The systems are different but they treat women the same
In this paper I will examine Biomedicine and Ayurveda and their approach to women. I will argue that despite the vast differences between these two systems, and their concepts of man, they treat women similarly. So, even though ethics plays different roles in each system, neither ethical discourse contains moral values applicable to all human beings in the same way. Hence it is necessary to evolve a new ethics which is based on values applicable to every human being.
Biomedicine is the result of a long process of interaction between medicine and the various natural sciences. The history of medicine has shown that the growth of anatomy and physiology promoted the development of biomedicine as a scientific discipline, sharing the spirit and methodology of the natural sciences. Nineteenth century Europe’s commitment to a scientific temper helped establish biomedicine as a system based on the current understanding of biology with its own method of diagnosis and cure.
Biomedicine presupposes that man is a part of the biological order or ‘machine’. Disease is a consequence of the machine breaking down; the doctor is a mechanic. The origin of this mechanical approach dates back to Galileo and Newton who challenged current thinking on the creation and working of the universe. Galileo viewed the world as a machine exhibiting a geometrical order. Human beings are physical bodies, part of the physical world, and mechanically governed by the laws of physics.
This mechanical model was enriched by the domination of Newtonian physics in the scientific community. Newton argued that the physical world is composed of indestructible particles moving in mathematically computable motions in mechanical regularity. Newton spoke of human beings as primarily sensory beings who are in immediate contact with the physical objects themselves. Objects in the world are perceived by man through his sensory organs. The application of the mechanical model in physics is an extension of this understanding of human beings as machines. Mechanism was extended to chemistry and later on to biology. Chemistry presupposed that living things have a chemical structure and could be treated as chemical machines. Given the occurrence of certain chemical actions human behaviour could be predicted in a mechanical manner.
The mechanical interpretation of human behaviour presupposes philosophical dualism of body and mind. For Descartes the body was an ‘extended substance’, a machine existing in space and time and subject to laws of the physical world. The mind, however, is a non-extended substance. It cannot be located in space and time; it is not governed by the laws of physical world, and its working cannot be predicted as can be that of the physical body. Body and mind are separate, independent but interacting substances.
Cell theory, germ theory, gene theory and DNA are all milestones in the search for structural and analytic components of living beings. They take for granted that living beings are nothing more than special combinations of materials and function like machines.
This understanding places man within the mechanism of society. At another level, it supports prevailing conceptions of role distribution. The development and practice of medicine is closely related to factors such as economic conditions, gender-relations and political ideologies within a society. When women are treated as reproductive machines, mothers and care takers, medical technology is geared towards enabling them to perform these roles. If medicine is meant to restore men’s health and well-being, the development of medical treatments for women is driven primarily by concern for their reproductive functions.
One example is the manner in which abortion became legal and available in India — not in response to women’s demands but those of the population control lobby. The 1971 law was enacted by a government committed to reducing birth rates, and does not even acknowledge women’s right to control their fertility. Abortion is used to promote the government’s interests without any concern for the woman’s psychological or physical health, or her rights. The same is true in the case of fertility control methods. In a society dominated by gender bias, the sex determination test is widely used to kill female foetuses, and continues to be available despite a ban. Such technologies either deprive women of their right to life or affect the quality of their lives.
Ayurveda is based on a medically relevant philosophy with a distinctive perspective towards human life. It views man as a microcosm of the universe. Ancient Indian physicians asserted that both nature and man are made up of the same matter, the five gross elements: earth, fire, air, water and space;additionally, man has consciousness. Man is a combination of body, mind and self; physical and psychological processes are inseparable and interact, both expressions of the life force. The treatment is given to the psychophysical organism (Bhutatma) and not to one or the other part of the body.
Ayurveda views the human being as a whole constituted of body, mind, intellect and self. The body is said to be of two types: the gross body, Sarira, which is observable and perishable, and the subtle body, Sukshma-deha, made up of elements like mahat, ahankara and sensory organs. The subtle body cannot be perceived.
