Skip to main content
Top
Published in: Journal of Religion and Health 6/2016

01-12-2016 | Psychological Exploration

The Soul in Medicine: Rabbinic and Scientific Controversies

Author: Henri Zukier

Published in: Journal of Religion and Health | Issue 6/2016

Login to get access

Abstract

The practice of medicine relies on a combination of two very different sources, and requires two kinds of talents: a cognitive-instrumental, knowledge-based and disease-centered approach; and a psychological, expressive-relational and patient-centered approach. Throughout the centuries, the mix between the cognitive and expressive dimensions, and the relative emphasis given to each approach, has varied considerably. Current evidence-based medicine privileges the cognitive-performative dimension. The recent developments within medicine are indicative of the inherent and lasting tension between the cognitive and expressive dimensions. Not surprisingly, then, related terms of debate are also apparent in medieval rabbinic discussions of medical practice. However, the rabbinic and medical traditions resolved the tension in very different ways. This paper explores a conceptual link between the modern dynamics of the cognitive and the socio-relational dimensions, and a complementary rabbinic controversy starting in the thirteenth century, originally between Maimonides and Nahmanides, both physicians. There are significant interactions between the modern evolution in the roles of doctors and patients, and the rabbinic approaches to physicians and illness. The mapping of the two debates about doctors and patients suggests that the tension between science and soul, and the dynamics of integrating them, has characterized medicine through the ages, though they can lead to different outcomes.
Literature
go back to reference Amanzio, M., Pollo, A., Maggi, G., & Benedetti, F. (2001). Response variability to analgesics: A role for non-specific activation of endogenous opioids. Pain, 90, 205–215.CrossRefPubMed Amanzio, M., Pollo, A., Maggi, G., & Benedetti, F. (2001). Response variability to analgesics: A role for non-specific activation of endogenous opioids. Pain, 90, 205–215.CrossRefPubMed
go back to reference Beecher, H. K. (1955). The powerful placebo. Journal of the American Medical Association, 159, 1602–1606.CrossRefPubMed Beecher, H. K. (1955). The powerful placebo. Journal of the American Medical Association, 159, 1602–1606.CrossRefPubMed
go back to reference Benedetti, F. (2009). Placebo effects: Understanding the mechanisms in health and disease. New York: Oxford University Press. Benedetti, F. (2009). Placebo effects: Understanding the mechanisms in health and disease. New York: Oxford University Press.
go back to reference Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory. Research and Practice, 16, 252–260. Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory. Research and Practice, 16, 252–260.
go back to reference British Journal of Medicine (1952). Editorial: “The Bottle of Medicine”, 1,149. British Journal of Medicine (1952). Editorial: “The Bottle of Medicine”, 1,149.
go back to reference Brody, H. (1997). The doctor as therapeutic agent: A placebo effect research agenda. In A. Harrington (Ed.), The placebo effect (pp. 77–92). Cambridge: Harvard University Press. Brody, H. (1997). The doctor as therapeutic agent: A placebo effect research agenda. In A. Harrington (Ed.), The placebo effect (pp. 77–92). Cambridge: Harvard University Press.
go back to reference Colloca, L., Lopiano, L., Lanotte, M., & Benedetti, F. (2004). Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. Lancet Neurology, 3, 679–684.CrossRefPubMed Colloca, L., Lopiano, L., Lanotte, M., & Benedetti, F. (2004). Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. Lancet Neurology, 3, 679–684.CrossRefPubMed
go back to reference Evans, D. (2003). Placebo: The belief effect. Hammersmith: Harper Collins. Evans, D. (2003). Placebo: The belief effect. Hammersmith: Harper Collins.
go back to reference Finniss, D. G., Kaptchuk, T. J., Miller, F., & Benedetti, F. (2010). Biological, clinical, and ethical advances of placebo effects. Lancet, 375, 686–695.CrossRefPubMedPubMedCentral Finniss, D. G., Kaptchuk, T. J., Miller, F., & Benedetti, F. (2010). Biological, clinical, and ethical advances of placebo effects. Lancet, 375, 686–695.CrossRefPubMedPubMedCentral
go back to reference Foddy, B. (2009). A duty to deceive: Placebos in clinical practice. American Journal of Bioethics, 9, 4–12.CrossRefPubMed Foddy, B. (2009). A duty to deceive: Placebos in clinical practice. American Journal of Bioethics, 9, 4–12.CrossRefPubMed
go back to reference Gawande, A. (2009). The checklist manifesto. New York: Holt. Gawande, A. (2009). The checklist manifesto. New York: Holt.
go back to reference Gawande, A. (2014). Being mortal. London: Profile. Gawande, A. (2014). Being mortal. London: Profile.
