Standard bioethics textbooks present the field to students and non-experts as a form of "applied ethics." This ahistoric and rationalistic presentation is similar to that used in philosophy of science textbooks until three decades ago. Thomas Kuhn famously critiqued this self-conception of the philosophy of science, persuading the field that it would become deeper, richer, and more philosophical, if it integrated the history of science, especially the history of scientific change, into its self-conception. This essay urges a similar reconceptualization for bioethics, arguing that the analysis of moral change ought to be integral to bioethics (and to ethics generally). It proceeds by suggesting the sterility of the ahistoric, rationalist applied ethics model of bioethics embraced by standard bioethics textbooks. It also suggests the fecundity of alternative conceptions of the bioethics that focus on the history of successful and failed attempts to negotiate moral change, and the history of multifaceted relations between moral philosophy and practical ethics.

Bioethics and History

The Discourses of European Practitioners in the Tradition of the Hippocratic Texts

INTRODUCTION The word, “bioethics,” was fashioned in 1970 by a biological scientist, Van Rensselaer Potter, to name his vision of a new conjunction of scientific knowledge and moral appreciation of the converging evolutionary understanding of humans in nature (Potter 1970). Hardly had the word been uttered by its author than it was appropriated to identify a related but much narrower vision: the ethical analysis of a range of moral questions posed to medical practice by the advances in the biomedical sciences and technologies. In 1971, the Kennedy Institute of Ethics was founded at Georgetown University to pioneer the development of a new field of joint research that its the Institute's founder, Andre Hellegers (1911–1979), chose to call “bioethics,” Warren Reich of the Institute began to plan The Encyclopedia of Bioethics in 1972, in which he defined bioethics as “the study of the ethical dimensions of medicine and the biological sciences” (Reich 1978, ⅹⅸ–ⅹⅹ; Reich 1995a). In 1974, Daniel Callahan, who founded the other major research institute in this new field, The Hastings Center, wrote an influential article entitled, “Bioethics as a Discipline” in which he suggested that this new field could develop itself into a unique discipline, using both the traditional methods of philosophical analysis and sensitivity to human emotion and to social and political influences with which medicine was practiced (Callahan 1973). This emerging discipline should be designed to serve those who were faced with the crucial decisions that arise within medicine.

The Discourses of Bioethics in the United States

INTRODUCTION This chapter's title is an interrogative: “What is the history of medical ethics?” Readers perusing the table of contents might be prompted to ask precisely this question. The expected chronological account seems hidden behind a facade of unfamiliar rhetoric about discourses, life cycles, and society. Our approach reflects a new era of scholarship on the history of medical ethics. Because readers may not be cognizant of the new scholarship, we introduce this volume with a chapter exploring the history of the history of medical ethics and the reasons why scholars have begun to take new approaches to the subject. HOW OLD IS “MEDICAL ETHICS”? Histories have to begin somewhere. The expression “medical ethics” was not coined until 1803, when Thomas Percival (1740–1804), a physician from Manchester, England, introduced it in his eponymous book Medical Ethics (Percival 1803b) as a description of the professional duties of physicians and surgeons to their patients, to their fellow practitioners, and to the public (see Chapters 18 and 36). As Percival was the first person to use the expression medical ethics, there is a sense in which the history of something designated medical ethics cannot predate 1803. Most historians, however, treat the history of medical ethics as coextensive with the history of medicine. They presume that it does not matter when the expression medical ethics was coined. As Juliet famously remarked, “What's in a name? A rose by any other name would smell as sweet.”

What is the History of Medical Ethics

The Discourses of Bioethics in the United Kingdom

Eighteenth century literature contains critiques of physicians' behavior, as for example in Goethe's Faust. These critiques aim at the physicians' therapeutical incapacity which they try to compensate with a behavioral code called "savoir faire". This paper compares the critiques with the advices of medical authors given to their younger colleagues in the "savoir faire" literature. These sources often discuss, how to hide doubts, how to maintain the authority over the patients or to prevent complaints of malpractice. Obviously, physicians often didn't trust in their therapeutical proficiency and tried to bind their patients by inspiring a behavior of confidence, independent of the question of the real effectiveness of their treatments.

[The behavioral code of "savoir faire" as a cover for physician helplessness? A contribution to the physician-patient relationship of the 18th century].

Ritzmann I

Papers

[The behavioral code of "savoir faire" as a cover for physician helplessness? A contribution to the physician-patient relationship of the 18th century].