Free Will: its Structure and Limits (Article)
Keywords: Will, Free Will, Contemporary Spirituality, Modern Culture
Klíčová slova: vůle, svobodná vůle, současná spiritualita, moderní kultura
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The word will in our ordinary language almost compulsively associated with free as its modifying qualification plays a crucial role in the modern culture and we can dare to suggest that it represents the very core of contemporary spirituality while having replaced values of former religions. Actually at least since the time of the renaissance thinker Giovanni Pico della Mirandola who lived at the break of 15th and 16th century, free will serves in the West as a main reason of attaching dignity to the human being.  Just due to this, we have started to consider every person endowed with a bunch of rights as its protection on both ethical and political levels. In spite of quarrels concerning a relevant list of such rights we all agree that some minimal code articulating them ought to be venerated as well as spread to other peoples. And still we have very scant knowledge regarding foundation of rights, which is the free will itself; in other words, we simply lack a thorough account of what the human will and freedom as its main feature are.
Here we have to mention one remarkable phenomenon that might bring about a change in the future and it is medicine. Medicine as a last field had retained a remnant of slavery until recently because doctors were largely overriding rights of the patients and only the last World War that revealed threats of misuse of medicine as well as the rapid progress in technologies have prompted us to switch our attitude to the patient in front of us. The delay in development of medicine had manifold resources and cannot be treated here in details although one remark must be made here. There was a crossing point at the dawn of medicine in ancient
Unfortunately the Hippocratic Oath pursued the former tradition and we can conjecture that just this fact has exhibited crucial impact upon Europe later on in the sense of constrains of liberties also in other realms of society; simply we could have achieved implementation of rights much sooner and thereafter avoided atrocities like gulags and holocaust altogether. In other words, we are suggested here that the relation between doctors and patients represents a paradigm for the whole society and is therefore capable of influencing it. This assertion is of course daring since we usually assume that the contrary sway holds. Although it is difficult to put forward arguments on behalf of this assumption as well as it is almost impossible to prove any general contention concerning historical laws there are some historical hints  at this hypothesis and we can adopt it as an imperative for our selves.
Being prompted by this imperative and led by our responsibility we should pay particular attention to the concept of will that has been rather disregarded in the scientific medicine so far (therefore our understanding of psychosomatic relations is poor too) in spite of its importance for it. Alongside and in accordance with the above mentioned proposal we are to follow the promise that by amplifying our knowledge of the human will and by applying it to our practice in the sense of esteem rendered to the patient also our civilization would get boosted.
A splendid opportunity to make some research on the human will comes from now blossoming medical ethics since ethics in general can be considered a philosophy of the will and has at its disposal tools for it. When tracing the concept back in the past we might be stunned by the fact that the ancient Greeks did not coined it at all (the Greek terms like PROAIRESIS, BOULÉMA, THELÉMA etc. do not render it). The word voluntas in our sense has started to be used in Latin by stoics from
The ethical sense is however rather intricate and even mysteries so that it is not surprising that the progress in understanding it is too sluggish. To point to the baffling gist of freedom I can remind you a famous sentence of the distinguished thinker and knower of the human soul Arthur Schopenhauer who proposed that we can do what we want, but we cannot want what we want.  This riddle can be approached and unraveled a little bit by quoting another wise remark of Dostojevskij who wrote somewhere, that people finish their meal and ask: what now? The last notice suggests the source of riddles accompanying freedom which is the fact that freedom cannot be thought of unless the concept of ought or, if you wish a more traditional utterance, of good and evil is introduced.
Certainly, we have to assume that also the notion of free choice itself is something that is contrary to our grasp of determinism and necessity in the nature and destroys it. Yet this academic question can be left to the scholars without any detriment to ordinary life, whereas the question of evil permeates every human activity and many of us cannot sleep well due to it. Moreover, we are still more haunted by the fact of evil in health care and medicine, which is by its definition an endless fight with the ill aftermath of illness. Therefore, we physicians should square up with this question while relying upon the outlook that the whole culture will benefit of our study in the future and get matured too.
The concepts of evil and good reflected with reference to the free choice beget bewildering puzzles and we cannot but regard them here.
