In defence of utility: the medical humanities and medical education

Abstract

The idea that a study of the humanities helps to humanise doctors has become a leitmotif within the field. It is argued that the humanities (especially, literature) help to foster insights beyond those provided by biomedical training. Healthy young medics, it is claimed, can thereby gain significant insights into patienthood, and obtain important skills that may be valuable for their professional life. But the instrumentality of the humanities is not the only justification proffered for its inclusion in medical curricula. In this paper I critically examine the two overarching justifications recurrently cited in the mainstream literature—namely, (1) the instrumental worth and (2) the intrinsic value of the medical humanities in educating doctors. Examining these theses (and focusing on the views of a leading medical humanities scholar) I show that the bifurcation into instrumental versus non-instrumental justifications is not supported by the argumentation. Instead, I find that the particulars of the supposedly intrinsic justifications amount to an unambiguously instrumental defence of the humanities. Contextualizing the present investigation to probe further, I describe a long history of debate about the role of the humanities in British education and find that it rests on unsupported dichotomies (utility vs non-utility, theoretical vs applied, educated vs trained). I conclude that the medical humanities’ manifesto would be more intellectually honest and coherent, and provide a more robust defence of its value in medical education, if it chose to embrace a wholly instrumental rationale for its role.

Arts-based interventions in healthcare education

“…Charlotte Blease has advanced this debate by arguing that ‘intrinsic value’ motivations—which are justifications that emphasise not the usefulness of an intervention but its basic value to the healthcare professional—are somehow seen as the ‘nobler justification’ 11. This is contrasted with instrumental goals such as improving verbal communication skills.…”

Living with ‘melanoma’ … for a day: a phenomenological analysis of medical students’ simulated experiences

“…Compassion should be intrinsic to health care, but it is ever harder to promote this under the pressures of today's clinical education and practice. [1][2][3][4] Formal curricula and training may lead to a further disconnect between biomedical knowledge and empathic care. A wealth of evidence suggests that medical students' levels of empathy decline during medical school and residency, [5][6][7][8] although this may not be true of all medical schools and students.…”

“…Compassion should be intrinsic to health care, but it is ever harder to promote this under the pressures of today's clinical education and practice . Formal curricula and training may lead to a further disconnect between biomedical knowledge and empathic care.…”

Scholar spotlight on Dr Charlotte Blease and Prof Allan Peterkin

“…The first reason is that many scholars in fact go on to list instrumental justifications under the very rubric of ‘intrinsic value’. The second reason is that the distinction between ‘intrinsic’ versus ‘instrumental’ values appears to promulgate problematic, sharp dichotomies1—theoretical versus applied, educated versus trained. The medical humanities, in my view, needs to be very careful about falling into the easy rhetoric of the two cultures debate.…”