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2 Med., Health Care & Phil. 1 (1999)

handle is hein.journals/medhcph2 and id is 1 raw text is: rl Medicine, Health Care and Philosophy 2: 1-2, 1999. O © 1999 Kluwer Academic Publishers. Printed in the Netherlands. Editorial Medical philosophy and the cultivation of humanity One of the astounding innovations of medical educa- tion has been the introduction of philosophy and bioethics into the preclinical, clinical and post- graduate curricula of physicians, nurses, dentists, and allied health professionals. In some countries, such as Denmark, the Netherlands and the USA, the expansion of ethics and philosophy teaching started decades ago, and is now well-established in medical schools. In the post-communist countries, medical ethics and philosophy teaching also have a long tradition, being part of the ideological educa- tion programmes, provided through departments of social sciences (former departments of marxist-leninist philosophy); however, in the transitional processes towards democracies, these programmes have suffered serious setbacks; nowadays, they must be restruc- tured and rebuilt completely. The foundation of the East Central and European Association of Bioethics, early February 1999 in Pecs, Hungary, expresses the need for close collaboration to revitalize ethics and philosophy education. On the whole, the situation across European countries is extremely variable. In the Netherlands, all medical schools provide ethics and philosophy teaching, often supported by medical ethics chairs and departments. In Germany, professorships in medical ethics are now being recognised and estab- lished as necessary infrastructure for contemporary medical education. In many countries, long-time experience with teaching is producing an increasing flow of textbooks and introductory volumes, while the number of courses and seminars is rapidly growing. In other countries serious efforts are made to institutionalize the teaching of ethics and philosophy in the healthcare setting. In Spain, for example, the Asociacion de Bioetica Fundamental y Clinica recently published a consensus document on bioethics education, specifying the objectives, contents, methods, and organisational issues of this type of teaching (Asociacion, 1999). In other coun- tries, initiatives are taken to start bioethical and philosophical enterprises, sometimes almost from scratch. What is impressive is the idealism and enthu- siasm of the organisers as well as participants. Two recent examples. In November 1998, the Lithuanian National Committee on Biomedical Ethics organ- ised a 3-day course in Vilnius on moral dilemmas in health care. In February 1999, the Croatian Academy of Sciences and Arts organised an inter- national symposium on biomedical ethics in Zagreb. Both events were characterised by a high degree of involvement from medical and nursing professionals. The topics discussed may seem old-fashioned by some philosophers: informed consent, confidentiality, ethics committees. But what is significant in all these efforts in various locations throughout Europe is the aspira- tion to cultivate humanity. Regardless of quite different histories, cultures and political systems, health profes- sionals see themselves bound by common human abili- ties; they recognize the worth of human life wherever it occurs. The malaise of medical philosophy Against this background, the thesis of William Stempsey in his contribution to this volume is surprising. He argues that philosophy education in its present setting will not succeed to train more humane caregivers. Curricular innovations, introducing ethics and philosophy, are intended as antidotes to the cynism and abuse prevailing in traditional medical education. Stempsey doubts whether they will be successful; what is worse, sometimes they will be counterproductive. The reason is that philosophy is quarantained within the curriculum. It is not integrated within core-subjects and it is separated from practical courses. The distinc- tions between facts and values, medical practice and theoretical reflection, between science and ethics, empirical data and normative judgment will inevit- ably lead to marginalisation of 'soft' disciplines such as philosophy and ethics. The solution advocated by Stempsey, is the development of integrated and interdisciplinary courses. We should try to transform physicians into philosophers.

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