Ethical Individualism as a Basic Therapeutic Attitude

Anthroposophic Medicine as a concept can be categorized as an integrative approach – not anti-modern but true to Steiner’s principle of recognizing scientific medicine as its foundation (1) (2, p. 7).  What is the basic ethical attitude behind it, though? What can it rely on if, on the one hand, it is based on natural science and makes use of high-tech intensive care medicine and, on the other hand, does not rely on collective values and norms? Anthroposophic Medicine is neither a religion nor an otherwise defined community of values having a predetermined ethical foundation. The only thing that it can build on is people who reflect on themselves and the world. What basic ethical attitude can emerge from such reflection?

The connection between good and evil and thinking 

Our attitude is always the result of the way that we have learned to think about ourselves and others. Steiner recognized the injurious nature of a mindset that pursues science without spirituality and thus without innermost human commitment. He pointed out the dangers involved: inhumaneness and the destruction of civilization. In lectures on education as a social question in August 1919, he remarked: “Consider how many cruelties permeate our culture, cruelties with which the cruelties of barbarian times cannot be compared. If you consider this, you will hardly doubt that a dawn is heralding the descent of intelligence. […] Two evidences of this can be definitely seen today: there are people who are very intelligent and who have a decided inclination toward evil; and many others who subconsciously suppress but do not fight this inclination toward evil, merely letting their intelligence sleep.” (3) Forty years after Hitler’s seizure of power, Hannah Arendt, observing the Eichmann trial in Jerusalem, coined the term “the banality of evil” (4), which needs to be reflected upon in more detail today. Her question is: to what extent is the problem of good and evil related to thinking and can really active independent thinking give rise to a capacity for conscience, enabling people to avoid evil? Steiner’s concepts of “intelligence that becomes evil” and “letting intelligence sleep” can only now be understood empirically and philosophically. The more holistic and open-minded that someone’s thinking is, the less it can lapse into isolated and ultimately hostile thought patterns as guidelines for action. In this context, however, it should not remain unmentioned how close some thought forms of present-day medical ethics come to the reality of the idea of “lives not worth living” that prevailed in the time of National Socialism. The crucial difference between then and now is only that individuals in Germany had no personal freedom of choice back then. Today, doctors and patients have the freedom to decide how they want to act ethically in matters of preimplantation diagnostics, prenatal diagnostics and active euthanasia (5, 6). Here we find that Steiner’s message of turning away from normative collective ethics and embracing individual ethics (“ethical individualism”) (7, p. 160), meets the trend of current ethical debate. Practice shows that ethical norms, legal, political, social and cultural safeguards, regulations and guidelines cannot ensure that in individual cases “the good” will happen for the person concerned. What can be considered ethically “good” or “bad” in individual cases depends on whether something is experienced as helpful and beneficial for the person’s development. There cannot be a given standard for this. Thus Steiner’s fundamental philosophical-ethical work bears the title “Philosophy of Freedom” and not “Philosophy of Ethical Action” (7, p. 260). Because the classical basic questions of ethics, “What is good, what is evil?” are necessarily subordinate to the concept of freedom or they depend on its definition. In order to define them more precisely, they require either an external legal framework that delineates what is “just” or “unjust”, “permitted” or “prohibited” and in this sense “good” or “evil”. Or they require a description of what the inner voice of conscience is based on or how it arises and where it is formed. If this cannot be described, if the reasons given are not transparent and comprehensible for the people concerned, then the result will be some form of dependence or lack of freedom. The degree of freedom that a person possesses will always prove to be the deepest motivation for his or her thoughts and actions. The dignity and values of individual and social life depend on it. It determines the characteristics of individual ethical behavior and the collective understanding of values in a society. Therefore, there can be no satisfying moral norms – because freedom cannot be explicitly standardized, it can only be realized implicitly and individually. Or, to put it another way: conditions of external freedom do not guarantee that a certain person will also feel free inside. The decisive factor is the experience of freedom in its inner dimension of soul and spirit. However, each one of us can only implicitly convey this to ourselves as a result of our own – authentic – thinking and feeling in dealing with ourselves and the world.

