique of science and the privileges associated with scientific discourse; on the other, there is a deep-seated quest for certainty in all medical matters. (shrink)