EBM and CQI Article of the Week 1.14.2021

Recent events are unsettling, in the tumult some disparaging descriptions:  “Person X is Machiavellian”,…..“Group Y is using Machiavellian strategies to push their agenda”.  Venal motives are implied.

Politics aside, this concerns me re: Niccolo Machiavelli (1469-1572), as he was hardly the “moral monster” routinely stereotyped by the unaware.  Machiavelli deserves kudos for being among the first Western writers to challenge monism – the oversimplified conception that in any given discipline or culture, it is one principle variable that explains everything.  You can scarcely overestimate the relevance of Machiavelli’s insight (and courage) brilliantly disputing this assumption.

He might be the first to postulate the veracity of value pluralism,…..human goods/beliefs/moral tenets vary between groups, are not necessarily resolvable, are often incommensurable, and not always irrational,……so we would be wise to adjudicate with sympathy, be reasonably tolerant, and co-exist peaceably with life’s uncertainty and suffering.  Society reliably devolves to hierarchy and chaos without such an ethos. 

Machiavelli’s insights juxtaposed two mutually exclusive constructs of morality – the ethics of Christianity (perfection of the individual life) in contrast to those of the Republic of Rome (power and glory of the body politic).  He believed there was no logical, rational criteria for choosing between these two value systems.  They were both valid, some favored one over the other, blood ought not be shed.  The past year’s conflicts suggest it might do well for us all to be “Machiavellian” in this regard.

Note BTW, Machiavelli was an impassioned admirer of women, championed their rights, wrote that women were every bit as fit to rule, and referred often to examples of female virtu (inherent qualities of merit).

In 2021 let’s nurture alternative insights, challenge dogma in a loving fashion, embrace uncertainty, and cultivate reasoned analysis.  Two engaging examples attached: a) pregnant women/fetuses should consistently have the option for safe breech deliveries,  b) just about anything we can do to safely reduce Cesarean section rates promotes long-term health.

Joe Kaempf, MD
District VIII Oregon Representative
Portland, OR

Volume 13, Number 2

https://pubmed.ncbi.nlm.nih.gov/32128861/

https://pubmed.ncbi.nlm.nih.gov/33211696/

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