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␈↓ α∧␈↓α␈↓ ¬↓MEDICINE AND THE INDIVIDUAL

␈↓ α∧␈↓␈↓ αTIn␈αthis␈αsection,␈αwe␈α
will␈αtake␈αthe␈αsame␈αrationalist␈α
approach␈αto␈αimprovements␈αin␈αmedicine␈α
that
␈↓ α∧␈↓we␈α∪have␈α∪taken␈α∩to␈α∪improvements␈α∪in␈α∪other␈α∩areas.␈α∪ However,␈α∪this␈α∪is␈α∩in␈α∪sharp␈α∪contrast␈α∪to␈α∩the
␈↓ α∧␈↓dominant ideology of medicine, both among doctors and among the public.

␈↓ α∧␈↓␈↓ αTOur␈α∂view␈α∂is␈α∂that␈α∂we␈α∂should␈α∂look␈α∂to␈α∂medical␈α∂science␈α∂and␈α∂technology␈α∂for␈α∂ways␈α∂of␈α∂making
␈↓ α∧␈↓humans␈α
live␈α
as␈α
long␈α
as␈α
possible,␈α
as␈α
healthily␈α
as␈α
possible,␈α
and␈α
with␈α
as␈α
great␈α
as␈α
possible␈α
physical␈α
and
␈↓ α∧␈↓mental␈α∞powers.␈α∞ This␈α∞may␈α∞seem␈α∞uncontroversial␈α∞at␈α∞first␈α∞glance,␈α∞but␈α∞the␈α∞way␈α∞people␈α∞think␈α
about
␈↓ α∧␈↓medicine␈α∩is␈α∩dominated␈α∩by␈α∩certain␈α∩ideological␈α∩attitudes␈α∩peculiar␈α∩to␈α∩medicine␈α∩that␈α∩seem␈α∩to␈α⊃me
␈↓ α∧␈↓irrational and harmful.

␈↓ α∧␈↓␈↓ αTThe␈α
first␈α
of␈α
these␈α
is␈α
the␈αnotion␈α
of␈α
␈↓↓normal␈α
health␈↓␈α
vs.␈α
 ␈↓↓sickness␈↓.␈α The␈α
idea␈α
is␈α
that␈α
there␈α
is␈αa
␈↓ α∧␈↓␈↓↓normal␈↓␈αstate␈αof␈αhealth␈αfor␈αa␈αhuman␈αbeing␈αand␈αthat␈αdeviations␈αfrom␈αnormality␈αare␈αto␈αbe␈α
prevented
␈↓ α∧␈↓and␈αcorrected.␈α There␈αis␈αno␈αserious␈αconsideration␈αof␈αthe␈αidea␈αthat␈αthere␈αare␈αstates␈αof␈αhealth␈αbetter
␈↓ α∧␈↓than␈αnormal,␈αand␈αmedicine␈αshould␈αbe␈αjust␈αas␈αalert␈αto␈αopportunities␈αto␈αproduce␈αbetter␈αthan␈αnormal
␈↓ α∧␈↓states of health as with correction.

