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Posts Tagged ‘Immanuel Kant’

Adeline’s True Age

Lionsgate have released a trailer for The Age of Adeline . The film ...After miraculously remaining 29 years old for nearly eight decades, Adaline Bowman (Blake Lively) has lived a solitary existence, never allowing herself to get close to anyone who might reveal her secret. But a chance encounter with charismatic philanthropist Ellis Jones (Michiel Huisman) reignites her passion for life and romance. When a weekend with his parents (Harrison Ford) threatens to uncover reality, Adaline makes a decision that will change her life forever. This Kantian decision, to tell the truth always, irrespective of the consequences, ironically sets her free from the bondage and chains of time.

The ‘Customer’-Physician Relationship

Medicine is subtly shifting from an emphasis on what is ideally best for the patient to an environment where hospitals are marketed from survey results and physicians are instructed on how to encourage customers to check the ‘Excellent’ box when rating their care. The danger in primarily viewing a patient as a consumer is that well known adages like ‘the customer knows best’ can gravitate toward motivations based primarily on the profit motive rather than the apparent benefits of collaboration, patient voice, and better service.

The philosopher Immanuel Kant reminds us to ask whether we are treating persons (customers) as a means to some end (profits) or as ends themselves (patients). When push comes to shove at medicine’s financial margins, decisions tend to lean toward monetary gain. Efficiency and profits are needed components of every venture (even Kant says not to use people as a means only but as a means as well as an end). Yet this move from taking care of patients to customers—while promoting friendlier hospital environments—may be damaging to the health care system in the long run.

The Hippocratic Oath has been condemned for promoting a ‘guild-like’ environment and its ancient author set aside in the hope of adopting the examples of other tightly managed industries (ironically, some business academics call for managers to take on the guild-like professionalism of the medical field). While some combination of treating patients as a means and as an end is probably acceptable, it seems that the customer/consumer metaphor is being adopted wholesale.

To Hippocrates, a physician’s first consideration was to use his/her art for the patient’s well-being—a re-emphasis that can benefit all stakeholders. Otherwise, this move to make the medical environment more patient-friendly has the potential to make it ultimately more vulnerable.

Written in conversation with Cory Wilson, M.D.