Ethics and Medical Practice Essay -- Medicine Healthcare

Ethics and Medical Practice Since Alasdair MacIntyre's landmark book, After Virtue, there has been renewed interest in the role of the virtues in the moral life and attention paid to reappropriating the Aristotelian notion of a "practice." (1) Recent reappropriations of the virtues and virtue theory in medical ethics have contributed to conceiving more adequately the nature of good medicine. In this paper, I wish to explore some of these insights and the special relevance the notion of a practice has in an account of good medicine. Yet, I want to suggest, too, that much remains to be done. This renewed attention to the virtues needs to be supplemented by a similar reappropriation and transposition of the notion of nature in order to navigate successfully the Dardanelles of an ahistorical essentialism and the Bosphorus of a historical relativism. (2) Practices are essentially cooperative endeavors. In order to satisfy some need, individuals perform certain acts in the hope of relieving some distress or of attaining some object. Rarely if ever, though, can either be done through one's own efforts alone. When we act, we participate in already expected and agreed upon ways of doing things, and our participation in them is structured in large measure by mutual sets of expectations to which we hold each other accountable. Because it makes possible the attainment of desired goods on a regular basis, this pattern of cooperative human activity is itself a good. For this reason, Bernard Lonergan termed the actual functioning of human institutions a "good of order." (3) While particular goods may satisfy some human want or need, the regular and recurrent enjoyment and the ordering of human action are themselves distinctly valuable. ... ...ysician, and the Ethics of Medicine," p. 246, and Pellegrino and Thomasma, For the Patient's Good, Chapter 9, p. 118. (20) See Lonergan, Method in Theology, Chapter 3, p. 80. (21) See Kai Nielson, "Critique of Pure Virtue: Aniadversions on a Virtue-Based Ethic," in Virtue and Medicine, pp. 133-150. Robert Veatch's criticism is, in part, similar (see his, "Against Virtue: A Deontological Critique of Virtue Theory in Medical Ethics," in Virtue and Medicine, pp. 329-345). If one defines virtue as a praiseworthy habit or characteristic, then it may very well be the case that what is praised is in fact neither good nor right. For this reason, the virtues must be defined not in terms of praise and blame but in terms of the ends of medicine and the good it seeks. (22) Lonergan, Insight, Chapter 18, p. 629.23 See MacIntyre, After Virtue, Chapter 12, p. 139.121