APA Newsletters Volume 06, Number 1 Fall 2006 NEWSLETTER ON PHILOSOPHY AND MEDICINE FROM THE EDITORS, ROSAMOND RHODES & MARK SHELDON FROM THE CHAIR, DAVID DEGRAZIA ARTICLES JOHN HARDWIG “Medicalization and Death” FELICIA NIMUE ACKERMAN “In Praise of Fairy Godmothers: A Limited Defense of Medicalization” JAMES LINDEMANN NELSON “Boxing with Shadows: Medicalization and Other Fetishes” SANDRA L. SHAPSHAY “Compassion, A Double-edged Scalpel” LEE M. BROWN “The Role of Compassion in Medicine” BEN RICH “Breeding Cynicism: The Re-education of Medical Students” HOWARD SPIRO “Comments on Empathy” FELICIA NIMUE ACKERMAN “Henrietta Pratt, 80, Has a Surprise for You” © 2006 by The American Philosophical Association ISSN: 1067-9464 APA NEWSLETTER ON Philosophy and Medicine Rosamond Rhodes & Mark Sheldon, Co-Editors Fall 2006 Volume 06, Number 1 without impeding the responsibilities of the doctor. In “The Role of Compassion in Medicine,” Lee M. Brown argues for the FROM THE EDITORS importance of compassion in science-based medicine, showing how better healing can be achieved through compassion. Ben Rich sheds light on aspects of the problem that arise in This is a fascinating edition of the Newsletter on Philosophy and medical education. In his paper, “Breeding Cynicism: The Re- Medicine. It includes papers from two Committee-sponsored Education of Medical Students,” Rich explains the phenomenon sessions and a wonderful poem. of the hidden curriculum which tends to purge compassion Mary V. Rorty of Stanford University organized this year’s from trainees in the process of becoming doctors. Howard Committee-sponsored session at the APA Pacific Division Spiro’s “Comments on Empathy” distinguishes empathy from meeting. The topic of this year’s meeting was, “Medicalization: compassion. He explains why physicians must be empathic Rhetoric and Value.” The term “medicalization” itself usually in order to relate to their patients and how empathy implies carries a negative connotation. This session was designed to understanding rather than paternalism. look at the use of the term and the benefits and disadvantages We are also happy to include “Henrietta Pratt, 80, Has a associated with bringing a condition into the purview of Surprise for You,” a new poem by Felicia Nimue Ackerman. medicine. The panelists, John Hardwig, Felicia Nimue In order to continue offering our readers exciting issues Ackerman, and James L. Nelson, discussed the ways in which jam-packed with timely and informative pieces chock full of the incorporation of medical treatment into each stage of life provocative philosophical discussions, please continue to send is, in fact, a good or bad thing. us your work. We also remind you to think of this Newsletter as The papers by John Hardwig, Felicia Nimue Ackerman, and a place for your announcements, letters, papers, case analyses, James L. Nelson are all included within this issue and provide poetry, and stories. Please feel free to volunteer a book review. diverse opinions on the subject. In his paper, “Medicalization Your contributions and queries should be sent to Rosamond or and Death,” John Hardwig carefully analyzes the implications Mark at the addresses below. Please include your phone and of the term “medicalization” in today’s society and then delves fax numbers and email address. into the medicalization of the dying process. Hardwig explains how putting off death can cause harms to society and the patient. In her paper, “In Praise of Fairy Godmothers: A Limited Rosamond Rhodes and Mark Sheldon Defense of Medicalization,” Felicia Nimue Ackerman argues Co-Editors, Newsletter on Philosophy and Medicine that medicalization is not the evil it is made out to be. She maintains that if medicine could create a magic pill to solve Rosamond Rhodes a medical problem there would be little reason not to take it. Box 1108 In “Boxing with Shadows: Medicalization and Other Fetishes,” James L. Nelson looks at medicalization with a sympathetic but Mount Sinai School of Medicine skeptical eye. He shows us how to appreciate some implications One Gustave Levy Place of spreading the domain of medicine while being wary of other New York, NY 10029 expansions. Phone: 212-241-3757 Lee M. Brown of Howard University organized the APA’s Fax: 212-241-5028 Central Division Committee-sponsored session. The topic of Email: [email protected] this year’s meeting was “The Role of Compassion in Medical Education and Medical Practice.” For this session Lee Brown had recruited a large cadre of speakers: Laura Ekstrom, Gordon Mark Sheldon Greene, Ben Rich, Sandra Shapshay, Howard Spiro, and Angelo Department of Philosophy and Volandes. The panel offered their views on empathy in regards Medical Ethics and Humanities Program to medicine. They raised