What should we aim for with medicine?

[stone]

I've wondered what the "aim" is for improving medicine? We are all going to fall apart at some point. Should we be aiming to put ourselves together if non-age related medical mishaps occur, manage the aging process with greater comfort and convenience, extend life by any means for a few more decades?

[Greg]

I'm big on the idea of "quality years", which is why the research that I worked on in grad school focused on rehabilitation which could also lead to furthering prosthetics and orthotics for mobility. Mobility is such a crucial part to our well-being and our ability to contribute to society in an easier fashion (IMO at least). If you could get a wheelchair-bound person to be able to stand and walk through a doorway, I think that can lead to huge boosts in self-esteem and productive output.

Stating that, I'm all for building robotic devices or biomedical advances to grow organs, etc. to improve the quality years of people. Not necessarily elongating people's average lifespan, but if you have a 20 year old who lost their legs, they can contribute much more in society with new legs.

But that's just one person's opinion. I'd be interested to hear what others have to say on this subject.

[dualstow]

What should we aim for? Everything. Quality of life, longer life, growing organs in a lab, keeping viruses at bay until they regroup and change again (same for bacteria, prions, etc), vision for the blind, easing PTSD, fighting breast cancer and giving bald men (who want it) hair.

Of course, the way capitalism works, we will aim for everything.

[KevinW]

I favor Dr. Andrew Weil's notion of "compression of morbidity:" having an full, active, healthy life with a short period of decline at the very end.

http://weilpod.com/2009/09/02/compression-of-morbidity/

That seems similar to the "quality years" idea.

[MachineGhost]

I've wondered what the "aim" is for improving medicine? We are all going to fall apart at some point. Should we be aiming to put ourselves together if non-age related medical mishaps occur, manage the aging process with greater comfort and convenience, extend life by any means for a few more decades?

The "aim" for improving medical-cum-sicknesscare is to make all those involved a profit.  I suspect what you're really asking is what is the "aim" for improving medical-cum-healthcare which is an entirely different paradigm at present (at least institutionally).  I believe that disruptive technology and consumer-driven demand will force "medicine" to integrate preventive healthcare, anti-aging and life extension bottoms up so that one day in the future there will no longer be a distinction.  All will be one and one will be all.

The biggest flip the bird ever will be to transcend the repugnant limitations of biology.  So in that respect, I see the "aim" for medicine as transhumanism.

[Mountaineer]

I believe the goal of "medicine" should be to improve ones physical, mental, emotional and spiritual well-being as measured by the individual desiring the improvement.  If each of us continually grow in those four dimensions, the process will be self-correcting.  Ideally, the deliverers of that "medicine" should be each one of us using our unique gifts as we help our fellow man.  Ideally, each of us would come to believe that God is first, everyone else is second, and self is third.  Would that not make for a better world - even if the non-believers leave out God being first?

... Mountaineer

[dualstow]

Ideally, each of us would come to believe that God is first, everyone else is second, and self is third.  Would that not make for a better world - even if the non-believers leave out God being first?

... Mountaineer

No it would not. No offense, but I don't want God in my medicine, thank you very much. Ideally, it would not even be a part of this conversation.

[stone]

Machine Ghost

The biggest flip the bird ever will be to transcend the repugnant limitations of biology.  So in that respect, I see the "aim" for medicine as transhumanism.

You mean like in "The Matrix" ?

[BearBones]

No it would not. No offense, but I don't want God in my medicine, thank you very much. Ideally, it would not even be a part of this conversation.

I don't think that was the point. If I interpret Mountaineer correctly, it is that health needs to be balanced, not just on the physical being but also the mental/emotional/spiritual. Can't have one without the other. And anyone assisting with that goal needs both to respect each of our unique gifts and goals and also to be mindful of a final common pathway toward the health of the soul (and, no, I am NOT a religious person).

