Abstract
This paper first distinguishes governance (collective, autonomous self-regulatory processes) from government (externally-imposed mandatory regulation); it proposes that the second of these is essentially incompatible with a conception of the medical humanities that involves imagination and vision on the part of medical practitioners. It next develops that conception of the medical humanities, as having three distinguishable aspects (all of them distinct from the separate phenomena popularly known as “arts-in-health”): first, an intellectual enquiry into the nature of clinical medicine; second, an important dimension of medical education; third, a resource for moral and aesthetic influences upon clinical practice, supporting “humane health care” as the moral inspirations behind organised medicine. Medical humanities sustains these three aspects through paying proper attention to the existential and subjective aspects of medicine. By encouraging authentic imagination among health care practitioners, medical humanities aligns well with both humane health care and governance in the sense of self-regulation. However, it can neither be achieved mechanistically nor well-measured through proxies such as patient satisfaction. Above all, it should not be allowed to supply, through inappropriate qualitative “targets,” new forms of management tyranny.
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Notes
“Governance,” in Wikipedia, http://en.wikipedia.org/wiki/governance.
J Macnaughton, “The Humanities in Medical Education: Context, Outcomes and Structures,” Journal of Medical Ethics: Medical Humanities 26 (1): 23–30.
S Toulmin, “Knowledge and Art in Practice of Medicine: Clinical Judgement and Historical Reconstruction,” in Science, Technology and the Art of Medicine, eds. C Delkeskamp-Hayes and MA Gardell Cutter (Dordrecht: Kluwer, 1993), pp. 231–249.
HM Evans, “Medical Humanities: An Overview,” in Priniciples of Health CAre Ethics, 2nd ed., eds. R Ashcroft et al. (Chicester: John Wiley and Sons, 2007).
This seems true of the four academic conferences to date of the UK Association for Medical Humanities in Durham, 2003; Swansea, 2004; Truro, 2005; and London, 2006 and to some extent, the 2006 meeting of the European Society for Philosophy of Medicine in Helsinki.
See H James, The Art of the Novel (New York: Scribner’s, 1948) from which Martha Nussbaum takes her title, “ ‘Finely aware and richly responsible’: Literature and the Moral Imagination” in Love’s Knowledge (New York: Oxford University Press, 1990), pp. 148–167.
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Evans, H.M. Affirming the Existential within Medicine: Medical Humanities, Governance, and Imaginative Understanding. J Med Humanit 29, 55–59 (2008). https://doi.org/10.1007/s10912-007-9051-z
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DOI: https://doi.org/10.1007/s10912-007-9051-z