Medicine. Humanity. Cooperation

Medicine. Humanity. Cooperation

26 April 2021
 Corinne Doria, PhD, professor at the School of Advanced Studies, talks about Medical Humanities, problems and prospects of this scientific direction.

Within the framework of the Year of Science and Technology in the Russian Federation, Corinne Doria, PhD, professor at the School of Advanced Studies of the University of Tyumen, talks about what Medical Humanities are, why do we need them, problems and prospects of developing this field.

Corinne Doria is a historian specializing in the history of medicine, science and technology, and in the histories of political ideas. She received her MA degree in Literature and Philosophy at the University of Milan in 2007 and a doctoral degree in Modern History at Paris 1-Panthéon-Sorbonne University and the University of Milan (1st-grade honors) in 2012. In 2013-14 she was a Post-doctoral Fellow at Paris-4 University and co-director of the joint project Écrire Une Histoire Nouvelle de l’Europe (Writing A New History of Europe), with the Universities of Paris 1, Paris 4, and Nantes.

Dr. Doria is developing a new research project dedicated to the social history of medicine and disability. In her work, she takes an interdisciplinary approach that brings together methodological approaches from the history and philosophy of medicine, the history of technologies, visual studies, and disability studies.

In 2020, Dr. Doria received an international grant for visiting researchers at the Deutsches Museum in Munich. The research will focus on the social history of ophthalmology in Europe between the 1850s and 1950s.

- What are the Medical Humanities and why do they matter?

- The Medical Humanities are an interdisciplinary academic field that acknowledges health and illness as related in the first place to the experience of being human, hence deserving to be studied beyond a mere biomedical viewpoint. The expression Medical Humanities was coined by chemist George Sarton (1884-1956) in an article published in 1948 in the journal ISIS, an academic publication devoted to the history of science. In this text, he claimed that science alone could not provide a sufficient foundation for fully understanding health and illness. In addition to clinical expertise, a physician necessitates “compassion, sensitive listening skills, and broad perspectives from the humanities and social sciences. Medical Humanities is nowadays a growing academic field that includes many peer-reviewed journals, professional societies, international conferences. It is also expanding at a global level. Programs in Medical humanities are offered by medical schools of almost every European country; the university of New South Wales and the University of Western Australia have integrated humanistic disciplines in their medical curricula; in Russia, several institutions such as the Sechenov University in Moscow, the ITMO University in St. Petersburg, and the School of Advanced Studies of the university of Tyumen, are developing integrated curricula spanning from undergraduate courses to advanced interdisciplinary research projects; in China, governmental policies have strengthened medical humanities education and established partnerships with European universities with a more established tradition in this field; India is presently undertaking an ambitious program willing to introduce medical humanities into the undergraduate medical curriculum of numerous universities across the country. As this trend is proceeding fast and at a global scale, it is worthy to look more closely to Medical Humanities and to the contribution they can give to the medical profession. 

- Why is it important to recognize the humanitarian aspect of this field, even if it was ostracized not so long ago?

- To see things more clearly we need to consider the criticisms addressed to medicine and the medical profession in the last decades, mostly within the medical profession itself. Complains have been formulated against the increasing presence in and influence on healthcare by actors like politicians, bureaucrats, pharmaceutical companies, who have other priorities than patients’ well-being. Criticisms have also been directed against the organization of modern medicine itself, whose hyper-specializations and hyper-technicization reduce patients to objects or numbers instead of considering them as human. Furthermore, medicine is seen as incapable of responding by itself to the multiple and complex issues (social and individual, emotional and psychological) raising during a sanitary crisis, as the ongoing COVID-19 pandemic is demonstrating. In sum, medicine has lost its humanity. A way to reverse this tendency is seen in introducing humanities and social sciences in medical education. To re-humanize medicine, what better way than Humanities? 

- What is the stance of the medical community about integrating humanities in their practice?