␈↓ α∧␈↓␈↓ αTThe␈α
second␈α
ideological␈α∞vice␈α
of␈α
medicine␈α∞is␈α
moralism.␈α
 Liking␈α∞to␈α
eat␈α
and␈α∞disliking␈α
exercise
␈↓ α∧␈↓are␈α⊃regarded␈α⊃as␈α⊃vices␈α⊃to␈α⊃be␈α⊃punished␈α∩by␈α⊃ill␈α⊃health␈α⊃rather␈α⊃than␈α⊃as␈α⊃matters␈α⊃of␈α∩personal␈α⊃taste.
␈↓ α∧␈↓Doctors␈α
naturally␈α
acquire␈α
such␈α
attitudes,␈α
because␈α
when␈α
the␈α
patient␈α
gets␈α
sick,␈α
it␈α
is␈α
less␈α
unpleasant
␈↓ α∧␈↓for␈α
the␈α
doctor␈α
to␈α
consider␈α
it␈αthe␈α
patient's␈α
fault␈α
than␈α
his␈α
own,␈αor␈α
even␈α
to␈α
believe␈α
that␈α
the␈αpatient
␈↓ α∧␈↓has␈αbeen␈αwasting␈αhis␈αtime␈αand␈αmoney␈αwith␈αexpensive␈αvisits␈αand␈αlaboratory␈αtests.␈α The␈αintellectual
␈↓ α∧␈↓tendency␈αto␈αmoralize␈αis␈αexacerbated␈αby␈αthe␈αdesire␈αto␈αbelieve␈αthat␈αone␈αwill␈αlive␈αforever␈αif␈αonly␈αone
␈↓ α∧␈↓does␈αeverything␈αexactly␈αright.␈α Medicine␈αshould␈αseek␈αways␈αof␈αletting␈αpeople␈αlive␈αas␈αthey␈αwish␈αand
␈↓ α∧␈↓still␈α∩enjoy␈α∩good␈α∩health.␈α∩ Naturally,␈α∩at␈α∩a␈α⊃given␈α∩state␈α∩of␈α∩medicine␈α∩the␈α∩individual␈α∩may␈α∩still␈α⊃be
␈↓ α∧␈↓confronted␈α∞with␈α∞hard␈α∞choices,␈α∞but␈α∞doctors␈α∞often␈α∞don't␈α∞do␈α∞all␈α∞they␈α∞can␈α∞to␈α∞let␈α∞people␈α∞live␈α∂as␈α∞they
␈↓ α∧␈↓wish.

␈↓ α∧␈↓␈↓ αTA␈αthird␈αproblem␈αis␈αthe␈αattitude␈αtowards␈αdeath.␈α Death␈αis␈αthe␈αmost␈αunpleasant␈αaspect␈αof␈αlife.
␈↓ α∧␈↓There␈α∂is␈α∂said␈α∂to␈α∂be␈α∂a␈α⊂failure␈α∂of␈α∂our␈α∂society␈α∂to␈α∂face␈α⊂death␈α∂-␈α∂whatever␈α∂that␈α∂may␈α∂mean.␈α⊂ In␈α∂my
␈↓ α∧␈↓opinion,␈α
the␈α
biggest␈α
failure␈α
is␈α
to␈α
squarely␈α
face␈α
the␈α
fact␈α
that␈α
death␈α
is␈α
unpleasant␈α
and␈α
that␈αsociety
␈↓ α∧␈↓should␈αcontribute␈αas␈αmuch␈α
as␈αpossible␈αto␈αthe␈α
individual's␈αdesire␈αto␈αpostpone␈α
it.␈α There␈αseems␈αto␈α
be
␈↓ α∧␈↓some␈α⊃kind␈α⊃of␈α∩"death␈α⊃is␈α⊃nice"␈α⊃lobby.␈α∩ Maybe␈α⊃it␈α⊃is␈α∩a␈α⊃residue␈α⊃of␈α⊃the␈α∩belief␈α⊃in␈α⊃life␈α∩after␈α⊃death
␈↓ α∧␈↓according␈αto␈αwhich␈αdeath␈αis␈αjust␈αa␈αtransition␈α
to␈αa␈αhappier␈αlife.␈α There␈αis␈αan␈αunjustified␈αbelief␈α
that
␈↓ α∧␈↓unless␈α
death␈αcan␈α
be␈αpopularized,␈α
people␈α
will␈αbe␈α
so␈αunhappy␈α
that␈α
they␈αwill␈α
refuse␈αto␈α
live.␈α This␈α
one
␈↓ α∧␈↓is less prevalent among doctors than among writers.

␈↓ α∧␈↓␈↓ αTFinally,␈αmedicine␈αsuffers␈αto␈αan␈αextreme␈αdegree␈αfrom␈αthe␈αtendency␈αof␈αprofessionals␈αto␈αregard
␈↓ α∧␈↓their patients as objects and to make decisions for them.