Puzzle one (Socrates):
Socrates as a founder of ethical thinking was troubled by the plain and unfussy question that entails rather fussy answers; it can be formulated as follows: Can people perpetrate evil knowingly? The main worry of Socrates and his pupils as well as many other philosophers after him was that the true knowledge (epistémé) cannot be dragged about by instincts, passions and other wild outbursts. Such incontinence or weakness of will (akrasia) might have plenty of pernicious and pestilent consequences particularly for ethics itself, since nothing ethically reliable would remain and even the divine reason (nous) that affords to the soul its immortality would be surrendered to jeopardy of being vanished.
Due to this menace, Socrates and his descendents refused such feebleness and assumed that when people do something wicked; it is not an outcome of their indulgent will but is simply a result of their ignorance concerning either facts or values. Accordingly they all put much emphasis on upbringing and teaching (PAIDEIA) since for them a person briefed enough necessarily avoids every moral bias. Missing concept of the human will in the classic Greek should not astonish us since it would be under such conditions utterly futile.
Unfortunately, their solution never satisfied even themselves and still less other philosophers as well as lay people who has always been stunned by the human experience of sinning. Yet there is another and much more sever threat affecting ethics as such since ethics is then a mere pun: when everything depends upon education then everybody has an alibi and nobody is responsible for anything. When I am caught with my pants down, I have a reply ready: it is because of my training and if you are annoyed or shocked by it please turn to my tutors while the tutors would probably repeat the same and so on in an infinite regress. 
Arguing in this way, we are prompted to switch our attitude again and to reckon with our frailty although it appears to be macabre for our soul: we are the poorest among creatures since we perpetrate evil in spite of our perfect awareness of its badness.  Indeed, we are gist and rogues who deserve no pardon while the assumption of mercy exhibited by God releases another cluster of puzzles that cannot be treated fully here.
Puzzle two (Aquinas):
Aquinas who commented almost everything and who sometimes attempted to contribute to it something original was struck by the question concerning conscience while he was again faced by the conflict between the exigency of assumption regarding sound conscience and the empirical acquaintance with perverted human heart. He rose for ethics essential and simple question concerning the human soul: can conscience fail? Maintaining that such laps cannot come about opposes general human experience whereas concession of any flaw in conscience asks for solving another riddle as to what else than conscience might be trustworthy.
Therefore, an ensuing question that asks the same in a slightly different way might be raised: is it sometimes right to act against one’s own conscience and still remain a moral being? If yes, then when and who should be our leader? Some divine authority or a dice? If not, then why do we judge at all? Everybody sets up her/his own criterion that is utterly subjective while nothing objective can be referred to here. We can criticize solely those who betray their own tenets and no one else. Yet in the name of conscience, even abhorrent cruelties were done. Is there any redemption from this misery?
Actually already Aquinas himself worried about solution of this puzzle and he proposed one that employs two almost synonymic Greek words rendering conscience, i.e. syneidésis and syntÉrÉsis while syntÉrÉsis was a reminiscence of the God’s gleam (scintilla conscientiae) in the human heart suggested by Jerome that guides everybody in the right way and that can never be spoiled. On the contrary, syneidésis can be both biased and amended by various influences.
Unfortunately assumption that there is a divine spark in the human soul can hardly be proved and maintained face to face critical thinking. Although some attempts to replace such a mythical notion by procedural setting of moral rules have been made (here we have to mention first the Golden Rule of Jesus as well as of other thinkers and then the “categorical imperative” of Immanuel Kant or further the “veil of ignorance” of John Rawls etc.), arguments could be gathered that it is too leaky.
Puzzle three (Leibniz):
Leibniz was also a philosopher who hinted at some facet of freedom when he retrieved the age long puzzle of torment face to face God himself. We attach to the God at least from Aristotle on three basic attributes: omnipresence, omniscience and omnipotence. Omnipotence then entails a huddle of questions that can hardly be answered. Of course, we necessarily assume that the God is good and at the same moment, we encounter evil in the world. Yet these three propositions cannot be logically reconciled.
When we take with regard to our thorny experience, reality of evil seriously then there is no room for almighty God simply because such a God ought to intervene against it. If nothing occurs then this God is in short powerless and therefore is no God but someone resembling us. This notion leading to atheism prevails in the modern society and arguments on its behalf can hardly be defeated unless we switch the sign and consider the God wicked. Although this opinion seems to be bizarre to many of us it appeared in the movement of gnosis blossoming at the dawn of Christian era as its shadow and repeatedly reemerged in various garbs while, among famous ones, there is necessary to mention the existential thinking. 
