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dcyphr | What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics

Abstract

This article uses philosophy to look at euthanasia, health and disease, and psychiatry. Three main claims of this article are:

  1. Philosophy justifies euthanasia but other obstacles do not make it practical.

  2. Disease is complicated and can be classified in many categories.

  3. Psychiatry is different from all other medical fields because it is about more than just physical health.

The author claims that using philosophy in medicine shows that more needs to be done than simply curing the illness of the patient.

Background

Philosophy in its essence is about challenging the things we assume. This makes it perfect to apply to the medical system. Euthanasia is an example that puts two common moral values against each other, and medical students are often asked to choose which is the most important. When we talk about health and disease, it brings up a complex question: are physicians trying to cure a disease, or promote health? Philosophy can be used to understand this complex balance. And regarding psychiatry, there is a lack of understanding of this field that causes us to treat psychiatric disorders like other medical conditions. But this is not the full picture, because talking therapies and societal norms seem to influence mental illnesses, not just medical treatments.

Euthanasia

For aspect of medical ethics should be considered when thinking about euthanasia: beneficence, non-maleficence, justice, and autonomy. Denying someone euthanasia goes against autonomy. But at the same time, allowing someone to go through with it would be going against non-maleficence. It is legal, however, to let someone passively die. Supporters of euthanasia say that there is not moral difference between passive and active euthanasia. This way, if you agree with or disagree with one, you must feel the same way about the other.

An argument against euthanasia is that if it were legal, it may become cheaper than keeping a dying patient alive and physicians would not but as much effort into helping a dying patient. But using the logic that passive and active euthanasia are the same, this claim does not have strong evidence behind it. Also, legalizing active euthanasia may increase the about of accidental or involuntary euthanasia, and an example of how this could happen is that the medical team euthanizes a patient who was under the pressure of coercion. More problems can arise because euthanasia can categorized as a medical and legal issue.

Overall, philosophy can rationalize active euthanasia. However, there are so many practical issues that we do not have a realistic policy on active euthanasia.

Health and Disease

Since there are not clear definitions of health and disease throughout society, it is difficult to classify certain conditions that need treatment. Once something is termed a disease, we try to find a cure and treatment for it. There are two ways to classify a disease, as normative and naturalistic. 

Normative refers to if the condition is bad for the patient, but this is a problem because maybe being ugly or short could be considered a disease in that case. Some things we classify as disease also end up being helpful in another aspect as well. 

Naturalistic refers to a dysfunction or irregular function of the body. This allows for statistical based classification of disease. But this is an issue too, because sometimes we see irregular function in a healthy patient like someone who has donated an organ.

The normative and naturalistic perspectives must be combined to better classify disease.

Psychiatry

Though psychiatric diseases cause problems for patients just like medical diseases, we do not understand mental illness as well as physical illness. Determining what health means in the context of the mind is difficult and may be influenced by society. Social norms can determine whether someone suspects they have a mental illness or not. Often in cases of psychiatric treatment, patients are treated against their will, which rarely happens with physical ailments. To classify psychiatric diseases into medicine, we assume that there is some type of dysfunction in the brain physically that leads to the symptoms of the patient. This works best with our current understanding of medicine. This can create issues though, because the current diagnostic criteria for mental illness depends on the combination and frequency of certain symptoms, not the physical dysfunction of the brain. There are rational explanations to have isolated symptoms of mental illnesses based on our society today. Mental disorders can be partially treated by the application of medical treatments, but more knowledge is needed to fully treat the patient.

Conclusion

Applying philosophy to medicine allows us to see that there is more to medicine than just the treatment plan. Philosophy should be applied to make sure physicians and patients are making the best decisions for their health.