go back to reference Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon and Schuster. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon and Schuster.
go back to reference Graber, M. (2005). Diagnostic error in internal medicine. Archives of Internal Medicine, 165, 1493–1499.CrossRefPubMed Graber, M. (2005). Diagnostic error in internal medicine. Archives of Internal Medicine, 165, 1493–1499.CrossRefPubMed
go back to reference Groopman, J. (2004). The anatomy of hope. New York: Random House. Groopman, J. (2004). The anatomy of hope. New York: Random House.
go back to reference Groopman, J. (2007). How doctors think. Boston: Houghton Mifflin. Groopman, J. (2007). How doctors think. Boston: Houghton Mifflin.
go back to reference Halbertal, M. (2006). Al derekh ha-emet: Ha-Ramban viy’tziratah shel masoret. Tel Aviv: Keter. Halbertal, M. (2006). Al derekh ha-emet: Ha-Ramban viy’tziratah shel masoret. Tel Aviv: Keter.
go back to reference Harrington, A. (Ed.). (1997). The placebo effect. Cambridge: Harvard University Press. Harrington, A. (Ed.). (1997). The placebo effect. Cambridge: Harvard University Press.
go back to reference Harrington, A. (2008). The cure within. A history on mind-body medicine. New York: Norton. Harrington, A. (2008). The cure within. A history on mind-body medicine. New York: Norton.
go back to reference Idel, M. (1988). Kabbalah: New perspectives. New Haven: Yale University Press. Idel, M. (1988). Kabbalah: New perspectives. New Haven: Yale University Press.
go back to reference Jackson, R. W., Ewing, W., Ewing, J. W., et al. (2002). Arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347, 1717–1719.CrossRefPubMed Jackson, R. W., Ewing, W., Ewing, J. W., et al. (2002). Arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347, 1717–1719.CrossRefPubMed
go back to reference Kahneman, D. (2011). Thinking fast and slow. New York: Farrar, Straus and Giroux. Kahneman, D. (2011). Thinking fast and slow. New York: Farrar, Straus and Giroux.
go back to reference Kassirer, J. P., & Kopelman, R. I. (1989). Cognitive errors in diagnosis: Instantiation, classification and consequences. American Journal of Medicine, 86, 433–441.CrossRefPubMed Kassirer, J. P., & Kopelman, R. I. (1989). Cognitive errors in diagnosis: Instantiation, classification and consequences. American Journal of Medicine, 86, 433–441.CrossRefPubMed
go back to reference Kleinman, A. (1988). The illness narratives: Suffering, healing and the human condition. New York: Basic Books. Kleinman, A. (1988). The illness narratives: Suffering, healing and the human condition. New York: Basic Books.
go back to reference Lehman, D. R., Wortman, C. B., & Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash. Journal of Personality and Social Psychology, 52, 218–231.CrossRefPubMed Lehman, D. R., Wortman, C. B., & Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash. Journal of Personality and Social Psychology, 52, 218–231.CrossRefPubMed
go back to reference Levi, Primo. (1989). The drowned and the saved. New York: Vintage. Levi, Primo. (1989). The drowned and the saved. New York: Vintage.
go back to reference Maimonides (1964) In Y. Kapach (Ed.) Mishna im perush ha-Rambam. Jerusalem: Mossad ha-Rav Kook. Maimonides (1964) In Y. Kapach (Ed.) Mishna im perush ha-Rambam. Jerusalem: Mossad ha-Rav Kook.
go back to reference McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171–179.CrossRefPubMed McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171–179.CrossRefPubMed
go back to reference McRae, C., Cherin, E., Yamazaki, G., Diem, G., Vo, A. H., et al. (2004). Effects of perceived treatment on quality of life and medical outcomes in a double-blind placebo surgery trial. Archives of General Psychiatry, 61, 412–420.CrossRefPubMed McRae, C., Cherin, E., Yamazaki, G., Diem, G., Vo, A. H., et al. (2004). Effects of perceived treatment on quality of life and medical outcomes in a double-blind placebo surgery trial. Archives of General Psychiatry, 61, 412–420.CrossRefPubMed
go back to reference Nahmanides (1964) In C. Chavel (Ed.) Kol kitvei ha-Ramban. Jerusalem: Mossad ha-Rav Kook. Nahmanides (1964) In C. Chavel (Ed.) Kol kitvei ha-Ramban. Jerusalem: Mossad ha-Rav Kook.
go back to reference Norcross, J. C. (Ed.). (2011). Psychotherapy relationships that work. New York: Oxford University Press. Norcross, J. C. (Ed.). (2011). Psychotherapy relationships that work. New York: Oxford University Press.
go back to reference Ofri, D. (2013). What doctors feel. Boston: Beacon Press. Ofri, D. (2013). What doctors feel. Boston: Beacon Press.
go back to reference Patterson, O. (1982). Slavery and social death: A comparative study. Cambridge: Harvard University Press. Patterson, O. (1982). Slavery and social death: A comparative study. Cambridge: Harvard University Press.
