Conversations between doctors and philosophers about the “objectification of patients” often result in unproductively accusing one another. A couple of weeks ago, I witnessed this once again. During a presentation at a conference, a philosopher, who, obviously, acquired all his knowledge and wisdom from books and papers and not from clinical observations, claimed that modern medicine tends to objectify patients. And this is not something desirable, he said, because, ‘to objectify’ implies that the existence of a person is reduced to the existence of a thing or an object.
Most philosophers in the audience were nodding, in approval, but not very animatedly since it is a rather well-known, even worn out, philosophical claim. The discussion became rather lively, however, when a physician in the audience objected that he felt deeply disrespected by such a claim. It is an insult to consider physicians as people who treat other people as objects, he said. If this philosopher would have known just a little bit more about what in actual fact happens in clinical encounters he would not come up with such a characterization of medicine, so the physician argued. The philosopher, clearly not prepared for such an attack, stammered that it was not his intention to insult anyone, and that ‘objectifying’ should not necessarily be considered as the work of individual doctors, but rather as a force or power at work within contemporary medicine.
Although I felt that the discussion that followed on who or what to hold responsible for the act of objectifying was not very productive, I found the physician’s emotional engagement in this discussion very interesting. He, in fact, defended his daily practice of treating patients against the words of someone who never had felt the accountability of professional caregiving. For philosophers it is indeed rather easy to disqualify contemporary medicine because of its Cartesian way of considering patients; that is, not as human beings but rather as the composite of two different things: a body (comparable to a machine) and a mind (or soul). And it might be true that when patients presents themselves with physical ailments, physicians – who are thoroughly trained in anatomy, physiology and cell biology – analyze these ailments with a technical and indeed objectifying eye. What the physician in the audience wanted to underline is that, for him, a clinical encounter entails much more than only this objectifying stance.
What struck me most in this discussion was that both the philosopher and the physician shared the opinion that the objectifying stance in medical practices is not something desirable, but more likely, a sometimes necessary evil. At first sight this might not be so surprising since, as said, objectifying involves a reduction of human beings into things, and since it seems to be allowed to treat and approach things far less respectfully than humans, such a reduction may result in a threat of humans’ humanness. On the basis of this kind of reasoning, contemporary pleas for humanization of health care virtually always go together with a disapproval of the objectifying stance.
And yet, this is a rather disputable way of reasoning, because the objectifying stance is not only typical for humans, but may also significantly contribute to humans’ physical and existential well-being. Objectifying another person’s body or, for that matter, objectifying one’s own body is not just an invention or a result of modern medicine. Instead it is one of the modes according to which we, modern humans, can relate to ourselves, to our own bodies. We are able to create a distance toward ourselves, to view ourselves from a distance, to look at ourselves as if we were someone, or something, strange. Indeed we are able to not just coincide with ourselves, with our bodies. It is on the basis of such a distance towards our own bodies that we can objectify it. And we’re doing it all day: mirroring, inspecting, monitoring, and evaluating our bodies.
Obviously, there is a difference between our daily self-objectification and objectification that takes place within medical settings. Whereas our own self-objectification is limited by the fact that we can never totally distance from our own bodies, that we always remain attached to our own bodies, the medical objectifying stance may result in treating a body, or body, part as if it were something totally detached from a human being. As such we could say that the medical objectifying stance nourishes and fortifies our wish (and phantasy) of distancing ourselves from our bodies, which can be very liberating indeed.
Medical professionals could use this imaginative power to reassure patients. In her book Bodies in Formation (2012), Rachel Prentice provides a telling example of this while referring to a surgeon who had to operate on an arm of a rather anxious patient, and who said: “if you just lend your arm to me, I will give it back to you when I have fixed it.” With these words, the surgeon explicitly aimed at turning this patient’s arm into an object, something “on loan.” Rather than resulting in disrespect for this patient’s humanness or his bodily dignity, this surgeon’s objectifying approach provided comfort; it relieved the patient, temporary, from his inextricable responsibility for his sick body part.
Objectifying a patient’s body, then, is not always such a bad thing. If we want to humanize health care, if we want to improve the clinical encounter between patient and medical professional, we should not uncritically discard the objectifying stance. Instead, medical professionals should be trained to oscillate between different perspectives on a patient’s body. They can do justice to the complexity of patients’ humanness if they appreciate when body objectification only reduces a patient into a number or a case and thus should be disapproved and, conversely, when body objectification can help patients to deal with illnesses and their treatment and thus should be encouraged.
Picture: Kaisu Koski, Living anatomy (2013). By courtesy of the artist.