Medicine as Enlightenment cure: Benedetto Frizzi, physician to eighteenth-century Italian Jewish society

This article examines modern Jewish doctors and the Enlightenment in action through its analysis of Dr. Benedetto Frizzi (1756–1844) as an Enlightenment Jewish physician and public intellectual in Habsburg northern Italy. Frizzi sought to spread the new Enlightenment gospel of polizia medica—public health policy or social medicine—that he learned from its pioneering exponent, Dr. Johann Peter Frank, his teacher at the University of Pavia. Frizzi dispensed Enlightenment medicine for the benefit of the state and society in general, as well as Jewish society and culture in particular, for he saw himself as both public health crusader and doctor-priest ministering to his own people. His commitments to Enlightenment science and rationalism led him to criticize Jewish social practices harshly even as he creatively reinterpreted classic Jewish texts; accordingly, Frizzi was regarded in some quarters as subversive, while in others as an apologetic defender of Jews and Judaism. Situating Frizzi within the traditions of Jewish as well as European Enlightenment physicians, this article raises broader questions about religion and secularism in the modern discourse of medicalized Judaism.     

The worthless remains of a physician’s calling: Max Weber,William Osler,and the last virtue of physicians

On the centenary of Max Weber’s “Science as a Vocation,” his essay still performs interpretative work. In it, Weber argues that the vocation of a scientist is to produce specialized, rationalized knowledge that will be superseded. Weber says this vocation is a rationalized version of the Protestant conception of calling or vocation (Beruf), tragically disenchanting the world and leaving the idea of calling as a worthless remains (caput mortuum). A similar trajectory can be seen in the physician William Osler’s writings, especially his essay “Internal Medicine as a Vocation,” in which the calling of a physician is described as both rational and noble. While Osler’s conception of the physician’s vocation has been formative for contemporary medicine, physicians are reporting burnout and leaving medical practice at escalating rates. As physicians abandon their noble vocations, an alternative conception of a physician’s vocation is needed. From the worthless remains of the physician’s rational and noble vocation, the labor of a physician can find grounding in humility.     

Viktor Emil Von Gebsattel on the doctor-patient relationship

This article provides a summary overview of the ideas on medical anthropology and anthropological medicine of the German philosopher-psychiatrist Viktor Emil von Gebsattel (1883–1974), and discusses in more detail his views on the doctor-patient relationship. It is argued that Von Gebsattel's warning against a dehumanization of medicine when the “person” of both patient and physician are not explicitly present in their relationship remains valid notwithstanding the modern emphasis on respect for patient (and provider) autonomy.     

Is This Relevant? Physician Perceptions,Clinical Relevance,and Religious Content in Clinical Interactions

Despite wide support among physicians for practicing patient‐centered care, clinical interactions are primarily driven by physicians’ perception of relevance. While some will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, the greater his or her perception of religion's impact on health outcomes and his or her inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the United States and mediated path models, I estimate models for five different physician actions to evaluate these relationships. I find that a physician's religious background is strongly associated with whether or not he or she thinks religion impacts health outcomes, which is strongly predictive of inclusion. I also find that not all of the association between inclusion and physicians’ religious background is mediated by thinking religion impacts health outcomes. Issues of religion's relevance for medicine are important to the degree that religious beliefs are an important dimension of patients’ lives.     

On the disenchantment of medicine: Abraham Joshua Heschel’s 1964 address to the American Medical Association

In 1964, the American Medical Association invited liberal theologian Abraham Joshua Heschel (1907–1972) to address its annual meeting in a program entitled “The Patient as a Person” [1]. Unsurprisingly, in light of Heschel’s reputation for outspokenness, he launched a jeremiad against physicians, claiming: “The admiration for medical science is increasing, the respect for its practitioners is decreasing. The depreciation of the image of the doctor is bound to disseminate disenchantment and to affect the state of medicine itself” [1, p. 35]. Heschel’s reference to “disenchantment” suggests that he may have been familiar with the work, or at least the outlook, of sociologist Max Weber, whose 1917 address “Science as a Vocation” portrays the modern world as disenchanted by the progress of rationalism. Heschel’s life’s vocation had been to uncover the inner meaning of religious faith and to translate that faith into principled action. Heschel saw disenchantment not as an inescapable aspect of modern life but rather as the byproduct of physicians’ conscious choices to seek worldly success and material comfort. Yet, because of their privileged position as witnesses to human vulnerability, physicians possess an obligation to develop their own personhood, to re-enchant medicine, and through medicine to spark a positive transformation in all of modern life. As Heschel says, “The doctor must realize the supreme nobility of his vocation, to cultivate a taste for the pleasures of the soul. … The doctor is a major source of moral energy affecting the spiritual texture and substance of the entire society” [1, pp. 34, 38]. While Heschel’s conception of the physician’s role is romanticized and idealized, changes in the organization and practice of medicine have validated his concerns.     

