An A–Z of medical philosophy: U is for Übermensch — why care?

David Misselbrook

doi:10.3399/bjgp14X681469

Nietzsche developed his own philosophical ideas after reading Schopenhauer’s The World as Will and Representation. Nietzsche rejected moral realism and saw morality as mere convention. In his books Beyond Good and Evil and The Genealogy of Morals Nietzsche rejects traditional morality as a restrictive enslavement to a Judeo–Christian petty bourgeois mentality. He argues that most of mankind is doomed to share such a cowardly ‘herd’ or ‘slave’ morality but that the strong should reject it.

He offers instead a Dionysian morality based on a liberated ‘will to power’ that will motivate our actions to mould the world to our own will. One who has the strength to follow such a path becomes the Übermensch or Over-man (sometimes translated as Superman). Nietzsche sees the liberation of one’s will in the Übermensch to be a transformation towards a new nobility in which the strong assume their natural dominance over the weak.

In a naïve sense one can identify some aspects of such a morality with a Darwinian battle for dominance, especially when seen though the eugenic theories of Darwin’s cousin Francis Galton. Indeed Nietzsche is commonly seen as providing a philosophical springboard for the dominance of the strong glorified by Nazism. It would certainly be grossly unfair to see Nietzsche as responsible for Nazism — he was used by Nazi intellectuals post hoc. However, it is hard not to see Nietzsche as providing some intellectual justification for Nazism but this has mistakenly been used as an argument ad hominem against him. Such arguments fail to address Nietzsche’s philosophy itself, although one might accept them as a cautionary tale about the ends to which philosophy may be used.

But if morality is indeed a Darwinian survival adaptation we are left with the question as to why the Christian concept of ‘charity’ survives. How can care for the vulnerable or weak compete with the dominance of the strong? Clearly naïve Darwinism is a straw man. Remember that the ‘selfish gene’ hypothesis is not about genes for selfishness but rather that altruism is explained as a cooperative project to perpetuate one’s own genetic line. But isn’t this tribalism? And if we systematically help weak members of our tribe won’t that have a negative effect on the tribe? So why do most mainstream moral systems teach that I should care both for the weak and also for members of other tribes? Why does our own College have as its motto ‘with science we care’, not ‘with science we care for our own strong’?

Nietzsche despised caring for the vulnerable as a Christian virtue that had perversely challenged Iron Age and Roman cultures where the strong took their rightful dominance. He famously asserted that ‘God is dead’ and therefore there was no persuasive reason to care for others beyond one’s own immediate group. One cannot help feeling that Nietzsche would now be on the side of the robber barons of our modern world, not the doctors. Some see Nietzsche as a bit of a monster. Perhaps so, but he was at least a genuinely thoughtful and original monster. As for me, I’ll stick with ‘cum scientia caritas’. After all Nietzsche is dead.

CPD further study and reflective notes

The notes in Boxes 1 and 2 will help you to read and reflect further on any of the brief articles in this series. If this learning relates to your professional development then you should put it in your annual PDP and claim self-certified CPD points within the RCGP guidelines set out at http://bit.ly/UT5Z3V.

Box 1.