Care and Cure: An Introduction to Philosophy of Medicine

by Jacob Stegenga

The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field.

The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.

Genres: Philosophy, Medicine, Nonfiction, Medical

288 pages, Paperback

First published January 1, 2018

Reviews

[Steven R. Kraaijeveld · Rating 4 out of 5]

This was a surprisingly readable and engaging introduction to the philosophy of medicine—a relatively recent yet fascinating field that applies philosophy to the practice of medicine. The book is divided into 14 short chapters that have a more or less logical structure; as Stegenga shows, much of what one does in and thinks about the practice of medicine depends on one's conception of health, disease, and death (hence these concepts form the first three chapters). Also crucial are one's conception of causation, whether diseases are natural kinds, and whether medicine ought to be reductionist or holist in nature, which are covered in the next chapters. As Stegenga shows, many of these ideas are related and (become) mutually reinforcing. What he does very well is provide an overview of the arguments that have been given for each side of the many debates that he covers, and, although I would have preferred a more extensive reference list, he does point to the major works in each area. The fact that he does not actually scatter numerous references in the text, but simply refers to names and ideas while offering a 'further reading' list at the each of each chapter (with discussion questions, since this is supposed to be an introductory textbook) probably helps to make it a pleasant reading experience. His terminology and use of examples do tend to get repetitive, but what may seem like a slight fault is actually a strength—through the repeated examples, he ties together many different areas and debates within the philosophy of medicine.

[Miguel Angel Lozano · Rating 4 out of 5]

As a recently graduated physician, I think this should be taught to every medical student, it would be useful as a conceptual guide through the discipline.

I also recommend this to physicians who ponder on questions such as: what is health? what is a disease? how do we know an intervention is effective? to what extent non-epistemic values influence medical research?----- in many cases, the answer isn´t obvious.
Most of us attach to a position regarding a specific topic, not because we know both sides of an argument, but because we do not know the strength of the alternative view, and this book strives to present you with those.

Regarding the debate about what health is, I must admit to being seduced by the idea of "positive health" (not the mere absence of disease). But, this view carries some intrinsic problems to medicine. The profession itself, to function the way it does, requires established parameters for describing what a disease is and what it´s not. I mean, as physicians we cannot "treat" socioeconomic induced stress. We create criteria for a disease, that have at least some "measurable" parameter and pathophysiological basis (leaving outside some undescribed factors that could potentially restrict the well being of an individual). In essence, it's a trade-off due to ignorance of what homo sapiens are, how they function as individuals, and on a societal level. Don´t get me wrong, we have discovered a whole lot about who we are, but there's still a long way to complete knowledge (if that's even possible). Nevertheless, I think we should aim to describe evermore those factors that keep us from achieving "positive health".

[Lori · Rating 5 out of 5]

I read this in preparation for a talk given by the author sponsored by the Medical Library Association. It was designed as a textbook so is really a starting point for discussing questions like: What is disease? How should resources for medical research be distributed? My favorite chapter on the philosophy of psychiatry highlights the flaws in the current way conditions are both defined and diagnosed by symptoms. Where in other fields of medicine, diseases are defined by what happens at a biological or microbiological level. Very interesting read!

[Diana Benford]

important, but especially for those in or going into healthcare-related professions