Contemporary Philosophy of Medicine

by

James Marcum

• LAST REVIEWED: 11 January 2024
• LAST MODIFIED: 11 January 2024
• DOI: 10.1093/obo/9780195396577-0216

Introduction

Contemporary medicine is fragmented in terms of approaches to what it is or should be, as well as to how it is or should be practiced. Approaches to the nature of medicine range from traditional logical and empirical accounts to humanistic and phenomenological ones, while approaches to its practice range from Evidence-Based Medicine to Patient-Centered Medicine. These approaches often involve different philosophical perspectives. For example, a reductionist perspective is foundational to standard biomedicine, whereas a holistic perspective is foundational to integrative medicine. In the present bibliography, entries on General Overviews, Edited Volumes, professional Journals, and online resources are listed initially, followed by different approaches to medicine’s nature and practice, ranging from the Logic of Medicine to Integrative Medicine. The bibliography concludes with entries on Medical Ontology, including Disease, Health, and Medical Causation, and on Medical Epistemology, including Medical Knowledge and Explanation, Medical Informatics, and Clinical Judgment and Decision Making. Finally, the bioethics and medical ethics literature has not been included, since it constitutes a separate field of scholarship in the philosophy of medicine.

General Overviews

Contemporary philosophy of medicine begins with the publication of Pellegrino and Thomasma 1981, with almost twelve hundred citations, according to Google Scholar—impressive for a non-bioethical book. Since its publication, the frequency of introductory expositions has increased considerably—at least four since the late 2010s (Broadbent 2019, Giroux 2018, Stegenga 2018, and Thompson and Upshur 2018). Most of the recent works acknowledge that contemporary philosophy of medicine is “a burgeoning field” and is now comparable to other fields, especially in philosophy of science (Thompson and Upshur 2018). Indeed, a chapter on philosophy of medicine was included in a companion to the philosophy of science (Giroux 2018); and Johansson and Lynøe 2008 and Lee 2012 use philosophy of science to frame and construct a philosophy of medicine. The entries in this section represent not only general overviews of the discipline (Bunge 2013) but also views from particular philosophical perspectives and with specific agendas (Tomasi 2016).

• Broadbent, Alex. Philosophy of Medicine. New York: Oxford University Press, 2019.

  DOI: 10.1093/oso/9780190612139.001.0001

  “This book sets out,” as the author states, “to answer two big questions about medicine: ‘What is medicine’ and ‘What attitude should we adopt toward it?’” (p. xv). He insists these two questions are urgent since “Mainstream Medicine”—as he calls the biomedical model—is on the one hand more effective today in terms of therapy, but on the other, the public is less trustful of it. In two major parts of the book, he sets out to answer the two questions.

• Bunge, Mario. Medical Philosophy: Conceptual Issues in Medicine. Singapore: World Scientific, 2013.

  DOI: 10.1142/8825

  The author’s main thesis is that “medicine has always been saturated with philosophy” (p. xiii). For him, philosophy is of service to medicine in terms of its nature and practice. To that end, in the first two chapters, he explores the role of philosophy in historical medicines and modern medicine. In the remaining eight chapters, he examines how philosophy functions with respect to conceptions of disease, diagnosis, pharmaceutical drugs, clinical trials, therapy, prevention, iatroethics, and medicine’s role in society.

• Giroux, Élodie. “Philosophy of Medicine.” In The Philosophy of Science: A Companion. Edited by Anouk Baberousse, Denis Bonnay, and Mikael Cozic, 464–509. New York: Oxford University Press, 2018.

  DOI: 10.1093/oso/9780190690649.003.0013

  The author informs the reader that the chapter represents philosophy of medicine as the domain of philosophy of science in contrast to bioethics. To that end, the concepts of health, disease, and illness are initially analyzed vis-à-vis the scientific nature of medicine. Next, the author examines the causes and explanations of diseases, especially in terms of proof, from a biomedical theoretical perspective. Finally, problems arising from causal analysis and experimentation are explored, along with the nature of clinical reasoning.

• Johansson, Ingvar, and Niels Lynøe. Medicine and Philosophy: A Twenty-First Century Introduction. Frankfurt: Ontos, 2008.

  DOI: 10.1515/9783110321364

  The authors frame the book in terms of the philosophy of science, initially discussing the notions of scientific fact, argumentation, and knowledge. They then introduce a number of topics contextualized with respect to a clinical paradigm that envisions the patient in terms of mechanism. They subsequently discuss topics such as placebo and nocebo phenomena and medical pluralism, as well as both clinical and research ethics. Finally, they conclude with examining the ontology of taxonomy and partonomy in science.

• Lee, Keekok. The Philosophical Foundations of Modern Medicine. New York: Palgrave Macmillan, 2012.

  DOI: 10.1057/9780230353251

  Divided into three parts. In the first, the author covers topics in the philosophy of science, including reductionism, mechanism, and theoretical biology. In the next part, she discusses the patient as mechanism, as well as the technological developments to diagnose and treat diseases. In the final part, she covers issues concerning disease causation, including nosology and the monogenetic conception of disease, and proceeds to linear disease causation, along with causation in random control trials and epidemiological studies.

• Pellegrino, Edmund D., and David C. Thomasma. A Philosophical Basis of Medical Practice: Toward a Philosophy and Ethic of the Healing Professions. New York: Oxford University Press, 1981.

  A classic in terms of a general overview of philosophical issues involved in contemporary medicine and its practice. The authors discuss initially what constitutes medicine as a profession. They then tackle the moral nature of medicine with respect to individual and social ethics. In a review of the book, although Eric Cassell expressed some reservations about it, he acknowledged, “It is an important book that should be widely read” (The Quarterly Review of Biology 57.4 [1982]: 493–495).

• Stegenga, Jacob. Care and Cure: An Introduction to Philosophy of Medicine. Chicago: University of Chicago Press, 2018.

  DOI: 10.7208/chicago/9780226595177.001.0001

  “Philosophy of medicine,” claims the author, “has become a vibrant intellectual landscape” and the book represents “a map of that landscape” (p. 1). The book is divided into four parts. The first examines the critical concepts of health, disease, and death. The next part discusses the notions of causation, holism and reductionism, and controversial diseases. The third part explores evidence and inference, along with associated issues. The final part pertains to issues in psychiatry and public health and in policy formation.

• Thompson, R. Paul, and Ross E. G. Upshur. Philosophy of Medicine: An Introduction. Abingdon, UK, and New York: Routledge, 2018.

  In agreement with Giroux, the authors claim that philosophy of medicine is “a sub-field of philosophy of science” (p. vii). Accordingly, logic, metaphysics, and epistemology rather than ethics drive their introduction. The authors discuss various topics in medicine, such as health and disease, theories and models, materialism and reductionism, causality and induction, randomized controlled trials and meta-studies, phenomenology, and clinical reasoning. They also explore various models of modern medicine, such as evidence-based medicine, evolutionary medicine, precision and personalized medicine, and alternative medicine.

• Tomasi, David Låg. Medical Philosophy: A Philosophical Analysis of Self-Perception in Diagnostics and Therapy. Stuttgart, Germany: Ibidem-Verlag, 2016.

  According to the author, the book’s intent “is directed at a deeper understanding of human nature, examining the links and mutual influence between perception, beliefs, sense of meaning and purpose, and the healing process” (p. 23). To that end, the author briefly explores the history of medical philosophy before examining the role of philosophy in medicine and its practice, especially in terms of reasoning and cognitive processes. The focus is on the patient’s self-perception as the center of both diagnosis and therapy.