A new path for humanistic medicine

Understanding understanding in psychiatry

Originally put forward to defend history from the encroachment of physics, the distinction between understanding and explanation was built into the foundations of Karl Jaspers' 'phenomenological' psychiatry, and it is revised, used and defended by many still working in that tradition. On the face of it, this is rather curious. I examine what this notion of 'understanding' amounts to, why it entered and remains influential in psychiatry, and what insights for contemporary psychiatry are buried in the notion. I argue that it is unhelpfully associated with the view that the mental is epistemologically and methodologically autonomous, but that it nevertheless highlights an important lacuna in many views of psychiatry and the scientific study of humans more generally.

The Montescano effect: Being resilient through challenges and changes

Hospitals are places where you live a piece of your life, no matter you are healthcare professional, patient or caregiver. This editorial describes the humanistic approach to medicine adopted by the Montescano Institute, an Italian research and clinical hospital dedicated to the rehabilitation of neurological and cardiopulmonary diseases according to updated international guidelines. The aim of these “notes from the field” is to provide a sound example of humanistic clinical practice before, during and after the challenges posed by the COVID-19 pandemic. In this environmental each individual is indeed engaged in relationships, which trigger mutual empowerment and growth.

Frankenstein; or, the modern Prometheus: a classic novel to stimulate the analysis of complex contemporary issues in biomedical sciences

BACKGROUND

Advances in biomedicine can substantially change human life. However, progress is not always followed by ethical reflection on its consequences or scientists' responsibility for their creations. The humanities can help health sciences students learn to critically analyse these issues; in particular, literature can aid discussions about ethical principles in biomedical research. Mary Shelley's Frankenstein; or, the modern Prometheus (1818) is an example of a classic novel presenting complex scenarios that could be used to stimulate discussion.

MAIN TEXT

Within the framework of the 200th anniversary of the novel, we searched PubMed to identify works that explore and discuss its value in teaching health sciences. Our search yielded 56 articles, but only two of these reported empirical findings. Our analysis of these articles identified three main approaches to using Frankenstein in teaching health sciences: discussing the relationship between literature and science, analysing ethical issues in biomedical research, and examining the importance of empathy and compassion in healthcare and research. After a critical discussion of the articles, we propose using Frankenstein as a teaching tool to prompt students to critically analyse ethical aspects of scientific and technological progress, the need for compassion and empathy in medical research, and scientists' responsibility for their discoveries.

CONCLUSION

Frankenstein can help students reflect on the personal and social limits of science, the connection between curiosity and scientific progress, and scientists' responsibilities. Its potential usefulness in teaching derives from the interconnectedness of science, ethics, and compassion. Frankenstein can be a useful tool for analysing bioethical issues related to scientific and technological advances, such as artificial intelligence, genetic engineering, and cloning. Empirical studies measuring learning outcomes are necessary to confirm the usefulness of this approach.

A Medical Education Recommendation for Improving Sexual Health and Humanism and Professionalism

INTRODUCTION

Sexual health in the United States is poor, yet most physicians do not address the topic. Sexual health education (SHE) guidelines are available but not used. The lack of SHE in undergraduate medical education (UME) impacts sexual and general health outcomes, as SHE in UME increases physicians' awareness of and ability to address sexual health, which is bidirectionally correlated with other health.

OBJECTIVE

To design and assess the need, feasibility, and outcomes of an educational recommendation for increased incorporation of SHE in UME.

METHODS

Comprehensive literature review was used to assess current and future needs of SHE in UME and humanism and professionalism education (HPE). Qualitative analysis was used to assess a potential solution. The main outcome measure was an educational recommendation based on qualitative analysis of (1) the benefits of SHE and HPE in UME, (2) the SHE and HPE overlap, and (3) the potential effect of a formally combined delivery on UME and patient and practitioner outcomes.

RESULTS

Available literature on medical SHE supports increased SHE is necessary and should be incorporated into existing HPE whenever possible, secondary to numerous intersections. Qualitative analysis supports HPE could be enhanced when consistently exemplified through SHE, and this approach could be beneficial for (1) increased understanding, retention, application, and advocacy of both topics; (2) long-term improvement of sexual and general health at the patient and population levels; and (3) increased practice of humanism and professionalism, potentially resulting in better patient outcomes and professional satisfaction for physicians.

CONCLUSION

Cross-disciplinary qualitative analysis supports using SHE as the primary topic to teach HPE is a viable method to increase SHE and potentially creates physicians who address sexual health and practice with increased humanism and professionalism, leading to population-level sexual and general health improvements. Gordon EG. A Medical Education Recommendation for Improving Sexual Health and Humanism and Professionalism. Sex Med Rev 2021;9:23-35.

"Patient's lived experience" : New insights from the "scene" of deep-brain stimulation medical care

This editorial presents a special issue gathering four contributions about the patient's lived experience in the context of deep-brain stimulation. It aims at clarifying the meaning of such an experience and its scope for medical practice, the health system and its legal frame.