Biomedical subjects
Publications and source records attributed to D Seedhouse.
It has been said that I am against medical philosophy. This is a misrepresentation of my position. I am against conventional medical ethics teaching as it has to be done in medical schools, but very much in favour of philosophy in medicine.
Bioethicists are increasingly commenting on health care resource allocation, and sometimes suggest ways to solve various rationing dilemmas ethically. I argue that both because of the assumptions bioethicists make about social reality, and because of the methods of argument they use, they cannot possibly make a useful contribution to the debate. Bioethicists who want to make a practical difference should either approach health care resource allocation as if the matter hinged upon tribal competition (which is essentially what it does), or they should do political philosophy in the traditional sense, and examine the health system from the outside.
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Those who would enquire into the relationship between "health conceptions" and "health care consequences" are faced with a formidable task. In order to make this challenge manageable it is necessary to define the scope of the task as precisely as possible. Are we, for instance, faced with a purely theoretical challenge; a task for applied philosophy, or must we employ multi-disciplinary methods? This paper argues that while philosophy has a central clarifying role, inquiry into the relationship between "health conceptions" and "health care organisation" can be done properly only through the combined efforts of several disciplines. Unless we are to be concerned only with abstract models it is essential to take account of the reality of health care situations. Given this it is suggested that the study of "health conceptions" is only a part of a greater task (unless all conceptions are to count as "health conceptions"). What is needed is understanding of the possible and actual purposes of health care, and detailed study of their practical implications.
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There is growing agreement among the medical profession that medical ethics should be taught at undergraduate level. We present a model which can be taught in a way which is lively and entertaining, and which allows students to discuss ethical problems freely in small groups. This brief teaching package maximizes the learning experience. It could be used as part of a more extensive programme of ethics teaching.
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