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Tag Archives: medical ethics

The medical ethics of posthumous diagnosis of artists

The tradition of posthumous diagnosis of famous artists goes back at least to Sigmund Freud writing about Leonardo da Vinci in 1910. In his essay “Leonardo Da Vinci and a Memory of His Childhood” Freud’s psychoanalytical examination of Leonardo focused on Leonardo’s painting The Virgin and Child and St. Ann. In this examination Freud as art connoisseur and Freud as psychologist are confused and ultimately Freud’s analysis and outing of Leonardo as a “passive homosexual” is unethical.

It is not uncommon for physicians to write papers where they give a posthumous diagnosis of medical conditions in notable dead artists or other identifiable historic figures, for example, that El Greco had astigmatism. However, I would urge that both the authors and the editors of medical journals to be consider the ethics and relevance of such papers.

The publication of inaccurate posthumous diagnosis created with the authority of a physician makes for both bad art history and bad medical science. Even though there is often more information about a notable artist, due to the existence of diary, letters and their works of art, than other people the likelihood of the posthumous diagnosis being incorrect is still very high. Of course it is not just physicians who make errors in art history, everyone is going to be wrong, however, what makes the physicians errors worse is that they are not making them using anything like proper medical methodology. The only things that can be learnt from the incorrect diagnosis of breast cancer in Rembrandt’s model for Bath of Bathsheba (1654) is that paintings are not a useful diagnostic tool, something that should already be obvious.

There needs to be some guidelines for both writers and editors regarding the ethics of publishing papers containing diagnosis of famous dead artists. I propose for reasons of both accuracy and ethics that priority be given to articles that explain a diagnosis made public by the artist during their lifetime and where there is a benefit to the public in making and explaining a diagnosis. If the diagnosis was not made during the artist’s lifetime it is more than likely to be incorrect. There is the potential for a diagnosis damaging the reputation of the artist and the reputation of their art.

Is it ethical for a physician to provide an unsolicited posthumous diagnosis of medical conditions in notable artists or other identifiable historic figures that they have never examined, simply as a matter of historic conjecture, because the person is both famous and dead?

“At their strongest, confidentiality protections after death would be equal to those in force during a patient’s life. Thus, if information about a patient may be ethically disclosed during life, it likewise may be disclosed after the patient has died.” (Opinion 5.051 – Confidentiality of Medical Information Postmortem, AMA website, accessed 18/12/2015)

The AMA does lay out some ethical reasons for the disclosure of medical information postmortem. In most articles about dead artists there is a clear failure to consider both “the impact disclosure may have on the reputation of the deceased patient” and the “personal gain for the physician that may unduly influence professional obligations of confidentiality.” (Opinion 5.051) There maybe some research and educational purposes in doctors writing about famous dead artists but in examining the literature there didn’t seem to be one clear example.

As a basic guidelines for physicians writing about famous dead artists or other famous dead persons: don’t write anything that you wouldn’t write when the person was alive. Writing about a diagnosis that was made during the person’s life that the person made public themselves provided that has a public benefit. But this is not a simple matter as can be seen in “Before and After and Superman – Andy Warhol” James C. Harris, MD JAMA Psychiatry January 2014 Volume 71, Number 1 (Downloaded From: http://archpsyc.jamanetwork.com/ on 12/17/2015) Does the fact that Warhol openly discussed his childhood illness Sydenham chorea (historically known as St. Vitus dance) imply permission for further discussion of the effects of the illness on him? Is this different from an examination Warhol’s denied but widely reported use of amphetamines and cocaine? The confidence of Harris’s diagnosis that Warhol’s obsessive compulsive behaviour and hoarding an effect of Sydenham chorea ignores alternate explanations and Harris does not mention alternative explanations for Warhol’s behaviour. At what point does such discussion become inappropriate? Would making Warhol the post-child of the disease for an advertising campaign be appropriate?

These complicated cases aside lets have no more articles about El Greco’s eyesight, Richard Dadd’s mental illness or Giorgio De Chirico’s migraines. Instead let the final word be from: Bogousslavsky J “The last myth of Giorgio De Chirico: neurological art” (Front Neurol Neurosci. Epub 2010 Apr 6) who concluded that De Chirico’s art practice was “…a continuous, organized process to which organic brain dysfunction never contributed.”

(Thanks to Catherine Voutier for her assistance in the medical research.)

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