First off, a question from me: Why should the term "medical ethics" be designated as an oxymoron? This can be answered from almost any point of view in a similar fashion; scientific, religious, political, practical, etc.

Secondly, my thanks to Dennis The Hall obtaining the article, "A Lecture on Ethics," by Ludwig Wittgenstein. It contains the quote to which I referred earlier, "I can only describe my feelings by the metaphor, that, if a man write a book on Ethics which really was a book on Ethics, this book would, with an explosion, destroy all the other books in the world. Our words used as we use them in science, are vessels capable only of containing conveying meaning and sense, natural meaning and sense. Ethics, it is anything, is supernatural and our words will only express facts; as a teacup will only hold a cup of water and if I were to pour a gallon over it................."

Of Course There Is Such a Book. The combustion mentioned above is really somewhat of a slow burn, similar to the combustion that is taking place in your body and mind as we speak. We speak of a controlled burn in the science of forestry but as one can see, the thing can get totally out of control. There is also Entropy to consider which makes the above all the more difficult to comprehend from a purely scientific point of view. The additional problem is that pure science does not exist either. The more I think about it, whether as a scientist or one interested in metaphysics, the more I see that we are up against the famous failure of "The Critique of Pure Reason." The French Revolution of course attempted to create a new a new goddess out of a mental construct called Reason and the results were quite unreasonable!

I would further contend that what we have today is not Science as such but "science -- so -- called." It is commonly recognized among relatively reasonable scientists that, outside of technology, science is culturally determined. Of course this is precisely the critique of postmodernists as well as a number of feminists. As I have said previously, "science proves".... very little. To reason by induction is logically speaking very difficult in the first place and extremely restrictive. Science generally advances by deduction, a much easier process, but inherently much less certain than proof by induction. The scientific method or what I would call bench science is restricted to repeatable phenomenon that can be controlled. Historical deduction is outside the realm of science just as much is Ethics, as Wittgenstein mentions.

(Incidentally, Wittgenstein was initially mentored by Bertrand Russell but quickly outgrew Russell's rather contracted universe. Dr. Russell acknowledged that Wittgenstein's abilities in mathematics etc. far outstripped his own. Wikipedia has an interesting summary of Wittgenstein's career. I also note that T.S. Eliot was a good personal friend of Dr. Russell and they had an interesting correspondence in the early years of Eliot's literary career. They also parted ways I would say on good terms but apparently Dr. Russell was unable to pass on his beliefs to either Wittgenstein or T.S. Eliot, a fact that I find quite fascinating to me from both scientific and literary points of view. I have copies of this correspondence if anyone is interested.)

I heard the Editor of the Journal of the American Medical Association speak a few years back and she confessed that 15% of medical research is not just flawed but deliberately deceptive, to speak kindly about it. She also stated that this was probably just the tip of the iceberg and that even with peer review it was impossible to detect much of the deception unless one had access to the original data which, as we have heard recently, is often destroyed or altered to fit the conclusion already chosen previously. The whole study would have to be repeated by different people who do not have a vested interest in making a name for themselves or fulfilling their vaulting ambitions. Not to mention the money and grants. She also acknowledged that she wasn't sure that medical ethics hadn't hit lows never previously seen.

The ethics and science that we generally use -- largely without thinking about it in any depth -- are part of a large and growing subculture which has an priori commitment to naturalism. Ironically this also rules out free will and puts sheer political power in its place. The Hippocratic oath is a particular example. The original Hippocratic oath had specific content. The current replacement in the AMA pantheon is so vague as to be completely useless in any practical sense. In other words no one uses it. I think it is quite interesting that those who abhor violence and war often subscribe to the same commitment noted above but that assumption also does not mandate anything even remotely akin to pacifism. I like Walt Kelly's and Walker Percy's approach to the difficult problem of war and peace. I also do hope that everyone has read The War Prayer, by Mark Twain. I particularly liked the introduction in which Mr. Twain confesses that he has told the whole truth in this poem and he would not allow it to be published until after his death. He was apparently afraid of the backlash in spite of his established reputation and fame.

I am hoping for some feedback on this. One final question: which book did Mark Twain consider his best? Any ideas why? Any ideas why one never hears about it?