Philosophy and ethics

You are about to have the honor and great pleasure of working with a group of patients I have come to know and respect over the years. While I cannot tell you how to practice medicine, I feel no reluctance to tell you what made it so worthwhile for me.  

A recent article in USA Today talked about Regina Holliday’s efforts to make the medical record more easily and promptly available to patients so it becomes as a tool patients use as they engage in co-managing their own care. Her cause is just and her story is compelling, so I was dismayed at the pushback saying: Not so fast.

What is True North for medicine? Is there an enduring core value that serves as a reliable touchstone across the nearly infinite range of medical activities? Given how medicine and society change, can there even be an enduring True North? If we have one, are we pursuing it faithfully?  

I was asked by a colleague at work (someone who frequently but privately agreed with me but never spoke up publicly), “Why do you tilt at windmills?” Many have answered this better than I.

Niels Bohr said: “There is no quantum world. There is only an abstract quantum physical description. It is wrong to think that the task of physics is to find out what nature is. Physics concerns what we can say about nature…”

I think this parallels the enduring human drive to search for Truth. There may or may not be an absolute Truth, but it is wrong to think we can discover Truth or understand what Truth is.  Science, philosophy and religion are merely our endeavors to see what we can say about Truth. 

The wave of the future is bringing game-changing cultural shifts in patient awareness and expectations. These are paralleled (and fed) by paradigm changing technologies.  Clinicians and medical institutions will sink or swim depending on how well they ride these waves.

Those who choose the comfort of the familiar and predictable, who sit safely on the beach while they watch and wait, who allow others to build the future, these late adopters will ultimately be forced to enter the water. I predict they will never catch up, and will struggle merely to survive.

It’s frustrating when they won’t let you be a playwright, but then complain when you become a critic.