Ayurveda views the human being as a whole person and not as a machine but how does it look upon male and female? The male is the giver of seed, nourished by the female, the field. The seed has potential for life; the field is inanimate. Both Caraka and Susruta use the word field for the womb. The language of Beeja and Kshetra sees woman as an object and hence a lesser being. The four goals of life, the system of four stages of life which provide a context for moral life, are not for her. Her duties are mainly two – giving birth and acting as a sexual partner. In her youth she is in the custody of her father or brother. Later on, the husband has a right over her and in old age she is under the control of her sons. She is always a dependent being. Medical treatment by Ayurveda has the effect of controlling a woman’s life. For example, Ayurveda does not permit the practice of abortion because it violates the principle of non-violence. This forces a woman to reproduce against her will. Ayurveda sees women as having a certain social status. Women are seen as objects of enjoyment for men. Medical treatment for a woman is meant to keep her fit to perform these two functions.
The notions of physical and mental cleanliness, necessary parts of Ayurveda, are also intimately related to the ideas of purity and pollution, and used to deprive women of the right to participate in certain rituals, or during certain periods.
Because of its commitment to the western scientific perspective, biomedicine cannot and does not have a just approach to women’s problems. Despite its holistic point of view, Ayurveda does not provide a nonexploitative alternative, because of its commitment to religious beliefs,.
Medicinal systems are created by human beings, so they can be changed by them as well. This requires the evolution of a new perspective. The issue is not the hegemony of this or that system but how we use it for the health of all human beings. Both systems are influenced by socio-cultural practices that appropriate and use techniques to fulfill political purposes. At this level, one’s understanding of ethics and commitment to values become important.
Biomedical ethics is limited to interpersonal relations such as those between doctor and patient or patient and health care institution. Questions such as a patient’s right to health, to refuse treatment, a doctor’s duty to save and not kill, his commitment to his profession, problems of maintaining severely brain-damaged human beings on life support systems, infanticide, abortion, mercy-killing, are ‘paramedical’ problems. There is no viable and consistent relationship between the theoretical basis of biomedical medicine and the value-framework in which it operates. Ethical issues either remain at the periphery or are redundant.
Ayurveda is based on a philosophy of life. Man as a miniature of the cosmos must represent the order and organisation of nature. A healthy life is based on order and discipline. It presupposes a harmonious relation to nature and society, while preserving the integrity of one’s personal private world. The world extends beyond the natural world to the social and private worlds. Man uses his imagination to create a culture, based on normative values, with goals of life which provide space for all stages, from birth to death. Thought and action are geared to move from self-centered interest to the broadest possible social vision. Activities such as art, science, philosophy, and medicine belong to this larger context. Every inquiry supplements and nourishes the others. Life becomes a whole; different ways of relating oneself to others and to nature exhibit different lifestyles.
Ayurveda therefore prescribes a medically relevant lifestyle which includes proper diet, proper exercise and proper mental attitude. This is reflected in day-to-day practice, dinacharya. Thus ethics becomes an integral part of Ayurveda. In this ethics, obligation is the keyword. Human beings are part of a social world and they have an obligation to nature, society and to themselves. These obligations are determined according to varna and ashrama.
However, this system of specific values (visesa-dharmas) presupposes a hierarchical structure: all human beings are not equal; they do not have rights independent of caste, gender and social status. Women do not have any status in terms of varna; hence there is no question of their having basic rights like right to life, right to freedom of thought and action. (Men also do not have rights but have obligations.)
Today, we are committed neither to Ayurveda nor to bio-medicine but have a confused attitude to both systems. The same confusion exists at the level of evolving a new ethics. On the one hand, we are more inclined to use biomedicine and are receptive to the new ideas of basic human rights. On the other hand, our psyche is governed by traditional values. Therefore, constructing a new ethics becomes an ambitious task. This task cannot be restricted to evolving a new methodology to interpret moral rights and obligations. It requires the creation of a new form of life based on general values equally applicable to all human beings.