This article examines the contribution that poetry written over the last fifty years might make to the established and burgeoning field of Medical Humanities. It takes poems by women about cancer and depression as a case study of how they can offer insight into the impact of these conditions on the sufferer. Collectively, the poems document and effect shifts in knowledge about, and the associated stigmas concerning, illnesses that carry secrecy and shame, specifically cancer and depression. Additionally, drawing on Virginia (...) Woolf’s remarkable essay “On Being Ill”, we see how the non-verbal features of poems, particularly metaphors and symbols, mark the space of what a patient cannot fully articulate. Accordingly, the poems discussed illuminate how literature can express human interiority but at the same time remind the reader – or health professional – that interiority can never be fully presented. Thus, poetry both contributes to and also checks the ways in which literature is appropriated by the biomedical sciences. The poets included are Eavan Boland, Julia Darling, U.A. Fanthorpe, Jackie Kay, Gwyneth Lewis, Carol Satyamurti and Jo Shapcott. Some poems specify a female subjectivity, some express agency as autonomous individuals, while others presume to speak of common human experience. (shrink)

Since the nineteenth century the theory and practice of mainstream Western medicine has been grounded in the biomedical model. In the later years of the twentieth century, however, it has faced a range of serious problems, which when viewed collectively, remain unresolved despite a variety of responses. The question we now face is whether these problems can be dealt with by modifying and extending the principles underlying the biomedical model, or whether a more radical solution is required. Recent critiques of (...) Western medicine have focused mainly on the biopsychosocial model in relation to the former approach, but it will be contended that this cannot deal adequately with the challenges that medicine currently faces, because although it addresses both the scientific and humanistic aspects of medicine it fails to harmonise them. I shall therefore argue for the necessity of a more radical approach, and suggest that what is required to accomplish this is the development of a new medical cosmology, rooted in an older and more global framework. Such a fundamental change would inevitably involve a long term process which it is not yet possible to fully comprehend let alone specify in detail. Some of the necessary features of such a new medical cosmology can, however, already be distinguished and the outline of these is described. (shrink)

Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed (...) to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology. (shrink)