ABSTRACT
This chapter explores the work of the eminent physician and philosopher, Edmund Pellegrino, who argues that three interrelated phenomena set the boundaries for medical activity: the nature of illness, the act of profession, and the end of medicine. Pellegrino notes that the person as patient suffers a break in the usual connection between one's self and one's body. Consequently, the end of medicine is to exercise a form of clinical judgment that is informed by both scientific and technical expertise as well as a narrative and relationship-centered understanding of the patient. Thus, what constitutes the internal morality of the medical profession is bounded and contextualized by the nature of illness, the act of profession, and the ends of medicine as a practice in the service of the ill and vulnerable. Regardless of the particular form of social organization for medical practice, the patient-physician interaction has always been, and will always be, the core of the profession.
