Concept of Man in Homeopathic Therapy

What our time demands of good doctors and quality care is the self-understanding of a personality that looks beyond the laws of mere utility and is able, beyond their respective expertise, to ask the question of the whole. This whole is the person in their relationship to the world that surrounds them and that they, in turn, are."

Giovanni Maio (transl. by CHS)

The concept of man - a controversial perspective

The actions of all professional groups represented in the healthcare sector are based on concepts of man which characterise the understanding of illness and health through ideas about what it means to be human and humanity itself.

Current medical practice follows different ideas and models, which are presented here with their advantages and disadvantages in a heuristic[1] perspective in order to make it easier to differentiate between the focal points and differences of the various approaches.

The contrast "we don't treat illnesses, we treat sick people", which is usually boldly propagated in alternative-complementary medicine, can be resolved in the further question of how the most appropriate attitude can be adopted in each situation for the benefit of the patient by combining all perspectives.

Different approaches can be described for people in dealing with themselves and others, which, with their differing emphases, have characterised modern medicine over the last 50 years. Four perspectives can be summarised and presented as models, which are contrasted with two alternative approaches (Maio, 2017).

The patient as a human machine

Modern, technically orientated medicine is based on the idea of the body as a function - analogous to a machine - and a primarily mechanistic view of the human being. From this perspective, physiological processes can be isolated, separated and broken down into their biochemical components in order to understand and analyse them. From this perspective, the human being can be described entirely in terms of scientific laws.

The success of this way of thinking can be found in the progress made in physiology and pathology, which can make generalisable statements about bodily functions and their deviations in defined diseases.

At the same time, this reductionism ignores everything outside of scientific research, as it sees itself as an extended arm of mechanisation, in the sense of an applied, narrowly focused pure natural science.

On this basis, clinics are developing into mechanised factories that (should/must) be run cost-efficiently according to market economy principles. At the end of this development is the profit-orientated repair operation, which views illness as a defective mechanism. The lifeworld and the spiritual dimension of being ill are not recognised and consequently existential questions are ignored.

This model lacks the realisation that healing is more than just an operation and the application of specific therapeutic procedures, but that people are sentient, relational beings. The uniqueness of each individual and their illness has no place in this system of thought and is consistently ignored.

The purely mechanistic approach to therapy also ignores complex interrelationships and creates secondary problems of its own accord, wherever a purely technical solution without a broader view of the whole is not sufficient or the repair simply does not succeed.

The patient as sovereign

From this perspective, the individual corresponds to a self-determined being who can "afford" medical services out of a free decision and optionally purchase them in addition to a minimum level of basic care. The model corresponds to that of a customer who utilises a market-oriented service provider.

The services are limited to what can be purchased, knowledge and technical expertise. The market regulates supply and demand.

Under this condition, the relationship between the practitioner and patient is purely rational. This means that a flawless service with the guarantee of a smooth process in terms of time and content, the service to be provided, takes centre stage in order to meet the wishes of the "customer".

From the patient's point of view, such an approach emphasises the freedom of the individual, who knows their needs and can take care of their fulfilment themselves. This approach presupposes a high degree of personal responsibility and a reflected self-image; it formally and practically promotes and supports freedom and self-determination in personal responsibility.

Social service to others is not the maxim of action in this way of thinking. The focus is therefore much more on fulfilling wishes. The criteria for action are based on what is technically feasible, depending on whether and how it can be financed.

From the practitioner's point of view, this is the attitude of needs-orientated purpose fulfilment, which is based on economic aspects and moves away from the original purpose of serving people towards the delivery of a perfect service. The patient's wishes and expectations then no longer need to be scrutinised.

A person in distress who is suffering from illness and needs help is quickly side-lined in this way of thinking, because in rare cases he will be able to fulfil all the conditions mentioned in order to make an appropriate decision on the necessary and sensible treatment for him alone.

The human being as an atomistic individual

This perspective refers to the modern tendency for society to consist of a collection of largely autonomous individuals. Social values, institutions, developments and procedures therefore develop from the interests and actions of the individuals who make up society. The individual is comparable to an "atom", the only true object of interest and reflective analysis. Integration into a context can be neglected.

In this way of thinking, the practice of medicine follows the idealisation of the individual, on whom consent is imposed for far-reaching decisions about their existence, including options for their death, after appropriate informal information.

