The Sumerian patron of medicine.
I obtain my conception of the good life, the end toward which I strive, from Aristotle. In his Ethics, he describes the good life—what he calls eudaimonia—as an objective state of happiness and flourishing that obtains when a person lives a life full of rational action, guided reliably by wisdom and the practical virtues.
I am pursuing medicine as a career because, given my particular intellectual strengths and dispositions, the study and practice of medicine will most completely fulfill my conception of the good life. In other words, I am the sort of individual who flourishes when engaging in activity that (1) actualizes my moral and humanitarian sensitivities; (2) is complex and novel, presenting interesting challenges requiring the meticulous application of intellectual resources for resolution; (3) allows creativity and innovation; (4) is pragmatically substantive, permitting the most fruitful use of my acumen; (5) allows fertile engagement with talented peers; (6) is in part devoted to contributing to a long-lasting body of knowledge; (7) is valued by society, allowing a degree of material comfort; (8) is of such a global nature as to be justifiably constitutive of my identity and world-view. Of all professions, medicine practiced at its best satisfies all of these conditions, I think, and so life as a physician will for me be the most eudaimon. Medicine, I trust, is an endeavor worthy of lifelong commitment.
I’ve wondered a lot about whether this perception fits the profession as actually practiced. And as a philosophy student, I’ve thought about what it means for a pre-med to be properly motivated and suitably constituted to practice medicine. I’m primarily interested in (1) understanding the moral disposition of the physician—her quintessential motivations and character traits, (2) exploring how the physician as a moral agent is distinctive from other heroic and compassionate professions like firefighting, military service, inner-city teaching, and charity work, and (3) discovering what it is about pre-meds that motivates them to pursue, of all careers, medicine. I would like to offer my thoughts on these matters, as some indication of the extent to which these sorts of reflections on have played an integral role in my decision to become a doctor.
Like crimefighting and academia, medicine is fundamentally a normative enterprise—it is directed toward the convergence of the actual state of affairs with particular ideal ends. The profession is best practiced, then, by those (like Atul Gawande, Jerome Groop, and Pauline Chen) that understand their work in an encompassing ethical context and who are capable of articulating the social goals they endeavor to attain. In our formative years, we work most scrupulously to develop a moral worldview that concords with and facilitates our development into the sort of professionals we aspire to be.
I’ve learned from my fellow pre-med students (mostly from the discussions we hold in the Eudaimonic Society, a bioethics/medical ethics literary society) that we are predominately utilitarians at heart. By this I mean that we are particularly impressed by those moral arguments which tell us to pursue projects and activities that produce the most Good, the most human well-being. Most of us structure our opinions about social justice around a utilitarian theory of right and gamely accept the demanding obligations that such an ethical outlook entails. When prompted to justify our fervent devotion to medicine, we offer justification along these lines.
You don’t need to look far to find the appeal. Utilitarianism seems to embrace our egalitarian intuition that people are equally worthy of moral regard—that injured persons are persons in need of help, period—most directly. Plus, as a theory involving rational calculation to do the most good, it fits snugly with our commitment to meticulous and judicious action. Utilitarianism is, at first pass, a faithful theoretical articulation of basic humanitarian intuitions.
But I think that my peers who adopt this view have in some way missed the mark. I’m not alleging them disingenuous in their compassion and commitment to foster the Good (I have the highest respect and admiration for this quality). I concede, too, that the whole and complete goal of medicine as a discipline is the health of the members of society and that physicians should work fully toward that consequentialist end. I am claiming merely that the utilitarian model is an incomplete image of the individual physician, that a compassionate heart is necessary but insufficient to properly motivate the excellent practice of medicine and thus that undergraduates who pursue the pre-med track solely on compassionate grounds aren’t seeing the whole picture.
Upon further reflection, it seems that you need more than an eager and heroic heart to be a physician. For instance, there’s a clear difference between being a physician and being a fireman, but you can’t find that difference in the respective amounts of compassion or heroism required for the two jobs. We need a different model of the medical practitioner to explain why it is that pre-med students are pre-med students and not firemen.
I propose different paradigm: the doctor as a virtuous agent. The physician must be motivated by sincere compassion (concern for the vulnerable and suffering + interest in promoting their betterment) and by a yearning to exercise her intellectual talents to the fullest (a virtue the fireman fails to develop). The physician seems more than just an instrument or mechanism subserving the proliferation of the communal Good. Though centrally interested in the welfare of her patients, she is concerned also with developing within herself the wisdom and the character traits—compassion, courage, temperance, generosity, equanimity, fairness, and practical and theoretical wisdom—that make the manner and mode in which she practices medicine of concern to her own moral condition. There is something about medicine practiced excellently (and being fulfilling to the individual physician), in other words, that has nothing to do with health outcomes and patient well-being, distributive justice, or economic efficiency.
I plan to apply this summer to the University of Chicago, Pritzker School of Medicine (among other medical schools), as well as to the UChicago school of graduate studies. My goal is to pursue a M.D.-Ph.D. under the MeSH (Medicine, the Social Sciences, and Humanities) interdisciplinary program at Pritzker, which provides full funding for the M.D. degree when it is pursued in conjunction with a Ph.D. in the social sciences or the humanities. I hope to attain a Ph.D. in philosophy, with concentrations in value theory, the philosophy of biology, and bioethics (and perhaps in epistemology).
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