The humanising power of medical history: responses to biomedicine in the 20th century United States
The humanising power of medical history: responses to biomedicine in the 20th century United States
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医学史的人性化力量：20 世纪美国对生物医学的反应
DOI：
10.1136/medhum-2011-010034
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发表时间：
2011
影响因子：
1.2
通讯作者：
J. Warner
中科院分区：
文献类型：
--
作者：
J. Warner
今天，大多数美国医学历史学家对任何声称医学史使医生、医学生或更大的医疗保健企业人性化的说法都会非常犹豫。然而，历史可以而且应该为现代医学服务，使其成为一种人性化的力量，这一观点一直是美国医学界的老生常谈。这篇文章探讨了这一思想从19世纪末开始的出现，正是现代生物医学开始崛起的时刻。在那些最积极地接受新版本科学医学的机构里，一些专业领袖警告说，对科学的忠诚推动了该行业的技术和文化成功，正在危及专业精神和医学艺术的基本人文价值。他们在历史中看到了一种使现代医学重新人性化、抵御文化危机风险的手段。虽然这种历史观的一些迭代非常持久，但附加在“人文主义”上的含义既多样又不断变化，并且在人文主义干预中为历史设想的角色也发生了转变。从20世纪60年代开始，作为对医疗机构假定的“非人性化”的更大文化批判的一部分，一些倡导者将病史作为一种工具来帮助塑造一种新型的人道主义医生，并对抗医疗保健系统中的社会不平等。随着时间的推移，历史作为一种人性化力量的理念几乎总是作为一种缺陷的话语发挥作用，这是对生物医学、医疗机构和医疗专业主义的明显缺陷的回应。
Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to ‘humanism’ were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative ‘dehumanisation’ of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency—a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.