Saturday, December 22, 2012

The Physician Philosopher


Describing oneself as a physician may be something that is more easily understandable to most people than describing oneself as a philosopher. If one were to list one's occupation on a job application as "physician," for example, most people would have a much clearer understanding of what one meant than if one were to list one's occupation as "philosopher." However, if the meaning of the term "philosopher" is restricted to "professional philosopher," i.e. to an individual who has an advanced degree (such as a Ph.D.) in philosophy and who earns his/her living as a professional philosopher, teaching and writing in the field, then the term becomes somewhat clearer and more comprehensible. But what about those students, writers, thinkers, and other laypeople who engage in philosophy but are not professional philosophers? Can public philosophy be meaningfully engaged in only by professional philosophers?
      I'm a physician and also an aspiring philosopher. I suppose that my ambition to become a "physician philosopher" began a number of years ago when a friend graciously, and quite surprisingly, referred to me as such. I'll leave it to others to judge whether my aspirations are mere pretensions. My profession is that of physician. However, I feel a calling to both medicine and philosophy. Which is the higher calling? Is there a higher calling than that of healing the sick and helping the needy (as in the case of medicine)? Is there a higher calling than that of discovering the meaning of truth and justice (as in the case of philosophy)? Does the career pathway that I've chosen mean that I can never become a "real philosopher"?
      And what exactly is a "physician philosopher"? The question may be an important one, because medical decision-making may in some cases require a physician to be able to think philosophically as well as scientifically. Practice in philosophical thinking may to some degree enable an individual to become a better physician. Indeed, it may be argued that the philosophy of medicine is founded on the premise that philosophical thinking may be useful in analyzing the practice of medicine and the treatment of medical problems; thus, engagement in the philosophy of medicine can yield insights that will lead to improved practice and treatment.
      Perhaps the best answer that I can give to the question, "What is a physician philosopher?" is that a physician philosopher is a person whose vocation is to be both physician and philosopher, inspired by love of both vocations (medicine and philosophy). A physician philosopher is a physician who has qualified as (or been certified or recognized as) a philosopher by virtue of his/her work (writing, teaching, research) in the field. A physician philosopher may also be a philosopher who is engaged in the practice of medicine, or a physician who does philosophy in an academic setting, or a physician who specializes in the philosophy of medicine, in bioethics, in the philosophy of neuroscience, in the philosophy of psychiatry, or in some other related field.
      How can one become a physician philosopher? Simply put, one can become a physician philosopher by obtaining academic degrees in medicine and philosophy. Many schools offer dual degree programs in medicine and philosophy. Bioethics training may also be available in relevant fields, such as clinical bioethics, research bioethics, public health ethics, global bioethics, health care economics, and health care resource allocation. Job opportunities for physicians with training in clinical or research bioethics may include employment as a board member or ethics consultant for a hospital ethics committee, employment as a compliance officer for an institutional review board (IRB) overseeing scientific research, employment as an instructor in bioethics at a health care institution (hospital, school of public health, medical school, or nursing school), and employment as a faculty member (academic bioethicist) at a center for bioethics. Websites that offer information regarding careers in bioethics may be found at http://www.nature.com/nbt/journal/v22/n2/full/nbt0204-247.html, and at http://www.bioethics.net/jobs/.
      What kind of person should a physician philosopher be? Perhaps the best answer that I can give to this question is that the ideal physician philosopher is a person who has a (moral, intellectual, and social) commitment to, and engagement in, both vocations, and who does not view philosophy as a means to practice medicine or medicine as a means to engage in philosophy. An ideal physician philosopher is a person who has a love for medicine (a love for curing illness and alleviating suffering, not out of any sense of paternalism or superiority in relation to those in need of medical care, but out of a selfless need to help and care for others, and out of a sense of wanting to serve humanity and contribute to human well-being), and who has a love for philosophy (a love of wisdom, clarity, precision, intellectual discipline, and discovering the true nature of things). An ideal physician philosopher is a physician who is engaged in philosophy not merely for its medical applications, but for its wider applications to human knowledge, understanding, and well-being. 
      What role should a physician philosopher play in society? One of the most useful roles that a physician philosopher may play in society is that of questioning and clarifying unspoken assumptions about the nature of human life and existence that impact care for the sick, the helpless, and the needy. The physician philosopher may attempt to clarify and answer epistemological, ontological, ethical, linguistic, social, and political questions that influence our response to sickness and health. 
      Another role that the physician philosopher may play is that of clarifying the meaning of good health, of disease prevention, of distributive justice in health care, etc., and providing an analysis or explanation of how these goals may best be achieved.
      The following is a list (admittedly, very incomplete) of noted physician philosophers: Galen, Sextus Empiricus, Ibn Sina, Ibn Rushd, Al-Kindi, Moses Maimonides, John Locke, William James, Sigmund Freud, Karl Jung, Albert Schweitzer, Maria Montessori, Karl Jaspers, Victor Frankl, Frantz Fanon, Thomas Szasz, R.D. Laing, Walker Percy, Edmund Pellegrino, Nawal El Saadawi, Antonio Damasio, Nayef Al-Rodhan, Drew Leder, Leon Kass, Daniel Sulmasy, and Deepak Chopra.
      It should be noted that there may in some cases be a closer link between medicine and philosophy in Eastern society (e.g. China, Tibet, Korea) than in Western society. Traditional Chinese medicine, for example, may be more holistic in its approach than Western medicine, and may place a greater emphasis on the relation between spiritual healing and physical healing. The role of the physician as philosopher (or at least as the vehicle of a particular philosophy) may in such cases be a potentially more integrated one than in cases (in the East and the West) where there is a more scientific, technological approach to medicine. The latter approach may sometimes make it more difficult to define the proper relation between medicine and philosophy.

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