A small plea for more humanities in medical education

In 1910 a professional educator named Abraham Flexner published Carnegie Foundation Bulletin Number Four, also called the Flexner Report. Flexner visited all 155 medical schools in the United States and wrote a scathing report on the general condition of medical education in this country. Based on his findings, he made several recommendations for medical education reform, which for the most part were adopted by the medical schools (at least the ones that were not closed as a result of the report!). Part of the effect of the report was to ground and immerse medical training in basic sciences and scientific research.

A perhaps unintended consequence of the reforms the report sparked is that some medical personnel and researchers are well-versed in science, with data and empirical observation and precise methods, but lack acquaintance with the humanities. This has great implications for ethics. Data is important; all good ethics begins with good data. But scientific inquiry can only tell us what is, what can be done. It can say nothing directly about what ought to be done; that is, at least partly, the job of ethics. To get any deeper than very superficial ethical skimming requires engagement with the humanities, with the best thought and writing and wisdom and beauty of centuries of philosophy, theology, literature, social studies, and the arts.

The overweening optimism, bordering on hubris, exemplified in some research agendas such as genetic manipulation, cloning, or transhumanism might be tempered by conversation with the great thoughts and acts and perspectives of the past. The infatuation, bordering on worship, of the new and technological that imbues medicine and medical research today might be softened by realizing that it is not only the new and shiny that has value, but the old and well-worn also.

Would embedding scientific medical education in the humanities make the difference I hope it would? It is hard to say, but as long ago as 1926 Hugh Cabot, dean of the University of Michigan Medical School, wrote that “I am not prepared to admit at the present time that in the equipment of the practitioner a knowledge of science is of more real value than a knowledge of the way in which mankind has behaved in the past and how he is on the whole behaving at the present time. The problems of medicine, on the whole, are quite as likely to require sound judgment based upon a knowledge of history, sociology, philosophy and psychology as on the facts of science.”

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