Hermeneutics in science and medicine: A thesis understated

Drew Leder's “Clinical Interpretation: The Hermeneutics of Medicine” [1] is an essay which understates its case and thereby opens itself to misinterpretation. This response to Leder argues for a more thorough-going hermeneutic for both medicine and science. At the conceptual as well as the practical level, modern medicine and its scientific foundations are hermeneutic enterprises. The purpose of this essay is to argue that we should not back away from this more radical thesis. Embracing it will result in less alienation of physicians from patients, and of physicians from the tasks of medicine.     

TECHNO‐SECULARISM AND “REVEALED RELIGION”: SOME PROBLEMS WITH CAIAZZA'S ANALYSIS

Abstract. Instead of focusing my remarks on John Caiazza's interesting and important thesis about the way in which modern technology is drastically secularizing our culture today, I examine the frame within which he sets out his thesis, a frame I regard as seriously flawed. Caiazza's argument is concerned with the broad range of religion/science/technology issues in today's world, but the only religion that he seems to take seriously is what he calls “revealed religion” (Christianity). His consideration of religion is thus narrow and cramped, and this makes it difficult to assess properly the significance of what he calls techno‐secularism. I suggest that employing a broader conception of religion would enable us to see more clearly what is really at stake in the rise of techno‐secularism. Instead of defining the issues in the polarizing terms of revealed religion versus secularity, I argue for a more integrative approach in which concepts are developed that can bring together and hold together major religious insights and themes with modern scientific thinking. If, for example, we give up the anthropomorphism of the traditional idea of God as creator and think of God as simply creativity, it becomes possible to integrate theological insights with current scientific thinking and to formulate the issues posed by the rise of techno‐secularism in a more illuminating way. This in turn should facilitate effective address of those issues.     

The value of emotionally expressive visual art in medical education

This paper approaches the topic of visual art in medical education from a philosophical perspective, drawing on arguments from epistemology, philosophy of science, aesthetics, and contemporary ethical theory. Several medical ethicists have noted that the traditional clinical paradigm may increase the epistemic and emotional distance between patient and physician in part by focusing on the physical body and medical technology. Some of these same writers recommend a new approach to patients based on empathy and increased attention to suffering. After reviewing these arguments, supporting examples, and recommendations, I explain how visual art that expresses or symbolizes the emotional response to illness could be used to introduce an additional paradigm into medical education. This would be a paradigm based on empathetic attention to patients' emotional experiences in illness. My own argument is that this additional way of perceiving and relating to patients may reduce the distance between patient and physician and may allow physicians to better meet the ideal of treating the patient as a person.     

Are archetypes transmitted or emergent? A response to Christian Roesler

In this paper the author argues that Jung's concept of archetype should not be reduced to an univocal definition. Jung himself proposed many definitions of this concept, some of them being partially or totally contradictory to others. A univocal and logical way of thinking can lead us to refute and reject part of those definitions, but a complex way of thinking, as proposed by Edgar Morin or Roy Bhaskar for example, can allow us to consider that those apparent contradictions in Jung's definitions of archetype reflect the complexity of the psychic reality. The main argument of the author is that Jung was missing the epistemological concept of emergence (which appeared in science at the time of his death) and that he tried to express it with the epistemological concepts of his time.     

Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

Suicide and Drug Abuse in the Medical Community

ABSTRACT: In the United States each year the equivalent of an average-size medical school graduating class commits suicide, with the highest incidence occurring in the decade following the completion of training. Of these suicides, 20% to 30% are associated with drug abuse and 40% with alcoholism. Various problem areas are considered. Role strain, leading to excessive drug use in an attempt to increase work efficiency, is coupled with a denial of the physician's own dependency needs and gratification. The problem of identity occurs in relation to the exaggerated sense of duty and obligation the physician feels in attending to the demands of the patients and their families. Medicine as magical thinking is also discussed, revealing the physician's belief in his own immunity, which is strenuously tested when he actually sets up in practice. The community's high regard for the physician further complicates the situation. Too little has been done about working with emotional problems of medical students during their training and after they begin to practice. Unfortunately, physicians feel uncomfortable in turning to colleagues for help; rather, they tend to isolate themselves, resorting to alcohol and drugs. One should question the selection of medical students and their overall training, not only in terms of academic learning but also with more consideration for the stresses and strains of the future career.     

A Defense of Partisan-Science: An Assessment of Stenmark's Non-Partisan Science3

Abstract

In his influential book “How to Relate Science and Religion,” Mikael Stenmark argues for the legitimateness of what he calls “partisan science”: “science that is aligned with or supports a particular ideology, religion, or worldview over another.” However, he maintains that we should make an exception: the justification phase of science (phase 3) requires neutral science. Thus, he argues for “non-partisan science₃.” In this article, I assess his arguments for non-partisan science₃. I find them wanting and I will argue for partisan science₃ and maintain that we should adhere to “Augustinian” or “theistic science.”     