As ideally valuable as self-sufficient living wills are, for example, they must not decouple or isolate the person concerned either in their decisions or from the interpersonal relationships on which they depend, because that would also be reductionist thinking.

It is therefore important to adequately respect the patient's capacity for judgement in his or her context and without pressure-inducing circumstances. This includes essential aspects of dialogue:

Always provide relevant and understandable information
To support comprehension as a process of individual information processing in such a way that the content conveyed can also be absorbed and understood.
Avoid being influenced by psychological pressure and time-pressured circumstances
Achieve voluntariness and consent primarily through fear reduction
Recognising and helping to reduce situations of paternalism, including by relatives

In particular, the patient's social environment and social conditions should not be formally ignored. This is the only way to avoid prematurely blaming decisions solely on the person concerned, who can become stuck in a situation of overwhelming self-alienation, recognisable by statements such as: "I don't know" "it's all too much for me" "just do what you think" "I don't want to be a burden on anyone" "maybe it would be better if I left", etc. ...".

It is precisely this interdependence that characterises people as connected, social beings whose needs cannot be met if, from a medical point of view, their decisions are tacitly viewed and treated as individual beings in isolation.

Man as the feasible

Illnesses are not understood as part of one's personal destiny, to which one can enter into an accepting relationship, but exclusively as something to be countered with fighting, defence and rejection.

Behind this is the attitude that everything is feasible, self-designed or can be freely designed at any time. Essentially, this leads to the idea that not only the external conditions of life, but also oneself, can be "made" indefinitely and continuously.

However, a world that already existed before the individual was born, with all the preconditions of his or her existential situation, is filled with the imponderable, the unpredictable and the limits imposed by everything that interacts.

Unlimited feasibility thinking therefore leads to overconfidence and prevents us from developing a good relationship with the realities of the world and our own existence in a reflective and relaxed manner.

Consequences of the dominant concepts of man

The concept of man of a sovereign, self-sufficient person whose individual parts can be analysed scientifically and who is oriented towards what is technically feasible means that, all in all, illness is seen as a deficit phenomenon of normality that needs to be combated. This means that being ill, becoming weak, frail and in need of help is not seen as a manifestation of being human in itself, but as a malfunction to be repaired, which contradicts the desired model of the valuable life of a person who is always fully capable in all its basic features.

In contrast to this is the fact that a healthcare professional can only really help a sick person if being sick is perceived and recognised as belonging to the human being, as a form of human existence - as an individually different, new experience of life that needs to be integrated in order to be able to continue to live a meaningful life and die with dignity.

Only medicine that makes the person in need of help, the vulnerable, the person affected by illness and the person who wants to die with dignity the starting point for its actions can really help to develop a good relationship with one's own being.

This means not just diagnosing and naming, but understanding the person, not just giving information, but actually counselling - not just treating, but accompanying along the way.

These consequences result in two alternative ethical attitudes that emphasise the care of the practitioner towards the patient. This is not simply about more time and payment for talking medicine and a corresponding organisation and structure of medical practice. Rather, it is about the attitude and identity of what constitutes medicine: the authentic care in the encounter that determines the form of practical action, as an unconditional commitment to help and acceptance.

Medicine as an unconditional promise to help

As soon as the vulnerable person in need of help forms the actual basis for action, a new perspective emerges that places service to those in need at the centre.

Whether in diagnostics, therapy or care, from this perspective on the patient, a look at their face is enough to trigger the motivation to help in all representatives of the healing professions and to follow this calling, regardless of insurance companies and their reimbursement behaviour.

What constitutes this unconditional commitment to help is the promise of the practitioner to provide this service to the patient proactively, out of inner motivation, and to provide help to the best of their knowledge and belief.

This promise must not be confused with a claim to cure or a guarantee of success. From this perspective, it is solely the promise of unconditional willingness to help, which can be realised as the essence of practised medicine, with means appropriate to the individual case.

Help with acceptance as part of the healing process

Healing is neither a service nor a product that can be purchased, nor does therapy simply produce health. The complexity of becoming healthy is a comprehensive process that often ends incompletely or can only be realised in part. Accepting this fact and actively shaping it for the benefit of the patient entrusted to our care is a primary task, especially when dealing with severe cases and the suffering of terminally ill patients.

Healing processes will not come about solely through the will and ability of the practitioner, through specific interventions or through the patient's wishes.