questions about whether and how Northwestern University empathy contributes to medicine or hinders the practice. These insightful discussions led directly to consideration of the Evanston, IL 60208 implications of empathy for medical education. Phone: 847-328-2739 We have four contributions in this section, three from Email: [email protected] session presenters along with the comments of the organizer, Lee Brown. In her paper, “Compassion, A Double-edged Scalpel,” Sandra L. Shapshay explores the proper level of compassion between doctor and patient. She explains a fitting level of compassion as one which allows a bond to form — APA Newsletter, Fall 2006, Volume 06, Number 1 — a panel tentatively entitled, “Parental Discretion in Decision- ROM THE HAIR Making for Children: The Case of Genetic Testing for Adult-Onset F C Disorders,” for the Pacific meeting in San Francisco. And Mark Sheldon is working on a panel on ethical and philosophical issues connected with the pharmaceutical industry for the On Compassion, Collaboration, and Some Central meeting in Chicago. Things Coming Up In addition to planning panels, the committee is undertaking to update our webpage. We will replace the 1997 survey David DeGrazia of bioethics programs (primarily a list) with links to several With summer beginning and the three Divisional meetings for up-to-date listings. The improved webpage will also include 2005-06 in the past, it seems a good time to record some notes the Newsletters we have published since 2000 and more on the Philosophy and Medicine Committee’s activities. comprehensive information on our panels. In consultation with My previous column discussed the panel we ran at the the APA, we may make other improvements. Eastern Division meeting in Boston, so let me move to those In closing, one more piece of good news. I had expected that took place this spring. At the Central Division meeting in in this column to wish the best to Lee Brown, whose three- Chicago, Lee Brown of our committee chaired a panel on the year term was coming to an end. But, energized by the panel role of compassion in medical education and clinical practice. he organized and noting his earlier inability to participate fully The speakers were Laura Ekstrom (William and Mary), Gordon due to medical issues, Lee requested another year on the Greene (University of Hawaii–Manoa), committee member Ben committee—a request I enthusiastically endorsed. Thanks to Rich (University of California–Davis), Sandra Shapshay (Indiana Bill Mann, acting executive director of the APA, for giving Lee University), Howard Shapiro (Yale), and Angelo Volandes and the rest of the committee another year of collaboration. (Harvard). As Lee related afterwards, the panel addressed, Best wishes for the summer. among other themes, the concept of compassion and its relation to pity, sympathy, and empathy; their roles in humane treatment; the distinction between technical competence and humane competence; the effects of a work environment in which doctors are encouraged to spend little time with each ARTICLES patient; the optimal quality of contact between doctors and patients; the ways in which medical education desensitizes future practitioners; and the effects of sensitivity on patient Medicalization and Death recovery. Following the talks, interactions between the panel and audience were animated and illuminating. Panelists agreed John Hardwig that the topic merited a day-long event, so Lee is exploring the University of Tennessee possibility of organizing such a program at Howard University. I was delighted to hear this report of our panel at the Central Americans have enormous faith in medicine. A 1994 study found meeting. that 34 percent of Americans believe that modern medicine I am equally pleased by the developing collaboration “can cure almost any illness for people who have access to 1 between our (American Philosophical Association) committee the most advanced technology and treatment.” One has to and the American Society for Bioethics and Humanities (ASBH). wonder what these Americans think they will die of. Lack of As discussed in my previous column, a panel organized by access, presumably. By contrast, only 11 percent of Germans Rosamond Rhodes—coeditor of our newsletter and ex officio believe that modern medicine can cure almost any illness. committee member—on the twenty-fifth anniversary of the The unbounded confidence of many Americans in modern Belmont Report ran at both the annual ASBH meeting in medicine is clearly related to medicalization. I myself have Washington, D.C., last October and the Eastern APA meeting in worked on what I call the medicalization of death. I will return New York last December. Now we have arranged with ASBH to that topic. But,