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Prof. Paweł Łuków - Moral and emotional specificity of the experience of illness

10 December 2022

Illness is not only a physical suffering, but also a moral and emotional specificity. Often people think it won't happen to them, but in reality illness stirs up emotions and moral distress. As doctors, it is important to be prepared for these aspects of illness and to focus on both professionalism and empathy towards patients. In this way, we can provide them with support during difficult times and help them overcome their illness.

Diseases can have a social and moral dimension. Some diseases, such as those associated with a lack of an appropriate culture of public life, can lead to isolation and degrading treatment of patients. Doctors, like other people, are susceptible to good and bad social influences. It cannot be stated unequivocally that there is always a moral dimension to illness in the medical profession. It all depends on the nature of the illness and its impact on the patient. Illnesses, such as allergies, are often not perceived as illnesses at all, whereas severe illnesses can lead to a sense of illness and suffering.

Illness is a moral evil because, unplanned and unwanted, it ruins our plans and overwhelms us with its severity. It can be particularly troublesome for people who are not prepared to deal with ailments. Although the reaction to illness can vary greatly, its impact on our lives is great and requires us to make an effort to cope with it.

Admitting that we can't do something is often difficult, especially in this day and age when efficiency, assertiveness and confidence are so valued. However, admitting that something is beyond us is important for our health and wellbeing. It doesn't mean we are socially and professionally incompetent, but simply people who give themselves permission to be weak and in need of support. Let's remember that we can't win at everything and we don't need to. What is important is that we can honestly admit when something is beyond us and accept our weaknesses.

Doctors often have to make difficult decisions when caring for the health and lives of their patients. However, there is also an important moral aspect that should be taken into account when making medical decisions. Patients have the right to influence their treatment and should be fully informed about their treatment options. Doctors should also take patients' individual needs and preferences into account when making decisions about their care.

The mechanism referred to in the text is understandable, but this does not mean that we should give in to it. In fact, there is a phenomenon in which its frequency is disputed. Studies on the subject are not comparable and their methodology is often questionable. Nevertheless, I think it is fair to say that people tend to believe that what is medically indicated and backed by science is simply the right thing to do.

However, patients often see things in the personal, individual context of their experiences, expectations and prejudices. This is an additional challenge for doctors who have to confront patients with biases. In such a situation, it can be difficult for a doctor to understand a patient's objection to a procedure because they believe it is justified. An example of such a situation could be a patient's objection to a procedure recommended by a Jehovah's Witness.

Medical education should be located in the context of moral and social values. The phenomenon we are talking about is known in the literature as the 'specialist perspective'. It may be common among the medical professions, but it is not specific to them alone. The belief that a specialised perspective is better than another perspective, albeit also a specialised one, can be naturally developed.

However, if we consider the huge scientific knowledge base behind medicine, and therefore the authority of science, we find ourselves in a strange situation. The confrontation between doctor and patient relies, on the one hand, on knowledge and skills based on the authority of science and, on the other hand, on the individual beliefs, expectations and desires of the patient.