View/Open - Scholarly Commons Home

nineteenth century, influenced by major scientific discoveries, such as Darwin’s theory
of evolution (Hutcheon, 1972, p. 6).
Value-free approaches to law and medicine
This segmentation has repeatedly been attributed to the influence of Descartes
(Loughlin, 1998). Loughlin (p. 26) explains that acceptance of value-free philosophies
stems largely from the Cartesian conviction that the world to be studied is an objective,
impersonal mechanism which we can only hope to understand by impartially viewing
the “cold, hard facts”. Kennedy (1981) sees Descartes’ influence in the way modern
medicine views the body as a machine and illness as a mechanical failure. Through this
paradigm, the doctor approaches disease as a mechanic approaches an engine. This
results in a reductionist approach to illness which isolates disease to the malfunction of
a body part rather than seeing the person as a whole.
The objective, scientific approach depicts man as an automaton, devoid of feelings,
emotions, life experience and removed from his social or cultural environments. It
influences not only the treatment of disease, but also the perception that medical
decision making can be value-free.
The medical science approach and the premise that value-free empirical knowledge is
preferable remains highly influential in modern day health care systems. Evidence-
based medicine takes it for granted that the scientific method is the governing method
in advancing the field of medicine (Mayer, 2004). Evidence-based medicine urges
health professionals to base their care on empirical studies, rather than simply on
“opinion” (Meulen & Dickenson, 2002). Empirical methods in medicine have even
spawned a new approach to bioethics called “evidence-based ethics” which claims to
“delineate popular attitudes” relating to issues such as abortion, stem cell research and
euthanasia (Goldenberg, 2005, p. 2). Evidence-based medicine may be a sensible
approach to health care delivery, offering providers and consumers accountability and a
firm knowledge base from which to plan treatment provision. However, purely
evidence-based approaches promote the perception that medical decision making is
16