The eighteenth century is commonly thought of as the “age of reason”, an age in which the imagina... more The eighteenth century is commonly thought of as the “age of reason”, an age in which the imagination was not given a central role in the arts, far less in science. But in Hume's attempts to account for our belief in a continuing external world he is forced into invoking the activity of the ...
This article aims to engender discussion about the nature and future of medical humanities. First... more This article aims to engender discussion about the nature and future of medical humanities. First, a normative personal vision of medical humanities as an inclusive movement is outlined. Some of the problems that may emerge if medical humanities conceives itself ...
Supererogation can be distinguished from altruism, in that the former is located in the category ... more Supererogation can be distinguished from altruism, in that the former is located in the category of duty but exceeds the strict requirements of duty, whereas altruism belongs to a different moral category from duty. It follows that doctors do not act altruistically in their professional roles. ...
In an editorial (1) Dr Gillon looks at some recent difficulties which have been raised about phil... more In an editorial (1) Dr Gillon looks at some recent difficulties which have been raised about philosophy and the teaching of health care ethics. This matter is of sufficient importance to the readers of this journal that it is worth looking at it again, this time in an historical perspective. One ...
... Issue. Journal of Philosophy of Education. Volume 24, Issue 2, pages 147–159, December 1990. ... more ... Issue. Journal of Philosophy of Education. Volume 24, Issue 2, pages 147–159, December 1990. Additional Information. How to Cite. ... Journal of Philosophy of Education, 24: 147–159. doi: 10.1111/j.1467-9752.1990.tb00230.x. Publication History. ...
ABSTRACT – One of the aims of both postgrad-uate and undergraduate medical education is to help d... more ABSTRACT – One of the aims of both postgrad-uate and undergraduate medical education is to help doctors to think for themselves, or to have minds of their own, in the complex process of interpreting evidence and adapting it to fit indi-vidual patients. But phrases such as ' ...
Although at risk of falling into the category of one of Foster's 'turbulent pri... more Although at risk of falling into the category of one of Foster's 'turbulent priests'(at ix), it is clear that this is an important addition to the ongoing ethical, as well as medico-legal debate regarding autonomy. Its significance may be lent further import, given the continuing ...
A medical view on 'the value of life' can be inferred from medical accounts of th... more A medical view on 'the value of life' can be inferred from medical accounts of the quality of life: a life has value if it embodies certain qualities. Scales have been developed to quantify quality of life. While the term 'quality of life', is used frequently in everyday discourse, perceptions of what it might actually mean differ greatly and are often incompatible. This incompatibility can be illustrated through an examination and development of the Greek myth of Sisyphus. The different models that the author explores rest on 'significant toil', 'choice', 'happiness or well-being', or 'social factors' being the prerequisite for quality of existence. These models are incommensurable and, as intangible concepts, cannot be quantified. Decision-making in medicine does not require a complex evaluation of quality of life: it consists of the doctor's offer of treatment based on the best evidence, and the patient's consent to, or refusal of, that offer. Apart from the need to obtain consent, the main ethical constraint on the doctor is equity.
Patient choice is becoming the centre of health policy in the UK and other countries. But there i... more Patient choice is becoming the centre of health policy in the UK and other countries. But there is ambiguity about what choice means. As the term is used in everyday life, choice is the foundation of the doctrine of patient consent. The doctor is responsible for choosing appropriate treatment, and the patient is responsible for choosing (for consenting to or refusing) what is offered and accepts responsibility for that choice. That simple and ethically acceptable doctrine is being replaced politically by consumerist choice. But consumerism in healthcare is incompatible with a publicly funded service. Moreover, consumerism changes the locus of responsibility from the doctor to the consumer (the patient). The doctor will cease to have the values of a professional and will become simply an agent of the patient's demands.
It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were ... more It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were legalised doctors must be essentially involved in the whole process including prescribing the medication and (in euthanasia) administering it. This paper explores some reasons for this assumption and argues that it flatly contradicts what it means to be a doctor. The paper is thus not mainly concerned with the ethics of AS/VE but rather with the concept of a doctor that has evolved since the time of Hippocrates to current professional guidance reflected in healthcare law. The paper argues that the most common recent argument for AS/VE--that patients have a right to control when and how they die--in fact points to the involvement not of doctors but of legal agencies as decision makers plus technicians as agents.
