“Can you make an argument against funding basic science research?” began Dr. Ray Barfield, Professor of Pediatrics and Christian Philosophy. There was a momentary silence in the room as we parsed this unexpected question. The paramount importance of fundamental research is generally a foregone conclusion within academic circles. Dr. Barfield was inviting us to challenge our basic assumptions; harkening back to Descartes’ modus operandi in his Meditations, he was asking us to follow the French polymath in challenging every single belief we held and then starting from a blank slate to establish our truths.
While none of us personally opposed funding basic research, the Huang Fellows played devil’s advocates and brought up the necessity of funding immediate relief programs, engendering a long discussion about values. Dr. Barfield spoke to us about the value of pursuing knowledge for its own sake. He said that knowledge being a worthy end in itself does not require external justification for its pursuit. He even went one step further to question our current system of assigning value; asserting that we cannot choose to live in a world where value is predicated upon concepts like money, fame, or power. These ideas are in principle opposed to what we value at an interpersonal level and therefore lead us astray if we use them to guide our decision-making.
I think that the above notion is widely transferrable, applying not only to medicine but also to climate change, welfare policy, education, and conceivably every other facet of our lives. For example: at its crux, climate change is not caused by greenhouse emissions inasmuch as it is caused by perverse profit incentives for corporations, and the modern culture of consumerism that they help engender. An education system that uses tangible, statistical, ostensibly “scientific” metrics of success like standardized testing scores fails to account for the backgrounds and behavioral tendencies of the people involved. It only serves to propagate existing socio-economic inequalities among students, while forcing teachers to teach to the tests instead of focusing on meaningful personalized instruction.
These examples seem to indicate a shortcoming in our idea of the worthiness of our possible goals. Dr. Barfield believes we have to pause and reconsider how much weight we assign to traditional perceptions of value, based on “measurables” like money, as opposed to accepting a more intangible, humanist conception of value that incorporates empathy, meaning, and is cognizant of suffering.
Intangibles are especially important in medicine, argues Dr. Barfield. For him, understanding the patient and empathizing with them constitutes the practice of “doctoring”, a process disparate from the formal hospital workflow. Doctoring does not show up in an electronic medical record or on hospital bills, is not taken into account by hospital administrators, is not strictly necessary for treatment. And yet, it is of unquantifiable importance to the patient because it is the sole acknowledgment of their human condition. Doctoring brings awareness of the patients and their families as people living out their worst crises. It marks a refusal to conflate their stories with numbers or vital statistics that represent just another day on the job.
“Doctors need to stop thinking they are pure scientists.” He thinks that doctors are uniquely positioned among scientists and caregivers in that they individualize science to apply it to different situations. They spend time bridging the gap between spaces where biology knows the answer and spaces where it fails. When science finally reaches its limit, this humanistic connection underpins the conversation between the doctor and the patient’s family. In Dr. Barfield’s experience providing palliative care to children with cancer, this connection has brought interpersonal understanding and humility to the forefront of the doctor-patient-family discussion. By openly admitting the boundaries of medicine, the doctor can adopt a patient-centered rather than a treatment-centered approach. Instead of providing a false sense of hope by encouraging the patient to register for Phase I trials of experimental treatments, the doctor might discuss with them what their goals and wishes are, working in concert to come up with a plan that fulfills these criteria.
Let us hope that we can adopt this people-centered mode of thought without compromising on or neglecting technical excellence. But what would such a humanistic value system look like for you or for me? How would it be incorporated into our daily lives? What would happen when there is a disagreement or an anomaly? These unknowns are for each of us to reconcile, by starting from our individual blank slates to realize our own truths. Or, as Ray Barfield would say, “I can’t offer you an answer, but I have offered you a provocation.”
Dev is from Indore, India and plans to pursue a Program II in “Artificial Intelligence & Society,” which combines physics, philosophy, computer science, and visual and media studies to study the future of humanity and our engagement with AI.