Saturday, January 26, 2013

Active passivism

In dealing with patients doctors decide on certain management actions when they judge that the probable benefits outweigh the probable harms. The same is true in life in general. However in some situations the only available course of action that promises significant benefits carries also significant risks of harm that may exceed the benefits. Pure objective thinking may favor avoidance of the action creating a difficult situation in the absence of a good alternative. One is left with the much less satisfactory option of trying to ameliorate symptoms, explain and support psychologically and hope for the best.
A subjective factor is sometimes added to the risk benefit equation. That is the tendency in all of us to do something significant to help. Consequently an action may be attempted (a drug is given or an operation is advised) to satisfy this impulse in spite of the improper balance between possible benefits and harms.
Resisting this tendency in such a situation is not easy and makes one feel and appear passive. This resistance is an active process though it results in an apparently passive stance. I like to call it active passivism!
The same thing occurs outside the field of medicine, in general life. Sometimes you do something not because you are convinced it is the proper thing to do but because you feel you must do something significant and obvious and that other people expect that from you. Abstaining from this is active passivism.