John Locke (1632-1674) another, empiricist, believed that at birth a mind is like a blank page and we obtain knowledge through our senses. He broke this down in to two types, sensation which he defined as input from the senses such as smell, taste and sight and secondly, reflection, which were the different operations of the mind such as thinking and believing.
Some would say that Empiricists views of how we attain knowledge through senses could be misleading since our senses can deceive us. For example, you see someone walking down the street and think it is your friend and wave only to discover it was someone entirely different. We believed our senses but they were mistaken. Where rationalists differ is that they believe knowledge is derived from our reasoning and thoughts.
In 1912, Bertram Russell (1872-1970) wrote Problems in Philosophy, in which he states ‘is there any knowledge in the world which is so certain that no reasonable man could doubt it?’ At first this question may not seem so difficult to answer but in reality it is probably one of the hardest. Russell believed that if he were sitting at a chair behind a desk with paper and books on it that any other normal person who came in to the room would see the same chair, desk, paper and books as him. However, in reality each person is seeing through his own eyes and therefore the interpretations may differ, as do their senses and knowledge.
In contrast, George Berkeley (1685-1753) a realist believed that Locke’s theory did not carry the principles of empiricism far enough and was critical of his perspective. He therefore, proposed a simple but startling alternative. Unlike Descartes and Locke, Berkeley’s theory was ‘to believe all you needed were the perceiver and what is perceived’. For Berkeley, only the ideas we directly perceive are real and there is no reliable account of the connection between ideas and material objects they are supposed to represent. The results of this failure, Berkeley believed, are bound to be scepticism and atheism.
B) In short explain why the Sceptic claims that knowledge is impossible to attain. Why is the study of Philosophy important for an understanding of medical ethics?
Sceptics believe in principle that the knowledge of how the universe really is, is unattainable. They doubt all knowledge. Sceptics will only believe the knowledge, which is definite and certain and cannot be changed, such as 2 + 2 = 4 not 5 or 6. The Sceptics view is that it is impossible to know anything with absolute certainty, or to know the world as it 'really' is. It can also mean a general reluctance to accept anything on face value without sufficient proof, and in modern day philosophy, although it does not generally take extreme sceptical arguments very seriously, still retains the influence of earlier sceptical thinkers.
Until recently, philosophers took little interest in medical practice or physicians' codes of ethics but it is becoming far more prevalent in today’s society. Medical ethics is the study of philosophical questions pertaining to the practice of medicine and healthcare and has long been governed by the Hippocratic oath. The licensing boards such as British Medical Council, hold those in the medical profession accountable for their decisions in the practice of medicine and by taking the oath they swear they will do no harm to their patients
Those in the medical profession rely upon medical ethics when they make judgments about issues of life and death. In the management of terminally ill patients, is it ethical to provide an ample supply of addictive pain medications? If a patient can no longer feed himself, is it ethical to withhold feeding or should nutrition be provided through artificial means? In cases of traumatic brain injury or disease, for how long should the body be kept alive by mechanical support? Some contemporary issues in medical ethics are the potentials of stem cell research, cloning, and genetic research. Other issues include pharmaceuticals research, experimentation upon animals, and xenotransplantation, where human subjects receive transplants of animal organs.
Within all walks of life, concerning many different topics, there will be people who agree and those who disagree. Within the medical profession we must ask ourselves where does the truth lie? By looking at the question of medical ethics from a philosophical perspective it allows those with difficult decisions to make to look at a situation from a balanced point of view. In the pursuit of truth there are no right or wrong answers. There will always be considerable tension and strain between a decision, which is ethically right, but wrong from a moral point of view.
Consider the case of a young man, 18 years of age in his prime with his whole life ahead of him, a bright scholar with a close and loving family and popular amongst his peers. One fateful evening, after a disagreement with his father he mounts his motorbike and 200 yards down the road he has a collision with an oncoming vehicle. In hospital, whilst on life support his mother, a nurse herself, is told that even he if were to survive independently of the ventilator, he will for all intensive purposes be so severely brain damaged that his life will be a mere existence of a ‘vegetable’. Morally it is right for the doctors and medical staff to do all they can to prolong and save his life and his mother refuses point blank to have the life support switched off and some months later he is able to sustain life independently of the ventilator.
Some would argue that this in itself means that his life was worth saving and that it would be wrong to have turned off the life support. However, some 18 years on, this once vibrant young man is so severely handicapped and brain damaged that he is confined to life in a nursing home where is fed liquid food through a peg into his stomach, is hoisted from his bed to his chair in the morning and back to bed at night. All daylong is placed in front of his TV for stimulation and yet he is incapable of any forms of communication. He wears incontinent nappies and is totally dependent on those caring for him. Those who do care for him talk to him as if he were a baby, or sadly do not bother at all and occasionally you see a flicker in his eyes that makes you question how much he understands. He may be alive in the sense he is breathing but ethically was it right to prolong this mans’ suffering? Is there any quality of life?
I have to ask myself that if this man were an animal would it have been kinder if he had been put out of his suffering and misery and that if one were to treat an animal in this way would they not be chastised for being cruel to animals. However, I have to consider if I was faced with the same decision would I rather he were alive in some form or would I be brave enough to let him go and grieve his death.
For all the opinions, beliefs, philosophical hypothesis, ethics and morals there is no right answer but having an understanding of these matters can help and guide us when faced with a medical decision that will never be easy to make.
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(Word Count: 1514)
Bases on information from:
- World Library & Encyclopedia of Philosophy 2 Edition
- Lecture hand out on Bertram Russell