By Delese Wear & Therese Jones
No one would argue that the definitions of “health” and “medicine” are different. However, when some of us began to urge a change regarding those words as modifiers—as in medical humanities being replaced by health humanities—there have been varied responses: from expressions of puzzlement to charges of academic nitpicking.
Words matter—an assertion often glossed over in academic medicine. For example, consider the thousands of words written about the important differences between “compliance” and “adherence” (though compliance is still commonly used) as well as an equally large number on the effects of derogatory labels of patients (many of those also still said and heard). Moreover, the sloppy, varied, and ubiquitous use of educational trends labeled as “professionalism,” “reflection,” and “competencies” has made significant pedagogical deployment and evaluation of them almost meaningless in medical education…
So it now goes with the “medical” humanities, a term that was appropriate when the field arrived during the 1970s, residing primarily in U.S. medical schools and working towards a goal of enabling and promoting more caring professionals and better caring practices. But over the past 40-plus years, humanities inquiry in health professions education—not just medical education—has morphed into something quite different from those early curricula focused primarily on doctors and the experience of doctoring explored through the lenses of traditional disciplinary knowledges and methods such as literature, history, philosophy and comparative religion.
In the last quarter of the 20th century, the academy began to mirror profound cultural and global changes, and the strict borders between disciplines began to break down with the emergence of inter- and multidisciplinary areas of studies. These included cultural and women’s studies as well as disability, postcolonial, and queer studies, which drew from multiple disciplines, theoretical orientations, and methods of analysis. The gaze shifted from the doctor as the central focus of inquiry to the complex cultural landscape of patients across race, class, ability, and gender identity; to new genres such as YouTube videos, TED talks, and graphic novels; and to all caregivers, formal and informal. For example, a standard course such as “Literature and Medicine” offered 25 years ago may now be replaced by one titled “The Perils of the Normal” that explores historical and cultural representations of “normalcy” through both written and cinematic texts.
Even more critical to the shift from medical to health humanities is the fact that humanities inquiry is happening in health professions education of all stripes in myriad locations outside medical schools and increasingly in undergraduate health professions curricula. The linguistic shift to “health humanities” acknowledges an important fact: that illness and all phenomena related to health are not just the purview of “medicine” and are, in fact, lived outside medical settings where doctors play a minimal role. Resonant with the original aspiration of the medical humanities to foster better care for patients is the clearly stated objective of the current academic movement towards interprofessional education: improved health outcomes for patients and better collaborative skills for all health professionals.
Therese Jones, PhD, is Associate Director at the Center for Bioethics and Humanities Director, Arts and Humanities in Healthcare Program, University of Colorado Anschutz Medical Campus