The Meaning of Medicine: The Human Person

B. Ars,

The Meaning of Medicine: The Human Person
Medical progress is increasingly being determined by developments in research, both in basic biology and in medical practice itself, as well as by progress in medical technologies that are mainly based on scientific developments. The amount of knowledge required to practice continues to increase, while at the same time acquired knowledge is constantly being challenged. As a result, specialization has become essential, the associated science and practice of medicine have an increasing tendency to be fragmented into relatively autonomous sectors, and the technical bases of medical intervention play an ever more important role. From the point of view of the actual practice of the art of medicine, this progress has had the two following consequences: on the one hand, there is now a techno-scientific screen that separates the patient and the physician and that gives medicine an esoteric aura, while on the other hand, the medical ‘outlook’ has become more and more analytical. Thus, communication between the physician and the patient has become purely functional, while at the same time, the diseased body becomes a fragmented body, perceived by each specialized field according to the specific system that is pertinent to it. This situation, as experienced by doctors and their patients, leads, more or less unconsciously, to an attitude that is both intellectual and practical and is based on what might be called implicit positivism. The principle of positivism is that the only valid form of knowledge is scientific knowledge and that knowledge cannot be accepted as scientific unless it is based entirely on empirical facts established by critically proven methods that are accepted by ‘experts’. Based on these basic principles, there is an absolute separation between the nature of facts that are accessible to science and the nature of values from the subjective domain. Moreover, the only way to gather theoretical knowledge is by induction. And yet, human beings cannot be reduced to purely empirical characteristics and patients cannot be treated like well-defined, purely somatic processes. On the contrary, developments in philosophical anthropology are increasingly emphatic about the unity of the complex reality that makes up a human being. A certain type of purely functional medical practice could result in the disintegration of personal human reality. The art of medicine absolutely must rediscover its authentic meaning: to help suffering human beings taken each as a whole and considered within the perspective of their destiny. But the demands of scientific medicine must also be included in this definition, i.e., that aspect of medicine that makes it efficient for modern culture, however relative this may be. This requires reflection. It is up to each physician to reflect upon this, based on her or his experience and on basic convictions. But serious reflection should be both critical and constructive. This implies that he should be able to consider the question of the meaning of medicine from a perspective that clarifies the status of the human person. To help practicing physicians place their work within this perspective, it seemed to me that it would be useful to provide them with a document that offered a reflection on the meaning of medicine based on a concrete vision of human beings and a reflection on the meaning of suffering and illness. Several eminent international philosophers, as well as several brilliant colleagues, have contributed to this book. In the first chapter, ‘The Body and the Mind’, Jean Ladrière explains the ‘classical’ idea and shows the basic motivation of the concept of soul, first mentioned in Greek thought then taken up and transformed by Medieval Christian thought. Bernard Feltz then evokes modern philosophical concepts that focus on the unity of human beings and on notions of a phenomenological nature. The second chapter, ‘The Human Person and its Destiny’, is the logical sequence to the first. Since the notion of the person is most commonly used to describe the status of human beings, Thomas De Koninck dedicates a chapter to this concept, emphasizing on the one hand, the body-mind relationship, and on the other, the meaning of person. He also introduces the idea of destiny which concerns the finality of human persons. In the third chapter, ‘Life and Death’, Dominique Lambert shows that the strange nature of human beings is due to their biological origins. This is the source of many of the difficulties of their existence, as well as of a number of the theoretical difficulties that arise when reflecting upon them. Dr. Lambert emphasizes this dual difficulty and the implications of this strange status. In particular, he shows the ambiguity of the concept of life, which is sometimes used in the sense of a biological reality, and sometimes in a metaphorical sense to indicate a relatively autonomous, existential process. The same comments are applied to the idea of death. Once again, this idea is sometimes used to refer to a biological process, and sometimes has an existential meaning, referring to something that belongs to human beings is tied by nature to a biological state, though not in a radical way. In the fourth chapter, ‘The Meaning of Suffering’, Wolfhart Pannenberg imagines suffering as an introduction to a reflection on illness, with illness being a specific type of suffering. He shows how suffering affects human existence, not in an accidental way, but somehow, constitutionally. He also mentions its negative aspects: it is never a good in itself. He goes on to link the meaning of suffering with the question of evil in general. Wolfhart Pannenberg presents a frankly theological perspective on the origins of evil and suffering, while opening the door to hope, made possible by Redemption. In the fifth chapter, ‘The Meaning of Illness’, Evandro Agazzi introduces a reflection on the nature of illness from a scientific and an existential point of view. It can then be related to the more general question of the meaning of suffering. The sixth chapter, ‘A Meaning for Medicine?’ was written by Bruno Cadoré and his colleague Gonzalo Herranz. They provide physicians with a source of reflection on the meaning of their practice. The authors analyse the status of medical practice in contemporary life, identifying in particular the risks of present trends and how medical practice is threatened by developments in scientific medicine. They touch upon the difficult question of how to integrate scientific medicine into a medical practice that takes into consideration each human being as a whole, i.e., according to his other destiny. They provide a necessary complement to the preceding chapters on the unity of each human being and on the existential nature of illness, which affect all of one’s existence and not only those aspects that are perceived by scientific analysis. Bernard Ars, M.D., Ph.D.

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