Excerpt
The third conference of the European Society for Philosophy of Medicine and Healthcare (ESPMH) took place in 1989 in Czestochowa, Poland. Some people wondered why the newly established society would organize a conference in a little-know provincial town after the first two conferences in Maastricht (1987) and Aarhus (1988). Insiders, however, were very well aware of the reason. The ESPMH had been established in order to promote the philosophy of medicine and healthcare. Its founders knew the rich tradition of this field in several European countries. Czestochowa was an iconic place in the Polish tradition of philosophy of medicine. It was here where its most productive scholar had lived and worked. Wladyslaw Bieganski (1857–1917) was chief physician at the local hospital, factory physician and private general practitioner. He wrote 116 publications in medicine and philosophy, covering especially the logic and epistemology of medicine. He was also a member of the editorial board of the
Medical Weekly published in Lwow. In his various books, Bieganski intended to clarify the scientific basis of medicine (Löwy
1990). For him, the purpose of scientific knowledge is not to understand the surrounding world but to predict the future. Systematic clinical methodology is therefore imperative. In order to find therapeutic indications, the physician formulates consecutive hypotheses. The first of these is a hypothetical diagnosis based on observations and tested by further investigation (with methods of exclusion, analogy and experimentation). For Bieganski, the right diagnosis (based on science) is the foundation for therapy. Like his colleagues within this epistemological tradition, he wanted to explore how medicine as a science could be distinguished from medicine as an art. Making the distinction demanded a thorough analysis of the basic concepts of medicine, such as disease, diagnosis, prognosis, therapy and prevention (Löwy
1990). Some of his colleagues, for example Edmund Biernacki criticized the priority given to diagnosis, assuming there are disease units in reality that should be identified before therapy could be rationality justified (Löwy
1990). Most Polish philosophers of medicine, however, agreed that it is important to strengthen the epistemological subject (i.e. the physician or medical scientist) with rigorous methodologies and conceptual analysis. They did not question the status of the knowing subject itself, as was done in the later movement of anthropological medicine that emphasized the personal qualities of the physician and that created sufficient space for ethical concerns to be articulated (Ten Have
1997). However, Bieganski was an exception. He complained about the absence of ethical reflection, pointing out that for most physicians ‘medical ethics’ refers to the rules regulating professional corporate interest rather than the rules determining relationships with patients. Corporate and patient interests are often in conflict, and at that point ethics comes in. …