From this perspective, we are talking about deep regulatory processes within the patient that want to and should be supported and accompanied.

Medicus curat natura sanat (the doctor treats, nature heals)

This simple sentence describes a piece of wisdom that has existed since the time of Hippocrates and which, on closer inspection, has lost none of its relevance to this day.

The extent to which the patient's basic attitude of acceptance accounts for themselves and their situation is difficult to measure in individual cases, let alone to analyse objectively. Nevertheless, acceptance characterises action in every case and is also significant in terms of prognosis. Successful action is therefore not an individual action on the part of the practitioner, but rather a result of joint action in interaction between the practitioner and patient. This applies in particular to the primary aspects of being human

the situation of being born
of becoming ill
recovery
of ageing and dying

Medicine and its representatives enter into a special relationship with these processes. This relationship places the basic conditions of human existence and togetherness at the centre of a practiced ethic that goes beyond efficiency, individuality, rationality and functionality and repeatedly asks itself the essential question in the encounter: "How can I best provide meaningful help in this case?"

Self-concept and human dignity

The concept of human dignity is complex and has been interpreted differently in different eras of human history. Since the Age of Enlightenment, ethics has referred to Kant's maxim.

According to Kant, the basis of dignity is the autonomy and self-legality of the will, a rational being capable of morality. Under these conditions, man has the ability to determine his own purpose and to express this in his actions, which thereby acquires an intrinsic value, human dignity. This dignity corresponds to the inner attitude of respect as an inalienable human good towards oneself and others. In anthropological terms, this realisation of the human being is an inviolable prerequisite of existence

"Human dignity is inviolable."

This sentence does not formulate a fact, but a norm (GG Art. 1) whose premises can be summarised as follows

Human dignity becomes a critical yardstick that obliges people's actions and attitudes to take the greatest possible mutual consideration of dignity, to detect and avoid its violation.
In the reflection of the self, the (pre-)gift of dignity becomes the (super)gift of its respect.
Neither illness, dying, nor death violate human dignity, any more than health, recovery and life are an expression of dignity.
Dignity is violated where people are reduced as patients to their illnesses or symptoms and the desire for healing and relief is realised at the expense of their self-determination.
It is not the demand for professionally appropriate action in itself that violates or limits human dignity, but the way in which this is realised by those acting.

Concept of man and self-concept in homeopathic practice

From the self-concept of homeopathic practice, the human being is not reduced to a disease and its symptoms, but is respected as a whole in his or her illness.

In illness, even in death, people should be respected as individuals, with their own particular life story and their own specific abilities and attitudes to life.

The ethical orientation of homeopathic medicine is characterised by these individual abilities and attitudes to face life and to help the patient discover goals for their path together with them and to support them in the knowledge of individual and general experience-based connections.

The basis of homeopathic practice is an attitude of unconditional promise of help, which places all available knowledge and one's own abilities at the service of alleviating suffering.

The underlying concept of the human being does not require a theoretical separation of mind, soul and body, as it makes it its core task to fulfil adequate responses to the need for help as well as possible.

Such an approach does not devalue itself in relation to other therapies, but rather, bearing in mind its own limitations, always seeks the best solution in the respective individual situation beyond its own possibilities.

Perceiving and understanding people in their dignity as a whole means understanding them as individuals in every case.

People with disabilities differ only in that caregivers can and should help to better understand the uniqueness of the person concerned.

Even the view of supra-individual relationships does not invalidate the fact that every person must be seen as an individual case, because from a holistic perspective, health is more and something different than the absence of illness (see also Homeopathic Understanding of Disease).

Each individual patient's self-determination, which is valid for him and his relatives, forms a corrective against the danger of guideline-compliant generalisation and ideologization, which is fed purely by statistically based procedures.

Sources and references

[1] Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

[2] Lindemann, G. (2011) in Graumann, S., & Rabe, M. (2011). Menschenbilder in der (Medizin-)Ethik. Ethik in der Medizin: Organ der Akademie für Ethik in der Medizin, 23(1), 1–3. https://doi.org/10.1007/s00481-010-0117-5

[3] Maio, G. (2017). Mittelpunkt Mensch: Ethik in der Medizin: Ein Lehrbuch - Mit einem Geleitwort von Wilhelm Vossenkuhl. 2. Edition. p. 477ff.