The Internal Morality of Medicine: A Matter of Faith

Abstract

AbstractTo seek an answer to the question of the presence or absence of an internalized morality for the medical profession is to search for a reason for its existence. To what end does it serve? The ancient Greeks categorized man’s actions into two basic classes, production (“poiesis”) and practice (“praxis”). The former is value neutral and consequential. It is judged by its product; its means of achieving that end are instrumental. Practice, however, is deontological or morally obliged to the actions of the practice itself as its end. In medicine, that end is the good of the patient. The commoditization of medicine is poiesis, but the professionalism of medicine is praxis. The latter is dependent upon the presence of an internal morality based upon the ancient concepts of humanitas and misericordia. Chief among its defenders is Dr. Edmund Pellegrino. His work is complemented by the thoughts of other contemporary theorists including Brody and Miller, Arras, and MacIntyre. All respect the primacy of the doctor-patient relationship and the Aristotelean concept of virtues. The internal locus of medicine’s morality, however, is not universally accepted. The theologically based opinion of its primary castigator, Professor Robert Veatch, is reviewed and critiqued as well.