The impossibility of a morality internal to medicine

After distinguishing two different meanings of the notion of a 'morality in ternal to medicine' and considering a hypothetical case of a society that r elied on its surgeons to 'eunuchize' priest/cantors to permit them to play an important religious/cultural role, this paper examines three reasons why morality cannot be derived from reflection on the ends of the practice of medicine: (1) there exist many medical roles and these have different ends or purposes, (2) even within any given medical role, there exists multiple, sometimes conflicting ends, and, most critically, (3) the ends of any prac tice such as medicine must come from outside the practice, that is, from th e basic ends or purposes of human living. The paper concludes by considerin g whether these ends external to medicine are universally part of the moral reality or whether they are socially constructed. The paper argues that, e ven if various cultural accounts of the common, universal morality are 'soc ially constructed', they may, nevertheless, be reflections, however imperfe ct, of a more universal common morality that should be thought of as real. Therefore, the morality of medicine must come from a more fundamental moral ity external to medicine. That external morality will be socially construct ed, but may nevertheless reflect an underlying common morality.