Health, Illness, and Disease: Philosophical Essays

Havi Carel & Rachel Valerie Cooper, eds. Health, Illness, and Disease: Philosophical Essays Durham, UK: Acumen Publishing, 2013Reviewed by: Howard A. DoughtyFew fields of social and technological activity are immune to change. Indeed, the extent and pace of change are the criteria according to which many human enterprises are judged. So, computer designers, software manufacturers, automobile makers, pharmaceutical laboratories, military ordnance developers, biomedical researchers, agricultural gene manipulators and educational authorities bang their respective drums loudly in keeping with the call to offer innovative new products and services to a public eager to be seduced by the very next new big thing.First, do no harm. - HippocratesOpinions differ as to whether the quality of life is substantially improved by the latest iteration of the mobile phone or the newest genetically modified food product, but it is plain that the commercial market and government sourcing agencies impatiently await whatever is deemed to be a cutting-edge technology or ground-breaking methodology-even if the promised improvements are unproven or the costs of the assured benefits are unknown. Generally speaking, the trend seems to be toward giving well-hyped novelties the presumption of credibility and, in some cases, that presumption is rewarded with immensely salutary results.One field in which change has won widespread and well-deserved approval is medicine and health care. As a three-time cancer survivor who would have not lived long enough to be rescued from impending death by robotic surgery had it not been for modern diagnoses, interventions and treatments for a ruptured appendix at age 16 and a subdural hematoma at age 55,1 count myself among the people who are looking forward to at least a fragile sort of survival into my eighties and nineties thanks only to the diagnostic and therapeutic developments that have taken place in the last century or two.What's more, not only have we learned how to deal better with trauma and to conduct radical interventions with some success, but we have also made extraordinary advances in areas such as public health. Initiatives in illness prevention, early intervention, nutrition and hygiene currently compete with antibiotics and other medicines for the claim to have saved more lives, added more years to people's lives and made the quality of life for survivors immeasurably better. From the clever people who figured out that it would be a good idea for surgeons to wash their hands before removing bullets from wounded soldiers' abdomens to those who invented fMRI machines and devices in the slightly scary-sounding domain of nuclear medicine, it seems to me that, broadly speaking, medical progress has been an irrefutable human good to be questioned, if at all, only in terms of its contribution to ecologically hazardous levels of human population and the prospect of irredeemable environmental degradation owing to the Malthusian implications of our collective success in delaying death.Dr. Frankenstein is now a role model and we are more or less his monsters.Considering the enormous achievements and implications of modern medical miracles, it is somewhat disconcerting to realize just how recent health care advancements actually are. It is true that physicians have been around for a lot longer than particle physicists, biochemists and macroeconomists. It is also true that they have been worrying some about the morals of their vocation ever since Hippocrates set out their foundational ethical principle: first, do no harm.Still, shortly after the Founders of the American republic had cobbled together their nation's (mostly) commendable Bill of Rights, their recently retired chief magistrate, George Washington, perished from a throat infection (epiglottitis) complicated by his physicians who bled him four times (removing 32 ounces at his last bleeding), a process that is said to have caused the hypovolemic shock that ultimately killed him (Grizzard, 2002: 105-107). …

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