Can the Medical Humanities Make Trainees More Compassionate? A Neurobehavioral Perspective
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COMMENTARY
Can the Medical Humanities Make Trainees More Compassionate? A Neurobehavioral Perspective Daniel Shalev 1
&
Ruth McCann 1
Received: 12 September 2019 / Accepted: 8 January 2020 # Academic Psychiatry 2020
In recent years, the medical humanities have been increasingly incorporated into medical school and residency curricula. However, medical humanities interventions have been criticized for being amorphous in their objectives and outcomes. We argue that, though limited, emerging evidence on the neurobehavioral construct of empathy and the effects of humanities-based interventions on such a construct might provide a path forward in terms of operationalizing medical humanities education. To do so, we examine existing evidence suggesting medical humanities education may increase medical trainee empathy and then contextualize this evidence in a discussion of the neurobehavioral basis of the relationship between empathy and the humanities.
The Medical Humanities: What They Are, and Why We Need Them The medical humanities involve the study and/or practice of various humanistic endeavors (such as law, history, and philosophy) and arts (including music, visual, literary, and performing arts) in relation to healthcare. Although the medical humanities constitute an emerging field, medicine and the humanities have been linked since antiquity [1]. Many of the great physicians of pre-modernity (Aristotle, Hippocrates, Maimonides, and Chekov, among others) exerted influence not only in medicine but also in the arts and humanities, positioning medicine as part of—rather than separate from— intellectual and cultural life. More recently, American physicians up until about the mid twentieth century were often
* Daniel Shalev [email protected] 1
Columbia University, New York, NY, USA
closely integrated into their communities, standing as examples (at least in theory) of moral rectitude, and providing personalized, humanistic care to multiple family members—in the home, in the hospital, and over the lifespan. However, in the mid to late twentieth century, the humanistic aspects of medicine became increasingly deemphasized. Medical specialization and sub-specialization, rapidly evolving technologies, and the hegemonic biomedical model of medicine came to define medical progress, with more humanistic aspects of medicine receding into the background. Furthermore, system-level issues in the practice of medicine have placed increasingly restrictive documentation and administrative burdens on physicians. And the ever-expanding financial pressures of large health systems have decreased the quantity of time physicians have to spend with and think about patients in a humanistic frame. The results of these shifts in medicine include the decline in the traditional doctor-patient relationships, the emergence of challenging new ethical dilemmas, an increase in systemic restrictions and requirements, and mounting dissatisfaction with the experience of medicine among both patients and clinicians [2]. Perhaps in response to
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