Medicine and thanatology

Apparently the Epicureans of old held that death was annihiliation, and so that it could not be a harm to be dead (and one could not be harmed "when" dead because unable to be pleasured or pained). This view of death is also apparently not popular these days. Perhaps this is a result of certain religious beliefs prevalent in current society. Supposing, then, that there is an afterlife, what would it be like? This is surely a specifically religious question suitable only for theologians. Since there is no evidence for there being an afterlife, and no evidence that there could be any such evidence, one has to conclude that these notions are, at best, comforting lies one tells oneself. The "truth" of the matter of "being" dead is that the concept of death is a way of thinking and talking about a person who used to exist, including about one's own future nonbeing. And that will fit fine with any way of talking about death that refers to it as just not being alive as I presently am, i.e. no longer conscious; it will also fit with any way of talking about death that thinks consciousness goes on after death, just in so far as it means not like now (of course, one has to wonder how much disanalogy actually occurs in, say, a conception of the afterlife as a paradise in which one has a body etc.). All of the above goes by way of preliminaries for the following:

Since there is no way to find out about an afterlife, or about a soul that need not attach to a physical body, it ought to be uncontroversial that our concern for people's welfare, if we have such concern, rightly attaches to their well-being in this present world. So here we draw explicitly the ethical result of thinking clearly about death: we cannot concern ourselves with ultimate salvation of others (perhaps someone would want to weaken this by adding "...more than we concern ourselves with their present-life well-being" but I do not). This does not contradict (without a further account that I decline to provide here) the thought that a person's believing their soul to have been saved is part of their well-being. That is to say, the comforting lie, if we are in the business of comforting, may (lacking that further account) be morally permissible even though prima facie lying is ethically impermissible (surely true).

Medicine is in the business of looking after people's well-being. If we allow psychiatrists into "medicine" then we can say both their mental and physical health are in medicine's sights; and if we have a further account about "well-being" that makes holistic claims about one's life circumstances being bound up with (physical and) mental health, then "doctors" are surely interested in the whole of the life circumstances of their patients. The above I think runs counter to one's (American) intuitions that doctors relieve symptoms, somewhat accidentally this involves curing diseases, and only accidentally does this involve things like advising someone to take a vacation to relieve the stress aggravating their high blood pressure (i.e. life circumstances generally). For of course one's such intuitions are bound up with libertarian ideals...

Let us set aside the elephant in the corner of the room, which is to say let us not here discuss whether removing religious beliefs is actually and in all normal cases a benefit in terms of well-being for the person so disillusioned (religion being itself a belief structure about unreal entities). The suggestion, without giving the argument to support it, is this: if we feel that those concerned specifically and professionally with beneficence are to be given as much as possible to accomplish the task we expect them to perform, it is in our interests to concern ourselves with obstacles placed in the way of thinking clearly about what that task is. The parish priest, qua counselor, is a healer of sorts, but his medicine is slow poison. If well-being that we can affect only takes place in this life, our ethics must guide us to actions affecting people only in this life, and so perhaps the comforting lie can be replaced with a placebo; it certainly seems it should be.

Are we asking too much of our healers for them to be guides and philosophers? Perhaps, and the general practitioner need not be a financial planner. Are we asking too much of the public for them to think more, and more clearly, about sickness and death? No. Misunderstanding and fear are reflexively reinforcing, and in this case instead of bed-rest the patient needs a breath of fresh air.