Hindu Bioethics for the Twenty-first Century

CHAPTER 3. A HINDU BIOETHICAL ANALYSIS of Health/Disease and Physician/Patient Relationships in American Society

CHAPTER 3 A HINDU BIOETHICAL ANALYSIS of Health/Disease and Physician/Patient Relationships in American Society HEALTH AND DISEASE Since the founding of the colonies, Americans have evinced extraordinary fascination for and experimentation with matters of health and disease, and the driving impulse of this interest has been their understanding of the role of religion in the common life. This is abundantly clear when one investigates the major involvements of churches in the building of hospitals , clinics, medical missions, and in their concern for diet, exercise, hygiene , and abstinence from alchohol and drugs. For instance, in 1840 Unitarian minister William Ellery Channing expressed religious sentiments of his times when he articulated his doctrine of health in his lecture on “The Elevation of Laboring Classes.” He declared: “Health is the working man’s fortune and he ought to watch over it more than the capitalist over his largest investments. Health lightens the efforts of the body and mind.”1 With similar conviction for the church’s involvement in health issues, Mary Baker Eddy and the Christian Scientists made the mind-body connection central to their theology, while Mormons, Seventh Day Adventists, Jehovah’s Witnesses, and Methodists emphasised lifestyle. Most churches were in the vanguard of the temperance movement . Their common inspiration was Christ as the Great Physician, and Paul’s dictum to treat the body as the temple of the Holy Spirit. In recent years, the religious roots of America’s preoccupation with health and disease have been strengthened and surpassed by another Crawford: Hindu Bioethics page 93 penchant of Americans—their fascination for technology to exorcise the demons of disease, debility, and death. As medical practice moved from caring to curing, technology has rapidly become the modus operandi of healthcare delivery, featured by lasers, heart-lung machines, neonatal units, CAT scanners, and genetic engineering. All of this has come with a big financial price that Americans have not been reluctant to pay, even when it has amounted to more than 11 percent of the gross national product. Ethicist Arthur L. Caplan notes that “we spend more than any other nation on the planet for health care and health related services.”2 Caplan thinks that important political and social values, characteristic of American society, are additionally responsible for our placing a special premium on health and the avoidance of disease. He observes: Ours is a highly individualistic society deeply committed to freedom and autonomy as the core values of both our law and morality. Sickness and disease are more threatening to our sense of selfhood and self-assurance than they might be in societies less committed to individualism and less worried about using personal achievement as the measure of a person’s worth.3 The special meaning of health and disease for American society calls for a clear understanding of the nature of the relationship between health and disease. “Defining what does or does not constitute a disease determines both the authority and power of those charged with alleviating its consequences as well as the scope of the social obligations of those beset by medical problems.”4 Therefore in order to delineate the specific bounds of medicine and the healing arts, we must first construct a precise understanding of these views. Four major views concerning the relationship between health and disease contend for position. They are: 1. A Value-free Definition of Health 2. A Statistical Conception of Health 3. Health as the Absence of Disease 4. The Normativist View of Health In each case we will give a brief sketch of the Western position as cited by Caplan and others, and then suggest how insights from Åyurveda can further illuminate more ample definitions of health and disease. A Value-free Definition of Health and Disease The first view is based on biological evolution. Its orientation is scientific, basing its understanding of health and disease on empirical facts. As Crawford: Hindu Bioethics page 94 94 Foundations such, it finds no reason to invoke values or morals into its analysis of health. It is confident that we can arrive at objective notions of health or disease without reliance on values. A prominent exponent of this position is philosopher Christopher Boorse. He makes his case in an article “On the Distinction Between Disease and Illness.”5 Boorse claims that inasmuch as all organisms, including humans, are the products of a long course of biological...