Medicine and Philosophy Collide

Later this month, philosophers from around the world will gather in Toronto to explore health care from a philosophical perspective at the biennial International Philosophy of Medicine Roundtable. They’ll also connect with physicians and health sciences, humanities and medical education researchers at the Clinical Judgment: Multidisciplinary Perspectives Symposium. Previously, the biennial roundtable was held in Europe and the United States. MD/PhD student Jonathan Fuller and recent MD graduate Benjamin Chin-Yee — who are organizing the event along with Department of Family and Community Medicine’s Professor Ross Upshur — spoke with writer Erin Howe about the roundtable.  

What is the philosophy of medicine? 

Fuller: It is the philosophical study of subjects like medical reasoning and knowledge, medical reality, the ethics of practice and even basic concepts like disease, health, illness, well-being. It includes a broad range of topics that spans traditional areas of philosophy, concentrating on health care, public health, medicine and medical research. The field in its modern form is relatively new; if you look at the philosophy of science, the biggest focus over the last 100 years has been on physics and, more recently, biology. Medicine was kind of late to the game, which is surprising because medicine is a universal component of all societies and is monumentally important in terms of dollars spent and the impact on our lives.

This is the seventh roundtable event, and the first time the event will include an open lecture. What inspired you to add this to the program? 

Fuller: We wanted to open the event up to the broader U of T community with a topic that would be of wide interest, so we’re introducing the Ruggles Lecture in the Philosophy of Medicine. The talk will feature Maya Goldenberg, who is an Associate Professor of Philosophy at the University of Guelph.

Chin-Yee:  Goldenberg does great work around the issue of vaccine hesitancy. She explores why there's growing skepticism surrounding the scientific evidence behind vaccinations. She also looks at the vaccine hesitancy movement and what it tells us about public understanding and trust in science and medicine. This is a crucial area for the philosophy of science and medicine. It’s important to understand what informs those perspectives so we can do a better job of fostering dialogue. 

How did you determine the subject of the first-ever Ruggles Lecture? 

Fuller: Vaccine hesitancy is relevant to just about everyone, whether you’re a physician who gives vaccines, or you design public health policy or are a parent confused about the sometimes conflicting messages about what to do for your kids.

We hope the Ruggles Lecture becomes an annual event; we want to create a tradition in Toronto for exploring the connections between philosophy and health care. We see this is a way to kick start that. 

What else can people look forward to during the roundtable?

Chin-Yee: The clinical judgment symposium is open to everyone and geared toward clinicians and researchers. It will provide an overview of various challenges facing practitioners in their everyday lives through perspectives from philosophy, psychology, medical education, the health sciences and the humanities — challenges like how to: make judicious health care decisions and avoid over or undertreatment; think about clinical decision-making in an era of evidence-based medicine, information technology and information overload; communicate complex risk information to patients; and how to adapt clinical judgment to context.

Ben, you’ve got a Master’s degree from U of T’s Institute for the History and Philosophy of Science and Technology, and Jonathan, you defended your PhD thesis in the Philosophy of Medicine last spring. How have your experiences here contributed to your interest in this area?

Chin-Yee: I’ve been fortunate to find amazing mentors here at U of T — both within and outside the Faculty of Medicine — who’ve encouraged me to think deeply and differently about a range of topics in healthcare — many of which will be discussed at the Roundtable. I’m excited to continue doing research in this field and to do my residency in Internal Medicine here in Toronto, where this work is gaining increasing momentum — especially related to initiatives in person-centered care.

Fuller: I did an undergraduate degree in physiology and although I was always interested in philosophy, I never realized you could apply it to the study of medicine. Then I joined the MD/PhD program here and learned about the work of Ross Upshur, whose research focuses on the intersection of public health and primary care and the relationship between ethics and evidence, as well as many other topics. He’s made a career of being a bioethicist and physician, but also a philosopher — he completed undergraduate and Master’s degrees in philosophy before he became a physician. That’s when I came to the idea of pursuing a PhD in the philosophy of medicine, which I defended last year under Ross’ supervision. It explored what I call ‘the new medical model’, which represents the evolution of modern medicine in response to the rise of chronic disease and evidence-based medicine.  

The three-day event begins on June 22. The symposium and Ruggles Lecture are open to the public and free to attend, but registration is required. There is a small fee to register for the roundtable conference. For more information or to register, please click here.