Practising humility: how philosophy can inform general practice

Chris Murphy in BJMP:

As a philosopher turned GP myself, David Hume has long been my favourite philosopher. He lived in 18th-century Scotland, with renowned Scottish physician William Cullen as his own doctor and friend. Hume attended university at age 12, early even in those days, pushing himself so far that he ended up developing the ‘Disease of the Learned’ — a malady that seems to have been a sort of depression or nervous breakdown. Philosophers can suffer from burnout too.

In philosophical circles, Hume is considered to be ‘one of the most important philosophers to write in English’1 but his isn’t the name that springs to mind if the man on the street is asked to name a famous philosopher. In fact, there’s much to recommend Hume as the most ‘GP’ figure of the Enlightenment. In An Enquiry Concerning Human Understanding he sets out to apply the scientific method to the study of human nature. I can’t think of a more succinct way to describe the aims of modern general practice. A morning surgery can provide several patients with not much in the way of textbook pathology, but human nature is always on full display. If Hume himself was sitting in on my consultations, I imagine him suggesting that, because reason is ‘impotent’, I must ‘excite the moral passions’ of my patients. If smokers really wish to change their behaviour, Hume would think that it is not enough to print ‘SMOKING KILLS’ on the packet — you must also include a disgusting picture of a diseased lung. And he might have a point.

Hume teaches humility. A recent thoughtful editorial about medically unexplained symptoms2 drew a variety of responses. It is clear that, for some doctors, the idea that certain things might be ‘unexplained’ or even ‘unexplainable’ is anathema. Their message is clear: we must simply try harder.3

But Hume spilt a lot of ink concerning the idea of cause and effect, and indeed expressed ‘sceptical doubts concerning the operations of the understanding’.4 He thought many of the beliefs we form seem to be the product of ‘some instinct or mechanical tendency’ rather than any truly rational process.

More here.