The role of the doctor: technician or statesman?

Editor's note In this paper Mr Stalley explores the role of the doctor through comparing and contrasting medicine and politics, but aims to illuminate the role of the physician rather than look at the nature of politics as many previous philosophers have done. Mr Stalley takes the extremes of the doctor as a 'philosopher king' and then as a 'technician' to illustrate the point that either one of these roles would seriously threaten the freedom of the individual to choose. The role of the doctor as an adviser, he feels, is much more what we want and need, as in that role he is more likely to combine scientific knowledge with the ability to achieve a sympathetic understanding of his fellow beings. From very early times philosophers have made comparisons between medicine and politics or between the role of the physician and that of the politician or statesman. These comparisons have generally been intended to cast light on the nature of politics but in this paper I wish to consider whether they can also illurminate the role of the physician. The philosophers who have compared medicine and politics have adopted widely divergent attitudes to the comparison. Plato, for example, seems to have believed that the two pursuits are precisely parallel to one another: in medicine we must bow to the authority of the expert physician and in politics to that of the wise statesman.' Some modem philosophers, on the other hand, have assumed that medicine and politics are contrasting rather than parallel cases: we may submit to authority in medicine but must on no account do so in politics.2 I suspect that there are also many who would argue for a third position, that neither in politics nor in medicine should the individual give up his autonomy: in medicine ultimate authority must rest with the patient, in politics with the individual citizen. I shall begin by considering two possible models for the role of the doctor in society. The first is that of the philosopher king. In his Republic, Plato suggests that in an ideal society all political power would be entrusted to rulers (usually known as 'guardians' or 'philosopher kings') who have undergone a long training in philosophy. They would have this authority because they alone have knowledge of the good and therefore know what are the right policies for the state and for the individuals within it. In …