The Philosophy of Medicine: On the Ethical Discussion about the Life and the Death
DOI:
https://doi.org/10.57125/FP.2023.12.30.04Keywords:
existentiality of death, value of life, human existence, philosophy, medical and ethical discourseAbstract
The purpose of the article is to highlight the key philosophical cases in the medical and ethical debate on life and death - ontological, axiological and anthropological. For the philosophy of medicine, the concepts of life and health are fundamental dimensions, as they combine elements of nature and human existence. The aim of the article is to differentiate the existential, value and human contexts of philosophy in the medical space. The methodology used in the study is focused mainly on the analytical cluster of general scientific knowledge. The analysis of the literature on the problem of life and death in medical and ethical discourse allowed us to separately group the medical, philosophical and scientific and worldview clusters of this problem. Through generalising and comparative analysis, an attempt is made to unify the problem of life and death in the context of a single philosophical and scientific paradigm. To achieve these objectives, it is advisable to use the principles of interdisciplinarity, which help to bring to a common understanding the various ideas and views on the ethical component of the dichotomy of life and death in medicine. The results of the study indicate that the human-dimensional philosophical component dominates the ontological and axiological components in the modern worldview of human existence. This is the result of the policy of anthropocentrism in its global manifestation and the consequence of the use of a pragmatic approach in the system of human sciences. However, the COVID-19 pandemic, a minor factor by civilisational standards, has managed (albeit for a short period) to reorient the philosophical issues of life and death to existential dimensions. A promising area of research is modelling the situation of a socio-cultural crisis of a global scale in the healthcare system and the readiness of society to re-position the problem of life and death. Thus, the philosophy of medicine clearly structures the problem of life and death in three fundamental cases: ontological, axiological and anthropological, which change their priority in the scientific and philosophical discourse depending on the socio-cultural trends in the development of society and civilisation.
References
Abrams, T., & Abbott, D. (2020). Disability, Deadly Discourse, and Collectivity amid Coronavirus (COVID-19). Scandinavian Journal of Disability Research, 22(1), 168-174. https://doi.org/10.16993/sjdr.732
Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations in end-of-life care. SAGE Open Medicine, 9. https://doi.org/10.1177/20503121211000918
Amundson, R. (2022). Disability, Ideology, and Quality of Life. A Bias in Biomedical Ethics. In Reynolds, J. M., & Wieseler, C. (Eds.), The Disability Bioethics Reader (eBook Pub). Routledge. https://doi.org/10.4324/9781003289487
Arnold, R., & Youngner, S. (2018). The Dead Donor Rule: Should We Stretch It, Bend It, or Abandon It. In Francis, L. P. (Ed.), Death, Dying and the Ending of Life (eBook Pub). Routledge. https://doi.org/10.4324/9781315258447
Arras, J. (2018). The Severely Demented, Minimally Functional Patient: An Ethical Analysis. In Francis, L. P. (Ed.), Death, Dying and the Ending of Life. Routledge. https://doi.org/10.4324/9781315258447
Berwick, D. M. (2020). The Moral Determinants of Health. JAMA, 324(3), 225-226. https://doi.org/10.1001/jama.2020.11129
Bolmsjö, I., Tengland, P.-A., & Rämgård, M. (2019). Existential loneliness: An attempt at an analysis of the concept and the phenomenon. Nursing Ethics, 26(5), 1310-1325. https://doi.org/10.1177/0969733017748480
Boldt, J. (2019). The concept of vulnerability in medical ethics and philosophy. Philosophy, Ethics, and Humanities in Medicine, 14(6). https://doi.org/10.1186/s13010-019-0075-6
Boveiri, H. R., Khayami, R., Javidan, R., & Mehdizadeh, A. (2020). Medical image registration using deep neural networks: A comprehensive review. Computers & Electrical Engineering, 87, 106767. https://doi.org/10.1016/j.compeleceng.2020.106767
Braun, M. (2021). Represent me: please! Towards an ethics of digital twins in medicine. Journal of Medical Ethics, 47, 394-400. https://doi.org/10.1136/medethics-2020-106134
Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: A scoping review and discussion. Nursing Ethics, 28(5), 590-602. https://doi.org/10.1177/0969733020966776
