Reimagining Medicine as a Practice of Solidarity: A Corrective to Spaceship Ethics.

Abstract

The culture of medical training and contemporary medicine is largely influenced by "spaceship ethics," where healthcare professionals are taught to take "refuge in principles that place them outside, or above, the complicated, ambiguous, contradictory lives of those others who sicken and die" (Irvine and Charon 2016). Is there a better way that medicine can care for individuals immersed in ambiguous, contradictory lives of sickness and death? In this paper, we argue that one corrective to spaceship ethics is reimagining medicine as a practice of solidarity. At its conceptual core, solidarity is a cooperative relationship that transcends self-interest and respects each person's dignity and sense of belonging-a collective human need that does not distinguish caregivers from patients. We build a theory of solidarity in the context of medical training by describing the life and legacy of Father Damien as well as the ongoing HIV-focused work of Shalom Delhi. We then discuss three practical ways in which contemporary medical training can encourage solidarity: (1) proximity to patients and communities; (2) choosing careers based on a community's needs; and (3) an openness to transformation by patients. We conclude that solidarity can be a corrective to spaceship ethics by enabling healthcare professionals to engage in complicated social realities of sickness, death, and provider-patient dynamics. A practice of medicine that is animated by a commitment to this type of solidarity reorients clinicians' lives and professional priorities around the experiences of the patients they care for. In a medical culture that trains healthcare practitioners to distance themselves from patients as whole persons, practicing solidarity encourages sustained proximity, advocacy, and dignity.