Respice...prospice: Philosophy, ethics and medical care- past, present, and future.

The notion of philosophy, ethics and humanities in medicine is important, as it communicates an appreciation for ethics and humanitarian concern(s) as essential to each and all of the dimensions that contribute to and constitute medicine as a profession and practice. The papers appearing in PEHM illustrate this, and also seek to inform, educate, and at times, provoke debate and controversy. This year has seen a fine complement of papers: some re-examining longstanding questions and constructs of medicine [1-3]; others focusing upon issues that reveal the shifting exigencies and contingencies of healthcare in an evermore technololgic and globalized world culture [4-10], and still others that look to philosophy and history to portend the potential constructs, contexts and concerns that will establish the ethical landscape of medicine in years to come [11-14] Certain papers remain the focus of discourse - and dialectic - for some time as the issues they raise seethe anew in the crucible of professional, public and/or political conversation. To be sure, this has been the case with Prof. Thomas Papadimos' essay "Healthcare Access as a Right not a Privilege: A Construct of Western Thought" [15], that has stimulated ongoing deliberation and debate upon putative right to medical care, the relationship of ethics to policy, and the assertion of Aristotelian philosophical claims to healthcare-as-right.Each and all of these themes are relevant - and controversial - in light of recent healthcare reforms and the changing climate of healthcare provision. There is some question as to whether Aristotle actually endorsed healthcare as a right, and Prof. Pellegrino (working with the staff of the National Reference Center for Bioethics Literature at the Kennedy Institute for Ethics at Georgetown University) has raised this point by noting specific citations from Annas, Long, Miller, Schofield, et al. [16] The reader is recommended to this work (vide infra), as both commentary upon the