For example, I had a patient that was developing severe complications from type 2 diabetes, in turn from his morbid obesity. Traditional medicine too often approaches this as a physical problem to be solved: lose weight, and if you cannot do that go on medicines to control the DM and consider gastric bypass, etc. A more balanced approach, however, is to look at the cause of the obesity, which is the mental/emotional/spiritual realm, right? Turns out this guy saw things in Vietnam that most humans should never have to see, then he was literally spat on upon returning to the US, then he was unable to hold down a job. He felt worthless and miserable, and he flirted constantly with suicide. One of the few pleasures he had was eating. So who was I to tell him, from the perspective of my privileged little life, to get it together and lose weight? He did not need my advice! What he needed was someone to hear that he was in agony. What he really needed was a lot of love.

I recently saw the Dalai Lama speak, and I was stuck by the following message. There are 2 kinds of selfishness. The first is "foolish selfishness:" concern only for oneself to the detriment of others. The second is "wise selfishness:" concern for others, ultimately done to care for oneself. A life centered around altruism and compassion naturally leads to joy and serenity. A natural reciprocity. That is the way social animals are built. That is the way we are nourished, just as the brain is built to be nourished primarily by the simple sugar, glucose.

What is the aim for medicine? I'd say, eudaimonia: human flourishing, joy, and serenity. This comes from health of the body, but also of the mind, emotions, and spirit. When you read this Wikipedia link about eudaimonia, it is apparent that Socrates', Plato's, and Aristotle's view of the health of the human soul was not all that different from that of the Dalai Lama. And perhaps not all that different to what Mountaineer is saying?

http://en.wikipedia.org/wiki/Eudaimonia

[Mountaineer]

Wow, BearBones .... you said it much clearer and better than my attempt.  Thank you and my very best wishes.

... Mountaineer

No it would not. No offense, but I don't want God in my medicine, thank you very much. Ideally, it would not even be a part of this conversation.

I don't think that was the point. If I interpret Mountaineer correctly, it is that health needs to be balanced, not just on the physical being but also the mental/emotional/spiritual. Can't have one without the other. And anyone assisting with that goal needs both to respect each of our unique gifts and goals and also to be mindful of a final common pathway toward the health of the soul (and, no, I am NOT a religious person).

For example, I had a patient that was developing severe complications from type 2 diabetes, in turn from his morbid obesity. Traditional medicine too often approaches this as a physical problem to be solved: lose weight, and if you cannot do that go on medicines to control the DM and consider gastric bypass, etc. A more balanced approach, however, is to look at the cause of the obesity, which is the mental/emotional/spiritual realm, right? Turns out this guy saw things in Vietnam that most humans should never have to see, then he was literally spat on upon returning to the US, then he was unable to hold down a job. He felt worthless and miserable, and he flirted constantly with suicide. One of the few pleasures he had was eating. So who was I to tell him, from the perspective of my privileged little life, to get it together and lose weight? He did not need my advice! What he needed was someone to hear that he was in agony. What he really needed was a lot of love.

I recently saw the Dalai Lama speak, and I was stuck by the following message. There are 2 kinds of selfishness. The first is "foolish selfishness:" concern only for oneself to the detriment of others. The second is "wise selfishness:" concern for others, ultimately done to care for oneself. A life centered around altruism and compassion naturally leads to joy and serenity. A natural reciprocity. That is the way social animals are built. That is the way we are nourished, just as the brain is built to be nourished primarily by the simple sugar, glucose.

What is the aim for medicine? I'd say, eudaimonia: human flourishing, joy, and serenity. This comes from health of the body, but also of the mind, emotions, and spirit. When you read this Wikipedia link about eudaimonia, it is apparent that Socrates', Plato's, and Aristotle's view of the health of the human soul was not all that different from that of the Dalai Lama. And perhaps not all that different to what Mountaineer is saying?

http://en.wikipedia.org/wiki/Eudaimonia

[BearBones]

What is the aim for medicine? I'd say, eudaimonia: human flourishing, joy, and serenity. This comes from health of the body, but also of the mind, emotions, and spirit. http://en.wikipedia.org/wiki/Eudaimonia

Sadly, there's no money in that.

Two thoughts:
1. There is money in it. Just not as much as in pharmaceuticals and diagnostics and procedures (which have a definite roll but which are disproportionately utilized because of higher reimbursement).
2. Medicine is in no different a position than education, politics, nutrition, law, clergy, investment advice or the like, is it? Same discussion: how to reward that which is the most skillful, virtuous, and beneficial to human well-being in the midst of capitalism.

