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Dissertation Information for Ezekiel Jonathan Emanuel

NAME:
- Ezekiel Jonathan Emanuel

DEGREE:
- Ph.D.

DISCIPLINE:
- Political Science

SCHOOL:
- Harvard University (USA) (1989)

ADVISORS:
- None

COMMITTEE MEMBERS:
- None

MPACT Status: Incomplete - Not_Inspected

Title: The ends of human life: Medical ethics in a liberal polity

Abstract: This dissertation is a study in the relationship between political philosophy and medical ethics. It advances four theses:

($1$) Conventionally it is argued that the advances of medical technology have created the ethical questions which confront us. This is the technological axiom of medical ethics. We shall reject this axiom arguing that such questions are inherent in the practice of caring for the sick; medical ethics is a constitutive element of medicine itself. This means the reason medical ethical questions have suddenly become so important cannot be advances in biomedical technology. (Chapter 1)

($2$) Liberal political philosophy plays a prominent role in justifying laws, policies, and practices within our society. (Chapter 2) Certain fundamental tenets of liberal political philosophy, such as the ideal of neutrality, underlie the crisis in medicine and medical ethics, especially the irresolution characteristic of the debates about terminating treatment and allocating medical resources. (Chapters 3 and 4)

($3$) Like all professions, medicine is committed to moral ideals. For medicine these ideals include the health and well-being of the sick patient as well as the relief of suffering and the amelioration of ill health when health is unobtainable. These ideals are not self-defining, but can be interpreted and applied to particular questions only by understanding the fundamental conceptions of political philosophy. Hence, medical ethics is a subfield of political philosophy. (Chapter 1)

($4$) Resolution of these medical ethical dilemmas requires an alternative political philosophy in which laws and policies can be justified by appeal to conceptions of the good life. Liberal communitarianism is such an alternative which can create an ethical framework for deliberation on these medical ethical issues. The liberal communitarian vision is characterized by a commitment to democratic deliberations which aim to develop (1) political autonomy in which citizens control the social circumstances in which they lead their lives, (2) certain personal characteristics, such as responsibility for a community and engagement in moral deliberation, and finally (3) a community. The liberal communitarian ideal can guide the creation of a practical medical system in which individuals receive their care through community health programs in which they establish policies through democratic deliberations. Such a system would provide an ethical framework in which the issues of terminating care and the allocation of medical resources could be addressed. (Chapters 5 and 6)

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