Rudolf Steiner’s philosophy of freedom

The ethical individualism envisaged by Rudolf Steiner is directed at people whose self-understanding is to ensure their capacity for autonomy through thinking. On the other hand, there may also be inner power conflicts revealing how people may be in danger of asserting themselves and exercising their freedom at the expense of others – or they may think of themselves evolutionarily as nature-driven, genuinely unfree “animals”, an attitude that places human beings “beyond freedom and dignity” (8). In a world ruled by laws of nature, freedom can only appear as a disposition, it cannot become manifest. For, if there were a law of nature which could produce the ability to be free “on its own”, i.e., in a natural way, this would be proof of its non-existence. Freedom can be conceived and grasped only in a sphere that, although it has its own laws, is not subject to the laws of nature. Steiner recognized such a sphere in human thought. Human thinking describes all accessible laws of nature without being dependent on nature. Thinking is at work in nature but is not caused by it. In addition, beyond understanding the world of nature, thinking also encompasses every form of ethical-moral value setting and self-determination that is culturally creative but not controlled by nature: “Nature makes man merely into a product of nature; society makes him into a being who acts rationally, but he alone can make himself into a free being.” (7, S. 170).

Steiner aims to precisely observe and describe the way in which this self-determining ability to think works. To what extent the capacity for freedom can manifest in the thinking activity of a person and be expressed through his feelings and actions necessarily depends on his personal understanding of autonomy or his will to be free. For freedom is never a “given” – it requires constant practice. Thus, even freedom-based ethics cannot establish a norm for ethics, but it can describe inherited ethical norms as steps towards overcoming them. The starting points in Steiner’s philosophy of freedom are therefore conscious thinking activity, on the one hand, and sensory experience which perceives the environment and the person’s own body, on the other. This duality manifests the interplay between necessity (i.e., the driven, predetermined nature of human beings through their physicality) and the capacity for freedom in the form of thinking self-determination. However, through the fact that human beings can discover new things by thinking, whereby they also learn to see themselves again and again in new ways, they find that their physical condition and/or associated experience of self may also change when they cultivate certain thoughts that they recognize as correct. Steiner calls the human physical constitution, which changes under the influence of thinking, the person’s characterological disposition. He contrasts this natural characterological disposition with purely spiritual, free thinking. The way in which each individual arrives at self or I-consciousness is very different, due to individual biographical experiences and development. And the respective thinking and acting of a person depends to a large extent on which life experiences that person has had and how these have been processed. That is, a person’s actions are in each case the result of an interaction of the world of thought and imagination (from which the motives for action originate) with what is possible through the characterological disposition as a body-bound “driving force” (7, p. 151).

Ethical individualism and moral norms

Steiner calls the thinkingly produced motives for action ethical (moral) goals and divides these as follows:

1. Imagining one’s own or others’ well-being – in the sense of the proverb: do unto others as you would have them do unto you.

2. The purely conceptual content of an action – e.g., from a system of principles that can ensure ethical action in a given social or value context. The establishment of these ethical principles is the responsibility of the responsible authorities in the family, religious community, scientific community, state or even the voice of conscience shaped by their teachings.

3. Acting from individual insight – independently from authoritative moral concepts and terms. For this purpose, the individual person takes into consideration his or her own expectations and requirements for what he or she sees as ethical actions. These can be objectives like:

  1. to promote the greatest possible good of the whole of humanity,
  2. to serve the cultural progress or the cultural and moral development of mankind,
  3. to realize purely intuitively grasped ethical goals.

In the case of a) and b) there are goals/ideals according to which we can orientate our actions. In decision-making situations, we can consider in each case how these goals can best be met by our actions. The course of action in individual cases depends on the ideas or concepts a person has about the common good or cultural progress. The more this bears ideological traits, the more blatantly action can become something mercilessly unindividual, as, for example, in seemingly idealistic Nazi slogans such as “the common good takes precedence over self-interest”, in the final consequence of which the individual is extinguished. Accordingly, this also applies to economic-ethical paradigms of efficiency and economic proportionality.
Situational or context-oriented action can only be realized where the individual faces the full challenge of personally and intuitively adjusting his or her actions to the given situation. But then also the above mentioned human ‘I’ is directly involved, by identifying itself with its way of acting as much as possible. If this is given, this commitment can at the same time be called love – and one person’s freedom can be congruent with the freedom of the other.
Steiner calls such an individually realized ethical standpoint, which is rooted in an intuitively accessible world of thought, and to which also the mental conception of one’s own self or ‘I’ belongs, “ethical individualism” (7, p. 160).

