|Year : 2010 | Volume
| Issue : 1 | Page : 465
In the News! An opinion Use of Humanities in Health Professions Education
J van Dalen
Associate Editor, Education for Health
|Date of Submission||27-Mar-2010|
|Date of Web Publication||20-Apr-2010|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
van Dalen J. In the News! An opinion Use of Humanities in Health Professions Education. Educ Health 2010;23:465
At regular intervals we hear rumors about financial turmoil of Health Care. Just as recent as the week in which I write this article, the passing of the new Health Care Reform Bill in the USA was accompanied by fierce debate of its cost, while in the Netherlands major plans for cutting down expenses in health care are leaking out to the public.
Tough times indeed, and for dedicated staff members committed to preparing health professions students to contribute to proper health care in the future, it is difficult to stay optimistic. When addressing health care in troubling times, we often think about the basics (equity in health care, health for all), whereas humanities in the profession are seen as the fringe.
When health care is under financial fire, which priorities are set and how is this being done? Which arguments do promoters of humanities in health care actually use to support their claims and what is the value of these arguments?
Precisely this is the topic of a paper by Edgar and Pattison1 that appeared as long ago as 2006. In this paper the authors depart from the point of view that: “Medical humanities should not simply consist of the transfer of ‘good’ and ‘delightful’ arts and humanities to the situation and practice of health care. It should be a place where the humanities disciplines, too, are subject to hard questioning and, perhaps, fundamental change.” “It is not good enough just to ‘like what we do’”. “Nor does it behoove us to justify our work and existence on the utilitarian, instrumental basis that it contributes to the leisure economy (books publishing, films, theatres, etc.), or that it provides students with transferable skills such as writing and analysis.” The authors suggest that all disciplines connected with humanities are united in asking one important question: what is it to be human? Their grounding contention is that the products of human existence (artworks, belief systems, political structure or science and technologies) are shaped by and are expressions of some deeper beliefs about what human beings are and what human beings ought to be. Edgar and Pattison1 also state that the present age is dominated by ‘instrumental reason’, a specific form of rationality focusing on the most efficient or cost-effective means to achieve a specific end, but not in itself reflecting on the value of that end. Thus, to the extent that rationality is concerned with critically evaluating actions, instrumental rationality tends to focus on the 'how' of an action, rather than its 'why'. The humanities, in contrast, have little or no instrumental purpose. In their view, “At best, good medical humanities may, instrumentally, contribute to better scores in patient satisfaction surveys, even if they do nothing for the efficacy of medical treatments.”
In defense of the value in humanities, the authors turn to Kant’s distinction between ‘craft’ and ‘art’, where the ‘craft’ object has an extrinsic purpose and ‘art’, as an object of beauty, has no extrinsic purposes. They justify humanities by their intrinsic value. “The intrinsic value that matters is that of being human.” This way, the work of art makes explicit our self-understanding. Art offers ways of seeing the world that express communal experience and values. This can be painfully witnessed in the many television series taking place in hospital settings, from ER and House to Scrubs, among other international examples. These drama series give a caricatural presentation of the values the viewers have in common and, in return, these values are influenced by the drama series. Since these communal values may inform ethical decision making in medicine, the ethical values run the risk of being corrupted; that is why I used the word ‘painfully’, above.
These insights are driven by artistic values, rather than by scientific progress. The authors conclude that “answers (…) can come only through a combination of the arts (including art, religion, secular speculation and historical narratives) and the critical disciplines of the humanities.” This allows the ‘why’ of humanities to be answered by imaginative, critical and disciplined argumentation among “people like us” –and, as significant in the context of ostensibly universal health care provision in a pluriform nation, “people like you”.
The paper is not easy to understand. However, it exemplifies a philosophic way of thinking that allows the importance of humanities in the health care context to be justified with more than: because…
You cannot get much more scientific than that.
Jan van Dalen
Education for Health
1. Edgar A & Pattison S. Need humanities be so useless? Justifying the place and role of humanities as a critical resource for performance and practice. Medical Humanities. 2006; 32:92-98.