Loving Wisdom, Living Wisdom, Teaching Wisdom
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Abstract
Though she does not put it in these terms, Specker Sullivan’s (2022) article is an important and timely reminder that bioethics is a branch of philosophy; that philosophy is, literally, philo-sophy—the love of wisdom; that wisdom cannot be crystallized in algorithms; and that (as articulated particularly in Buddhism and Eastern Christianity) there is a crucial circularity: Wise thinking results from wise living and wise living results from wise thinking. Modern bioethics is embarrassed by talk of wisdom. Wisdom seems suspiciously religious, and is hard to define, locate, measure, and teach. It will always be difficult, in an end-of-year audit, to assert confidently that one’s work has resulted in a net increase of wisdom. Part of the problem may be due to bioethicists’ infection with the notion of evidencebased medicine (EBM). The zeitgeist suggests that we should have evidence-based ethics. It is hard to find a place for wisdom in such an idea. EBM “has taken the health care world by storm” (Mykhalovskiy and Weir 2004, 1059). A storm rarely results from, or results in, nuance. There are many well-documented criticisms of EBM: evidential, political, and so on (e.g., Straus and McAlister 2000). But the most potent is the most philosophically fundamental: Anything that aspires to prescribe a linear approach to creatures as complex as humans and phenomena as mysterious as their diseases should be immediately suspect on the basis of the aspiration alone. EBM may “reduce patients to technological objects and physicians to technocratic managers” (Frankford 1994, 776), “stripping patients of their stories and the meaning of their experience, reducing them to passive recipients of doctor-centered communications” (Mykhalovskiy and Weir 2004, 1062). The obsession with EBM is a symptom of a more general philosophical malaise. That malaise stems from two dogmas: that everything real and worthwhile can be quantified, and that thinking is only worthwhile insofar as it is reasonable (in the very narrow and recent sense of logical). These two heresies have arisen, thinks Iain McGilchrist, because the right hemisphere’s holistic appreciation of context and relationship has been trumped by the nerdish, fearful, conservative left hemisphere (McGilchrist 2021). His work is an attempt to re-recruit intuition, emotion, and imagination into the process of assessing the world and making decisions. “Acquiring a degree of judgment that can make these elements intelligibly cohere is—or used to be,” he says, “the whole purpose of education. It is why we study the humanities” (McGilchrist 2021, 398). This attempt at re-recruitment is necessary because “reason” plainly isn’t up to the job. Mercier and Sperber observe that “reasoning is generally seen as a means to improve knowledge and make better decisions ... [but] much evidence shows that reasoning often leads to epistemic distortions and poor decisions ... reasoning pushes people not towards the best decisions but towards decisions that are easier to justify” (Mercier and Sperber 2011, 57, 69). In some medical contexts, too much reliance on reasoning is recognized as pathological. “The most deluded patients with schizophrenia,” noted Sass and Pienkos, “tend to be those whose thinking is more logical” (Sass and Pienkos, 2013, 649). Reasoning shouldn’t be seen as distinct from other modes of dealing with information, but as part of the one holistic processing method used by normally functioning psychosomatic unities. The false dichotomy between rationality and