What is philosophy of medicine
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Doctors have to deal more and more intensively with the economization of the health system. In addition, there is a disproportion between diagnosis and therapy. Medicine has lost a good deal of its wholesome balance.
Despite its enormous progress, medicine is in a crisis of meaning. It seems to have lost a good deal of its wholesome balance. The human being is almost only seen as a body and natural being and less and less as a social cultural being with fears, worries and hopes. The scientific perception threatens to displace a more integrative humanistic perspective. This can be seen, for example, in the discrepancy between diagnosis and therapy. More and more diseases can be diagnosed earlier and earlier, but not necessarily treated. Illness, even symptom-free or just future illness, becomes a constant threat and hangs over everyday life like a sword of Damocles.
Dignity of the patient
Not only patients but also doctors are unsettled by these developments. Of course, patients want and should be the focus of medical art. They have a right to be treated or even "treated" not only as carriers of diseases and as bare bodies. Rather, respect for the dignity of the patient dictates that they be viewed as individuals with a specific life story. It would be easy (but also wrong) to blame doctors for this one-sided development. They too want to focus on the patient.
The problem lies elsewhere, namely in the increasing complexity of the health system and the one-sided training of the medical profession. This can be shown with two examples: First, doctors have to deal more and more intensively with the economization of the health system in their everyday work. Because more and more is possible from a medical technology point of view, but the costs are also enormous, technology and medication are becoming a scarce commodity. Hardly anything can be done about that. The problem, however, is that doctors are made the managers of this shortage. This distracts from their actual activity, namely the medical art. The patient threatens to become a customer or, worse still, a commodity.
The second example has to do with the challenge for doctors to overcome the growing disparity between diagnosis and therapy. Should they advise their patients about all possible tests and preventive examinations and thus possibly contribute to a "medicalization" of everyday life or not? How do you communicate it when a difficult or incurable disease could occur with a certain probability in the future? How do you deal with your patients' fears? Doctors are expected to contribute through advice and action to a sensible and enlightened approach to illness and death. But they are not trained for this at the university.
Then where do they get the wisdom and the narrative power to deal competently with moral and ethical questions? The question arises as to how doctors should respond to such challenges in an increasingly complex health system. Of course, you could simply complain about being completely overwhelmed as a manager, life coach, medical professional, healer, helper and accountant. Or they can supplement their scientific education at the university with a more holistic further education. It is urgent to gain a more comprehensive perspective on one's own work and thus gain new freedom in everyday practice. Analytical stocktaking, critical self-reflection and future-oriented creativity are equally in demand so that doctors can find new ways to put the patient back at the center of their work.
To take responsibility
Of course, this plea for assuming responsibility should not hide the fact that there are also serious systemic pressures that doctors are exposed to. But only when they have done their part and accepted their responsibility can they argue convincingly against these compulsions. In addition, a rethought and holistic self-image provides doctors with the right arguments for changes in the health system. You can then make demands that are really suited to putting the patient back into focus.
It must remain the task of the doctors themselves to redefine their healing art in the face of systemic complexities and changes. You can get help with this, but it is your profession that is being scrutinized. If you do not want to lose the patients' trust in the future, you have to show that you can reinvent yourself and face the challenges. To do this, they have to step out of their everyday lives and think through their profession analytically, review it critically and develop it creatively.
Christian Neuhäuser is the director of studies and lecturer in the university continuing education programs MAS Philosophy and Medicine / Philosophy and Management at the University of Lucerne.
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