Saturday, July 14, 2018

Evening Note for Saturday, July 14

Thought for the Evening: Humanitarian Traditions

Consider the peculiar character of medicine. Medicine as we find it is not merely a skill, like plumbing; there are in fact a great many medical skills. It is not merely a profession, although there are medical professions -- but there are, in fact, many medical professions, each with their distinctive features. Despite this plurality, medicine is quite unified. Medicine is generally seen as heavily devoted to the human person, and as tied up in treating human persons with justice and compassion; it is very natural to talk about human dignity in a medical context. Medical professionals are regularly seen as engaged in a service, not merely to clients or customers, but to humanity in general as well. And this is something that is handed down, first, in the fact that there is a significant apprenticeship component to much of medicine, in the form of bone-wearying internships and more experienced practitioners guiding less experience practitioners, and, second, in the symbolic act, very common, of passing down the Hippocratic Oath, either fully, or just in the general, but explicit, expectation of being guided by 'Do No Harm'.

Medicine cannot be adequately understood unless it is seen as a tradition. It is something handed down, and it has been handed down in one form or another for a very long time. This handing-down of medicine is tied up with the handing-down of skills, of responsibilities, of ethical subtraditions. But it's not just any kind of tradition. It is particularly focused on upholding human life, not just barely, but as human. Thus we can call it a humanitarian tradition.

Medicine is not the only humanitarian tradition, although it is easily the one that is most obviously both traditional in character and humanitarian in focus. Two fields that obviously also function as humanitarian traditions in this way are law and ministry. They are very different from both medicine and each other; traditions do not fit exact templates because they are organically grown rather than artificially built. But humanitarian traditions tend to have certain kinds of features. A few that come to mind:

(1) They all are concerned in some sense with helping people precisely because they are people, and thus are concerned with some facet or other of human dignity.

(2) They are intrinsically traditional -- because they deal directly with human beings, and all sorts of ethical issues, they have to be handed down, from more experienced to less experienced, in such a way that the less experienced can develop not just the knowledge but the practical skills required.

(3) They always and everywhere exhibit an ethical component; but this ethical component is not a set of general ethical principles but is specifically developed in response to the historic problems that the tradition has faced.

(4) Part of their ethical component is the development of what might be called deferential responsibilities to those affected by their skills. A doctor cannot do whatever he pleases; he has to work with the patient, and ultimately defer to the patient as the primary decision-maker. A lawyer has to do something roughly analogous with the client; and rabbis, priests, and pastors, all in different ways given religious differences, have to do similar things with those who come to them for help.

(5) Since helping people requires communication, and deferential responsibilities require that the participants in a humanitarian tradition work to protect those they are helping, they develop traditions of privileged communication. There are things you cannot divulge without the permission of the person you are helping. Exactly what this means will vary a bit depending on the nature of the tradition, but doctors have doctor-patient confidentiality, lawyers have legal professional privilege. Catholic priests have a complicated mix: pastoral confidentiality (which is a lot like doctor-patient confidentiality, although less rigorous), the pontifical secret (which is the canon law version of legal professional privilege, although it covers a lot more), and the seal of the confessional (which is distinctive to the priesthood).

(6) Because the tradition is seen as one of helping people there is a widespread cultivation of opportunities for work pro bono publico, either in the strict sense of unpaid professional work, or in the looser sense of accommodating the public being served in time, money, and the like.

(7) As traditions, they tend to develop specific forms of etiquette devoted to making it easier to work together in some kind of common cause, which, as they spawn particular professions, translate into various forms of professional courtesy.

Medicine, law, and the various forms of ministry tend to be quite stable as humanitarian traditions, but I think there are a lot of cases where a field might be a humanitarian tradition in some cultures and not in others, or that might have most of the materials for a humanitarian tradition but are not currently operating as one (e.g., they may once have been, but have drifted from either traditionary means or humanitarian concerns). Being a citizen, or a politician, or a teacher, may itself be a humanitarian tradition in one culture and nothing more than a formality or a career in another.

I think humanitarian traditions are quite important, because there is a good argument that they are the most healthy breeding grounds for ethical ideas. That they are breeding grounds for ethical ideas is easy enough to establish; lots and lots of our ethical ideas can be traced back historically to medicine, or to law, or to pastoral work. This is because all of these are constantly dealing with real problems of ethical importance, and have had to work out practical solutions to those problems, solutions that are often ingenious and well-adapted to the problems they are trying to solve. (The history of the concept of triage is an excellent example.) And this very practical element is also why the ideas developed tend to be more healthy contexts for development than, say, the brain of an academic in an office, as long as the practical element maintains the concern with people. This, of course, is not to say that every such idea is a good one, or that they will always be thought through. A lot of the ethical ideas that tumble around in medicine, law, or pastoral ministry are pretty obviously rigged together out of whatever was at hand. They can be distorted by cultural forces like anything else. But over time they are refined and given new forms and adapted, and, after all this tumbling, what went in as a rough stone comes out as a gem. And the results are often more creative and adapted to their situations than the ideas of any one person can have been.

It's also the case, I think, that humanitarian traditions are the major mediators of higher-level ethical concepts, and for related reasons. If you say that someone has a right to liberty, and leave it there, it's very difficult to say what that really involves in practice. To understand the right, you have to start working through how it applies to real-world problems. Thus, for instance, talk of human rights is almost useless on its own, despite the importance of what is being discussed; much of what we practically understand about human rights has been worked out cooperatively by various kinds of law professionals drawing on legal history and trying to solve specific problems. If, for instance, you are lawyers interested in upholding the people of your society as a free people, saying they have a 'right to liberty' doesn't do anything for you but set the kind of problem you are working on. You have to translate this into actual institutional and procedural processes -- things like 'relevant authority' or 'due process' -- and work out what is relevant for these particular cases, sometimes by just estimating from prior attempts and experience. As a lawyer you have to settle not just for what you are trying to get, as if the practice of law were nothing but hoping that justice would be served; you have to think about the how. It's not much use to talk about rights, or, indeed, many other ethical concepts, unless you have humanitarian traditions applying them, specifying them, and developing them. In a sense, humanitarian traditions are the only things big enough and rich enough to do any of these three things adequately.

Various Links of Interest

* Frederick Douglass's novella, The Heroic Slave

* Monwhea Jeng on the Mpemba effect -- the phenomenon of hot water freezing more quickly than cold water, which has been noted since Aristotle. It fell off the scientific radar, but continued to be a part of folklore until about fifty years ago when a Tanzanian high school student, Mpemba, kept puzzling about it and convinced a skeptical physicist to try the experiment, which, to the physicist's surprise, showed the phenomenon to be real. ('Antiperistasis', which the essay attributes to Aristotle is a word that is used by Aristotle to mean something different; the use of the term to mean the intensification of a quality when opposed by a contrary is, I think, primarily seventeenth-century.) But still nobody knows for sure what the cause of the effect is; all the theories so far proposed explain some, but only some, of the variations on the phenomenon.

* A look at some of the difficulties in translating Sun Tzu.

* Adam Young, Stalin's Political Pilgrims

* Varlam Shalamov, Forty-Five Things I Learned in the Gulag

* Steven Nemes and Jordan Wessling, The Medicine which Heals the World: Praying for Salvation with Catherine of Siena

* Colin Chamberlain, Our Bodies, Our Selves: Malebranche on the Feelings of Embodiment

Currently Reading

Booker T. Washington, Up from Slavery
Antonio Rosmini, Rights in God's Church
Pierre Hadot, The Inner Citadel
Reginald Lynch, OP, The Cleansing of the Heart
Edmund Husserl, Ideas
Jules Verne, North Against South

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