Lucien Karhausen
This book describes the philosophy of medicine as a subset of the philosophy of science. It is grounded in an epistemological bottom-up account that arises from the clinical situation, the epidemiologic and the resulting public health account. The volume offers a set of coherent beliefs that are deductively closed, which means that any statement which is logically entailed by the theory belongs to the theory. Medicine does not originate, as usually admitted, with the notion of disease inasmuch as concepts of disease, malfunction or health are evolved, sophisticated and advanced constructs. Medical norms, i.e., pathological features, are logically and conceptually prior to normal features. Following Ludwig Wittgenstein, by analogy with the way members of a family resemble each other, diseases are often what Ludwig Wittgenstein called 'family-resemblance concepts', which manifest a similarity shared by things classified into certain groups in the way members of a family resemble each other: each shares characteristics which many but not all the others, and there are no necessary or sufficient conditions for belonging in that classification. This book analyses the confusions associated with the concept of health, and subsequently turns to medical interventions, preventive, therapeutic and palliative as well as to the caring relationship, patients’ autonomy, doctors’ authority, and paternalism. Finally, the epistemic, ethical, or ontological limits of medicine, are being discussed, and the final account leaves us at the end of the scale with the perspective afforded by the patient facing suffering, impairment, death and tragedy, not to mention the physician’s predicament, which give rise to the principle that undergirds them all, i.e., the value of life.
