Whatsoever things are true: ways, means and values in modern psychiatry

Epistemology and ethics are fundamental disciplines to understanding the nature of the medical enterprise. Values of truth, goodness, faith and love dominate the knowledge and practise of medicine. Each epistemological model of truth (truth as useful, truth as correspondence to fact, and truth as coherence) has strengths and weaknesses in guiding us in the scientific method in medicine. Dialectic skills are also important epistemological tools in exploring truth in relationship to diagnosis and treatment. By dialectic and analogy we approach the good as we explore and debate available technique and desirable goal. All of the doctor's scientific discipline and technical skill must be brought to bear within a relationship. It is here that the medical enterprise becomes intensely concerned with ethics. Most ethicists describe the doctor-patient relationship as a fiduciary relationship in which the doctor commits himself to his patient in faithfulness. The doctor-patient relationship is a special form of the "I-Thou relationship" grounded not only in trust but also in love.