Catita, M., Águas, A. & Morgado, P. (2020). Normality in medicine: a critical review. Philosophy, Ethics, and Humanities in Medicine, 15(3). https://doi.org/10.1186/s13010-020-00087-2
Champney, T. H., Hildebrandt, S., Gareth Jones, D. & Winkelmann, A. (2019). BODIES R US: Ethical Views on the Commercialisation of the Dead in Medical Education and Research. Anatomical Sciences Education, 12, 317-325. https://doi.org/10.1002/ase.1809
Cooter, R. (2020). The Ethical Body. In Cooter, R., & Pickstone, J. (Eds.), Medicine in the Twentieth Century (eBook Pub). Taylor & Francis. https://doi.org/10.4324/9781003078456
De Panfilis, L., Di Leo, S., Peruselli, C, Ghirotto, L., & Tanzi, S. (2019). I go into crisis when ...: Ethics of care and moral dilemmas in palliative care. BMC Palliative Care, 18, 70. https://doi.org/10.1186/s12904-019-0453-2
Dunson III, J, (2020). Stoicism and Contemporary Medical Ethics. In Arenson, K. (Ed.). (2020). The Routledge Handbook of Hellenistic Philosophy (1st ed.). Routledge. https://doi.org/10.4324/9781351168120
Ehni, H.-J., Wiesing, U., & Ranisch, R. (2021). Saving the most lives - A comparison of European triage guidelines in the context of the COVID-19 pandemic. Bioethics, 35, 125-134. https://doi.org/10.1111/bioe.12836
Fei, D. (2020). From the mind isolated with the body to the mind being embodied: Contemporary approaches to the philosophy of the body. Cultures of Science, 3(3), 206-219. https://doi.org/10.1177/2096608320960242
Foley, H., Bugarcic, A., Adams, J., Wardle, J., Leach, M., & Steel, A. (2023). Criteria for the selection, evaluation and application of traditional knowledge in contemporary health practice, education, research and policy: A systematic review. Health Information & Libraries Journal, 40(3), 233-261. https://doi.org/10.1111/hir.12499
Frank, J. R., Taber, S., van Zanten, M., Scheele, F., & Blouin, D. (2020). The role of accreditation in 21st century health professions education: report of an International Consensus Group. BMC Med Education, 20(1). https://doi.org/10.1186/s12909-020-02121-5
Frankish, K. & Sklutová, K. (2022). Illusionism and its place in contemporary philosophy of mind. Human Affairs, 32(3), 300-310. https://doi.org/10.1515/humaff-2022-0023
Fumincelli, L., Mazzo, A., Martins, J. C. A., & Mendes, I. A. C. (2019). Quality of life and ethics: A conceptual analysis. Nursing Ethics, 26(1), 61-70. https://doi.org/10.1177/0969733016689815
Gómez-Vírseda, C., de Maeseneer, Y., & Gastmans, C. (2020). Relational autonomy in end-of-life care ethics: a contextualised approach to real-life complexities. BMC Medical Ethics, 21. https://doi.org/10.1186/s12910-020-00495-1
Gordon, J. S. (2020). Building Moral Robots: Ethical Pitfalls and Challenges. Sci Eng Ethics, 26, 141-157. https://doi.org/10.1007/s11948-019-00084-5
Gudat, H., Ohnsorge, K., Streeck, N., Rehmann-Sutter, C. (2019). How palliative care patients' feelings of being a burden to others can motivate a desire to die. Moral challenges in clinics and families. Bioethics, 33, 421-430. https://doi.org/10.1111/bioe.12590
Hemberg, J., & Bergdahl, E. (2020). Dealing with ethical and existential issues at the end of life through co-creation. Nursing Ethics, 27(4), 1012-1031. https://doi.org/10.1177/0969733019874496
Hildebrandt, S. (2019). The Role of History and Ethics of Anatomy in Medical Education. Anatomical Sciences Education, 12, 425-431. https://doi.org/10.1002/ase.1852
Huda, A. S. (2020). The medical model and its application in mental health. International Review of Psychiatry, 33(5), 463-470. https://doi.org/10.1080/09540261.2020.1845125
Kaczmarek, E. (2019). How to distinguish medicalisation from over-medicalisation? Med Health Care and Philosophy, 22, 119-128. https://doi.org/10.1007/s11019-018-9850-1
Kaufman, S., & Morgan, L. (2023). The Anthropology of the Beginnings and Ends of Life. In Helman, C. G. (Ed.), Medical Anthropology (eBook Pub). Routledge. https://doi.org/10.4324/9781315249360
Kooli, C. (2021). COVID-19: Public health issues and ethical dilemmas. Ethics, Medicine and Public Health, 17, 100635. https://doi.org/10.1016/j.jemep.2021.100635
Levin, M. (2021). Life, death, and self: Fundamental questions of primitive cognition viewed through the lens of body plasticity and synthetic organisms. Biochemical and Biophysical Research Communications, 564, 114-133. https://doi.org/10.1016/j.bbrc.2020.10.077
Macedo, J. C. (2022). Ethical and Legal Issues in End-of-life Care: The Case of Life Prolongation. Research Developments in Arts and Social Studies, 6, 119-132. https://doi.org/10.9734/bpi/rdass/v6/3309B.
