Martin Buber's Religious Humanism as an Ethical Basis for Secular Medical Practice
Alan Astrow, M.D., Chief, Medical Oncology and Hematology, New York-Presbyterian Brooklyn Methodist Hospital/Weill Cornell Medical College
The Hippocratic oath advances an ethical vision for medical practice, "I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing.” At the same time, the oath safe-guards the perquisites of the physician guild "to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else." Biblical religion shares Hippocratic ethical concerns, but goes beyond Hippocratic medicine, aiming to bring holiness to the created universe through values understood as divine. In this talk, I will explore the theology of 20th century Jewish philosopher Martin Buber as outlined in the recent biography by Paul Mendes-Flohr, suggest how Buber's biblical humanism applied to medical practice might complement Hippocratic medicine, how as an experiential and non-dogmatic form of religious faith, it might have appeal in a secular age, and indicate where as a practical basis for medical ethics, it falls short. For Buber, rabbinic rules and regulations, Halacha, that had governed Jewish life for centuries were not relevant to contemporary living and were spiritually deadening. At the same time, he rejected the idea of religious seeking disconnected from ethical concern, which he saw as a path to nihilism. God "whispers to us in the course of the everyday," he wrote. The divine "attains its earthly fullness only where . . . individuals open themselves to one another, disclose themselves to one another, and help one another." "True human life," he wrote, "is conceived to be a life lived in the presence of God" with God's presence encountered in the realm of the "Between." Is there any place for this kind of religious language in contemporary medical care? Perhaps. The imbalance in power between doctor and patient, realistic limits on the human ability to overcome self-interest, and the practical demands of medical practice, cast doubt on whether Buber’s idealized conception could ever be fully realized. Still, Buber's religious humanism might be might be understood as providing philosophical grounding for contemporary "shared decision-making" and as the motivating basis for a "healing relationship" between doctor and patient, as described by Schenck and Churchill in their treatise, Healers: Extraordinary Clinicians at Work. Schenck and Churchill recommend specific healing behaviors and so advance Buber's concepts from the poetical into the realm of potentially real. I will illustrate with specific examples from my oncology practice.