- Edmund Pellegrino, one of the ‘founding fathers’ of Medical Humanities, stated in his landmark article of 1974, “Our technical proficiency is extolled, but in its application we are said to be insensitive to human values. This assertion is painful because there is some truth in it” . Nowadays this perception is widely spread across the medical profession. It has been intensified by the difficulties of practicing medicine in an era increasingly dominated by economic constraints, and complexified by multicultural differences and globalization. Physicians continue struggling with the dehumanizing tendencies we mentioned and are more and more open to look at humanities as a mean to reconnect healthcare workers to the original meaning of their profession. We need to remember that that medicine became a science less than 150 years ago. For centuries, medicine has not been an exact science, but as an art and a learned profession. From the Middle Ages throughout the Early Modern Era, a licensed physician was a highly educated man versed in the first place in philosophy, theology, literature. He had to master Latin and Greek in order to read the works of Hippocrates, Aristotle, and Galen. A broad humanistic culture was an essential part of his identity as a doctor and allowed him to distinguish himself from subordinate practitioners, such as barber-surgeons. It was only from the middle of the nineteenth century that medicine took a merely scientific turn. Disciplines such as physics, chemistry, and biology acquired more and more importance in the education of physicians, as well as clinical training. By the end of the century, biomedical science had displaced the old humanistic medicine as a source of professional identity and authority. Conquered by the experimental method, medicine ceased to be art and became an empirical, quantitative, exact science.

Embracing humanities will reconnect health practitioners with the original roots of their profession.

- Would the field drastically change, if a strictly scientific approach would be taken?

- I would say that it will depend on the level of integration and interaction between medicine and the humanities. Humanities can bring vital contributions to medicine and medical practice. History and anthropology can provide an understanding of the social, cultural, and temporal dimensions of medicine. They can foster the awareness that medicine does not exist outside society, and that is hence important to be mindful that culture, politics, and economy have always had a role in shaping health and illness, therapy and care. Literature and psychology can be useful to improve doctor-patient relationships. Through these disciplines, physicians are brought to reflect on ideas, terms, and issues related to medicine. They are led to think about what it means to be a patient, what are her /his concerns, expectations, fears; this condition impacts one’s relatives. Visual and performing arts can provide a unique insight on how medicine is perceived outside the medical environment, allow a patient to express her/his condition more effectively, hence providing precious information to the healer, or be a useful therapeutic tool. If both disciplinary areas will engage in a mutual and deep cooperation, medicine as we know and understand it today will certainly change. And for the best.

- As a researcher, do you think that this year's events will leave a mark in the social history of medicine? What long-lasting effects do you foresee?

- The global pandemic we are experiencing has demonstrated that physicians can be called to face unexpected challenges and to respond to questions for which scientific knowledge is insufficient. The Medical Humanities are currently experiencing an impressive expansion and becoming overtime more complex. They are reaching medical schools across the globe and developing new topics and methodologies. This will influence how future generations of physicians will be educated and possibly reshape medicine as a discipline as we know it. That been said, it is difficult to make a forecast. Nowadays in academia the relationship between humanities and medicine is organized according to three different models: 1) as an add-on to medical curricula. This approach sees humanities as a complement to traditional scientific medical education. The teaching of humanities tends to have a low-impact on medical students, who tend to perceive such classes as a ‘decompression chamber’ between the ‘serious stuff’, or an easy way to higher their grades; 2) a humanities-centered. We encounter this approach in university departments of humanities and social sciences where individual scholars work on a medical-related topic. Medical professionals are rarely involved in these researches because of their lack of training in the humanities. This is the case of many universities in the United Kingdom or France, where humanities departments reclaim the medical humanities' ownership. In this case, medical humanities are disconnected from the medical professional environment and hence they have no impact on medical education. 3) Cooperation. Medical professionals and specialists in humanities and/or social sciences work together on a level playing field. In terms of research, that means developing a joint project in which the questions addressed are relevant for both sets of disciplines and require both kinds of competencies. In terms of teaching, it implies to put in place specific strategies, blending different pedagogical traditions, for example proposing courses co-taught by a philosopher and a biologist. This last configuration is probably the one that gives the best guarantees for humanistic training to be beneficial to healthcare professionals. But it is also the most difficult to put in place. It implies a to refocus the whole medical training in relation to an understanding of what is to be fully human. I personally believe that medical schools should frame their medical humanities programs according to the principle of cooperation if they want this training to become a valuable part of medical education and avoid that medical students dismiss humanities classes as a waste of their time. This is actually one of the main obstacles to the integration of humanities in medical schools. The perception that humanities and sciences belong to two different worlds and are too different to cooperate is still broadly diffused. To acknowledge humanities as complementary rather than incompatible with medicine requires to stop thinking about medicine as a discipline analogue to physics or chemistry, and to recall that medicine “enjoys a unique position among disciplines – as a human science whose technology must ever be person-oriented”. I believe that the humanities in medicine have a bright future, and that nowadays there are the best chances to overcome the obstacles that are still preventing humanities from becoming (again) a core component of the professional identity of a medical doctor. 

Source: UTMN Department of Strategic Communications

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