14 Mayo 2019
Medical ethics is fundamental. Currently, the relationship between philosophy and medicine goes through the neurosciences, as they study our way of thinking, knowing, understanding, reacting and acting.
We're talking philosophy and medicine. And ethics. And the relationship between them. Philosophy and medicine are like old good friends: with times when you don't see much or feel more distant, but, in the end, the important thing is that their relationship lasts through years and ups and downs.
They were born by the hand. With time they followed their paths, but they get along well, they like to see each other, they have a lot to tell each other... This is a quick tour of some of their points of encounter and conflict.
As soon as you have read some of the classic philosophical texts, it is very possible that you have come across the name of Hippocrates. The so-called father of medicine appears in numerous books, for example, by Plato, such as Gorgias, La República, Las Leyes and, above all, in Fedro. There, through the mouth of Socrates, Plato skilfully adds Hippocrates to his "panda" of scholars of "the whole", of complex, interrelated natures:
-Socrates: Do you think that it is possible to adequately understand the nature of the soul, if it is separated from nature in its totality?
-Fedro: If we have to believe Hippocrates the one of the Asclepiads, not even the one of the body without this method.
-Socrates: And you are quite right, mate.
Quite far from the current methods based on the strict tandem diagnosis-treatment, Hippocrates studied and noted in his time the symptoms of the ailment (fever, pain, color, pulse) and other peripheral such as family history, diet, environment ... He devised a theory according to which much of the conditions were due to imbalances between four moods: phlematic, melancholic, blood and choleric, and defended general therapies. For the history of philosophy, its relevance focuses on the fact that it was able to professionalize medicine by separating its work from other disciplines with which it had traditionally been associated, such as philosophy and religion. In this sense, his text On the Sacred Disease is very valuable, where he manifests the total independence of ailment: "Nothing seems to me to be more divine or more sacred than the others, but it has its own nature, like other diseases, and from there it originates. But its foundation and natural cause was considered by men as a divine thing because of their ignorance and amazement, since in no way does it resemble the others. But if by their inability to understand it they preserve that divine character, by the banality of the method of healing with which they treat it they come to deny it. Because they treat it by means of purifications and spells.
For Hippocrates, the illness was due to imbalances
The inseparable couple of classical philosophers also practices in this field of combining philosophy and medicine. Often, as the historian Geoffrey Ernest Richard Lloyd points out, in their texts both establish analogies between the morality of the individual, the justice of the State and a healthy body, for example, and vice versa; disorder in the State and in the psyche are diseases that need a cure and professionals who perform them. "Medicine, then, has an absolutely central role in the Platonic recommendation that there is an objective truth in the political and moral fields, that there are experts in those fields and that the profane, or the idiot current, should follow their advice and submit to their treatments. The same as Aristotle in raising his ideas and parallels on health, morality and good governance. It is thought that Aristotle could have gone even further in his interest and sketched out a treaty on health and disease.
In his work Greek Thinkers, Theodor Gomperz analyzes the influences between medicine and philosophy and cites the spirit and method of research as a special nexus, as the "really important". He divides the Greek physician-philosophers into two groups: those for whom philosophy is a priority and prior, going from idea to fact, from theory to praxis, such as Parmenides, Heraclitus or Empedocles and Anaxagoras; and a second more scientific group, genuinely Hippocratic, which, from the observation of facts, originates theoretical reflection. His path would be from praxis to logos. Aristotle and Plato would follow his path.
In any case, as the philologist Werner Jaeger writes in the chapter entitled Greek medicine as paideia (Paideia. The ideals of Greek culture), the essential thing was that "Greek medicine only became a conscious art under the action of the Ionic philosophy of nature (...). It would never have become a science without the inquiries of the first Ionic philosophers of nature, who sought a natural explanation for all phenomena. That's how it all began. Important nuances would follow.
The best doctor is also a philosopher
Galeno applied to medicine the parameters that used to apply to philosophy: logic, physics and ethics.
Galen applied to medicine the parameters that used to apply to philosophy: logic, physics and ethics.
Galen, a doctor and thinker born in Pergamon in the second century, gave a strong and definitive push to medicine for a long time. His discoveries were numerous and transcendental (he identified the cranial nerves, the functions of the kidney and the bladder, he described the valves of the heart...). And his influence spread over 10 centuries. Only that in the subject of the relations of his already consecrated profession with philosophy he got a little entangled: it occurred to him to write a text titled The best doctor is also a philosopher, applying to medicine the parameters that traditionally applied to philosophy: logic, physics and ethics. In this way, the physician would have to be a professional capable of knowing the methods of logical and scientific reasoning, of mastering the phenomena of nature and physics and also of working on ethics in order to become good. At this point the questions are unleashed, the moral problems: should a doctor always be good? What if he is not? Can a good doctor be a bad person? Can he let his personal inclinations mix with the professionals? Many years later, a discipline was invented - clinical ethics - that tries to answer these kinds of questions, if not to deal effectively with them.
Descartes established the separation between body and soul. The problems of the body were solved by doctors and those of the soul, God.
For many centuries (which lasted even longer - and last longer - depending on geography), these problematic questions either did not exist or there was a brilliant answer that answered and annihilated them: everything was like this because God, one or several, in one form or another, wanted it that way. Divine providence was ultimately the one that decided who should die and who should heal. The reasons, often incomprehensible to relatives and acquaintances, were known only to God. The doctor's job was to do everything that was in his hand, but in the end it turned out that the hands that were worthwhile were those of God.
A very useful tool at the service of this cause was to separate the things of the body and the things of the soul; the former belonged to the realm of human beings, and their arrangement was a matter for doctors; those of the soul belonged to God, with small parcels of participation and submission reserved for human beings. Descartes invented this radical dualism and its influence was very extensive in time. But the triumphant had some interesting replicas like Spinoza's, who had a brilliant intuition: something must have seen the lens tuner that made him think that it was not so and that the soul was in the body, and the body in the soul, and that both things went hand in hand, or better, they were the same.
In the "New Philosophy of Man's Nature" of 1587, Oliva Sabuco confronted the dualism of discards. (CC-BY-SA 3.0). With permission of NIH-DC
In the "New Philosophy of Man's Nature" of 1587, Oliva Sabuco confronted the dualism of discards. (CC-BY-SA 3.0). With permission of NIH-DC.
Before him, the unknown Oliva Sabuco of Nantes had published a text entitled New Philosophy of Man's Nature in which she also stood up to Descartes and where, moreover, she drew attention to the fact and the benefit that optimism brought to the body. The suggestive intuitions were a gateway to modernity. Today, now scientifically confirmed, both suppositions still give rise to countless studies and are at the heart of the research of scientists and, above all, neuroscientists such as Antonio Damasio, who has dedicated his efforts to the research of emotions in relation to the brain.