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SAAP Annual Meeting

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The American Roots of Medical Ethics – Care and Virtue

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John Kaag
University of Massachusetts Lowell
United States

Kim Garchar
Kent State University
United States

Josh Thomas
St. John's University
United States

This panel explains how contemporary medical ethics can benefit from the longstanding commitment of classical American thinkers to articulate the philosophical significance of virtue and care. Its three papers express a similar philosophical position, but do so by addressing three distinct historical moments in the creation of the American philosophical canon. In the process, the panelists will explain how contemporary medical ethics can be understood as having its roots in classical pragmatism and American Transcendental thought.

This is no small task. It requires a close examination of generally forgotten figures of American intellectual life (1850-1950) and an explanation of how these thinkers directly impacted modern medical ethics, what is now one of the dominant sub-disciplines of applied philosophy. The first paper will set the historical and theoretical groundwork by examining the definition of virtue and care in the writings of James Elliot Cabot (1821-1903). Cabot is generally overlooked in accounts of classical American philosophy, a regrettable fact owed at least in part to Cabot's reticence to publish and the burning of his unpublished works. During the 19th century, however, he was regarded as the authority on Kant, Schelling, and Hegel, and more notably, as Emerson's literary executor and biographer. In 1887, at the bequest of Henry James and the Emerson family, Cabot wrote the definitive memoir of Emerson, a book that will be at the center of this paper’s analysis of virtue and care. Here, Cabot and Emerson speak in unison on the importance and cultivation of virtue and care. This paper will focus on the theoretical importance of Cabot's writing on Emersonian virtue, but also the practical ways that virtue was handled in the Cabot household. At first glance this discussion may appear far afield from the scope of medical ethics. It is not. In the early years of the 1890s, James Elliot Cabot faced an ethical dilemma that bears directly on medical ethics, a dilemma made especially poignant by the way that it affected two of Cabot's sons. One was Ted Cabot, who suffered from diabetes and eventually died from related ailments in 1893. The other was Richard Cabot who was instrumental in the care of his brother, in the euthanized death of his brother, and in the establishment of clinical practices in the United States at the turn of the century. The author of this paper argues that the death of Ted Cabot in 1893 signaled the birth of medical ethics in the United States; it was from this point that Richard Cabot, with the help of his wife Ella Lyman Cabot, went on to write 21 books on medical treatment and medical ethics, transforming the landscape of American medicine in the 20th century.

This is where the author of the second paper picks up the story, exploring these books, many of which have been forgotten by contemporary ethicists. She/ He argues that Richard Cabot expresses philosophical positions, echoing his Transcendentalist father, that could reintroduce care and virtue into today's medical practices. This reintroduction, the author argues, is sorely needed. Care and virtue have given way to the mechanization of treatment and a model of medicine that has taken scientism as its guiding principles. Both Cabots objected explicitly to this model of medicine, and Richard’s writings make this clear. What is significant about Richard Cabot's writing is the way that it amends and expands his father's thinking, taking a uniquely pragmatic turn. In effect, the young Cabot brings Emersonian ethics down to earth and applies it in the most practical of settings.

The third panelist, will go into more detail concerning the possible contributions that pragmatism might make to toady’s medical ethics. The panelist brings to bear his/her expertise in this burgeoning field (a field in which members of SAAP could be actively engaged), to explain that many of the finding of the most recent studies of evidence-based medicine suggest the adoption of a pragmatic ethic inspired by John Dewey.


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