[stone]

Perhaps spreading the word about how many doctors wouldn't want intrusive end of life medical treatment for themselves is a good way to move in the right direction. I heard about that on here from Bearbones and WiseOne (I think) but I've never seen a TV show or anything like that about it. The overwhelming thrust of medical TV shows seems to be about miracle cutting edge intensive treatments (which in some circumstances are wonderful).

[Benko]

Why wait till things go wrong and you need the services of conventional medicine?   Prevention is MUCH easier than fixing things after they go wrong.  

Right now a lot can be done with very simple things:

--Healthy diet and there is large agreement on what this constitutes
--aerobic exercise
--at least some weight lifting/balance to prevent older people falling, etc.  PREHAB is much better than rehab.
--I would argue TCM i.e. chinese medicine at least in the form of customizing one's diet and chinese herbs.
--Some very simple supplements e.g. Vit d to normalize levels, fish oil...

But the vast majority of people are not interested in their health till things go wrong.    and so are doomed to have to deal with the less than optimal conventional medical system.

[dualstow]

Hey, it all sounds good, guys. It's just that I make a distinction between emotional and spiritual, because I don't believe in the spiritual. But, I won't split hairs and I don't mean to be combative.

I'm all for emotional and mental healing along with physical healing. I've had enough experiences with callous doctors for one lifetime. For example, as a kid, I had a doctor say, "What you have here is a hernia." Not only was he wrong, but he walked out of the room and a half hour later, I had to wander into the hall in my gown, flag someone down, and ask if I could get dressed and leave. Good bedside manner goes a long way, and not just for PTSD. For everyone.

[Xan]

http://gyroscopicinvesting.com/forum/ht ... 158#p42158

Perhaps spreading the word about how many doctors wouldn't want intrusive end of life medical treatment for themselves is a good way to move in the right direction. I heard about that on here from Bearbones and WiseOne (I think) but I've never seen a TV show or anything like that about it. The overwhelming thrust of medical TV shows seems to be about miracle cutting edge intensive treatments (which in some circumstances are wonderful).

[stone]

http://gyroscopicinvesting.com/forum/ht ... 158#p42158

Perhaps spreading the word about how many doctors wouldn't want intrusive end of life medical treatment for themselves is a good way to move in the right direction. I heard about that on here from Bearbones and WiseOne (I think) but I've never seen a TV show or anything like that about it. The overwhelming thrust of medical TV shows seems to be about miracle cutting edge intensive treatments (which in some circumstances are wonderful).

Xan, thanks for the link back to your link and sorry for forgetting it was you that posted it!

[Pointedstick]

We're a pretty entrepreneurial bunch here; who wants to start the Eudaimonia Clinic? 

[MachineGhost]

But the vast majority of people are not interested in their health till things go wrong.  [/b]  and so are doomed to have to deal with the less than optimal conventional medical system.

But is it really their fault per se or the crony captialists co-opting education, media, etc..?  Tough for me to come down on either side, even though the former are easier targets.

[MachineGhost]

You mean like in "The Matrix" ?

I don't know if you're being sarcastic or joking, but that is the opposite of what I meant: empowerment and living in reality, not disempowerment and escapism.

[stone]

You mean like in "The Matrix" ?

I don't know if you're being sarcastic or joking, but that is the opposite of what I meant: empowerment and living in reality, not disempowerment and escapism.

Sorry Machine Ghost, I genuinely thought you were saying that we should leave the confines of our physical bodies by living in computors or something. I actually thought you (or rather my misunderstanding of you) had a valid point that that would entirely solve all medical issues. Like you, I want the real world though.

[Reub]

Stone, as with everything else, we should aim that everybody gets their "fair share" when it comes to medicine.

[Mountaineer]

Stone, as with everything else, we should aim that everybody gets their "fair share" when it comes to medicine.

Would that be "fair share" based on earning it or "fair share" based on being entitled to it because one breathes?  Just asking.

[Reub]

The latter, of course!