Still another solution has been proposed by Leibniz himself who treated this puzzle “theodicy” and who wrote a book devoted to this topic while bearing the same name.  Sagacity of his handling this puzzle was that evil is evil merely in our eyes because we have limited capacity to understand whereas everything that seems to be ill now will turn to weal in the last. This strategy is nonetheless exposed to protests coming from honest hearts that can be summed up by the wording of Ivan Karamazov who told to his brother Aliosha that he returns the ticket to paradise when even a single baby is to be sacrificed for its sake.
I dare assume that a similar reply would be stated by all the physicians who deal with destitution of the human being. Is there any outcome from this wretchedness? Of course, logic is beaten here again and gives us no chink away while the source of troubles is freedom itself.
Thus, we are baffled by the concept of freedom and tempted to refuse it as a junk. Yet there are many other reasons to accept it and therefore we should make a slight progress in understanding it. There are several fields, which are to contribute to this research. Surprisingly we can expect very little form disciplines like politics, economy and psychology although they reckon with human freedom as its covert prerequisite; actually they do not have pertinent tools to inquiry into it at their disposal and therefore they consider the human mind as a bare black box while being tempted to explain its behavior by instinctive causes.
Significant contribution can be on the other hand expected from several other branches that work with methods suitable for comprehension of the structure of freedom as well as the human will as its backbone.
Fist we have to mention ethics. Ethics treats the human will and its freedom as an execution of practical rationality when rationality in itself is a manipulation with rules and its practical application means:
1. to appoint tenets,
2. to pursue tenets,
3. to endure possible somber consequences when tenets are breached.
This triad expounds the category of autonomy that means setting of law (nomos) by one’s self (autos) as well as ability to draw the chain of reasons from an exerted act to the adopted principle. Because esteem attached to autonomy plays a crucial role in the modern medicine and medical ethics as such, further research of autonomy that is rather enigmatic issue must be designed.
Since execution of autonomy presupposes conscious practical judgment and since judgment is an intentional act that cannot be reified as other things there is necessary to revamp phenomenology as a method capable of grasping entities that cannot be reified by any means. In this way we should describe particularly how our practical endeavor as well as how reference to values that are worth to us are arranged. 
Yet the trouble is that we can neither touch nor see nor hear the will of others and therefore their will seems to be a mere metaphysical raving. In fact, we are to elaborate a new hermeneutics that would help us to guess intentions of our neighbors.  Such hermeneutics will have to focus less upon unconscious drives and more upon conscious decision making and therefore must work out original concepts suitable for it.
Last but not lest there is a broad field deserving further research and it is neurology since every mental activity is performed in the brain. Here we have to point at the remarkable frontal lobes that seem to be an organ of ethical behavior in the sense that their impairment by some lesion manifests itself as immoral deeds,  I dare to propose the name “pseudo-anethical syndrome” for it. Yet of course also function can sway structure and therefore when this like any other organ lacks training it vanishes by atrophy while training here means simply moral manners.
You may notice that there are plenty of ambitious tasks in front of us. We are to envisage that various experts will likely work on them and that medicine will employ results of their effort but medicine itself is committed to coordinate those activities and to pave new trails for the future.
 Pico della Mirandola, G.: De dignitate hominis / Über dir Würde des Menschen. (Transl: Baumgarten, N.) Felix Meiner,
 The most conspicuous example is the fact of Nazi doctors who had either twisted or breached ethical precepts of medicine before the holocaust was launched while we can conjecture that the war could have been more temperate if doctors were more morally liable. Yet less apparent cases permeate the history at large.
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(MUDr. Mgr. Jan Payne, Ph.D., filosof a neurolog, je předsedou Společnosti lékařské etiky J. E. Purkyně. Do roku 1989 pracoval jako neurolog, poté nastoupil na 1. lékařské fakultě UK, kde přednáší etiku a filosofii. Dříve působil jako předseda Centrální etické komise a dnes je vedoucím Centra pro bioetiku při Ústavu humanitních studií v lékařství na 1. LF UK v Praze.)