Faith without Dogmatism: Karl Jaspers’ Critique of Bultmann's and Barth's Dogmatic Theologies

In his mature philosophical writings, Karl Jaspers juxtaposes his own theory of reason with what he considers irrational and dogmatising tendencies in the works of Rudolf Bultmann and Karl Barth. On Jaspers's view, both Bultmann and Barth construct theologies that serve as a priori frameworks through which to understand all the contingencies of existence. In opposition to such dogmatisms, Jaspers advances a hermeneutics that forbids, in advance, any permanent conclusions by proposing that we understand religious, artistic, and other approaches to transcendence as ciphers. Such ciphers, Jaspers holds, offer no fixed and final interpretation of transcendence but offer a way to remain non-dogmatically open to a wide range of possible understandings of it. As opening up a non-dogmatic form of communication, cipher-reading is guided by reason's will to openness and communication. However, as I ultimately point out, Jaspers's own effort to develop a non-dogmatic hermeneutics is beset by some of the very difficulties he identifies in the theologies of Barth and Bultmann.     

To succeed in failing—a dialectically constructed unity in Jaspers's thought

ABSTRACT

Jaspers is justly famous both for his exploration of aportas (Grenzsituationen,) in various fields, as well as for his trenchant pre- and post-war criticism of life in both Germany and in the world at large. In this article I attempt to indicate the extent to which his analyses of both are informed by a metaphysics of foundering/failure (das Scheitern). His apparently paradoxical thesis is that our very failure to achieve sufficient comprehension—in the fields of science, in self-understanding, and in metaphysical striving—ensures us a measure of reconciliation with our fate which may enable us to cope with recurrent crisis-situations. Like Adorno, Jaspers propounds a negative dialectics through which he hopes to indicate how we might succeed in overcoming in practice what seems insoluble in theory. I critically explore the theory-practice relationship, while indicating the underlying unity of his thought.     

Christopher Wren, Thomas Willis and the Depiction of the Brain and Nerves

This paper is about Christopher Wren’s engravings for Thomas Willis’ The Anatomy of the Brain and Nerves of 1664. It is a study in the intersection of medicine and art in 17th century Britain. Willis, an eminent English physician and anatomist, was a major figure in the development of modern neurology, and The Anatomy of the Brain and Nerves was his most famous and influential book. Wren was Willis’ assistant and medical artist. I discuss the visual strategies employed by Wren to present their research and frame it as genuine knowledge.     

SCIENCE MEETS BIBLICAL EXEGESIS IN THE GALILEO AFFAIR

Abstract Although Galileo's venture into theology, as discussed by McMullin, is limited to Galileo's exegesis of Scripture, it can be seen as an important element in a broader role in theology, namely in ecclesiology and in the development of doctrine. From the Council of Trent, the Reformation Council, until today there has been a development in the Church concerning the manner in which Sacred Scripture should be interpreted and as to whether it can be said to be in conflict with our scientific knowledge of nature. Galileo made a significant contribution to this development. With his telescopic observations he was, in fact, undermining the prevailing Aristotelian natural philosophy of his day and was defending the birth of modern science against a mistaken view of Scripture. The Church of his time was not prepared to accept his contribution to this theological development. What does this history have to contribute to the challenges we face today in the interactions between science and religious belief?     

Toward a reconstruction of medical morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

The idea of the absurd and the moral decision. Possibilities and limits of a physician's actions in the view of the absurd

In reference to two central concepts of Albert Camus' philosophy, that is, the absurd and the rebellion, this article examines to what extent hisThe Plague is of interest to medical ethics. The interpretation of this novel put forward in this article focuses on the main character of the novel, the physician Dr. Rieux. For Rieux, the plague epidemic, as it is described in the novel, implies an unquestioning commitment to his patients and fellow men. According to Camus this epidemic has to be understood as a symbol of the absurd. Unable to base his actions on a Christian, metaphysical value system, Rieux sees his commitment as a continuous rebellion against the fact of the absurd, which opposes him in the form of evil, suffering and death. As a physician, Rieux is therefore forced to adjust his actions to life in its immediacy, that is, the suffering of his patients. In this article, it will be shown that Rieux's attention to the “immediate” is of particular interest to medical ethics: Theother person in need, rather thanmy moral convictions, sets the norm.     

现代医院人文关怀缺失的思考

科学技术的革命给医学事业带来了空前的发展机遇,也向广大医务工作者在精神、伦理、思想等方面提出了挑战.阐述了现代医院人文关怀缺失的主要表现,分析了医院人文关怀缺失产生的原因,并提出了相应的对策.