Marseille, E., & Kahn, J. G. (2019). Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philosophy. Ethics, and Humanities in Medicine, 14(5). https://doi.org/10.1186/s13010-019-0074-7
Menatti, L., Bich, L., & Saborido, C. (2022). Health and environment from adaptation to adaptability: a situated relational account. HPLS, 44. https://doi.org/10.1007/s40656-022-00515-w
Naik, N., Hameed, B. M. Z., Shetty, D. K., Swain, D., Shah, M., Paul, R., Aggarwal, K., Ibrahim, S., Patil, V., Smriti, K., Shetty, S., Rai, B. P., Chlosta, P., & Somani, B. K. (2022). Legal and Ethical Consideration in Artificial Intelligence in Healthcare: Who Takes Responsibility? Front. Surgery, 9, 862322. https://doi.org/10.3389/fsurg.2022.862322
Nerubasska, A., Palshkov, K., & Maksymchuk, B. (2020). A Systemic Philosophical Analysis of the Contemporary Society and the Human: New Potential. Postmodern Openings, 11(4), 275-292. https://doi.org/10.18662/po/11.4/235
Nordmann, A. (2020). If and Then: A Critique of Speculative NanoEthics. In Maynard, A., & Stilgoe, J. (Eds.), The Ethics of Nanotechnology, Geoengineering, and Clean Energy (eBook Pub). Routledge. https://doi.org/10.4324/9781003075028
Orentlicher, D. (2021). Matters of Life and Death: Making Moral Theory Work in Medical Ethics and the Law. New Jersey: Princeton University Press. 248. Retrieved from: https://ssrn.com/abstract=298203.
O'Sullivan, S., Nevejans, N., Allen, C., Blyth, A., Leonard, S., Pagallo, U., Holzinger, C., Holzinger, A., Sajid, M. I., & Ashrafian, M. (2019). Legal, regulatory, and ethical frameworks for the development of standards in artificial intelligence (AI) and autonomous robotic surgery. Int J Med Robotics Comput Assist Surgery, 15, e1968. https://doi.org/10.1002/rcs.1968
Roberts, P. (2020). Philosophy, Death, and Education. Oxford Research Encyclopedia of Education. Retrieved from: https://oxfordre.com/education/view/10.1093/acrefore/9780190264093.001.0001/acrefore-9780190264093-e-1271
Sabatello, M., Blankmeyer Burke, T., McDonald, K., & Appelbaum, P. (2020). Disability, Ethics, and Health Care in the COVID-19 Pandemic. American Journal of Public Health, 110(10), 1523-1527. https://doi.org/10.2105/AJPH.2020.305837
Sebring, J. C. H. (2021). Towards a sociological understanding of medical gaslighting in western health care. Sociology of Health & Illness, 43, 1951-1964. https://doi.org/10.1111/1467-9566.13367
Singer, P. (2023). Ethics in the Real World: 90 Essays on Things That Matter - A Fully Updated and Expanded Edition. Princeton: Princeton University Press. https://doi.org/10.1515/9780691237886
Svenaeus, F. (2022). The Hermeneutics of Medicine and the Phenomenology of Health. Springer Cham. 171. https://doi.org/10.1007/978-3-031-07281-9
Ursin, L. (2019). Withholding and Withdrawing Life-Sustaining Treatment: Ethically Equivalent? The American Journal of Bioethics, 19(3), 10-20. https://doi.org/10.1080/15265161.2018.1561961
Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Med Princ Pract. 30(1), 17-28. https://doi.org/10.1159/000509119
Vinson, A. H., & Underman, K. (2020). Clinical empathy as emotional labour in medical work. Social Science & Medicine, 251, 112904. https://doi.org/10.1016/j.socscimed.2020.112904
Wadmann, S. (2023). Disease classification: A framework for analysing contemporary developments in precision medicine. SSM - Qualitative Research in Health, 3, 100217. https://doi.org/10.1016/j.ssmqr.2023.100217
Xafis, V., Schaefer, G., Labude, M., Markus, K., Zhu, Y., & Yan Hsu, L. (2020). The Perfect Moral Storm: Diverse Ethical Considerations in the COVID-19 Pandemic. ABR, 12, 65-83. https://doi.org/10.1007/s41649-020-00125-3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 authors

This work is licensed under a Creative Commons Attribution 4.0 International License.
