For our fifth event, we had a stimulating conversation with Professor David Magnus and Dr Alyssa Burgart, both from Stanford University, where David is Thomas A Raffin Professor of Medicine and Biomedical Ethics and Professor of Pediatrics and Medicine, and Alyssa works as a board-certified paediatric anaesthesiologist and bioethicist in her role as Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine. The event was co-chaired by Dr Lauren Barron (DeBakey Chair for Medical Humanities, Clinical Professor, and Director of the Medical Humanities Program at Baylor University).

We don’t have the space to summarise all the insights David and Alyssa shared with us, but the full conversation is available to listen to as an episode of our podcast.

We do want to share some of the key messages we took away around the theoretical and practical delivery of ethics into clinical services, the role of the humanities to improve communication, and dealing with the limits of our knowledge.

The role of ethics

To understand ethics, practice ethically, and deliver ethical support can be deeply challenging in the complicated world that is modern medicine. We were privileged to hear from two people embedded in researching ethical care, delivering ethical care, and supporting patients and doctors alike. In these conversations, we revealed the power of the humanities to address questions beyond the reach of science, and of daily importance to the lives of people with illness and of those caring for them.

The ability to think clearly about situations of emotional and practical complexity, with care and compassion, requires a framework of ethical thinking and practice that can be studied, cultivated, taught, and used to support the care of patients. Strikingly, this practice is also amenable to meaningful and important research, and the conversation around ‘hedge’ words, exploring with doctors try to say and sometimes try not to say, and what patients hear, was especially insightful.

If you listen to the podcast, you’ll hear stories of how patients and their family have different interpretations of words and phrases like “comfort care” and “treatable”. Research into this area, underpinned by philosophy of language and linguistics, helps us to better understand when and why things go wrong – and what we can do to improve communication. The role of the bioethicist as insider and outsider to medicine is particularly intriguing here. Bioethicists are of course more familiar with medical jargon than the average patient or relative, but, as scholars trained in humanities, they also bring an outside perspective – especially if they are not formally trained in medicine. This in-between position allows bioethicists to pick up on misunderstandings that would otherwise go unnoticed.

More broadly, the role of the ethicist is not to act as “ethics police”, deciding on what’s right and wrong in medicine, and penalizing moral offenders. Instead, bioethicists typically draw on knowledge and approaches developed in philosophy and humanities to try and bring clarity to ethically complex situations – where distinctions between right and wrong are far from evident. This practice involves considering what perspectives are available and how they can be robustly supported by established moral frameworks.

The understanding illness – and its limits

The study of humanities within the context of health and illness allows us to explore what is evident and obvious: that illness is more than a process, more than a pathology. We need doctors who understand our illnesses, can measure our pathology, and weigh the scientific knowledge about our possible treatments. We need doctors trained and skilled in the practical procedures and delivery of care, such as Dr Burgart’s skills as an anaesthesiologist (or anaesthetist, if you’re reading this in the UK). But we also need doctors who can navigate the uncertainty, and reveal the landscape before our feet when treading uncertain paths.

One crucial aspect here – and it has been brought up time and again in our conversations – is coming to terms with the limits of understanding. It takes courage to be vulnerable and admit these limits.  There is an expectation that doctors and health professionals should know everything, because science offers the answers and solutions. This is wishful think of course. The role of bioethics in medicine exactly lies in addressing what to do in situations where scientific knowledge and technological know-how do not suffice to make the right path of action clear.

David and Alyssa showed how health professionals can begin to systematically walk those uncertain paths effectively together with patients – and we thank them for a thought-provoking conversation.

Listen to the podcast

We recommend you have a listen to our podcast to hear the full story.

If you have any further questions or comments, do contact us at aestheticsandhealth@kent.ac.uk.

Dieter and Ian