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Plato Speaks to Contemporary Bioethics

What can Plato possibly teach us about current bioethical topics? Plenty, says Smith Professor of Philosophy Susan Levin. Plato’s views of the clinical tie, human nature and political community are valuable right now as bioethicists aim to move forward on such issues as medical error, transparency, accountability and physician incentives.

/ Published February 24, 2015

Susan Levin’s bright, spacious office in Dewey Hall reflects her approach to her scholarship. One wall is solidly lined with weighty volumes, while her desk is uncluttered except for two copies of her latest book. Delving deeply into classical philosophy, Levin brings ancient themes clearly into focus, shining light on reinterpretations that could help address pressing modern challenges.

Levin has been teaching philosophy at Smith for more than 20 years, offering the course Topics in Medical Ethics since 2006. She’s spent the past eight years working on her latest book, Plato’s Rivalry With Medicine: A Struggle and Its Dissolution.

Fortunately, as is often the case in academia, Levin says there was a confluence of her teaching and research. At the same time she began delving into bioethics, she became interested in investigating Plato’s engagement with medicine.

Levin, a philosophy scholar who specializes in antiquity, sees many ways that Plato’s ideas might inform current issues. Despite the passage of more than 2,000 years, his profound influence is still deeply embedded in our views of nature, government and education.

In her first book, The Ancient Quarrel Between Philosophy and Poetry Revisited: Plato and the Greek Literary Tradition (2001), Levin proposes that Plato’s work sets a valuable precedent for contemporary reflection on how literature might enrich the study of philosophy.

So how could Plato contribute to current bioethics debates—applications he couldn’t possibly have conceived of in ancient Greece? For Levin, Plato’s views offer clues as to how we might effectively proceed in such controversial practices as genetic modification, artificial reproduction, organ transplantation and euthanasia—issues that tend to create wide divides, often with polarizing positions.

Professor Susan Levin believes the study of philosophy remains relevant for virtually any human endeavor, as philosophers ask fundamental questions that define and shape our humanity.

What today’s medical practitioners, policymakers and even bioethicists often overlook, she believes, are the enduring themes of human nature and how we view and value human life—precisely Plato’s domain.

Bioethical discussions often concentrate on challenges relating to technological and scientific advances, Levin says, creating a presumption that the spurs to reflection on bioethical cruxes must be of relatively recent historical vintage, too. This view “deprives us of avenues and impetuses of reflection that are distinctive and could help us negotiate present quandaries,” Levin writes in her blog post “Plato and Contemporary Bioethics.” Revisiting Plato could benefit our addressing of puzzles such as whether we truly want to pursue fundamentally extending our mental capacities and longevity through advances in artificial intelligence.

Levin argues that bioethical issues “ultimately grip us not on technological grounds but instead for their bearing on human flourishing,” the idea of eudaimonia in Greek. Neglecting this consideration “harms our prospects for existing in a way that is most thoughtful, accountable and holistic,” she writes.

What is bioethics, anyway?

Bioethics is rooted in medical ethics, which goes back to antiquity, Levin explains, mentioning that medical schools still routinely administer the Hippocratic Oath. Bioethics emerged as a professional field of inquiry in its own right in the early 1970s. Its launch was sparked crucially by developments in medical technologies, combined with important social movements, like those for civil and women’s rights, that aimed to challenge authority.

While medical ethics is concerned with the practice of medicine, bioethics is broader. It examines moral and philosophical questions that underpin the medical profession, healthcare, science, law and public policy, all intrinsically intertwined.

Levin’s research journey for Plato’s Rivalry With Medicine began with the Republic, widely viewed as Plato’s most important dialogue and the pinnacle of his middle period. In that dialogue, Plato undertakes an elaborate investigation of human nature and the optimal society.

Levin traces the development of Plato’s engagement with medicine through five key dialogues across his early, middle and late periods: Gorgias, Symposium, Republic, Statesman and Laws.

She also read through the Hippocratic Corpus—a collection of dozens of medical treatises, written by multiple contributors, that deal with the diagnosis and treatment of disease, as well as with suitable regimens for both the ailing and the well. The lion’s share of the corpus dates to the fifth and fourth centuries B.C.E. and serves as an important backdrop to Plato’s thought process.

In Plato’s time, Levin explains, “The disciplinary boundaries that we’ve come to take for granted were not firmly in place, and so part of what Plato is trying to make a case for philosophy’s authority as the arbiter and source of decisive proclamations and guidance on human nature and flourishing.”

