JACKSON, Tenn. — March 9, 2021 — The profession of medicine has lost its way by falling into the secular model of medical professionals as providers of services, Dr. Farr A. Curlin said at Union University March 8.
Curlin is Josiah C. Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities and History of Medicine at the Duke University School of Ethics. He is also co-director of the Theology, Medicine and Culture Initiative at Duke Divinity School.
Curlin delivered the first of four lectures in the 23rd Annual Scholar-in-Residence Lecture series in the Grant Events Center to an audience in person and via livestream. The series is sponsored by the Honors Community of Union University.
This year’s lecture series is entitled “Contending for Good Medicine in a Secular Age.” Curlin’s first lecture, “Two rival versions of what medicine is for,” framed the central problems those in the medical profession face in a secularized world and examined the question of the goal of medicine.
Curlin described his background in medicine and how he came to realize that the profession of medicine had lost its way. He was taught that the patient had autonomy when it came to medical decisions and that his own judgment and conscience should submit to those choices.
“I had set out to practice medicine because caring for the sick seemed to fit into the Christian vocation to love God and love one’s neighbor,” Curlin said. “Now, I found myself being taught that Christian commitments were personal values that must be kept from interfering with my professional obligations.”
The secular model of medical professionals as providers of services leads to erosion of professional authority, crises of medical morale and tension between physicians’ consciences and medical norms, Curlin said. As long as a service is permitted by law, technologically possible and chosen by the patient, the medical professional may be compelled to fulfill it.
“Medicine has lost its way because it lacks clarity about where the way should lead,” Curlin said. “We no longer have shared public understanding of what medicine is for, what the end of medicine is or should be. . . . Rather, medicine has substituted for its once clearly recognized purpose something amorphous and subjective, shadowy.”
Despite many efforts to the contrary, he said, no secular alternative truly addresses this problem.
The path away from the provider of services model is the way of medicine, Curlin said. Medicine is a “paradigmatic practice” with the objective purpose of health for human flourishing. A good physician looks to the good of health and practical reason rather than becoming entangled with other goods.
“The practice of medicine has its own integrity, but that integrity depends on and is accountable to the requirements of practical reason,” Curlin said. “Practical reason identifies that which is genuinely good for human beings, that is conducive to human flourishing, and the corollary implications as to what we should do and how we should live.”
Curlin pointed out that most practitioners operate along both models to some degree, but ultimately, the two cannot be reconciled.
“The future of medicine will be determined by which one governs the profession,” he said.
Curlin will deliver three more lectures in the Grant Events Center on March 9 at 7:30 p.m. and March 11 at 12:15 p.m. and 7 p.m. These are respectively entitled “Solidarity, trust, and Christian faith in the clinician-patient relationship,” “Medicine for those who cannot be restored to health” and “Contending conscientiously for good medicine.” A livestream will be available at uu.edu/events/scholarinresidence.