go back to reference Price, D. P., Finniss, D. G., & Benedetti, F. (2008). A comprehensive review of the placebo effect: Recent advances and current thought. Annual Review of Psychology, 59, 565–590.CrossRefPubMed Price, D. P., Finniss, D. G., & Benedetti, F. (2008). A comprehensive review of the placebo effect: Recent advances and current thought. Annual Review of Psychology, 59, 565–590.CrossRefPubMed
go back to reference Rosenthal, R., & Jacobson, L. (1968). Pygmalion in the classroom. New York: Holt. Rosenthal, R., & Jacobson, L. (1968). Pygmalion in the classroom. New York: Holt.
go back to reference Rozin, P. (1997). Moralization. In A. M. Brandt & P. Rozin (Eds.), Morality and health (pp. 379–401). New York: Routlegde. Rozin, P. (1997). Moralization. In A. M. Brandt & P. Rozin (Eds.), Morality and health (pp. 379–401). New York: Routlegde.
go back to reference Scholem, G. (1941/1995). Major trends in Jewish mysticism. New York: Schocken. Scholem, G. (1941/1995). Major trends in Jewish mysticism. New York: Schocken.
go back to reference Scholem, G. (1971). The messianic idea in Judaism. New York: Schocken. Scholem, G. (1971). The messianic idea in Judaism. New York: Schocken.
go back to reference Schweder, R. A. (1991). Thinking through cultures. Cambridge: Harvard University Press. Schweder, R. A. (1991). Thinking through cultures. Cambridge: Harvard University Press.
go back to reference Schweder, R. A., Much, N. C., Mahapatra, M., & Park, L. (1997). The “Big Three” of morality and the “Big Three” explanations of suffering. In A. M. Brandt & P. Rozin (Eds.), Morality and health (pp. 119–169). New York: Routledge. Schweder, R. A., Much, N. C., Mahapatra, M., & Park, L. (1997). The “Big Three” of morality and the “Big Three” explanations of suffering. In A. M. Brandt & P. Rozin (Eds.), Morality and health (pp. 119–169). New York: Routledge.
go back to reference Shorter, E. (2006). Doctors and their patients. A social history. New Brunswick: Transaction. Shorter, E. (2006). Doctors and their patients. A social history. New Brunswick: Transaction.
go back to reference Smith, N., Fuhrmann, T., & Tausk, F. (2009). Psychoneuro-oncology: Its time has arrived. Archives of Dermatology, 145, 1439–1442.PubMed Smith, N., Fuhrmann, T., & Tausk, F. (2009). Psychoneuro-oncology: Its time has arrived. Archives of Dermatology, 145, 1439–1442.PubMed
go back to reference Sontag, S. (1989). Illness as metaphor, and Aids and its metaphors. New York: Doubleday. Sontag, S. (1989). Illness as metaphor, and Aids and its metaphors. New York: Doubleday.
go back to reference Spinale, J., Cohen, S. D., Khetpal, P., Peterson, R. A., Clougherty, B., Puchalski, C. M., et al. (2008). Spirituality, social support, and survival in hemodialysis patients. Clinical Journal of American Society of Nephrology, 13, 1620–1627.CrossRef Spinale, J., Cohen, S. D., Khetpal, P., Peterson, R. A., Clougherty, B., Puchalski, C. M., et al. (2008). Spirituality, social support, and survival in hemodialysis patients. Clinical Journal of American Society of Nephrology, 13, 1620–1627.CrossRef
go back to reference Taleb, N. N. (2004). Fooled by randomness: The hidden role of chance in life and in the markets. New York: Penguin. Taleb, N. N. (2004). Fooled by randomness: The hidden role of chance in life and in the markets. New York: Penguin.
go back to reference Taylor, S. E. (2010). Health. In S. T. Fiske, D. T. Gilbert, & G. Lindzey (Eds.), Handbook of Social Psychology (pp. 698–724). Wiley: New York. Taylor, S. E. (2010). Health. In S. T. Fiske, D. T. Gilbert, & G. Lindzey (Eds.), Handbook of Social Psychology (pp. 698–724). Wiley: New York.
go back to reference Taylor, S. E., Lichtman, R. R., & Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of Personality and Social Psychology, 46, 489–502.CrossRefPubMed Taylor, S. E., Lichtman, R. R., & Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of Personality and Social Psychology, 46, 489–502.CrossRefPubMed
go back to reference Terr, L. (1994). Unchained Memories. New York: Basic Books. Terr, L. (1994). Unchained Memories. New York: Basic Books.
go back to reference Waldenberg, E. (1957). Responsa tzitz Eliezer. Ramat Rahel. Jerusalem: Itach. Waldenberg, E. (1957). Responsa tzitz Eliezer. Ramat Rahel. Jerusalem: Itach.
go back to reference Wolf, S., & Bruhn, J. G. (1993). The power of clan. New Brunswick, NJ: Transaction Publishers. Wolf, S., & Bruhn, J. G. (1993). The power of clan. New Brunswick, NJ: Transaction Publishers.
Metadata
Title
The Soul in Medicine: Rabbinic and Scientific Controversies
Author
Henri Zukier
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Religion and Health / Issue 6/2016
Print ISSN: 0022-4197
Electronic ISSN: 1573-6571
DOI
https://doi.org/10.1007/s10943-016-0280-1

Other articles of this Issue 6/2016

Journal of Religion and Health 6/2016 Go to the issue

Philosophical Exploration

When Brain Death Belies Belief