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5 Med., Health Care & Phil. 1 (2002)

handle is hein.journals/medhcph5 and id is 1 raw text is: #A Medicine, Health Care and Philosophy 5: 1-9, 2002. © 2002 Kluwer Academic Publishers. Printed in the Netherlands. Scientific Contribution Miracles and the limits of medical knowledge* William E. Stempsey Department of Philosophy, College of the Holy Cross, One College Street, Worcester MA 01610-2395, USA (E-mail: wstempsey@ holycross.edu) Abstract. In considering whether medical miracles occur, the limits of epistemology bring us to confront our metaphysical worldview of medicine and nature in general. This raises epistemological questions of a higher order. David Hume's understanding of miracles as violations of the laws of nature assumes that nature is completely regular, whereas doctrines such as C. S. Peirce's tychism hold that there is an element of absolute chance in the workings of the universe. Process philosophy gives yet another view of the working of nature. Physicians have no epistemological grounds for declaring any cure to be miraculous. Miracles are theological (or philosophical) entities, and not medical entities. All physicians can do is to determine whether or not a cure is scientifically inexplicable according to the current epistemological standards of medical science. As these standards change, what is currently unexplainable may become explainable. However, we can also come to realize that our current explanations are in fact unsatisfactory. Our justifications of knowledge claims about miracles will depend on our views about determinism and indeterminism. If the universe is not a deterministic one, we should be open to the possibility of encountering what appear to us as sui generis events. These would not be violations of immutable laws of nature, but manifestations of the true workings of nature, and certainly causes for wonder. Key words: determinism, epistemology, Hume, laws of nature, metaphysics, miracle, Peirce, Whitehead I. Introduction Talk of miracles in medicine has become common- place. One survey found that twenty-one percent of publications from children's hospitals contained articles that emphasized the accomplishments and potential benefits of the hospital in terms of miracles We need only to look at a few examples to see the bent of these articles. We're gearing up for another year of miracles for children. The happy kids and families at the reunion are a reminder of the miracles brought about by this special blend of technology and tender loving care Most blatantly, one hospital magazine cover proclaimed to its readers, Expect a Miracle (Manning and Schneiderman, 1996). Since miracle is not understood in any univocal way, and since the knowledge most patients have about the capabilities of modern medical technologies is not sophisticated, such advertising can create quite different expectations for patients and physicians. We might well ask whether such talk about miracles is leading people to have false expectations about the capabilities of medical practice. Philosophical discussions of miracles, following David Hume, have tended to focus on epistemological issues. That is, they investigate the sort of evidence that would be required to show that a miracle has taken place. In this article, I will examine the relationship of miracles and medical epistemology. I will first discuss the concept of a miracle and the epistemological turn. Next, I will argue that both religious and epistemolo- gical issues are essential in any analysis of miracle, and illustrate this with a case of a cure attributed to the intercession of a saint. I will then argue that the epistemological turn should not be allowed to obscure the more foundational metaphysical assumptions that physicians and patients hold about miracles. Finally, I will show the importance of this for medical practice. II. The concept of miracle 2.1 God and nature I take Richard Swinburne's definition to capture the essential features of a miracle. A miracle is an event of an extraordinary kind, brought about by a god, and of religious significance (Swinburne, 1970, p. 1). Different interpretations of the three facets of this definition can lead to disagreements about whether a particular event constitutes a miracle. The god, for

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