What is it good for?

Philosophy of medicine as the analysis of philosophical problems of medicine is an analysis of medicine itself to gain knowledge about medical language, knowledge, logic, practice, morals, and metaphysics. On the basis of such knowledge, one can inquire into whether the current state of medicine could be improved. For example, the analysis of the concept of diagnosis, as it is actually used in medicine, will enable us to recognize whether this use is adequate or inadequate. In the latter case, possibilities will be sought to improve the concept and its use. Likewise, the analysis of the conceptual, methodological, and moral presuppositions of efficient clinical judgment provides knowledge about the deficiencies and strengths of real-world clinical reasoning and decision-making.

The knowledge we gain about medicine through philosophical analysis can be used to change medicine and health care according to some specified goals. Thus, philosophy of medicine is in fact an instrumental science with consequences in the real world of medicine. It is not an inert humanistic discipline or activity to please medical philosophers themselves.

Philosophizing on medical issues has been exercised since Hippocrates and Galen. As a scholarly discipline, however, it gradually emerged in the first half of the twentieth century (the German "Philosophical Medicine" movement was only a speculative episode in the early nineteenth century). In interaction with the general philosophy of science and special philosophies of scientific disciplines such as biology, physics, and psychology, it grew in the second half of the last century. It cannot be overlooked that it has some problems and topics in common with the "philosophies of sciences" mentioned, for instance, the concepts and problems of causality, experimentation, empirical support of hypotheses, and other themes. Nevertheless, it is by no means a philosophy of science like the others, or the philosophy of a science. Actually, it represents philosophia universalis since the uniqueness of its subject, i.e., the suffering human being, brings with it that all relevant problems of philosophy and anthropology belong to the domain of its concern as well. Thanks to the distinctive nature of clinical field with its specific phenomena such as:

• the value-dependent, social origin of the concept of disease,
• the impairment of personality, intellect, and moral behavior by maladies,

on the one hand; and to the distinctive nature of clinical practice as a special field of human action, on the other, philosophy of medicine may enrich the philosophical sciences with a variety of fertile themes and useful solutions. Unfortunately, however, medical students remain largely unaware of philosophy of medicine because it does not have an appropriate place in the curriculum. In addition, medical teachers and authors of medical textbooks are unconvinced by philosophical arguments and neither apply nor communicate results of scholarly work in the philosophy of medicine. The latter statement pertains to Germany. I am not aware of the state of the art in other countries.