Bioethics and philosophy.

K. Danner Clouser was the first philosopher to teach ethics in a medical school. The question of the relationship of philosophy to the moral problems of medicine is one that has been on my mind almost daily for twenty-five years. From the very beginning of my career, I have been constantly alert to whatever connection I could find between the theories of philosophers and the everyday moral dilemmas of physicians and patients. Philosophy has indeed contributed significantly to medical ethics. Though the connection between the lofty theories of ethics and the moral dilemmas of health professionals and patients is complicated and problematic, the forced dialogue between the theories and the problems has been crucial in helping to systematize, to focus, and to pose the fruitful, organizing questions. Remember that twenty-five to thirty years ago, medical ethics was hardly even individuated as a field. It was a mixture of religion, whimsy, exhortation, legal precedents, various traditions, philosophies of life, miscellaneous moral rules, and epithets (uttered by either wise or witty physicians). I believe philosophy provided the push toward systematization, consistency, and clarity, as progress within medicine increasingly erupted into moral dilemmas. The maneuvers, ploys, and strategies of philosophy have been important for bringing system and organization to medical ethics. It asks probing and organizing questions; it understands how to discover and work with assumptions, implications, and foundations. Conceptual analysis, which is central to the "doing of philosophy," has been central also to the doing of medical ethics. In the late 1960s I often referred to what I was doing as "conceptual geography," to suggest that I was showing what and how these certain crucial concepts were related to each other. But do any of philosophy's contributions to bioethics imply that bioethics is philosophy? Of course not. At least not in any straightforward way. Other disciplines approach these moral problems from their own perspective--e.g., law, sociology, journalism, religion, and medicine itself. Bioethics essentially concerns a particular arena of human activity and the morality relating to it. Many disciplines have morally relevant insights into these activities, as well as organizing concepts. According to some, bioethics brought fame and fortune to philosophy, a public notice and acclaim it had never had: it brought burgeoning classes and massive opportunities for funding. It brought to philosophy a new air of excitement--a new challenge, a new database to explore and exploit. Bioethics brought purpose and immediacy to philosophy. Philosophers were needed--even wanted! They had to reach conclusions and make recommendations for action. exciting new world! On the other hand, however, many philosophers would claim that bioethics brought nothing but sophistry and degradation, a kind of prostitution of what was good and pure in philosophy. These latter believed either that bioethicists (so-called) were peddling sham knowledge (philosophy which was inadequate or inappropriate for the job to be done), or that bioethicists were doing something unworthy of the higher calling of philosophy--unworthy because bioethics was seen as a mechanic's job of merely applying the intellectual masterpieces of real philosophers to practical and mundane problems, and real philosophers, after all, do not traffic in the mundane. …