Notes in the Margin - 4 March 2025
Notes from a Family Meeting is a newsletter where I hope to join the curious conversations that hang about the intersections of health and the human condition. Poems and medical journals alike will join us in our explorations. If you want to come along with me, subscribe and every new edition of the newsletter goes directly to your inbox.
Every so often, I’ll share things I’ve been reading with a few words of mine scribbled in the margins. If you have something to share, please do! The comment section is open.
Also, issues have been sparse lately as I work on other projects. I suppose it’s better to write fewer, better essays than throw out many poorly considered reminders that I’m still here.
Practical Wisdom, Clinical Judgments, and the Agential View
Fabrice Jotterand and colleagues want to bring the moral formation of clinicians on par with our scientific education. They want us to see clinicians as whole people (this “agential view”) in which the clinician must develop a “personal moral philosophy of clinical practice that integrates the physician’s own good in the professional context, which should be contrasted, but not opposed to the good of the patient in the doctor-patient relationship.” Challenges about, but this seems to be a more promising heading than assuming clinicians are automatons working at the behest of healthcare consumers’ orders.
The Abortion Controversy and the Claim that This Body is Mine
I suspect my readership has a range of perspectives on abortion. Here’s an argument I had not before encountered. Before you respond with, “Of course…” one way or another, Wicclair’s argument is worth taking seriously not only for pregnancy, but for conjoined twins out living on their own. It also reminds me of the words of Ruth Bader Ginsberg from a dissenting opinion in Gonzales v. Carhart: “…legal challenges to undue restrictions on abortion procedures do not seek to vindicate some generalized notion of privacy; rather, they center on a woman’s autonomy to determine her life’s course, and thus to enjoy equal citizenship stature.” “Citizenship stature” is, of course, defined by the life course of a man, who can bear no pregnancy. Notions of “body ownership,” like citizenship in Ginsberg’s estimation, ironically appear to use the male body as the standard.
The Procedural Republic and the Unencumbered Self
A quirk of political philosophy that has trickled down to the masses is the belief that who I am exists apart from my chosen values and commitments; that there is some part of who I am, in fact the core of who I am, who stands apart and chooses. Michael Sandel argues this “unencumbered self,” a legacy of John Rawls, envisions itself as living without any unchosen commitments. This is, of course, a fiction. We’re born entangled. Yes, we can change, but that requires reflecting on the history and world we’ve inherited, and our change is always in reaction to that. In a real sense, we live in the light (or shadow) of what has come before. All this has ramifications for medicine and bioethics (not the focus of Sandel’s paper) because so much of our thinking presupposes this anthropology. As Carter Snead argues elsewhere, though, given that this anthropology is fictional, it overlooks critical aspects of our vulnerability, dependence, and natural limits.
From the Archives
Here's something, only a little dusty, that new readers may not have seen.
Who really is the historian in the clinical encounter?
The Poor Historian
