Singer talks about the “sum total” of suffering and how that must be diminished, which is the utilitarianism I was talking about. But as long as we don’t fall into the “sum total” mentality (CS Lewis writes very well against this), then I must admit there’s probably nothing wrong with saying that one of the goals of medicine can be alleviating pain within reason.

It seems to me like we agree on a great deal. But, you said that “the point of medicine is to heal illness and alleviate suffering.” I think you’re on to something with the “heal illness” part, because medicine must be considered mostly in a restorative manner: that is to say medicine should seek (as its purpose) to restore each person’s body, to the extent possible, to what a human body is supposed to be.

To think in terms of suffering however, begins to be overly utilitarian (cf. my Peter Singer comment). Medicine can certainly remove pain, but if that’s conceived as the main goal, things begin to get a little shady. I suffer when my child dies, but it’s not the place of medicine to remove that suffering. If I fall and break my leg, sure the doctor gives me some drugs to help with the pain, but if I’m going to die in three weeks and I will be in great pain for that time, I don’t just want the doctor to poison me, even though there would be “less” suffering in that scenario. Therefore the purpose (or, in your words, the “point”) of medicine cannot be to simply lower the sum total of suffering in my life – not to mention that idea that suffering is hardly quantifiable.

On the inevitability of death, I would say this:

I disagree with Mary Ann that the point of medicine is to alleviate suffering. This is completely impossible and, as you say, would lead to a culture where people were simply killed off to “alleviate suffering” – which is a great oxymoron. Peter Singer thinks along these lines – a type of radical utilitarianism I suppose. Needless to say, Mr. Singer and I don’t often find ourselves in agreement.

Yet to say that death is inevitable is not to say that we should encourage or expedite the inevitable, nor is it to say that we should embrace it – death is not a good thing. Yet the fight against the inevitability of death must be understood with respect to proportionality. We must ask: To what extent may we postpone death? and also: To what extent must we postpone death? Needless to say I won’t elaborate my viewpoints on these issues here, but I will note that these are obviously questions not of medicine but of morality – not is questions but ought questions. Ultimately I believe that medical science is subject to moral precepts – and further, these precepts cannot be determined by science itself.

Thus, the reason I chose the rather striking words “imperialism” and “conquer” was to highlight the fact that medical science (and much of modern science) seems to operate in a different moral sphere than other human action. Why? If the science of nuclear fission and fusion has given us an opportunity for clean power and also has given us Hiroshima and Nagasaki, then we must be willing to ask: is there no limit? Is the sum totality of what nuclear physics has allowed us to do as a human race good or bad? To refuse to ask this question is to embrace the newest “Manifest Destiny” of modernity – but the savages we seek to conquer and eradicate are ourselves as moral beings. I myself will not embrace this imperialism.

I will note that there is a distinction between a mechanistic viewpoint (what I call “imperialistic”) and a good scientific understanding of the body’s mechanisms. I said above: “There does not seem to be anything intrinsically wrong with understanding the body’s mechanisms (it is, after all, a material reality) as long as this understanding is used in a way which is congruent with the dignity of the body as a whole.” I may have also added: the dignity of the person as a whole.

Most medical practices rely on our understanding of the body’s mechanisms, which is great. But the reduction of the body to a strictly mechanistic understanding breeds what I referred to as the separation of “our sense of ‘body’ from our sense of ‘self’”. Note that the example I used to highlight this separation (pornography) has nothing to do with the understanding of the body’s mechanisms. One need not be a medical physician to be a pornographer. Mary Ann says very poignantly: “To say the body is a machine is not to understand what a metaphor is”. A mechanistic understanding misses the metaphor. Understanding the mechanism does not.

Hopefully this helps you understand that I am not against understanding mechanisms, but against a mechanistic understanding.

to be continued . . .

To understand what I have written, it will help to know the sense in which I am using some terms which you seem to have taken differently.

First of all, I believe you over-emphasize my point about what is “natural” – I used that word only once, in the sentence which you quoted in your second post. In that quote I did not mean to use the word “natural” as in “not artificial,” (cf. your reference to a human ‘in the wild’) but rather as in “pertaining to the nature of the body.” The example of autoimmune disease serves perfectly to illustrate this point. These diseases are not man-made, nor are they, in a sense, “foreign” to the body – the body is attacking itself. But, these diseases are not part of what we think of as a normally functioning body. Therefore, even an autoimmune disease is “unnatural” because it’s not part of the nature of the human body to have such a disease. The same applies to your examples of disease, eyeglasses, injuries, etc.*

It is on the other hand, part of the body’s nature to have a reproductive system – so the absurdity I’m trying to point out is in pitting a normally functioning aspect of a person’s body against the person’s body.

to be continued. . .

* I will note that I was greatly struck by the ingenuity of your comment about shaving. This is just one example of something where the body’s normal functioning is counteracted strictly for the sake of vanity (i suppose this fits in the category with liposuction or breast augmentation or getting braces). You’ll be delighted to know that I am clean-shaven, proof that I do not think that frustration of the body’s normal functioning is intrinsically evil. But I hope we’ll agree that reproductive system is far more integral to the person than the facial (or leg or armpit or whatever) hair.

Your romantisation of the body does not reflect modern understanding. The mechanistic view is not merely helpful in medicine: It *is* medicine. The field is founded entirely upon a mechanistic view.

Anyway, if the point of medicine is to ‘alleviate suffering,’ that means it’s eventual goal must be to eliminate death. Death is suffering, for those left behind – not to mention a great loss for the deceased.

You’ve also inadvertantly presented a very good argument for euthanasia there, arguing that medicine is obliged to alleviate suffering but not to prevent death. I get the impression that wasn’t your intention.

Ever heard of autoimmune diseases?

Under this line of reasoning, you couldn’t even try to treat acne.

“Any medical idea which does not recognize and operate within the pre-condition of the inevitability of bodily death if simply foolishness.”

Then what is the point of medicine? Why not simply allow those of fall ill to die naturally? If you accept death as inevitable, than at most you are buying more time and it really seems pointless. Die now, die later, dead either way.