For those involved with engagement activities, the following phrases might strike a chord…
“It may as well be in a foreign language!”
“Didn’t understand any of it but the punctuation was fine!”
“What do you study again?”
The above were often responses I received when sending drafts to friends and family to be proof-read. I soon gave up on sending them anything altogether, from which my degrees probably suffered.
These reactions do, however, allude to the problem of engaging various audiences and stakeholders with the philosophy of medicine.
Why does this field seem so inaccessible to those outside of it? Is this just the norm in academia? Or is the philosophy of medicine particularly baffling?
Are there any rules when it comes to engagement here? (Yes – I suggest a few at the end…)
As someone engaging various audiences with the work EBM+ do, I have experienced those looks of pure perplexity first-hand. When I explain our philosophical foundations and how they relate to practical applications in the world of EBM, I often find myself falling down a rabbit hole of ‘isms’, complex jargon and conceptual buzzwords. It seems that at least one party just doesn’t get it – or doesn’t want to.
Perhaps us philmeds suffer from a lack of intellectual authority. After all, Arthur Caplan famously questioned the very existence of philosophy of medicine as a field. Granted, some of its areas and concepts can seem complex (like causes and explanations, for instance), but to deny its existence is a step too far, in my opinion.
Moreover, it is important to emphasise just how useful the philosophy of medicine is, and EBM+ research on causes is a good place to start. Evaluating causal claims in medicine relates to various high-priority objectives such as assessing different types of clinical evidence, designing trials and improving medical decisions. Indeed, the EBM+ handbook is a perfect example of our efforts to put our philosophical work into practice.
It would also be naïve to view the philosophy of medicine as merely a branch of bioethics. Rather, philosophy of medicine acts as a strong foundation to support debates within bioethics. The consensus suggests that bioethics is a distinct field from the philosophy of medicine, the latter of which has undergone much development over the years. As Michael Loughlin and colleagues stated:
“Applied philosophy has moved a long way from the simplistic application of ethical theories to artificially constructed ‘dilemmas’, to become a rigorous engagement with questions of medical epistemology, metaphysics, and moral and practical reasoning”.
And even when considering bioethics and philosophy of medicine together (to humour the naysayers) Sir David John Weatherall writes:
“…on bodies like the Nuffield Bioethics Council and some of the government regulatory committees, the philosophers who joined the scientists and lay people who were grappling with the difficult decisions raised by modern biotechnology were of inestimable value in better defining the questions involved, not to mention generating a more sensible basis for their solution”
Take one of our cornerstone case studies like thalidomide, where the role of evidence of mechanisms was overlooked to leave devastating consequences. Or the conceptual assumptions that underpin RCTs and which, in turn, maintain their privileged position on the EBM pyramid. These are subjects that physicians are becoming increasingly worried about and that lots of students do not know enough about.
If philosophy of medicine hopes to grapple with the intricate physiological and biochemical complexities relating to health, disease, drug discovery, preventative treatment, etc., maybe the field should take a dose of it’s own medicine and de-jargonise itself, in order to be more widely manageable and palatable to a lay audience (then again, maybe it shouldn’t, otherwise I’d be out of a job).
To approach the end of this post/rant on a positive note, engaging key audiences – e.g. health practitioners, politicians, researchers, parents, teachers and students – with philosophy of medicine is far from impossible and happening right now. For example, CEBM at Oxford University regularly promotes engagement to teach EBM in the right way, and as our EBM+ School Volunteering Programme gets underway, it’s a pleasant surprise to witness the level of interest that schools and students demonstrate towards clinical research and EBM.
Moreover, our videos – like the one below – also aim to spread our message to a wider set of audiences and stakeholders in a clear and coherent manner. If you or a team you know are carrying out similar engagement work, please get in touch.
And finally, all things considered, I propose 5 of RULES of engagement which might prove useful…
Relevance – Ensure your messages are relevant. Make them personal to the specific type of audience you are targeting.
Understanding – It’s much easier to engage an audience when you really know and understand the content you’re wishing to communicate.
Language – It’s not just about what you say, but how you say it. Get creative to captivate an audience.
Exposure – Try to spread your ideas as far and wide as possible, use as many outlets as you can and use them consistently. You never know who could be listening.
Simplicity – Keep it simple. The more complex your message becomes, the more likely members of your audience are to roll their eyes and move on.
Please let me know if you found this helpful and stay tuned for more upcoming impact & engagement news.