Why Medicine Needs a Deeper Kind of Thinking
Exploring how Wittgenstein's philosophy provides essential tools for navigating complex bioethical challenges in modern medicine.
Explore the ArticleImagine a doctor facing a family torn over a difficult decision. Should they continue life support for a beloved elder who shows no signs of consciousness? Modern medicine provides extensive data on survival rates and neurological probabilities, but offers little guidance on how to navigate the profound moral questions about life, dignity, and what constitutes a "good" death. This is precisely the kind of problem that "Slow Cures and Bad Philosophers," a collection of essays on bioethics inspired by Ludwig Wittgenstein, seeks to address.
In an era of rapid medical breakthroughs where we expect swift solutions, this book proposes a radical idea: some of medicine's deepest challenges require not faster technology, but slower, more thoughtful consideration of the human contexts in which they occur.
The "slow cures" of the title don't refer to prolonged medical treatments, but to the patient, contextual understanding that Wittgenstein's philosophy brings to bioethics. The "bad philosophers" are those who approach complex human dilemmas with rigid theoretical frameworks that ignore the rich tapestry of human life .
This approach has never been more relevant. As we face increasingly complex medical technologies—from gene editing to artificial intelligence in diagnostics—we need more than just rulebooks for ethical decision-making. We need wisdom that comes from deeply understanding the particular situations, relationships, and forms of life that give moral questions their meaning 4 .
The patient, contextual understanding that Wittgenstein's philosophy brings to bioethics.
Those who approach complex human dilemmas with rigid theoretical frameworks.
Ludwig Wittgenstein, one of the 20th century's most original philosophers, wrote little directly about ethics or medicine. Yet as contributor James C. Edwards notes, ethical concerns permeate his entire body of work . Wittgenstein offers bioethics not a set of rules, but a method of seeing more clearly.
At the heart of this approach is Wittgenstein's concept of "language games"—the idea that words derive meaning from their use within specific forms of life.
Consider how differently we use the word "pain" when a toddler scrapes their knee, when a nurse assesses a patient on a pain scale, and when a poet describes heartbreak. In medical contexts, understanding what patients and families mean when they use terms like "suffering," "dignity," or "quality of life" requires careful attention to context rather than imposing predetermined definitions.
Emphasizes context over abstract principles, attending to particular narratives, relationships, and circumstances .
Recognizes that ethical theories often fail when confronted with the messy realities of clinical practice.
Champions description as the proper aim of philosophy—"assembling reminders for a particular purpose" .
"Wittgenstein's philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments" .
Consider how this approach might transform our understanding of "good dying"—a concept that becomes increasingly complex in modern medical settings. In his essay, Larry Churchill applies Wittgensteinian observations to medical rituals surrounding death .
Churchill suggests that by examining the rituals and practices surrounding death—the medical routines, the family conversations, the unspoken assumptions about what counts as "appropriate" dying—we can better understand the moral dimensions of end-of-life care. The focus shifts from applying abstract principles to examining the particular ways that meaning is constructed in these difficult situations.
This approach doesn't offer easy answers, but it does provide a more honest and nuanced framework for confronting medicine's most challenging ethical dilemmas.
Fascinatingly, while "Slow Cures and Bad Philosophers" explores conceptual approaches to medicine, recent scientific research reveals how literal "slow cures"—interventions that gradually modify disease progression—are proving powerful in managing chronic conditions.
A compelling 2025 study from the Aging Research Center at Karolinska Institutet followed more than 2,400 older Swedish adults for 15 years, examining how lifestyle factors affect the accumulation of chronic illnesses 1 . The researchers discovered that people who consistently ate a healthy diet developed chronic diseases more slowly than those whose diets were more "inflammatory."
| Dietary Pattern | Effect on Disease Accumulation | Strongest Associations |
|---|---|---|
| Mind Diet | Slower disease accumulation | Brain health conditions |
| Mediterranean Diet | Slower disease accumulation | Cardiovascular health |
| Alternative Healthy Eating Index | Slower disease accumulation | Overall chronic disease risk |
| Inflammatory Diet | Faster disease accumulation | Heart disease, diabetes |
The study identified that the benefits of healthy eating were particularly pronounced in the oldest participants—those aged 78 and above—suggesting that, much like Wittgensteinian bioethics, it's never too late to make meaningful changes 1 .
This research provides a scientific counterpart to the philosophical argument advanced in "Slow Cures and Bad Philosophers": meaningful healing often requires approaches that work gradually, contextually, and with attention to complex systems rather than seeking immediate technical fixes.
Interventions that work slowly but sustainably
Attention to complex systems rather than isolated symptoms
In scientific research, reagents are substances used to cause chemical reactions or detect their presence. If we extend this concept to philosophical bioethics, we might identify conceptual "reagents" that help reveal the moral dimensions of medical practice. These are the tools that help bioethicists conduct the kind of investigations advocated in "Slow Cures and Bad Philosophers."
| Tool | Function | Application Example |
|---|---|---|
| Narrative Analysis | Examines how stories shape moral understanding | Studying how patients narrate illness experiences |
| Ethnographic Observation | Reveals practices that constitute medical "forms of life" | Observing how moral decisions emerge in hospital units |
| Language Game Mapping | Tracks how key terms acquire meaning in context | Analyzing how "quality of life" is used differently by patients, families, and clinicians |
| Case Studies | Preserves particularity and context | Detailed accounts of specific ethical dilemmas without reducing them to general principles |
These methodological approaches stand in stark contrast to what the contributors view as the impersonal, rule-writing directives that too often characterize contemporary bioethics. Instead of anonymous guidelines advising healthcare workers how to behave, this volume advocates for approaches that remain rooted in the concrete particulars of moral problems .
As contributor Paul Johnston explores in his essay "Bioethics, Wisdom, and Expertise," the true aim of this philosophical investigation is practical wisdom rather than theoretical sophistication . The goal isn't just to understand medical ethics differently, but to practice medicine more humanely.
More than two decades after its publication, "Slow Cures and Bad Philosophers" continues to offer vital insights for medicine, bioethics, and how we think about human health and suffering. Its contributors demonstrate that Wittgenstein's philosophy provides powerful resources for confronting medicine's most persistent challenges: how to honor patient individuality while developing general practices, how to respect cultural differences while maintaining ethical standards, and how to embrace medical technology without losing sight of the human beings it serves.
In our current moment of rapid biomedical advancement—with artificial intelligence, genetic engineering, and telemedicine transforming healthcare—the lessons of "Slow Cures" grow more urgent. The book reminds us that as our technical capacities expand, we must equally cultivate our moral imagination, our capacity for careful attention, and our willingness to sit with complexity rather than reaching for premature certainty.
The "slow cure" this volume offers is philosophical rather than pharmaceutical, but its potential impact on healthcare is no less significant. By teaching us to see medical ethics not as a set of abstract rules but as a deeply human practice embedded in particular lives and relationships, it points toward a medicine that is not only more ethical but more truly healing.
As Carl Elliott notes, the scholars in this volume write in the spirit of Wittgenstein's belief that philosophy should be useful . For healthcare professionals, patients, families, and anyone concerned with the moral dimensions of medicine, "Slow Cures and Bad Philosophers" offers exactly this kind of usefulness—helping us navigate the complex terrain where technology, morality, and human experience intersect.