IS PHILOSOPHY IMPORTANT FOR MEDICAL STUDENTS?
One of the greatest revolutions that the humanity has ever witnessed is the information superhighway. Today’s student has access to limitless information through computer technology. But the important question is: how to use this information and is it enough just to have lot of information? Computers are designed to use the information in a specific, pre-programmed way, and increasingly they are able to answer more and more questions. So, what does the future hold? Can the machines and programs like Google replace humans? Can they replace doctors? Google may be smart, but it is not wise! Among other things it is vital that we also teach our students wisdom which will help them apply their knowledge appropriately because as the Japanese proverb tells us ‘Knowledge without wisdom is a load of books on back of an ass’.1
‘Philosophy’ comes from Greek words ‘phylos’ meaning ‘to love’ and ‘sophie’ meaning ‘wisdom’, i.e., love of wisdom; It uses logic and reasoning to analyze human experiences. Philosophy has always influenced medicine since the days of Hippocrates.2 It offers the theoretical, methodological, and analytical means for the analysis of concepts in medical practice such as disease, health and wellbeing.
Medicine is an art because in the diagnosis and treatment of patients, physicians do not make their decision just based on current knowledge, but often rely on their intuitive insight. The art of medicine therefore, involves ‘memory, listening to the patient, advising the patient, empathy, insight, equipoise, conceptualization, observation, and inference’, which are ‘thought to be learnt and/or improved by experience’.3
One of the aims of medical education is, of course, to produce good humanistic practitioners. Students should be taught to consider patient as an embodied being and not just a defective machine waiting for the technician to use technical knowledge to mend its defective parts. This approach of treating disease more than patient in modern medicine has been considered to be too impersonal and dispassionate towards the patient. Paying attention to the need of individual patient makes medicine more humane. For practitioners of humane medicine, ‘the body and the mind are complimentary aspects of the patient and both must be considered when making a diagnosis or choosing a therapy’. It is therefore important to take into consideration the psychosocial and cultural aspects of ailment as well when treating patients.4,5
In the daily medical practice of diagnosing and treating patients, philosophical issues in various areas including ethics may arise. It is to be appreciated that philosophy and medicine pursue the same goal of human wellbeing. Philosophy is aimed at combating the diseases of the mind: half truths, prejudices, cultural bias, etc. which distort the perception of self and community and may have an indirect impact on health. Aim of medicine on the other hand, is to fight somatic diseases caused by bacteria, viruses, tumours, genetic mutations etc. affecting the human body. One pursues to heal the soul while other heals the body with the ultimate goal of holistic well-being.5,6
Although importance of teaching philosophy in medical education cannot be over stressed, however if its scope increases beyond the students’ current experience level, it may become impractical. It is recommended that at undergraduate level, the ultimate objective of teaching philosophy should be at least to make the students recognize the humanistic and ethical components of health care, and to translate and integrate ethical principles into clinical practice. Philosophy provides basis of ethical principles and theories for the scientists and health care providers.5 Most of the theories and principles used in resolving bioethical issues today are derived from the theories of Plato, Aristotle, Locke, Kant, JS Mill, Rawls, and many other philosophers. There are four fundamental principles of ethics commonly applied in modern medicine, i.e., autonomy, beneficence, non-maleficence, and justice. These make a good starting point for teaching philosophy to medical students as these would help sensitize medical students to bioethics without affecting their busy schedules. These can be taught in undergraduate years either in lectures, small groups, and bedside teaching or case discussions.
The time to introduce the content of a medical ethics curriculum has been shown to be debatable in many studies.5,7 The content may be taught in the form of longitudinal module from first year MBBS. It should be taught preferably by psychiatrists because of their unique training in the full spectrum of medicine, their expertise in behaviour change, and their knowledge of group dynamics. The structure of ethics education also has to be closely calibrated according to student level. The curriculum goals should be realistic and well-defined.7,8 Since the physician’s role varies with requirement of each patient, therefore some elements of critical thinking should be part of the curriculum. A traditional source of this kind of critical thinking has been philosophy. A good starting point might be the clinical experience of the students themselves. The students may be asked the question, for example: What do they think is meant by wellbeing of patient? This can generate critical thinking and healthy discussion amongst the students.
The tools taught by philosophy are of great use in post-graduation too. It has been claimed that teaching philosophy to students makes them learn how to write clearly, and to read closely, with a critical eye; they are taught to identify bad reasoning, and how to avoid it in their own writing and in their own work. All these learned attributes would help our graduates in their future role as physicians, researchers and teachers. It is strongly recommended that philosophy should be taught to medical students during undergraduate years in small incremental steps with clear and realistic goals. Teaching philosophy with medicine will help them in giving empirical basis for viewing and treating the human body.8,9
Pak J Physiol 2017;13(4):1-2
2. Why study Philosophy? https://phil.washington.edu/why-study-philosophy
3. Louhiala P. Philosophy for medical students–why, what, and how. J Med Ethics; Medical Humanities 2003;29:87–88.
4. Mbih JT. The Role of Philosophy in Modern Medicine. Open Journal of Philosophy 2014;4(1):75–84.
5. Janicek M, Hitchcock DL. Evidence-based practice: Logic and critical thinking in medicine. Chicago, IL: American Medical Association Press; 2004.
6. Montgomery K. How doctors think: Clinical judgment and the practice of medicine. New York: Oxford University Press; 2006.
7. Marcum JA. An introductory philosophy of medicine: Humanizing modern medicine. Springer Science; 2008.
8. Ramesh K. Start sensitising medical students. Indian J Med Ethics 2007;4:25.
9. Karuna R. Ethics in medical curriculum; Ethics by the teachers for students and society. Indian J Urol 2009; 25(3):337–9.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.