There has been significant debate about whether the moral norms of medical practice arise from some feature or set of features internal to the discipline of medicine. In this article, I analyze Edmund Pellegrino’s conception of the internal morality of medicine, and situate it in the context of Alasdair MacIntyre’s influential account of “practice.” Building upon MacIntyre, Pellegrino argued that medicine is a social practice with its own unique goals—namely, the medical, human, and spiritual good of the patient—and that the moral norms that govern medical practice are derived from these goals. After providing an overview of Pellegrino’s work, I discuss some forceful objections to his theory—specifically, that it is too rigid and incapable of entering into dialogue with contemporary values systems; that it is dependent on an external conception of human flourishing; and that it is incompatible with the rapidly changing nature of modern medicine. In the final section of this article, I consider how theorists working in the Hippocratic tradition might respond to these objections against ethical essentialism by drawing upon MacIntyre’s historico-cultural method as well as what he calls Aristotle’s “metaphysical biology.”

中文翻译：

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Pellegrino，MacIntyre和临床医学的内部道德。

关于医学实践的道德规范是否源于医学学科内部的某些特征或某些特征，已经引起了广泛的争论。在本文中，我将分析埃德蒙·佩莱格里诺（Edmund Pellegrino）关于医学内部道德的概念，并将其置于阿拉斯戴·麦金太尔（Alasdair MacIntyre）对“实践”的影响力描述中。Pellegrino在MacIntyre的基础上提出，医学是一种社会实践，具有其自己的独特目标-即患者的医学，人类和精神健康-并且管理医学实践的道德规范是从这些目标中得出的。在对佩莱格里诺的工作进行了概述之后，我将讨论对他的理论的一些有力反对意见，特别是它过于僵化并且无法与当代价值体系进行对话。它取决于人类蓬勃发展的外部观念；并且它与现代医学的日新月异的性质格格不入。在本文的最后一节中，我考虑了在希波克拉底传统中工作的理论家如何通过借鉴麦金太尔的历史文化方法以及他所谓的亚里士多德的“形而上生物学”来回应这些反对伦理本质主义的反对。