- Michael Cheng-tek Tai,Ph.D.
Chungshan Medical & Dental College, Taichung, Taiwan
Eubios Journal of Asian and International Bioethics 10 (2000), 84-85.
"Medical humanity is like the soul of medical curriculum, only when it is implemented that the medicine is animated." (Bor-shen Hsieh)
The tremendous development of medical technology in the last few decades has changed the face of medicine. Besides caring, medicine today can also cure and even change a person's personality, looking and his genetic structure. We must explore a medicine that is not just responsive to the body of the patient, but also to his feelings, his mind, his will, his imagination, his creativity, his aspirations, his values, his capacity for making ethical choices_in short, a medicine responsive to the whole life of the person who is a patient.
Rapid progress in the pharmaceutical field, in mechanical devices and medical skills has raised new questions upon us, such as; where and when does human life begin ? what is the moment of death ? what are the limits in the research and manipulation of man ? what is the meaning and the destiny of man ? what kind of biochemical, pharmacological, surgical, psychological and genetic treatments affect the identity of the human person ? Undoubtedly, Contemporary medicine bears tremendous responsibility for man's meaning, his well-being and the world in which he lives.
In the past, the doctor enjoyed freedom in his self-chosen relationship with his patients to whom he offered his services and who, in return, honor him. Today most countries' medical systems are socialized. The right to proper medical care is recognized as part of the most fundamental human right. Such a situation inevitably leads to a socialization of medical profession. The doctor has become one of the various social servants working for the government's health insurance bureau. Such a change brings us new concerns, such as unnecessary physical tests, prescriptions and operation, the deteriorating patient-physicians relationship, the unfair distribution of limited resources.... etc
The nature of medical service, medical progress and its responsibility oblige the medical professionals to re-think the purpose of medicine and to ponder on how it can act responsibly. To achieve this goal, medicine cannot isolate itself from the rest of academic world but must act in absolute solidarity with other disciplines by initiating a sincere dialogue with behavioral sciences, philosophy and theologyc. Without this new attempt, medicine may lock itself in an ivory tower seeing man only from a narrow diagnostic-prognostic angle. This is the context and perspective in which medical humanity is set.
Because of the broad scope of medicine, preventive, therapeutic and planning for the future, medical scientists must seek a holistic vision of man. The modern physician can no longer approach biological and medical decisions without being ready to raise fundamental human questions and search for answers to them. He must take a courageous step towards an understanding of freedom expressed in terms of social responsibility for the whole of humanity.
These new realities and changes compel medical educators to reconsider the content of medical education. Is our goal simply to train a physician skilled in treating diseases yet unaware of human predicaments and the complicated social fabric that make a person what he is?
The main concern of medicine used to be human physical condition, as it was believed that a person's illness was due to physical problems. But this understanding has been challenged and a new understanding developed that moves from a simple biomedical paradigm to psychosomatic and then biopsychosocial emphases.
Bernard Haring, a well-respected theologian and ethicist suggested that medicine has to pay attention from the present to the future, from an individual personalism of the patient-doctor relationship to a social-collective accountability of medicine and to the whole human society. Robert Veatch, director of Kennedy Institute of Ethics also advocates a medicine, which treats not only diseases but also illness of the person, implies that medicine in 21st century must be expanded from merely a biomedically-oriented science to a holistic biopsychosocial emphasis. The physicians of tomorrow must know not only how to treat physical diseases with empathy but also to take his responsibility seriously as healers of whole person to the whole Hunan society. To fulfil this mandate, the content of medical education must be re-examined and re-structured.
An emphasis on medical humanity is one of the moves we must take to respond to the new reality of medicine. Medical humanity, literally speaking, refers to those humanity courses having to do with medicine based on a biopsychosocial understanding such as medical sociology, biomedical ethics, medical psychology, history of medicine, communication between physicians and patients...etc. In reality, medical humanity, when properly planned and offered, will enable medical students to develop a new understanding of life and a concern to social justice. It is a design to help students develop a new value theory so that they will become people-oriented physicians. But in order for students to understand the basic human nature, more courses must be considered as social customs, religious beliefs, cultural traditions all effect our attitutes toward health, life, and even death. Thus, a philosophy of life, religion and cultural anthropology must also be introduced. Medical humanity covers a wide spectrum of social sciences and humanity. The purposes of introducing these courses are no other than:
In an Taiwanese expression : a superior physician heals the ills of a nations. An ordinary physician heals the brokenness of a person. An inferior physician heals diseases."
"Medical education is to pass on a humanized medicine so that medical students may understand, experience and grasp the humanistic philosophy of medicine and thus establish their own value theory, ethical standard and eventually their own life philosophy. Only when we reach this goal can we say our education has succeeded". ( A quotation from Dr.B.S.Hsieh: Introduction to Medicine. Taipei. Taiwan University Medical College, 1997:85)
See also: Michael Cheng-tek Tai, "The Teaching of Bioethics & the Training of a Socially Responsible Physician", EJAIB 10 (2000), 17-19.