␈↓ α∧␈↓␈↓ αTOur␈αsecond␈αtheme␈αis␈αthat␈αindividuals␈αshould␈αhave␈αas␈αmuch␈αknowledge␈αand␈αcontrol␈αof␈αtheir
␈↓ α∧␈↓own␈α
states␈α
of␈αhealth␈α
as␈α
possible␈α
and␈αthat␈α
cost-benefit-risk␈α
decisions␈α
should␈αbe␈α
made␈α
as␈α
much␈αas
␈↓ α∧␈↓possible␈α⊂by␈α⊃the␈α⊂individual,␈α⊃and␈α⊂he␈α⊃should␈α⊂take␈α⊃the␈α⊂responsibility␈α⊃for␈α⊂the␈α⊃consequences.␈α⊂ This
␈↓ α∧␈↓means␈αthat␈α␈↓↓medical␈αadvice␈↓␈αshould␈αas␈αfar␈αas␈αpossible␈αbe␈αjust␈αthat␈α-␈α␈↓↓advice␈↓,␈αwith␈αthe␈αdecisions␈αmade
␈↓ α∧␈↓by␈αthe␈αadvisee.␈α Therefore,␈αwhen␈αalternatives␈αexist,␈αthe␈αdoctor␈αshould␈αwrite␈αout␈αwhat␈αhe␈αknows␈αof
␈↓ α∧␈↓the␈αalternatives␈α
and␈αtheir␈αconsequences,␈α
and␈αthe␈αadvisee␈α
should␈αsign␈αa␈α
paper␈αchoosing␈αa␈α
treatment


␈↓ α∧␈↓␈↓ ε|1␈↓ ∧



␈↓ α∧␈↓and␈α∀stating␈α∀he␈α∪is␈α∀aware␈α∀of␈α∀the␈α∪uncertainties.␈α∀ This␈α∀paper␈α∀should␈α∪have␈α∀the␈α∀legal␈α∀effect␈α∪of
␈↓ α∧␈↓immunizing␈α
the␈α
doctor␈α∞against␈α
suit␈α
if␈α∞an␈α
unfavorable␈α
result␈α
occurs.␈α∞ The␈α
only␈α
possibility␈α∞of␈α
suit
␈↓ α∧␈↓should␈αbe␈α
if␈αthe␈α
treatment␈αwas␈α
incompetently␈αcarried␈αout,␈α
and␈αthe␈α
doctor␈αhad␈α
misrepresented␈αhis
␈↓ α∧␈↓competence␈α∞or␈α∞if␈α
a␈α∞danger␈α∞mentioned␈α∞in␈α
the␈α∞"Manual␈α∞of␈α∞Medical␈α
Risks"␈α∞were␈α∞omitted␈α∞from␈α
the
␈↓ α∧␈↓statement.

␈↓ α∧␈↓␈↓ αTConservatism␈α⊗might␈α⊗suggest␈α⊗limiting␈α⊗complete␈α∃freedom␈α⊗of␈α⊗patient␈α⊗decision␈α⊗to␈α∃people
␈↓ α∧␈↓posessing␈α∂a␈α∂certain␈α⊂amount␈α∂of␈α∂medical␈α⊂knowledge.␈α∂ A␈α∂person␈α∂could␈α⊂become␈α∂master␈α∂of␈α⊂his␈α∂own
␈↓ α∧␈↓medical␈α⊂treatment␈α⊂if␈α⊂he␈α⊃passed␈α⊂an␈α⊂exam;␈α⊂the␈α⊂qualifications␈α⊃for␈α⊂this␈α⊂being␈α⊂far␈α⊂less␈α⊃than␈α⊂those
␈↓ α∧␈↓required␈α∂by␈α∂a␈α∂doctor␈α∂licensed␈α∂to␈α∂treat␈α∂other␈α∂people.␈α∂ Such␈α∂a␈α∂licensee␈α∂could␈α∂prescribe␈α⊂drugs␈α∂for
␈↓ α∧␈↓himself␈α∂and␈α∂contract␈α∂for␈α∂medcal␈α∂procedures␈α∂with␈α∂anyone␈α∂who␈α∂would␈α∂perform␈α∂them,␈α∂taking␈α∂the
␈↓ α∧␈↓responsibility␈αfor␈α
their␈αsuccess␈αhimself,␈α
and␈αwith␈α
only␈αordinary␈αcommercial␈α
rights␈αto␈α
sue␈αsomeone
␈↓ α∧␈↓who performed them incompetently.

