Tom Beauchamp

What is the organizational structure of Hume’s essay? The first three paragraphs are purely introductory and somewhat incidental. To someone untutored in Hume’s general religious skepticism, these opening remarks might appear to be the vain boasts of a philosopher in praise of philosophy. More plausibly, his opening remarks are stage-setting devices. They prepare the reader not for what Hume will argue but rather for how he will uncompromisingly challenge commonly held presuppositions about the sensitive issue of suicide. His comments are methodological or perhaps meta-philosophical in character. In more contemporary language, Hume is promoting the following two theses in these introductory paragraphs, each of which has to do with the inadequacy of non-philosophical foundations for reaching conclusions about the morality of suicide.

What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Thee influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal / external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each overreaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features.