Rivista per le Medical Humanities

Sandro Spinsanti
rMH 2, 2007, 75-79

Ethics between logos and pathos

The everyday effort to be rational when practicing medicine can conflict both with the strong presence of pathos in all decision making processes and with the multidimensional ethos related to the health care. Nowadays, a good medicine practise requires providing appropriate care to the patients (the principle of beneficence), in the right way (respecting the patient’s autodetermination: the principle of autonomy), to all those who have the rights and needs (thus taking in consideration the fair allocation of resources: the principle of justice).

Alberto Bondolfi
rMH 2, 2007, 80-84

Between dogmatism and arbitrariness

The essay exposes the models of rationality that have been asserted along the history of ethical philosophy. Minimalist models that reduce the ethical assertions to options based on one’s taste as well as maximalist models that claim to be able to demonstrate those assertions in a “geometric” manner are recalled. In health care the author suggests an intermediate model that considers as “rational” those choices that are made starting from the consequences they might have and from the values defined as priority. If those two elements are taken in consideration, the health care policy will have a proximity relationship with Ethics, without coinciding with it.

Riccardo Crivelli
rMH 2, 2007, 85-91

Economics and Medicine, an unavoidable ethical confront

Both Medicine and Economics approach Ethics, but they do itfrom different points of view. Medicine considers that rationality,“economically” intended as the need to reckon with resources (or with limits, costs, etc.), is not of it’s relevance but it is an Ethics’ prerogative. On the other side, Economics considers that homo economicus, due to his rational nature, is of it’s relevance and everything else, that is not rational, it is an Ethics’ prerogative. It seems that Medicine is lacking in (economic) rationality and that Economics exceeds in (economic) rationality: but both of them seem to rely on Ethics to solve the relative stalemates. Therefore, the question is if referring to Ethics, by assigning to it those prerogatives, is not a way to run foreword, that risks distorting the essences of the two disciplines and in the same time charging Ethics of problematic issues that were not originally of it’s own. It is possible to note that Medicine and Economics approach Ethics not only regarding the concept of rationality, but – surprisingly – also regarding numerous concepts and principles, and that the confrontation between Medicine, Ethics and Economics it is not located only on a theoretic level, but also on an empiric one. Therefore, rationality is a prerogative of none of these three disciplines. The “excess” of rationality in Economics and the “lack” of rationality in Medicine are two faces of the same medal; medical ethics meets the economic ethics in the Ethics tout court, and unavoidably they merge – enriching themselves – within the two disciplines, both of them focused on the human being and his welfare.