The following paper was written for a Bio-medical ethics class at the University of South Florida under the guidance of Mr. Nathan Draluck. May it be informative to you. Enjoy.
Platonic
philosophy provides a way for doctors and patients to operate on the
same intellectual plane by providing a stable and apparent ethical
system based on the 'form' of good and the derivatives of good
actions. The doctor and patient will be shown to rationally be of the
same biological entity. The differences between doctor and patient
are merely physical and the ability is real for all patients to be
doctors. Because of an overpoweringly strong current in the
biomedical community, dualism#
has become smothered and doctors have become intensely concerned with
biological treatment, even when it is harmful to intellectual
activity. Due to this lack of understanding on the part of doctors
they have effectively relegated the patient to a subjugated role in
lieu of affording them any large autonomy.
This paper will focus predominately on
the relationship between doctors and their patients through the prism
of Platonic Ethics. Furthermore, the paper will show that when
considered in a rational way, Platonic Ethics provides an approach
that is both safe for the doctor and engaging for the patient.
The
reader will find three imitative case studies in which will be found
a clear argument for the use of platonic ideals in treating a
patient. Case one will expound on The Theory of the Forms and attempt
to explain the actual differences between the patient and the doctor.
While this may seem clear on the surface, the true difference, I
believe, is actually nonexistent. In the second case we will examine
the dualistic nature of Platonism and how this is translated, or not,
into biomedical ethics. In the final case we will examine the
autonomy of both parties involved in medical decision making, the
patient and the doctor, and attempt to discover how autonomous each
party actually is by defining autonomy in a platonic sense.*
The
Platonic theory of the forms is a rationally sound argument for the
understanding of things around us. In order to give the reader a
basic understanding of the arguments that follow it is necessary to
provision the reader with the basics of Platonism. The chief
metaphysical quality for Plato is The Theory of the Forms.¤
The following will explain in detail the fundamentals of Platonic
philosophy which will then be expounded upon later.
The
basic principle upon which The Theory of the Forms is based is
participation, particularly participation in the the Forms
themselves. The Forms are metaphysical traits that exist separately
from humans but are present in the world through different objects
participation in them. For instance, a person is tall because they
participate in the form of Tallness. In a more basic understanding,
anything that can be denoted as a adjective, whether it is a color,
size, or description of any kind, is a reflection of that things
participation in said forms. In addition to these forms is an
overarching Form of The Good, under which all forms fall. A trait of
all forms are that they are forms of good. The way in which humans
understand the various objects around them and, in some sense, their
own being itself, is through their understanding of forms. These
forms are discoverable through dialectic discussions with other
intelligent beings.
One of the most important ideas
contained in The Theory of the Forms is the idea that once a person
has begun to understand forms as forms themselves they are ethically
required to help other beings, through dialectics, to understand
these forms. Now if dialectics is the only way to discover forms and
forms are what allow us to understand the intelligible things around
us, it stands to reason that through dialectics all knowledge has the
ability to follow. While these may seem like rather arcane ideas when
presented in short, it is strongly suggested that the reader view the
complete Platonic works for themselves.
This
brief overview has the ability to directly improve the doctor-patient
relationship through several means. If we understand that doctors
have a larger degree of understanding than their patients then we
must also concede that because of this the doctors have a larger
responsibility to impart this knowledge to their patients. The doctor
must be willing to impart information, through dialectics, to the
patient to increase the patients understanding of any medical
conditions, preconditions, possible and probable outcomes from
procedures, etc. A failure to do this on the doctors part would
result in actions that would not be in accordance with Platonic
Metaphysics and therefore would not fall under the form of The Good
but would rather be a privation of good.*
While the doctor would have the ethical obligation to inform the
patient of knowledge in which the patient was lacking, it is also the
responsibility of the patient, in pursuit of knowledge, to attempt to
discover, through dialectics, as much knowledge as possible. In doing
so, medical knowledge would naturally be incorporated into this
knowledge. From these interactions one may gather that through the
form of the Good anything that transpires between a patient and
doctor will be for the benefit of both parties as long as both
parties willingly engage in Good, Selfless acts in accordance with
Platonic Metaphysics.
Following
this, one must make the argument that in these situations the parties
involved have an overt obligation to do certain things. In order to
arrive at this point the reader must first realize the following:
that both the doctor and the patient are human beings who are capable
of knowledge. If this supposition holds true then we can infer that
there are obligation that each party must meet. The doctor has an
obligation to search for knowledge in the same manner as the patient
has an obligation to search for knowledge. With this primary
obligation the reader can draw, among others, two distinct
conclusions: That the patient should take into account the doctors
suggestions for treatment only if they are unwilling to complete
their own studies on the subject matter and, if this is the case,
paternalism is to be considered opted into at this point in time. In
cases in which the patient is unwilling, while possessing the ability
to, attain the same knowledge as the doctor they have themselves
mandated that their relation with their doctors will be a
paternalistic one. While paternalism carries a heavily weighted
connotation of loss of power, or immediate and unwarranted deference,
it carries the heavier connotation of the inability to use
dialectics. Therefore, paternalism should not be viewed as inherently
negative but rather negative due to its association with
non-dialectics.
