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The dispute over the foundations of medical ethics : teleologism

14 December 2022

Medical ethics is evolving today with the development of bioethics. Although it has distinct historical origins that have developed a medical ethos, the increasingly complex problems associated with the rapid development of modern biotechnology have led many researchers to reflect more broadly on bioethics, protecting both human and natural life from destruction through technocratic conquest and exploitation. The Kennedy Institute of Ethics at Georgetown University in Washington DC had been developing bioethics in the narrower sense, centred around problems of medical ethics, since the 1970s. By analysing the proposals for medical ethics developed there, it is possible to trace the fundamental disputes over its concepts and foundations. These proposals were developed by the founders and staff of the institute, who differed both in their training, their way of thinking and their ideas on how to justify the foundations of such ethics. The reconstruction and confrontation of the two different foundations of medical ethics, i.e. the teleological ethics of the good of the patient and the contractualist ethics of principles, should indicate the direction of its further development. These proposals are in competition with each other, the first one continuing and developing, with quite significant modifications, the medical ethics of Hippocrates, and the second one announcing its ultimate demise. The confrontation of the two positions can thus be instructive. Since some thinkers are too hasty in declaring the end of (their unacceptable) previous proposals for ethics and medical ethics, it is worth looking at what they propose in their place, as it often happens that they get caught up in the same assumptions and philosophical errors that they wanted to overcome.

-fragment of the introduction to the book