In making that case, Plato has to challenge rival approaches. Scholars have routinely assumed that Plato had no rivalry with medicine, Levin says. “In fact, what people have typically assumed is that Plato’s view of medicine was uniformly positive across the corpus.”

Rewind. Levin is suggesting something radically different.

Levin starts with the Gorgias, contending that we see there the seeds of what comes to be a full-blown rivalry with medicine. “Plato sees certain tendencies and trends in medicine and is reacting to...a problematic orientation to medicine on the part of its staunchest proponents.”

The Hippocratic Corpus contains an overriding conviction that medical experts, comprising a relatively select few, are afforded the ability to apprehend and define the nature of reality. Plato challenges this view directly for the first time in the Symposium. In the Republic, Levin explains, Plato continues his critique of medicine and pointedly restricts the role of medicine in the community to treatment. This is a huge demotion, since previously, much of what medicine had taken for granted as its bailiwick was not just healing, but lifestyle. In the Republic, lifestyle belongs within the purview of philosophers, who, in terms of insight and character, are assumed to be infallible. Inherent in this idea is a strong authoritarianism, the opposite of transparency.

By delving deeply into five of Plato’s dialogues, Susan Levin’s latest book offers scholars, bioethicists, medical historians and others in the medical field a fresh look at untapped ancient wisdom that could help us resolve some of our most pressing modern-day debates.

By the time you get to the Laws via the Statesman, says Levin, you see a transformation. The critical point is Plato’s recognition that even the best among us is fallible.

Plato’s realization could have led to great pessimism about humans in general, she says, “but one of the things that’s so amazing about Plato is that at one and the same time as he downgrades the best, he also upgrades ordinary citizens, seeing that humans are essentially on a continuum.” She believes the bioethical import of Plato, particularly the Laws, has been vastly understudied and largely untapped.

What is pivotal in the Laws’ account? Plato is saying that “we can acknowledge and appreciate real contributions toward the flourishing of individuals and communities by considering the intellectual and ethical capacities of ordinary citizens.” The implications for the field of medicine today are huge, as the arguments for embracing a more holistic view of medicine and encouraging patients to take more responsibility for their own medical choices are still being played out in our country’s healthcare system. In addition, as Levin notes in her blog post, “Remuneration’s increasing use to shape doctors’ behavior is harmful not just because it sends the flawed message that health and remuneration are commensurable but for what it reveals more generally about our priorities.”

Levin’s book incorporates Plato’s notion in the Laws that sociopolitical structures and institutions must be established with human limitations and fallibility in mind—something that was unprecedented in his previous work, says Levin.

In the book’s concluding chapter, “Plato’s Legacy to Contemporary Bioethics,” Levin tackles several prominent contemporary perspectives, finding areas where they fall short. She raises particular concerns about views that she believes are tinged with paternalism, while she argues for Plato’s view of doctor-patient relationships that promote partnership and equality without eroding doctors’ genuine expertise. Levin writes that contemporary solutions often fail to “preserve the delicate balance between authority and parity needed of the healing tie.”

In the Laws, Plato gives us a vision for a collaborative doctor-patient model founded on four key principles: that medical values are human values, hence do not derive from a self-contained sphere; that the doctor-patient tie must be firmly embedded in society; that both parties (doctor and patient) are equally equipped to participate; and that widespread transparency must exist. Levin covers a gamut of issues, ranging from accountability, education and financial compensation to extremes of paternalism and autonomy that plague doctors, medicine, the medical profession and society as a whole.

Bringing antiquity to bear helps us see more clearly what’s at stake, Levin says. She concludes in her blog post: “Not only the themes but also their intertwining makes further bioethical consideration of Plato vastly promising. I’m not proposing our endorsement of Plato’s account as such. Rather, some positions themselves, alongside the rich expansiveness and trajectory of his explorations, are two of Plato’s greatest legacies to us.”

Reflecting on Plato can give us a “fresh orientation to pressing debates on other bioethical topics,” says Levin, citing the current “high-stakes discord over...radical human ‘enhancement.’”

In her recent online article “Transhumanism and Enhancement,” Levin cites both the misuse and the ignoring of antiquity to expose weaknesses, ambiguities and tensions in arguments from current transhumanists, who theorize that humans can fundamentally surpass our physical and mental limitations thanks to technological advances in such areas as genetics, neuroscience and artificial intelligence.

Having extensively critiqued transhumanists’ arguments, Levin concludes that “whatever one’s position on technological enhancement, deeply acknowledging that our handling of ultimate human matters orbits our values—not just as specialists but as citizens and human beings—must be a key reference point as explorations within and across stances continue.”

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