Philosophy of Medicine
Dr Mohammed Dalmau
Any paradoxes in the biological behaviour, the unexpected result of scientific predictions, the incomprehensible changes that could not be foreseen in studying the creational processes, all that shows us that nature is not a system. Nevertheless systematisation and standardisation has been the characteristic of the medical procedures of the science of this century, from the theoretical realm to its pragmatic applications.
We read from Werner Heisenberg in his book Physics and Philosophy:
"The scientific method of isolation, explanation, and classification is aware of its own strict limitation, namely that the application of the method itself alters and reshapes the object of study, so that method and object can no longer be separated. The world picture formulated by natural science ceases at this point to be truly scientific."
Heisenberg's observation is about the fact that the method of apprehending the phenomenon is the frame through which the object of study is forced to reveal itself and is defined by it. Rational medicine is the method, and human organism is its object of study. Technology is the means by which the creational processes are forced to reveal themselves . And this way of revealing is the reduction of the vital phenomena to its mechanical behaviour with the determinism of cause and effect. The Greeks had the word "aletheia", for revealing. The Romans translate it as "veritas", which means truth. Anything brought forward by the experimental method is accepted as truth, and has made this science the new secular religion. This institutionalised truth sponsored by the medical research foundations sanctioned by the state, is now the universal basis for medical practice. Every university in the world now teaches the same medical curriculum.
From the French revolution man got the status of citizen. The corporative capitalism has gone a step further, and man is finally defined as taxpayer by the state and as consumer by the financial corporations . Both definitions are in concordance with this rational medical approach that belongs to a society which is in itself, a market place entirely dominated by the practice of usury. Physiology, pathology and therapy had to be looked at and defined in a standardised way to fulfil the economic purpose of the standard manufacturing of drugs and the systematic requirements of the technological instruments. Therefore it is easy to understand that medical science has reduced man to his organic dimension, and is directed only to the assessment of body mechanical failures and the procedures to correct them. Under this enframing, health is reduced to being only the absence of disease. And this approach is the one which takes pathology as the main reference .Medicine comes from the Latin "meder" meaning to heal. As the etymology shows, the intrinsic character of this method is indeed to look for a cure. Its overall purpose is to produce a profitable return on investment, and deflect peoples´ attention away from the social and economic framework that is making them ill. Medical science has lost sight of what are the dynamics of this healthy human form.
The resurgance of tuberculosis on the outskirts of New York is not the product of a new resistant strain of mycobacterium, but the result of social misery and depravation in a scenario of unemployment, poor nutrition, unhygienic housing conditions and a highly populated area. The nature of the human form under these conditions is forced to reveal itself in this specific way. Tuberculosis is therefore the metamorphosis of the specific social conditions that created it.
The pathologically centred approach is only looking for what has gone wrong in the body, and not for what is missing in the social human form. It will assess the presence of specific proteins in blood, the biochemical alterations of the organic fluids, the cellular changes in tissues, even the psychological profile, but will disregard as aetiology the existential condition of man reduced to a passive consumer, trapped by endless debt, worthless money, political impotence and submission to a society with complete disintegration of human behavioural patterns. Phenomenologically speaking we can say that rational medicine has no model of health.
Traditionally, the fundamental basis of medicine is the knowledge of what is normal, which we call physiology, and is defined as the science of the functions of the living organism and its parts.
"Phusis" in Greek means nature, from this comes "physis" meaning what is natural, and then "physiology" meaning therefore the science of what is natural.
At that point we should ask ourselves whose definition of what is natural are we to take, the scientific or the prophetic one?.
Knowing what is natural is in fact knowing about the limits within which the living form is meant to stay.
The living being is stable because it can be modified. The matter of which we are composed is in a high degree of instability. Engaged in a free exchange with the outer world, it is being continuously broken down by the wear and tear of daily activity, and being continuously built up again by processes of repair. But it is only the physiological effort to maintain the form that keeps stable the constants of life.
For instance when we make a muscular effort, the extreme heat generated it could coagulate the albumen of our blood, nevertheless the body has the means to maintain the blood unaltered, but if the temperature of the brain rises up only by five degrees, that is enough to damage it. The physiological limits define the function and protect the form. Keeping these limits is setting the possibility for the best life performance.
These limits mark the boundaries that can not be crossed. Beyond that point there is no other possibility except the appearance of pathos, suffering. Therefore the immediate effect of the physiological boundaries is to protect the organic form.
We read in the Qur'an:
" Whoever transgresses the limits of Allah, truly harms himself."
(Qur'an 65:1)
We see then that Physiology is about limits which are maintained by discrimination.
Discrimination is the continuous biological choice that the organism is made to confront in every moment. The biological values are the parameters for its life transaction. Through discrimination the best performance of the organism is achieved, which also implies the best outcome, which is health.
Health is therefore the dynamic performance of what is natural.
This performance is in itself the best existential practice, the one that suits the human form perfectly . This practice is a life-pattern, meaning it is a model. The model is indeed a pattern for life because it can be copied, and in doing so allows it to reproduce life in its physiological way, in its naturalness.
As we can see this model gathers the genetics of existence, the "how to live." It contains the pattern that unfolds life as it is, and can be copied and transmitted. And I am not talking here about DNA, but about Sunnah, whose meaning is practice, the root of the word meaning to form..
Sunnah is therefore a practice that brings about form, the form which is natural to the human being, because it unfolds the authentic parameters of our existence. Due to this, its practice is perfectly adequate to the characteristics of the living social organism that man is, and the performance of this model not only leads to personal health but to social health, because this life pattern creates social harmony and in doing so implicitly becomes moral.
The embodiment of this practice by the most perfect of the human beings that ever existed, the prophet Muhammad sallallahu alayhi wa salem, gave us the model that man can copy. Allah in His mercy took away the terrible burden of having to work it out for ourselves.
We read in the Qur'an:
"Truly in the Messenger of Allah you have a good example."
(Qur'an 33:21)
It is significant that the Arabic word used here for "example" (uswatun) has at its root the meaning "to be healed".
The conclusion is that the model is itself the healing. The model tell us about the dynamic relation with the Creator and His creation.
There is a hadith of the Messenger of Allah that says:
"The One Who sent down the illness, also sent down the cure".
Therefore it is of fundamental importance in our assessment of illness that we recognise whether the natural limits for the human being, as laid down in the Qur'an and the Sunnah, are being observed or not. This basic distinction is crucial. Illnesses that are clearly outside the limits are a warning to return to within the limits. Illness of the mumin who observes the limits of Allah is a mercy.
Disease is an indication about the limits within which man's life transaction is undergoing.
We only can understand disease by comparing it with health and not the other way round. Health is not the absence of disease but the performance of our condition as slave of Allah and khalif on earth.
Health is a model of behaviour that tells us not only what we can do and what we can not do but also what we have to do.
And that is about how we live, how we trade, how we worship and to which power we submit ourselves.
It is about salat and zakat.
It is about worship, but also about the responsibility of establishing justice.
And there is no health in an unjust society. Establishing health and establishing justice are the same thing. The true physician is the one who takes on the responsibility to establish health,.
From Imam Malik in the Muwatta, we have the hadith of the Prophet, sallallahu alayhi wa salem:
" I have left two things with you. As long as you hold fast to them you will not go astray. They are the Book of Allah and the Sunnah of His Prophet."
Islam is not a state concept, it is an organic life-pattern for man in society. And the only cure for our existence is Islam.
Dr. Mohammed Dalmau