The human ‘I’ that is present in this world of thoughts gets motives for action from it. However, because these motives become one’s very own and completely personal through one’s feeling of love for them, one also experiences one’s actions as starting from oneself, as being determined by oneself – and thus free. Moral norms will entail a compulsion of conscience or action, or acting out of a sense of duty until I have rediscovered the norms and values myself in a new and situational way for this one particular situation in which I want to act. But then the moral norm has become ethical individualism. Work on the basic ethical attitude associated with this also has a corresponding influence on the everyday life of anthroposophic physicians. For at the center of this ethical individualism is the fundamental insight that all people with their thinking are rooted in one and the same world of thoughts or ideas – which is why deep mutual understanding is always possible when people want to understand each other.

Living in the love of doing

A comprehensive understanding of autonomy, as well as self-development and self-reflection, are central for therapists, nurses and physicians seeking to train in Anthroposophic Medicine. Such understanding guarantees that the patient and his or her needs can be the focus of attention and that it will be possible to respond individually to individual cases. Then it will be possible to realistically evaluate what is appropriate to the concrete situation as well as to one’s own conscience and value context. To experience these possibilities individually is the prerequisite for free deeds – which in the above mentioned sense are at the same time deeds of love. Only when I love an action am I so connected to the action in my attitude that I like to do it. This in turn means for the other person, to whom my deed is directed, that I make my capacity to recognize and act available to him and his situation. When I have the will to understand the patient, the possibility is given that he or she will actually feel understood and thus respected in his or her autonomy – even in a state of great need. Rudolf Steiner summarizes the double aspect of a free act in this way: “To live in love of the action and to let live, having understanding for the other person's will, is the fundamental principle of free human beings.” (7, p. 271) In a therapeutic context, this maxim can become a guideline for a comprehensive development of empathy and a prerequisite for training of therapeutic intuition.

1 Glöckler M, Girke M, Matthes H. Anthroposophische Medizin und ihr integratives Paradigma. In: Uhlenhoff R (ed.) Anthroposophie in Geschichte und Gegenwart. Berlin: Berliner Wissenschafts-Verlag; 2011.

2 Steiner R, Wegman I. Grundlegendes für eine Erweiterung der Heilkunst nach geisteswissenschaftlichen Erkenntnissen. GA 27. 7th ed. Dornach: Rudolf Steiner Verlag; 1991. English translation: Steiner R, Wegman I. Extending practical medicine. Fundamental principles based on the science of the spirit. London: Rudolf Steiner Press; 2000.

3 Steiner R. Die Erziehungsfrage als soziale Frage. Die spirituellen, kulturgeschichtlichen und sozialen Hintergründe der Waldorfschul-Pädagogik. GA 296. 4th ed. Dornach: Rudolf Steiner Verlag; 1991, lecture of August 16, 1919, p. 93. English translation: Steiner R. Education as a Social Problem. Great Barrington: Anthroposophic Press; 1969.

4 Arendt H. Vom Leben des Geistes. Das Denken. Das Wollen. Munich: Piper; 2008, p. 14.

5 Glöckler M. Ethik des Sterbens und Würde des Lebens - Versuch einer anthroposophischen Stellungnahme zum assistierten Suizid. Der Merkurstab 2010;63(5):408-420.

6 Selg P. Der therapeutische Imperativ Rudolf Steiners - Zur ärztlichen Ethik. Der Merkurstab 2010;63(5):443-447. [Crossref]

7 Steiner R. Die Philosophie der Freiheit. Grundzüge einer modernen Weltanschauung. GA 4. 16th ed. Dornach: Rudolf Steiner Verlag; 1995, p. 160. This translation by Rita Stebbing: Steiner R. The philosophy of spiritual activity. New York: Rudolf Steiner Publications; 1963, Chapter “The Idea of Freedom”.

8 Skinner BF. Jenseits von Freiheit und Würde. Hamburg: Rowohlt; 2018.