The Art of Medicine: Benchtop to Bedside
Through the Microscope is a reoccurring Helix column that poses an issue to our community of experts. We asked Dr. Jeffrey Bulger to address how the humanities are crucial to teaching and learning around the practice of medicine, health care and research.
The Art of Medicine is an ethical, humanistic and evidence-based profession. The ethical aspects of medicine are based on reasoned argument, the humanistic aspects are based on the experiences of the parties involved and the technical aspects are based on the assessment of scientific data. “Science asks: What is the evidence that this is the indicated course of care and treatment? Philosophy asks: What are the reasons for the moral choices made?” 1 The humanities ask: What are the experiences of the patient, family and healthcare team?
The Art of Medicine needs to be taught by not only exposing students to benchtop, evidence-based medicine, but also to bedside ethics and experiences that make up the “Art” in the Art of Medicine. Such an education can only be accomplished by a medical curriculum in which ethics and humanities are seamlessly incorporated vertically, throughout every one of the student’s courses, and horizontally throughout every year of the student’s education. “We should advocate not just for longitudinal but lifetime experiences in the humanities for the health of our physicians as well as our patients.” 2
For centuries, ethics has been an academic discipline of philosophy. Biomedical ethics as a branch of ethics has likewise been categorized as a branch of philosophy. In this light, the Scottish philosopher David Hume argued that from statements of facts, it is impossible to conclude a statement of ought. In other words, for any specific medical situation, it is impossible to determine what ought or ought not to be done simply by addressing facts alone, as cognitive philosophical analysis is the only way to make any type of humanistic ought determination.
This means that any attempt to practice pure evidence-based medicine is ludicrous, since it is epistemologically impossible for empirical facts alone to determine moral appropriateness or inappropriateness independent of philosophical analysis and judgment.
The Art of Medicine is a humanistic activity, and since humanistic activities are ethical activities, and since ethical activities are part of the academic discipline of philosophy, it therefore logically follows that the Art of Medicine is part of the academic field of philosophy. Philosophy, as represented by biomedical ethics and the humanities, is central to the lifelong education and practice of the Art of Medicine.
- Dunn M and Hope T, Medical Ethics. Oxford: Oxford University Press. 2018; pg. 27.
- Todd CY. Curriculum Inventory in Context. AAMC. May 2016. Vol. 3, Issue 5.
Jeffrey Bulger, PhD, is director of the Chicago Medical School’s Office of Bioethics and Humanities and a full-time faculty member in the Department of Foundational Sciences and Humanities. He has taught more than 30 different philosophy courses, including in biomedical ethics, theoretical and applied ethics, healthcare issues, public policy, professionalism and medical ethics research.
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