Trusting Doctors by Imber Jonathan B.;

Author:Imber, Jonathan B.;
Language: eng
Format: epub
Publisher: Princeton University Press
Published: 2015-04-17T04:00:00+00:00

Insiders and Outsiders

Like the term “sociology,” bioethics is a neologism, that is, a new word coined for the purpose of crystallizing a new way of thinking, often about old problems. Comte’s vision of positivism, a philosophy and science that would guide the administration of society, finds parallels in the normative approaches in bioethics. That no comparable efflorescence of intellectual oversight has developed for other professions and occupations other than medicine suggests a deeper connection between sociology and bioethics than is revealed at first sight by the broadness and abstractness of the former and the relatively narrow and concrete focus of the latter.27

The first use of the term “bioethics” is generally credited to a biochemist, Van Rensselaer Potter, whose Bioethics: Bridge to the Future, first published in 1971, is an instructive reminder of how the ambitions of one individual may inspire (but not direct) an emerging movement that has gone on to define the public situation of medicine during the past quarter century.28 Potter’s own agenda for bioethics, including “A Bioethical Creed for Individuals,” has been summarized as “the enterprise of utilizing the biological sciences for improving the quality of life.”29

Closer scrutiny of Potter’s “Bioethical Creed” (and its subsequent elaboration in other writings) reveals diverging arguments about the future of medicine and the role of physicians in that future, whether in Potter’s mostly marginalized vision or in the mainstream vision that now dominates public understanding and interest in bioethics. Potter’s creed consisted of five beliefs and respective “commitments,” beginning with, “I accept the need for prompt remedial action in a world beset with crises.”30 The commitment following this belief called for an effort to create a worldwide movement “that will make possible the survival and improved development of the human species in harmony with the natural environment.” The second belief called for the acceptance of “the fact that the future survival and development of mankind” depends on present “activities and plans.” Potter’s Comtean inheritance is plainly stated in his third belief that each individual has an “instinctive need to contribute to the betterment of some larger unit of society in a way that is compatible with the long-range needs of society.” Comte coined the term “altruism,” which in its application to biological understanding remains one of the most powerful links between biological observations and social policy.

Potter’s final two beliefs, which acknowledged the inevitability of human suffering and death, called for a commitment to “work toward the goal of eliminating needless suffering among mankind as a whole.” As innocuous and reassuring as his creed may have been, Potter was more forthright about what he had in mind with respect to the role of physicians in the emerging gap between what medicine was promising and what it could always deliver, including sustaining life longer than ever before: “But what is to be the fate of the aging invalid? What is to be done while medical science tries to live up to the rising expectations of a society that breathes smoke-filled air frequently by

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