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VIRTUE AND MEDICINE PHILOSOPHY AND MEDICINE Editors: H. TRISTRAM ENGELHARDT, JR. The Center for Ethics, Medicine, and Public Issues, Baylor College ofMedicine, Houston, Texas, U.S.A. STUAR T F. SPIeKER School of Medicine, University of Connecticut Health Center, Farmington, Connecticut, U.S.A. VOLUME 17 VIRTUE AND MEDICINE Explorations in the Character of Medicine Edited by EARL E. SHELP Center for Ethics, Medicine, and Public Issues Baylor College ofMedicine, and Institute of Religion, Houston, Texas, U.S.A. D. REIDEL PUBLISHING COMPANY A MEMBER OF THE KLUWER • ACADEMIC PUBLISHERS GROUP DORDRECHT/BOSTON/LANCASTER Library of Congress Cataloging in Publication Data Main entry under title: Virtue and medicine. (Philosophy and medicine; v. 17) Bibliography: p. Includes index. 1. Medical ethics. 2. Nursing ethics. 3. 4. V irtue. I. Shelp, Earl E., 1947II. R724.V48 1984 174'.2 85-1836 Medicine-Philosophy. Series. ISBN-13: 978-94-010-8812-1 e-ISBN-13: 978-94-009-5229-4 DOl: 10.1007/978-94-009-5229-4 Publishing by D. Reidel Publishing Company, P.O. Box 17,3300 AA Dordrecht, Holland. Sold and distributed in the U.s.A. and Canada by Kluwer Academic Publishers, 190 Old Derby Street, Hingham, MA 02043, U.S.A. In all other countries, sold and distributed by Kluwer Academic Publishers Group, P.O. Box 322, 3300 AH Dordrecht, Holland. All Rights Reserved. © 1985 by D. Reidel Publishing Company. Softcover reprint of the hardcover 1st edition 1985 No Part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner. TABLE OF CONTENTS EARL E. SHELP / vii Introduction SECTION I / HISTORICAL ANALYSES GARY B. FERNGREN AND DARREL W. AMUNDSEN / Virtue and Health/Medicine in Pre-Christian Antiquity Virtue and Medicine from Early Christianity Through the Sixteenth Century 3 DARREL W. AMUNDSEN AND GARY B. FERNGREN / DIETRICH VON ENGELHARDT / 23 Virtue and Medicine During the Enlightenment in Germany 63 I Virtues, Etiquette, and AngloAmerican Medical Ethics in the Eighteenth and Nineteenth Centuries 81 LAURENCE B. McCULLOUGH SECTION II / THEORIES OF VIRTUE BERNARD GERT / 95 Virtue and Vice EDMUND 1. PINCOFFS / Two Cheers for Meno: The Definition of the Virtues 111 Critique of Pure Virtue: Animadversions on a Virtue-Based Ethics 133 KAI NIELSEN / GILBER T MElLA ENDER I The Virtues: A Theological Analysis 151 SECTION III / VIRTUE AND MEDICINE Virtues and Vices: The Social and Historical Construction of Medical Norms MARX W. WARTOFSKY / v 175 vi TABLE OF CONTENTS ED M U N D L. E R DE / ALLEN R. DYER / The Virtues of Medicine: Meaning and Import Virtue and Medicine: A Physician's Analysis EDMUND D. PELLEGRINO / 223 The Virtuous Physician, and the Ethics of Medicine 237 MARTIN BENJAMIN AND JOY CURTIS / Virtue and the Practice of Nursing KAREN LEBACQZ / 201 257 The Virtuous Patient Virtue and Public Health: Societal Obligation and Individual Need 275 MARC LAPPE / 289 SECTION IV / CRITIQUE TOM L. BEAUCHAMP / What's So Special About the Virtues? Against Virtue: A Deontological Critique of Virtue Theory in Medical Ethics