By Associate Professor Robert M Solomon
Adjunct Associate Professor of Medical Ethics
Medicine is a noble profession. What makes it so is the quality of the doctor patient relationship which is guided by the best of human virtues such as altruism, compassion and the desire to alleviate human suffering. For this to be true, the physician must first of all be a humane person, one with a soul.
In reflecting on how modern technology and utilitarian rationalism have the potential to erode our humanity, the great British writer C S Lewis wrote how in the future (and it is already happening), the morals and values of the majority will be negatively shaped by a misguided minority. Cold rationalism, the relentless pursuit of profits and avaricious personal gratification are examples of the mindset that would shrink our souls. The end result, in Lewis’s words, is “men without chests” – his way of saying people without souls.
The modern physician is challenged to go against the stream. This means that he or she practises ethics from internalised virtues. Such people have an inner life and growing character and wisdom, and no matter what the pressures or circumstances are, will remain true to their character and convictions. They will be humane physicians whose choices and actions will be guided by noble thoughts and character.
They will also see the patients not as impersonal numbers but as real persons. To be humane, one must recognise the other as a human being. The temptation is to treat the patient as an ‘It’, seen in language often used on wards (Bed XYZ is having a fever. Bed ABC needs an injection). The Jewish philosopher, Martin Buber wrote about the necessity of ‘I-Thou’ relationships if we are to remain human. We must consider others as no less than fellow human beings, made in the image of God.We, therefore, do not treat lab reports but patients. We do not cure diseases but heal individuals. The great Canadian physician Sir William Osler put it aptly, “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.”
When I was serving as a houseman, I learned a valuable lesson from the orthopaedic surgeon who headed the department. During one ward round, he chided the medical officer who had made a plaster of Paris cast for the patient’s fractured leg but had not cleaned the blood stains on the foot. The lesson was clear – you do not just cure the patient, you must also care for his well-being and dignity.
A humane doctor-patient relationship requires a humane and virtuous doctor as well as a patient who feels that he is treated as a human being. This is of great importance for the practice of medicine to remain as a noble and humane profession, especially amid growing technology and technical possibilities, which throw all kinds of ethical dilemmas at the modern physician. In all of this, the patient must be treated as a fellow human being, not just a body with organs or a digit in hospital statistics.
When SARS hit Singapore in 2003, some medical staff risked their lives in caring for infected patients. Two of them died; they remain as worthy examples of medical personnel who gave their lives in practising compassionate and courageous medicine.
We may not all be called to put our lives at risk in this way, but every day we are challenged to practise altruism in some way or other, giving up our comforts and time for the sake of our patients. When we do this, it will show that our patients have become our friends, for whom we will go the second, and even the third mile. This is medicine at its best, when it is practised by physicians with a soul.
Robert M. Solomon is Bishop Emeritus of The Methodist Church in Singapore. After graduating from the University of Singapore with an MBBS in 1980, Assoc Prof Solomon gave up a lucrative career as a doctor to go into full-time ministry. He went on to obtain a Masters in Divinity from the Asian Theological Seminary in 1984, an M.I.S. (Hons) (Intercultural Studies) from the Alliance Biblical Seminary in 1984, and a Ph.D. in pastoral theology from Edinburgh University in 1993.
He has served as a medical doctor, church pastor, principal of Trinity Theological College, president of the National Council of Churches of Singapore, and from 2000 to 2012, as Bishop of The Methodist Church in Singapore. He is currently adjunct Associate Professor of Medical Ethics at LKCMedicine.