The eighteenth century is commonly thought of as the “age of reason”, an age in which the imagina... more The eighteenth century is commonly thought of as the “age of reason”, an age in which the imagination was not given a central role in the arts, far less in science. But in Hume's attempts to account for our belief in a continuing external world he is forced into invoking the activity of the ...
This article aims to engender discussion about the nature and future of medical humanities. First... more This article aims to engender discussion about the nature and future of medical humanities. First, a normative personal vision of medical humanities as an inclusive movement is outlined. Some of the problems that may emerge if medical humanities conceives itself ...
Supererogation can be distinguished from altruism, in that the former is located in the category ... more Supererogation can be distinguished from altruism, in that the former is located in the category of duty but exceeds the strict requirements of duty, whereas altruism belongs to a different moral category from duty. It follows that doctors do not act altruistically in their professional roles. ...
In an editorial (1) Dr Gillon looks at some recent difficulties which have been raised about phil... more In an editorial (1) Dr Gillon looks at some recent difficulties which have been raised about philosophy and the teaching of health care ethics. This matter is of sufficient importance to the readers of this journal that it is worth looking at it again, this time in an historical perspective. One ...
... Issue. Journal of Philosophy of Education. Volume 24, Issue 2, pages 147–159, December 1990. ... more ... Issue. Journal of Philosophy of Education. Volume 24, Issue 2, pages 147–159, December 1990. Additional Information. How to Cite. ... Journal of Philosophy of Education, 24: 147–159. doi: 10.1111/j.1467-9752.1990.tb00230.x. Publication History. ...
ABSTRACT – One of the aims of both postgrad-uate and undergraduate medical education is to help d... more ABSTRACT – One of the aims of both postgrad-uate and undergraduate medical education is to help doctors to think for themselves, or to have minds of their own, in the complex process of interpreting evidence and adapting it to fit indi-vidual patients. But phrases such as ' ...
Although at risk of falling into the category of one of Foster's 'turbulent pri... more Although at risk of falling into the category of one of Foster's 'turbulent priests'(at ix), it is clear that this is an important addition to the ongoing ethical, as well as medico-legal debate regarding autonomy. Its significance may be lent further import, given the continuing ...
A medical view on 'the value of life' can be inferred from medical accounts of th... more A medical view on 'the value of life' can be inferred from medical accounts of the quality of life: a life has value if it embodies certain qualities. Scales have been developed to quantify quality of life. While the term 'quality of life', is used frequently in everyday discourse, perceptions of what it might actually mean differ greatly and are often incompatible. This incompatibility can be illustrated through an examination and development of the Greek myth of Sisyphus. The different models that the author explores rest on 'significant toil', 'choice', 'happiness or well-being', or 'social factors' being the prerequisite for quality of existence. These models are incommensurable and, as intangible concepts, cannot be quantified. Decision-making in medicine does not require a complex evaluation of quality of life: it consists of the doctor's offer of treatment based on the best evidence, and the patient's consent to, or refusal of, that offer. Apart from the need to obtain consent, the main ethical constraint on the doctor is equity.
Patient choice is becoming the centre of health policy in the UK and other countries. But there i... more Patient choice is becoming the centre of health policy in the UK and other countries. But there is ambiguity about what choice means. As the term is used in everyday life, choice is the foundation of the doctrine of patient consent. The doctor is responsible for choosing appropriate treatment, and the patient is responsible for choosing (for consenting to or refusing) what is offered and accepts responsibility for that choice. That simple and ethically acceptable doctrine is being replaced politically by consumerist choice. But consumerism in healthcare is incompatible with a publicly funded service. Moreover, consumerism changes the locus of responsibility from the doctor to the consumer (the patient). The doctor will cease to have the values of a professional and will become simply an agent of the patient's demands.
It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were ... more It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were legalised doctors must be essentially involved in the whole process including prescribing the medication and (in euthanasia) administering it. This paper explores some reasons for this assumption and argues that it flatly contradicts what it means to be a doctor. The paper is thus not mainly concerned with the ethics of AS/VE but rather with the concept of a doctor that has evolved since the time of Hippocrates to current professional guidance reflected in healthcare law. The paper argues that the most common recent argument for AS/VE--that patients have a right to control when and how they die--in fact points to the involvement not of doctors but of legal agencies as decision makers plus technicians as agents.
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Papers by Robin Downie