In spite of the seminal work A Philosophical Basis of Medical Practice
, the debate on the task and goals of philosophy of medicine still con
tinues. From an European perspective it is argued that the main topics
dealt with by Pellegrino and Thomasma are still particularly relevant
to medical practice as a healing practice, while expressing the need
for a philosophy of medicine. Medical practice is a discursive practic
e which is highly influenced by other discursive practices like scienc
e, law and economics. Philosophical analysis of those influences is ne
eded to discern their effect on the goals of medicine and on the ways
in which the self-image of man may be changed. The nature of medical p
ractice and discourse itself makes it necessary to include different p
hilosophical disciplines, like philosophy of science, of law, ethics,
and epistemology. Possible scenario's of euthanasia and the human geno
me project in the USA and Europe are used to exemplify how philosophy
of medicine can contribute to a realistic understanding of the problem
s which are related to the goals of medicine and health care.