What are the Medical Humanites? Two approaches competing for a definition.

December 2010 marked ten years from the birth of BMJ Medical Humanities journal. The anniversary was celebrated with an joint editorial by professor Martyn Evans (co-director, Durham Centre for Medical Humanities) and professor David Greaves (School of Health Science, University of Wales Swansea, Swansea).
The BMJ Med Hum was born first as a special edition, and then as a “spin-off” so to say, of the older and more established Journal of Medical Ethics. With the words of former editor Raanan Gillow, who was responsible for envisioning the need of a special edition, the creation of the Medical Humanities (hence, MH) journal filled in a “creative continuity between medical ethics and medical humanities”. The ten-year anniversary prompts a reflection not only on the first ten years and the future ten of the Medical Humanities journal (a topic already covered in the editorial by Evans & Greaves), but also on the state of the ‘discipline’ or ‘area of studies’ that takes this name.

Two are the main approaches that are competing today for a definition of MH. As pointed out by Evans, the emergence of a new sub-discipline is generally marked by the establishment of an academic journal, and of the community of scholars that revolves around it. While at a first glance this might seem what happened in the case of MH, a closer look will reveal that such analysis is not correct. The two concurrent views concerning MH are commonly referred to as ‘additive’ and ‘integrated’ view. According to the former perspective, MH emerged in the last ten years as a ‘new medical subdiscipline re-establishing and promoting the neglected relationship between medicine and the arts’. According to the latter view, instead, it is not correct to refer to MH as a subdiscipline, but it should better be understood as a ‘novel interdisciplinary perspective seeking to reunite arts and sciences in medicine, with the aim to provide a more rounded and humanitarian approach to medicine alltogether’.

As I see it, the existence of a journal or a community of academics do not constitute a defining characteristic of a discipline or sub-discipline. Instead, the existence of a common method of inquiry does. It does not seem to me the case that MH share a common method of inquiry and analysis (to note, this may not even be the case for the older sister of bioethics, as some recent discussion concerning the unity of the discipline seem to point out, and as there is no agreement on the methods to be employed in bioethics. See the Special Section of the Cambridge Quarterly of Healthcare Ethics published in the second quarter this year if you are interested in this discussion). In this regard, MH may be better understood as an interdisciplinary perspective which shares the common goal “to elucidate the experience of illness from the vantage point of the humanities”.

The interdisciplinary nature of MH is also evident in the make-up of the CHH scholars, who are affiliated to different departments (English, History, Art, Literature, Philosophy, Film Studies) but that converge in the same physical place everyday, and that may identify themselves to an equal or greater extent with the MH centre than with their academic department of affiliation. The interdisciplinarity of MH differs also in other regards from the interdisciplinary nature of perspectives not focused on medicine. Indeed, the support of the Wellcome Trust both in terms of public endorsement and of funding confer a stronger identity to the MH.

What some authors have identified as “weak academic credentials” for medical humanists could actually be interpreted as an added value of the field. The education and academic affiliation of the MH scholars will necessarily be grounded in different disciplines, but the MH scholars will converge towards the common aim of “representing illness through the humanities, and providing a humanities-based healthcare education and policy centered on the patient’s perspective“. Such a goal will inevitably require an interdisciplinary team work. Therefore, while the input (i.e. the academic background) could be classified as ‘weak’ as grounded in different disciplines, the same cannot be said of the output, in terms both of academic and of wider societal impact of the MH. Quite on the contrary. The multi-faceted projects of the CHH scholars represent an example of a successful output in academia with far-reaching implications on society, with projects ranging from the representation of illness in literature and art, to the analysis of the concept of well-being in mental illness and its implications on health policy, to the study of the role of nurses and women in cinema and in society, to the analysis of the concepts of ability and disability in relation to sports and the Olympics.

What may still be partially missing in MH today is the full awareness of the strength and potentialities of the MH interdisciplinary perspective. The CHH is actively involved in raising awareness in this regard, and is featuring a summer school on MH starting next Monday and running for three weeks at King’s College. More information on the summer school themes coming up soon on this blog. Stay tuned!

Further reading:

Evnas HM, Greaves DA. Ten years of medical humanities: a decade in the life of a journal and a discipline Med Humanities 2010;36:66-68 doi:10.1136/jmh.2010.005603

Special Section: Methodology in Philosophical Bioethics. Cambridge Quarterly of Healthcare Ethics 2011;20(2):159-276.

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2 comments

  1. A fascinating post. As the holder of a Ph.D from the only institution in the world that grants one in the medical humanities, I’ve spent no small amount of time working through some of these issues.

    My own thoughts, FWIW:

    Whatever else they are, the medical humanities are quintessentially interdisciplinary. It is difficult for me to see how anyone could legitimately gainsay this and claim that the MH itself constitutes a unique discipline. This seems almost self-evidently true to me. So I think one can immediately dispense with the idea of the MH as any kind of sub-disciplinary creature. Whether it constitutes a distinct field of inquiry is a separate question, but the MH is neither a discipline nor a sub-discipline, but seems to me to qualify as an effort to bring insights and modalities of a number of different disciplines into a cohesive whole not reducible to the sum of its parts. This implies that there is neither any common method of inquiry nor any unified research programme.

    While this last point is often regarded as a weakness of interdisciplinary studies, I reject that notion utterly. Indeed, it is actually a raison d’etre for an interdisciplinary approach; the world is not carved into disciplines that can exclusively be apprehended by common methods and unified research programmes. While the latter are important and powerful ways of knowing, there is a significant argument to be made that disciplinary approaches must be supplemented with interdisciplinary scholarship that attempts to integrate divergent insights and methods from distinct disciplines into something unique and irreducible.

    Of course, mastery of methods and deep understanding of scholarship in a specific domain is as important for interdisciplinary studies as disciplinary work, but my own approach to the MH has been to gravitate most closely to the disciplines in which I can claim proficiency (law, ethics, history, policy), and then build in/supplement those approaches with insights from other knowledge modalities, some of them second-order approaches in their own right (e.g., cultural studies, disability studies, etc.)

    This sounds a lot like some of the points you were developing in the second half of the post, and I am fairly confident in reporting that they reflect well the risks and advantages of interdisciplinary scholarship in general.

  2. Thanks a lot Daniel for this reply. Very insightful and even more as coming from somebody like you who spent quite a lot of time thinking this through. We should think about writing a paper someday together…like a small editorial or opinion piece for J Med Hum? Cheers

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