Recovering Authority in Medicine and Counseling: Polyani and Calvin as Strange Bedfellows
Brian Mesimer, MA, Associate Counselor, The Christian Counseling Center of First Presbyterian Church
Recent developments in the field of counseling and medical ethics have engendered a shift away from training models that emphasize a hierarchical healing alliance in favor those that champion a democratized alliance in which practitioner and client are seen as equals. Undoubtedly such changes should be encouraged as necessary correctives to perceived imbalances of power which can be exploited by practitioners with malcontent. Yet proponents of such models fail to acknowledge the fiduciary nature of the knowledge acquisition process that makes a hierarchical alliance a requisite condition of the transmission of knowledge in psychotherapy and medicine. In the last century, no two thinkers understood this dynamic better than the Anglo-Hungarian polymath Michael Polyani and the Dutch-American Reformed theologian Cornelius Van Til. Polyani left a lasting impact on the mid-century scientific community by challenging prevailing paradigms of analytical certainty, thereby positing a personal view of knowledge which required faith in authority structures in order to guarantee the proper transmission of truth. During the same period, Van Til, through his religious epistemology based upon the thought of John Calvin, proposed that all knowledge at its core is based upon unproven presuppositions accepted through faith. Although each thinker represents divergent religious perspectives, both come to the conclusion that faith and authority are essential prerequisites of knowing. Such assertions have far reaching effects, particularly upon the practice of medicine and the relationship between doctor and patient. Through a utilization and synthesis of key components of each philosopher's discoveries, this paper will attempt to defend a traditional view of hierarchy in the healing arts as essential to their success, however that may be quantified. This relationship is due to the reality that faith is an essential part of knowing, and where faith is concerned, authority must also be implicated.
Recent developments in the field of counseling and medical ethics have engendered a shift away from training models that emphasize a hierarchical healing alliance in favor those that champion a democratized alliance in which practitioner and client are seen as equals. Undoubtedly such changes should be encouraged as necessary correctives to perceived imbalances of power which can be exploited by practitioners with malcontent. Yet proponents of such models fail to acknowledge the fiduciary nature of the knowledge acquisition process that makes a hierarchical alliance a requisite condition of the transmission of knowledge in psychotherapy and medicine. In the last century, no two thinkers understood this dynamic better than the Anglo-Hungarian polymath Michael Polyani and the Dutch-American Reformed theologian Cornelius Van Til. Polyani left a lasting impact on the mid-century scientific community by challenging prevailing paradigms of analytical certainty, thereby positing a personal view of knowledge which required faith in authority structures in order to guarantee the proper transmission of truth. During the same period, Van Til, through his religious epistemology based upon the thought of John Calvin, proposed that all knowledge at its core is based upon unproven presuppositions accepted through faith. Although each thinker represents divergent religious perspectives, both come to the conclusion that faith and authority are essential prerequisites of knowing. Such assertions have far reaching effects, particularly upon the practice of medicine and the relationship between doctor and patient. Through a utilization and synthesis of key components of each philosopher's discoveries, this paper will attempt to defend a traditional view of hierarchy in the healing arts as essential to their success, however that may be quantified. This relationship is due to the reality that faith is an essential part of knowing, and where faith is concerned, authority must also be implicated.