Interview Directory 

IN FOCUS

Name: Prof. Dr. Giovanni Maio

Education:  Studied medicine and philosophy in Freiburg, Strasbourg and Hagen

Occupation: Physician and philosopher; holder of the Chair of Medical Ethics at the Albert Ludwigs University in Freiburg

Books: “Vertrauen in der Medizin“, “Den kranken Menschen verstehen“, Von Angesicht zu Angesicht", Ethik der Verletzlichkeit" and many more

Prof Maio, what do you consider a good doctor?

Prof Maio: A good doctor has to bring different worlds together. He must know something of the laboratory world and at the same time have understood something of the patient's world. He must recognise the illness and at the same time understand the illness itself. He must bring the body together with what really moves the other person. A person who becomes ill doesn't just have a sick body. Their whole life changes. A doctor who tries to repair a body and has no understanding of life's problems cannot help.

What made you decide to leave the practice and concentrate on your role as a medical ethicist?

I was an internist for a long time and this time shaped me for the rest of my life. Even as a young person I wanted to write about medicine, but I wanted to get to know it properly first. I studied medicine because I am interested in the problems that being ill raises, but this more fundamental perspective of what being ill means for people and the existential questions it raises were not addressed at all in medical school, so it was the one-sided medical studies that drove me all the more resolutely towards philosophy. Now I see my task as bringing medicine and philosophy together in a new way.

"Suddenly a person is ill and asks themselves, who am I now anyway, what will become of me? Does everything still make sense? They find themselves in a situation of heightened vulnerability."

The main thesis of your new book "Ethics of Vulnerability" is to set a corrective and place vulnerability as a fundamental characteristic of being human at the centre of medicine. You write that you see vulnerability primarily as a resource?

With this book, which is very close to my heart, I want to emphasise that as human beings we inevitably cannot exist without others, because without others we cannot find ourselves. Because we are dependent on others, we are vulnerable. Others can hurt us not only because they mean us harm, but also because they simply ignore us or are indifferent. That was the reason for me to focus on the vulnerability of human beings. What applies to a healthy person applies all the more virulently to a sick person. Suddenly a person is ill and asks themselves: Who am I now anyway, what will become of me? Does it all still make sense? They find themselves in a situation of heightened vulnerability.

Medicine only wants to repair and does not really see the existential need of the patient. These people are in life crises, and with "Ethics of Vulnerability" I want to emphasise that we need to take more interest in the needs of others. My hope is that the book will convince at least some people that we can only really help people in need if we develop a sense of community with them. I have emphasised the bond between people because we can only lead a good life if we are aware of this. We humans are all vulnerable, and it is our shared vulnerability that unites us all and can give us a sense of togetherness.

 "It was not the pandemic of the unvaccinated, as the politicians

 had labelled it."

You go on to write that the coronavirus pandemic has made you particularly aware of the issue of vulnerability and that you have warned against marginalising people who are afraid of the vaccine.

Corona has made us realise that everyone is vulnerable and we could have felt even more connected to each other as a result. But things turned out differently. The media fuelled a general mood of fear by constantly working through a rhetoric of threat. The fear thus fuelled led to a search for culprits and villains. In the search for the culprit, people could think of nothing else but to brand the unvaccinated as the cause of all evil. When individual politicians then started talking about a pandemic of the unvaccinated, it was the expression and result of a drifting apart of society as a whole.

I found this inhumane, not only because everyone should be able to decide for themselves whether they want to be vaccinated or not. But also because it is not right to pillory entire groups. People were morally condemned because there was a lack of tolerance and clear-sightedness.

How do you rate the media's handling of the pandemic?

Even back then, all the media were saying the same thing. The media neglected their mission to educate and instead made it their task to educate the population. That was a big mistake. Their job is not to educate, but to enlighten. They should have allowed dissenting voices. The effectiveness and safety of vaccination should have been relativised. In this respect, it was a bit like propaganda. In future, we must arm ourselves better against one-sided, moralising reporting.

"The moment of threat opens our eyes to the beauty of the fragile."

I particularly liked your thesis of recognising vulnerability as an aesthetic in its own right and opening our eyes to the beauty of fragility.

We carelessly pass by the essential things in life because we take them for granted. When a certain thing threatens to break, we recognise what we have in it. Then we see the beauty that we otherwise pass by. The moment of being threatened opens our eyes. That's what I mean by the beauty of the fragile.

You live with people and when they become ill, you realise what you have in them. I would like us to develop a stronger sense of the preciousness of the seemingly self-evident. Every person has a unique biography that has so much to tell us.

Your book goes on to say that globalisation and increasing interdependence have even led to an increase in structures of vulnerability. Can you give some examples of this?

When the transfer of goods was no longer possible during the coronavirus, people realised how dependent they had become. The delusion of market globalisation was rightly called into question. The more complex the world becomes, the more vulnerable we become. We need to ensure that such dependencies are minimised because this makes us too vulnerable. In medicine, we have seen how valuable hospitals are. People said to themselves: If we don't have a hospital now, my grandmother will die from the coronavirus. Corona has shown how important that is. But when it was over, the first thing politicians thought about was how we could close 30 per cent of hospitals. Now the beds are to be decimated, even though there are fewer and fewer doctors and GPs in private practice. People are incapable of learning from disasters.

Why do you think there are fewer GPs?

Many young people do not want to take on the responsibility, partly because of the risks and the enormous investments involved. Many practices are being closed or bought up by consortia. Many of these bought-up practices do not practise holistic medicine, but only operate. All of this is leading to a decline in genuine medicine. This is a misguided development, because people have not recognised that good medical care is necessary for people to have a good life.

"Medicine has not recognised that every person is unique."

In an interview with Deutschlandfunk radio, you also spoke about how you are in favour of a shift from hospital-based to relationship-based medicine. How can we imagine that?

That's exactly why I wrote the book. It is important to me not to see the sick person as a customer who buys something from medicine. Rather, sick people hope that someone will look after them. Caring has to do with concern. We need to see people as fundamentally vulnerable beings, because only when we see them in their vulnerability do we immediately recognise that we need to respond to this with a culture of care and are called upon to take responsibility for the well-being of the weakest.

"Vulnerability is not just a description, it is an appeal.“

Vulnerability is not just a description, it is an appeal, a very subtle and gentle appeal. The appeal that springs from vulnerability is: every person is vulnerable and we are all called upon to see something special in every vulnerable person, something that deserves our deep appreciation.

Medicine has forgotten how to see the whole person; it reduces people to what it sees under the microscope and on an X-ray. Medicine has not realised that every person is perfect and beautiful because every person is unique.