Can Illness Be Edifying?

Abstract

Havi Carel has recently argued that one can be ill and happy. An ill person can “positively respond” to illness by cultivating “adaptability” and “creativity”. I propose that Carel's claim can be augmented by connecting it with virtue ethics. The positive responses which Carel describes are best understood as the cultivation of virtues, and this adds a significant moral aspect to coping with illness. I then defend this claim against two sets of objections and conclude that interpreting Carel's phenomenology of illness within a virtue-ethical framework enriches our understanding of how illness can be edifying.

Notes

1. See Carel (2007, 2008, 2011).

2. See Boorse (1975, 1976, 1977); though see R. Cooper (2002).

3. See Burley (2011) for a discussion and defence of the use of anecdote and emotion in philosophy, with specific reference to Carel.

4. See, for instance, Carel (2008, pp. 6–7) on loss of bodily capacity and “surrendering vanities”.

5. See, for instance, Pellegrino (2007), Pellegrino and Thomasma (1993) and Putman (1988).

6. See Protagoras 329c6–d11 and, for a discussion of the “unity of the virtues” thesis, Devereux (2006).

7. Indeed, one could argue that certain virtues may be disabling, rather than enabling. Hume (1960, p. 286), for instance, described humility as “painful” because it involved a recognition of one's “deformities” (roughly, one's physical and psychological imperfections). In such cases, humility would be disabling, rather than enabling. That said, such humble awareness of one's limitations could also be a positive experience, for instance if it is interpreted as a liberation from otherwise excessive demands.

8. This claim, as I will develop it, is distinct from Marcum's (2009) proposal that clinicians should be epistemically virtuous.

9. Many recent writers have therefore welcomed the revival of “larger, and more exciting” conceptions of ethics than those which were current amongst many early-twentieth-century philosophers, such as Ayer (1936, Ch. 6) and D.E. Cooper (1998, p. 2).

10. It may also be the case that, for some persons at least, edification becomes easier or more achievable if they are acquainted with the relevant philosophical theories; however, that is a moot point, and one which many ethicists may question. Certainly many persons are quite virtuous despite little if any knowledge of or engagement with the literature on philosophical ethics, so such acquaintance is hardly a sine qua non of successful edification.

11. See Campbell and Swift (2000) and Broom and Whittaker (2004).

12. This principle is evident elsewhere, for instance in the form of “gym buddies” and students revising together; my father attends biweekly physiotherapy classes and reports that the value of those classes is partly social, insofar as the members can share and discuss their experiences and seek solidarity and understanding with one another.

13. See further Carel (2011).

14. Augustine and Boethius's restraint arises because their metaphysics of illness identify it as a symptom of our corrupt, “fallen nature”, so for that reason it cannot be valuable. Illness, as an evil, is a “privation”, and thus a particular subsection of the problem of evil.

15. Cynic ethics also emphasises parrhēsia, a “freedom of speech or frankness” or “freedom to speak the truth” (Piering, 2006, §3b). A self-sufficient person is able not only to cope with life's changing circumstances, but also can freely and frankly “speak the truth” about the social conventions which distort most people's moral reasoning. This, of course, entails that the Cynic will often, if not always, speak truths which are upsetting or disturbing because they challenge presumed conceptions of what is good and valuable. Carel arguably offers a contemporary instance of parrhēsia, both by exposing occluded features of the experience of illness and, in turn, by challenging presumptive social valuations (such as the idea that one cannot be happy, or that medical professionalism entails emotional detachment).

16. See, inter alia, McGhee (2003), Goldie (2008), and Cooper (2008).

17. I thank an anonymous referee for this journal for stressing the role of prudence.

18. An anonymous referee has pointed out to me that illness can also be voluntarily induced. Although I do not wish to discuss cases of voluntarily induced illness here, an edificationist response to such cases would likely focus upon, first, the motivation a person has for inducing illness and, second, the nature of the illness they are inducing. Sustained study of cases of voluntarily induced illness would offer an interesting future line of development for the sort of edificationist position I defend here.

19. Or, to use a rather crude popular idiom, construing illness as edifying is “the best that one can make of a bad situation”.

20. Compare with Nietzsche (1974, III, NP3 and §120).

21. That phrase appears in both Ecce Homo (“Why I am so wise”, Section 2) and Twilight of the Idols (“Arrows and epigrams”, Section 8). See Nietzsche (2005, pp. 77 and 335).

22. In private correspondence, Carel confirmed that she does not think that an ill person is obligated or otherwise required to seek edification.

23. I am very grateful to Havi Carel for reading and commenting on an earlier draft of this paper, which also benefited from the comments and suggestions of Alan Bowden, George Boys-Stones, David E. Cooper, H Martyn Evans, Mihretu Gupta, Simon P. James, Alan Kidd, Collette Kidd, David Kirkby, Jane Macnaughton, Andreas Pantazatos, Ana Espinal-Rae, Geoffrey Scarre, Hannah Shand, Benedict Smith and an anonymous referee.