The Soul in Medicine: Rabbinic and Scientific Controversies

The practice of medicine relies on a combination of two very different sources, and requires two kinds of talents: a cognitive-instrumental, knowledge-based and disease-centered approach; and a psychological, expressive-relational and patient-centered approach. Throughout the centuries, the mix between the cognitive and expressive dimensions, and the relative emphasis given to each approach, has varied considerably. Current evidence-based medicine privileges the cognitive-performative dimension. The recent developments within medicine are indicative of the inherent and lasting tension between the cognitive and expressive dimensions. Not surprisingly, then, related terms of debate are also apparent in medieval rabbinic discussions of medical practice. However, the rabbinic and medical traditions resolved the tension in very different ways. This paper explores a conceptual link between the modern dynamics of the cognitive and the socio-relational dimensions, and a complementary rabbinic controversy starting in the thirteenth century, originally between Maimonides and Nahmanides, both physicians. There are significant interactions between the modern evolution in the roles of doctors and patients, and the rabbinic approaches to physicians and illness. The mapping of the two debates about doctors and patients suggests that the tension between science and soul, and the dynamics of integrating them, has characterized medicine through the ages, though they can lead to different outcomes.