Medical Humanities. Recognition and reorganization within the Italian University

In recent years specific changes have characterized medicine, that range from the patient’s principle of self-determination to the new subjective meanings of quality of life, wellbeing and disease. The need to address and manage these changes inevitably means the recovery of the traditional humanistic roots of medicine that, by an educational perspective, involve the presence of academic medical courses focused on a holistic and critical perspective of medical care (1), able to take into account the patients’ human experience (2) and to promote a sensibility that respects different point of views in various areas of ethics (3). Such an integrative and complementary vision could be achieved by the so-called “Medical Humanities” which, however, at present enjoy little consideration, especially within the medical context (4).

Main problems concern, on the one hand, the recognition of the Medical Humanities as a “scientific” field of study and, on the other hand, the definition itself of “Medical Humanities” (5). The Italian medical educational landscape does not cover, except in rare cases, the teaching of Medical Humanities and where it does, it relegates them to a mere ancillary role. Therefore, it needs for a rigorous analysis, able to select the subjects that could be included into the sector of “Medical Humanities” and then to reorganize them within the Academic system.

Medical Humanities could be defined as Humanities aimed at directly studying the medical dimension, such as medical ethics, medical deontology, bioethics, biolaw, philosophy of medicine, history of medicine, medical psychology, logics of clinical reasoning and narrative medicine.

Within the Italian academic medical area, medical ethics and medical deontology are included within the legal medicine sector, bioethics in both the legal medicine sector (as “clinical bioethics”) and the medical history sector (as “bioethics”), history of medicine in the medical history sector and medical psychology in the psychiatry sector (as “psychiatric aspects of medical psychology”). In Italian academic system, the “scientific sectors” are groups of disciplines that have been established by the Ministry of Education, University and Research with the purpose to facilitate teaching at higher level.

For their humanistic features and their irreducibility vis-à-vis to medical subjects, it seems necessary to revise this current academic placement of Medical Humanities, also integrating them with the subjects that are currently absent (biolaw, philosophy of medicine, logics of clinical reasoning and narrative medicine). A proposal could be the creation of a specific sector, named in Italian language “Scienze umanistiche mediche (corresponding to the expression “Medical Humanities”), which includes medical ethics, bioethics, biolaw, philosophy of medicine, history of medicine, medical psychology, narrative medicine, medical deontology linked to ethical aspects (retaining its traditional affiliation to forensic medicine as a result of related legal aspects).

Such an approach could achieve the following challenging goals.

• a) Academic teachers’ requested skills could be more clear. According with our proposal, only experts with a humanistic education on a specific Medical Humanities’ topic (without necessarily a medical degree) could compete to reach a teaching position in Medical Humanities. The Physicians without a humanistic degree could take part into this competition but with, at least, a humanistic specialization, such as PhDs or masters, able to guarantee the required skills.

• a) Research in Medical Humanities could be independent expert with respect to the medical area: researchers in Medical Humanities could enjoy own research lines, according to their free critical analysis. In addition, teachers in Medical Humanities could join the same department, with the possibility to strengthen their research activities.

• a) Medical Humanities could be protected in their academic importance. The position of a full professorship in Medical Humanities within the medical academic degrees could guarantee a constant practice of these subjects, against the current situation where courses in Medical Humanities are too often only an optional choice.