Grappling with Vulnerability: MacIntyre in the Jiujitsu Gym and the Bedside
Peter Katz, University Hospitals, Cleveland Medical Center, Case Western Reserve University
This essay uses martial arts studies—an emergent field of inquiry that uses martial arts as both its object of study and as a methodology—to think about cultivating shared vulnerability and dependence as positive states particularly useful for clinical ethics and medicine. In ordinary language, vulnerability is often framed as a weakness; in philosophical literature, particularly studies in justice, vulnerability is understood as a capacity to be more adversely affected by the outside world. Even Philip Kitcher, a secular philosopher who sees vulnerability as the basis of ethics, frames ethics as a way to cover up for and account for vulnerability. But as the work of Alasdair MacIntyre suggests, vulnerability is fundamental to being human (and animal): it offers meaning and grounds our ethics. MacIntyre’s spin on vulnerability offers an important corrective to work like Kitcher’s, in that MacIntyre sees vulnerability as part of an unavoidable, mutually acknowledged dependence.
To make this argument, I draw on two examples: a clinical ethics case, and a Brazilian Jiujitsu roll with a new practitioner. It is easy to see both of these cases as examples of asymmetrical power where the other person is vulnerable. But, this talk argues, these relationships only work because of mutual vulnerability. Clinical ethics, like martial arts, is an entry into an embodied language-game, where not simply ideas but the emotional integrity of both sides are at stake. In both cases, the spaces where these conversations often take place impose unspoken agreement to implicit rules of communication and interaction: the presence of the hospital bed, the mat space of the jiujitsu gym. There are also explicit rules of communication: hospital policy on “disruptive” patients and families, the agreement not to punch or kick each other while grappling. But a truly productive conversation, whether grappling or goals of care, requires both parties to gradually and mutually open up the implicit boundaries on what can be said, how bodies can comport themselves, and how we receive one another's’ communications.
In a bioethics milieu (rightly) concerned with asymmetrical power relationships and protecting vulnerable patients and their families, it is tempting to frame vulnerability as something other people have as a reason why we should protect them—perhaps even pity them. But if we bring MacIntyre to the jiujitsu gym and the bedside, we can reframe vulnerability as a valuable quality that we should cultivate in ourselves and one another. Using martial arts studies as a methodology and not simply a metaphor opens up modes of bioethics inquiry beyond normative analytic philosophy, so that we can better understand in our bodies what it means to share vulnerability with one another.
To make this argument, I draw on two examples: a clinical ethics case, and a Brazilian Jiujitsu roll with a new practitioner. It is easy to see both of these cases as examples of asymmetrical power where the other person is vulnerable. But, this talk argues, these relationships only work because of mutual vulnerability. Clinical ethics, like martial arts, is an entry into an embodied language-game, where not simply ideas but the emotional integrity of both sides are at stake. In both cases, the spaces where these conversations often take place impose unspoken agreement to implicit rules of communication and interaction: the presence of the hospital bed, the mat space of the jiujitsu gym. There are also explicit rules of communication: hospital policy on “disruptive” patients and families, the agreement not to punch or kick each other while grappling. But a truly productive conversation, whether grappling or goals of care, requires both parties to gradually and mutually open up the implicit boundaries on what can be said, how bodies can comport themselves, and how we receive one another's’ communications.
In a bioethics milieu (rightly) concerned with asymmetrical power relationships and protecting vulnerable patients and their families, it is tempting to frame vulnerability as something other people have as a reason why we should protect them—perhaps even pity them. But if we bring MacIntyre to the jiujitsu gym and the bedside, we can reframe vulnerability as a valuable quality that we should cultivate in ourselves and one another. Using martial arts studies as a methodology and not simply a metaphor opens up modes of bioethics inquiry beyond normative analytic philosophy, so that we can better understand in our bodies what it means to share vulnerability with one another.