Lonergan Institute at Boston College, Boston, MA, USA.
Theor Med Bioeth. 2019 Jun;40(3):169-182. doi: 10.1007/s11017-019-09491-y.
After considering two of Pellegrino's papers that address the relation between philosophy of medicine and medical ethics, I identify several overarching problems in his account that revolve around his self-described essentialism and the lack of a systematic attempt to relate clinical medicine to biomedicine and public health. I address these from the critical realist position of Bernard Lonergan, who grounds both metaphysics and ethics on the normative structure of human inquiry and seeks to understand historical development, such as we are witnessing in health science and health care, in terms of the dynamic structure of the human good. I conclude that Lonergan's generalized empirical method and hierarchical account of world order provide a potentially dynamic framework on which to build a more comprehensive philosophy of medicine than one whose foundations rest primarily on a phenomenology of the clinical encounter and the telos of medicine.
在考虑了佩雷格里诺的两篇探讨医学哲学与医学伦理学之间关系的论文之后，我在他的论述中发现了几个突出的问题，这些问题围绕着他所谓的本质主义以及缺乏系统地将临床医学与生物医学和公共卫生联系起来的尝试。我从伯纳德·洛纳根的批判实在论立场来解决这些问题，他将形而上学和伦理学建立在人类探究的规范结构之上，并试图从人类善的动态结构来理解历史发展，就像我们在健康科学和医疗保健中所见证的那样。我得出结论，洛纳根的广义经验方法和世界秩序的层次结构为建立一种更全面的医学哲学提供了一个潜在的动态框架，这种哲学的基础不仅仅是临床相遇的现象学和医学的目的论。