Drawing
upon The Theory of the Forms as outlined above, the reader shall find
a discussion of Platonic Dualism, and how this is translated, or not,
into biomedical ethics, in the anteceding argument. The first
necessity in order to do this is a more thorough understanding of
Platonic Dualism itself. Like most dualistic philosophies Platonic
Dualism is a dualism of the mind an the body in which the mind is
always superior to the body. In Platonic Dualism the terms for mind
are many and varied but this paper will use only two interchangeably:
mind and soul. Upon the death of the body the soul/mind are loosed to
live among the forms and the forms are the highest ecstasy the mind
can have both while contained in a body and upon the souls release
from said body. Of paramount importance in this dualism is the idea
that one should not deliberately kill ones body in order to release
ones souls. To do so is an act of both desperation and an act
demonstrating the pinnacle of a privation of good. While suicide is
not acceptable in Platonic Dualism the body should always be treated
in an inferior manner while the mind should be treated in a superior
fashion. The reasoning behind this is that it is through our minds
that we control our bodies therefore making our bodies a tool for our
minds.
The dualism presented above has a very
real connection with contemporary medicine. While this type of
dualism is still extremely relative in contemporary society, many
doctors focus their attention solely on the bodily ailments of their
patients even when it can be detrimental to the patients mental
health. The focal point of modern medicine is to prevent the death of
the body through natural causes and this death is viewed as the
ultimate item to beat. However when viewed realistically through a
Platonic prism the death of the body can actually be a good act
because it frees the mind from the constraints of the body. This is
not to say that it is not worthwhile to treat the body, for it is
worthwhile but only to the extent that it helps the mind. Put another
way, the mind should be the focal point of medical procedures, while
the body should only be treated in a fashion that neither hinders the
mind nor makes the mind powerless. The example we can use to
illustrate this is hypothetical in nature but revealing none the
less.
A
patient who has experienced some worldly calamity is in a coma and
there is evidence that the brain has retained its capacity to
function. The body of the patient is kept alive through a life
support system. The doctors have the ability to bring the patient out
of the coma but doing so will have repercussions on the mental state
of the patient. Modern medicine will tell us that the patient is
alive but comatose and therefore removing the comatose state is of
the utmost importance even if this will result in a diminishing of
the patients intellectual capabilities. From a Platonic viewpoint
this is unacceptable. While the removal of the comatose state would
certainly benefit the patient, it would only be of benefit if said
removal was non-damaging to the intellectual abilities of the person
in question. Therefore the 'Good' act in this case would be to let
the patient either: remain in a coma or die of natural causes and
thus have their soul separated from their body thereby preserving the
intellectual capacity of that being.
The final sense in which Platonic
Metaphysics has a role in Biomedical Ethics is in the sense of
autonomy. The Platonic Sense of autonomy can be summed up in 4
points:
- Autonomy is based upon the mind and its power over the body. *
- Autonomy is for the mind to be free from coercive outside influence.
- To be autonomous one must understand that actions that are willed through the body from the mind affect other individuals, who also have autonomy.
- To be autonomous one must be cognizant of the fact that their mind has the capacity to learn any number of forms and their derivatives that are present in material objects.*
Through these four points
the reader can draw several conclusions about the roles of patients
and doctors in autonomous relationships.
In
order for a patient to be autonomous the mind must have power over
the body and therefore the patient must have an active mind.*
A patient must understand their medical conditions and should only
assent to things that they understand. If they do not understand
things then they are willing themselves into a paternal relationship.
This is acceptable but must be actively recognized by the patient.
This lack of understanding is a lack of participation in dialectics
on the part of the patient as the patient has the same mental ability
as anyone else to learn. This understanding is predicated on the
patient having an active mind.
Several of the obligations
that are required of patients are also required of doctors, namely
that they possess an active mind, among others. In addition every
doctor should understand their patient's medical conditions and only
recommend things that they understand. If they do not understand
things then they are responsible for informing their patients of
such. This is acceptable but must be actively recognized by both the
doctor and the patient. One of the most damaging things that a doctor
can do to impede upon the patients sense of autonomy is coercing a
patient into a therapy that is not agreed to by the patient unless
that patient has willingly approved of a paternalistic method of
treatment with said doctor. If the patient has knowingly entered into
a paternalistic relationship with the doctor then any treatment that
the doctor orders that is beneficial to the patient is acceptable.
To
display the way autonomy would work in a Platonic sense we turn again
to our coma patient. In this thought experiment the coma patient is
alive in the body but dead in the mind. In this situation the patient
would not be able to control their body as they have no mind of which
to speak. Without the use of their mind the patient would lack any
type of autonomy and if autonomy is central to person-hood then this
coma patient could not be considered to be a person. While they are
still a human being genetically and they have a living body, the lack
of a fit mind robs them of all right to person-hood. The doctor would
not be able to treat the patient due to the fact that without a mind
they are not human and therefore cannot understand their condition
nor their treatment and could not consent to any given medical
approach.
In conclusion the
doctor-patient relationship can be effectively governed by a thorough
understanding of Platonic metaphysics as they apply to Biomedical
Ethics. The doctor and patient are both capable of the same knowledge
and patients who willfully lack the knowledge of a doctor are
knowingly committing themselves to a paternalist relationship with
their physician. In addition, the modern medical approach places an
inordinately large emphasis on the bodily health of their patients
and not nearly enough of doctors resources are dedicated to ensuring
the intellectual activity of a patient is preserved. Finally, the
autonomy of a patient must be preserved at all times in order to
serve the best interests of the patient.
#Body-mind
dualism.
*In
this sense autonomy would involve the definition of 'self/soul' as
opposed to the definition of biological entity, further expanding
upon the dualistic nature of Platonic philosophy.
¤A
much broader understanding of The Theory of the Forms can be found
in other works by Plato: The Republic, Phaedrus, Parmenides, and
Sophist among others.
*Refer
to Platonic Dualism
*Refer
to Platonic Theory of the Forms
*Here
active is used to mean fully functional
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