Emanuel Levinas and the Vital Role of Face-to-Face Encounter
Richard Gunderman, MD, PhD, Indiana University, Indianapolis, IN

Born in Lithuania in 1906, Emmanuel Levinas became a refugee, a prisoner of war, and one of the most significant French philosophers and theologians of the 20th century, arguing that philosophy begins not in metaphysics but in ethics, and that ethics begins not in principles but in the encounter with another human being.  In his great work, "Totality and Infinity," Levinas argues that when we come face to face with another person, whether a patient or a colleague, that person speaks to us as a living presence, inviting us into relationship and placing us in a position of responsibility.  We recognize that this person transcends our purposes and feel the presence of God.  As Levinas sees it, we do not become ourselves until we are before the face of another.  We can no longer move others around like pieces on a chessboard.  Instead of manipulation or condemnation, we are called to mercy; instead of apathy we are called to sympathy; and instead of exploitation we are called to generosity.  Levinas' perspective is especially needed today, on the heels of the COVID-19 pandemic, when people sheltered in place, wore masks, and patient care and education shifted to online and often even asynchronous modes that undercut the possibility of face-to-face encounter.  We can teach medical ethics and professionalism from books and journal articles until we are blue in the face, but unless and until we restore the primacy of real-time, direct encounter between learners and teachers and health professionals and patients, we will be engaged in an essentially irresponsible mode of education and practice that cannot nurture the sense of personal responsibility on which good medicine -- and flourishing human relationships -- depend.