title: A method in search of a purpose: the internal morality of medicine.
abstract: I begin this commentary with an expanded typology of theories that endorse an internal morality of medicine. I then subject these theories to a philosophical critique. I argue that the more robust claims for an internal morality fail to establish a stand-alone method for bioethics because they ignore crucial non-medical values, violate norms of justice and fail to establish the normativity of medical values. I then argue that weaker versions of internalism avoid such problems, but at the cost of failing to provide a clear sense in which their moral norms are internal or can ground a comprehensive approach to moral problems. Finally, I explore various functions that an internal morality might serve, concluding with the observation that, while there may be a core of good sense to the notion of an internal morality of medicine, our expectations for it must be drastically lowered.
authors.affiliation: University of Virginia, Charlottesville, VA 22904-4780, USA. jda3a@virginia.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Arras
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D007389:Internal-External Control; D009014:Morals; D010686:Philosophy, Medical; D010819:Physician's Role; D011364:Professional Practice; D012941:Social Responsibility; D012945:Social Values