1 - Between the Normal and the Ideal
Published online by Cambridge University Press: 08 January 2010
Summary
When it comes to determining whether a condition is a medical one, philosophers such as Leon Kass or Christopher Boorse advance an essentially biological approach. They want us to look to the biological norms of the human species – our genetic, cellular, and organic functioning – for the foundations of what medicine should and should not do. Their understandable concern is that without such a biological anchor, we would have no grounds for refusing someone like Dartmouth Medical School professor Joseph Rosen, who ended a medical conference some years ago by “pounding the table … and announcing that, were he given permission by a medical ethics board, he would try to engineer a person to have wings.”
But as many critics have urged, and as I too argue in the Introduction, there is a serious weakness in the biological functioning approach to species normality. Unless we at the same time consult social norms, it tells us very little. Perhaps, as a proposition of biological functioning, our legs aren't even meant to carry us upright, as Dorothy Dinnerstein suggests. Nor would a reliance on natural biological functioning seem to allow medicine to concern itself with the vision sufficient for night driving. But once we admit that medicine's task is to take us to whatever happens to be socially normal, we then have to accept that the social norm itself is always evolving.
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- The Limits of Medicine , pp. 31 - 84Publisher: Cambridge University PressPrint publication year: 2006