Doctors and Philosophers in Step

Book reviewed in this article: Doctors' Dilemmas: Moral Conflict and Medical Care . By Samuel Gorovitz.     

Why the Progressives Failed

Book reviewed in this article: Conscience and Convenience: The Asylum and its Alternatives in Progressive America . By David J. Rothman     

For Experts Only?

How closely involved with hospital ethics committees should patients and their families become? Should they routinely have access to committees, or be empowered to initiate consultations? To what extent should they be informed of the content or outcome of committee deliberations? Seeing ethics committees as the locus of competing responsibilities allows us to respond to the questions posed by a patient rights model and to acknowledge more fully the complex moral dynamics of clinical medicine.     

The Experts Are Not Enough

As Achim Rosemann and colleagues rightly suggest in their article “Heritable Genome Editing in Global Context: National and International Policy Challenges,” in this issue of the Hastings Center Report, the scientific, ethical, and governance challenges associated with heritable genome editing are global in scope. Both the genetic interventions and the social and moral judgments about human identity and integrity associated with them will affect all humanity. Yet the worries, problems, and solutions that the study illuminates reflect only a partial picture of those challenges. That is to be expected from a study of this sort: the “stakeholders” who were consulted are a limited group and as such are bound to provide a particular, limited picture. One of the important contributions that such a study can make is in providing a picture of what problems particular kinds of experts see as the primary problems and how the framing of those problems may displace other questions and perspectives, especially when such parochial framings of problems are elevated to the level of the “global.” Rosemann et al. do not explain how participants were identified as stakeholders or, indeed, how the study identified the stakes. This is a missed opportunity, and it points toward a set of questions that themselves need to be asked about how the stakeholders—and the stakes—of global governance of heritable genome editing are identified.     

When Conservative Medicine Triumphed and Feminist Values Failed

Book reviewed in this article: A Calculus of Suffering: Pain, Professionalism and Anesthesia in Nineteenth Century America . By Martin S. Pernick. Sympathy and Science: Women Physicians in American Medicine . By Regina Markell Morantz-Sanchez.     

Philosophers and physicians on the scientific validity of Latin physiognomy, 1200-1500

The article surveys and contextualizes the main arguments among philosophers and academic physicians surrounding the status of physiognomy as a valid science from the thirteenth to the early sixteenth centuries. It suggests that despite constant doubts, learned Latin physiognomy in the later Middle Ages was recognized by natural philosophers (William of Spain, Jean Buridan, William of Mirica) and academic physicians (Rolandus Scriptor, Michele Savonarola, Bartolomeo della Rocca [Cocles]) as a body of knowledge rooted in a sound theoretical basis. Physiognomy was characterized by stability and certainty. As a demonstrative science it was expected to provide rational explanation for every bodily sign. In this respect, learned physiognomy in the Middle Ages was dramatically different from its classical sources, from Islamic and possibly from early-modern physiognomy as well.