␈↓ α∧␈↓␈↓ αTChildren␈αand␈α
people␈αbelow␈α
a␈αcertain␈α
level␈αof␈α
educatability␈αand␈α
interest␈αin␈α
their␈αown␈α
medical
␈↓ α∧␈↓life␈αwould␈αnot␈αpass␈αthe␈αexam.␈α I␈αwould␈αhope␈αthat␈αthe␈αexam␈αwould␈αbe␈αpassed␈αby␈αten␈αpercent␈αof␈α
the
␈↓ α∧␈↓population␈αafter␈αsome␈αyears,␈αbut␈αI␈αwould␈αconsider␈αthe␈αidea␈αa␈αsuccess␈αif␈αonly␈α.01␈αpercent␈αwere␈αable
␈↓ α∧␈↓to take advantage of its provisions.

␈↓ α∧␈↓␈↓ αTHere␈α∀are␈α∀some␈α∪developments␈α∀that␈α∀would␈α∪help␈α∀realize␈α∀the␈α∪twin␈α∀ideals␈α∀of␈α∪supernormal
␈↓ α∧␈↓individuals and individual responsibilit↓ for their own medical future:

␈↓ α∧␈↓␈↓ αT1. Medical books for the layman

␈↓ α∧␈↓␈↓ αT2. The ability to get diagnostic tests done independently of a doctor.

␈↓ α∧␈↓␈↓ αT3. Individual ownership of his medical records.

␈↓ α∧␈↓␈↓ αT4.␈α∀The␈α∀development␈α∪of␈α∀conveniently␈α∀wearable␈α∪condition␈α∀monitors.␈α∀ The␈α∀biggest␈α∪single
␈↓ α∧␈↓development␈α∞might␈α∞be␈α∞a␈α∞continuous␈α∞blood␈α∞chemistry␈α∞analyzer␈α∞whose␈α∞results␈α∞would␈α∂be␈α∞displayed
␈↓ α∧␈↓when␈α∂the␈α∂individual␈α∂pressed␈α∂the␈α∂appropriate␈α∂buttons␈α∂on␈α∂his␈α∂"digital␈α∂watch",␈α∂and␈α⊂which␈α∂would
␈↓ α∧␈↓alarm␈αon␈αconditions␈αfor␈αwhich␈αthis␈αhad␈αbeen␈αrequested.␈α The␈αanalyzer␈αwould␈αpresumably␈αhave␈αto
␈↓ α∧␈↓be␈α⊃surgically␈α⊃implanted.␈α⊂ Blood␈α⊃pressure,␈α⊃pulse,␈α⊂and␈α⊃electrical␈α⊃activity␈α⊂of␈α⊃the␈α⊃heart␈α⊃and␈α⊂brain
␈↓ α∧␈↓would also be monitored.

␈↓ α∧␈↓␈↓ αT5.␈α
The␈αnext␈α
step␈α
beyond␈αmonitoring␈α
blood␈α
chemistry␈αis␈α
controlling␈α
it.␈α This␈α
could␈α
be␈αdone
␈↓ α∧␈↓by servo-mechanisms that released appropriate chemicals in the blood stream when called for.












␈↓ α∧␈↓␈↓ ε|2␈↓ ∧