Knowing when to stop: the limits of medicine.

摘要: Enshrined in modern medicine is a distinct set of values. When assumes these values uncritically, host ethical problems results. A glimpse at the ancient roots reveals that an older scientific tradition entertained very different values--values provide wise counsel and shed light on specificf concern providing medically futile care to patients. Hippocratic Medicine physicians fifth through third centuries B.C. were among first question limits medicine. Historians regard one their achievements be understanding when not intervene. In work attributed Greek physician Hippocrates, it written purpose "to do away with sufferings sick, lessen violence diseases," but also refuse treat those who are overmastered by diseases, realizing such cases powerless." According this tradition, knowing related physician's appreciation art power nature (physis). The predominant meaning corpus "the essential substances which make up human beings." searched for being's natural state health had been altered changes wrought disease. writings caution should demand "from over what does belong art, or from nature, his ignorance is...allied madness." [1] For Greeks, techne, implies doing. doing, "bound...by potentialities object...[and] techne itself." [2] only understands uses boundaries avoids error excessive confidence. Greeks called hubris, tone approach counseled against it. words historian, "Those disregarded scope therapies stained authority medicine." [3] basis moderation atttention reflects medical theories upon was built. Ancient conceived its task working assist restoring disruptions order. Thus author Precepts enjoined "display discoveries preserving trying alter it." [4] This viewpoint developed out Health viewed as balance four bodily humors (yellow bile, blood, black phlegm); disease defined imbalance four. example, fever meant too much yellow so heat dryness, present body. To restore health, might instruct water used cooling agent: patient consume fluids immersed cool baths. emphasized importance environment climate maintaining within Since beings under influence essence situations where incurable must accept means used. spirit described Plato, extolled kind taught followers Asclepius. Republic, Plato emphasizes Asclepius...taught healthy nature...but suffering specific disease; he rid them it...then ordered live usual....For those, however, whose bodies always inner sickness did attempt prescribe regimen, or...to life prolonged misery...Medicine intended they treated, even if richer than Midas. …