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This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the model was first proposed and addresses key issues such as the model's scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model's scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social.

This collection examines prevalent assumptions in moral reasoning which are often accepted uncritically in medical ethics. It introduces a range of perspectives from philosophy and medicine on the nature of moral reasoning and relates these to illustrative problems, such as New Reproductive Technologies, the treatment of sick children, the assessment of quality of life, genetics, involuntary psychiatric treatment and abortion. In each case, the contributors address the nature and worth of the moral theories involved in discussions of the relevant issues, and focus on the types of reasoning which are employed. 'Medical ethics is in danger of becoming a subject kept afloat by a series of platitudes about respect for persons or the importance of autonomy. This book is a bold and imaginative attempt to break away from such rhetoric into genuine informative dialogue between philosophers and doctors, with no search after consensus.' Mary Warnock

Explores issue of how we should think about postmodern bioethics and suggests that many of the questions that bioethicists pose as problematic in postmodernity are, in fact, reactions to Wittgensteinian thought-- yet bioethicists as a rule are unfamiliar

Frontmatter -- Contents -- Acknowledgments -- Abbreviations -- 1 Introduction: Treating Bioethics -- 2 Religion, Superstition, and Medicine -- 3 Patient Multiplicity, Medical Rituals, and Good Dying: Some Wittgensteinian Observations -- 4 ''Unlike Calculating Rules''? Clinical Judgment, Formalized Decision Making, andWittgenstein -- 5 Wittgenstein's Startling Claim: Consciousness and the Persistent Vegetative State -- 6 Attitudes, Souls, and Persons: Children with Severe Neurological Impairment -- 7 Why Wittgenstein's Philosophy Should Not Prevent Us from Taking Animals Seriously -- 8 Injustice and Animals -- 9 Bioethics,Wisdom, and Expertise -- 10 Wittgensteinian Lessons on Moral Particularism -- 11 Wittgenstein: Personality, Philosophy, Ethics -- Notes on Contributors -- Index