For at least the past several decades, medicine has been embroiled in a crisis concerning the nature of its professionalism. The fundamental questions that drive this ongoing crisis are primarily three. First, what is the nature of medical professionalism? Second, who are medical professionals? Third, what does medicine or these professionals profess or promise? In this paper, the professionalism crisis vis-à-vis these questions is examined and analyzed chiefly in terms of both Francis Peabody’s and Edmund Pellegrino’s writings. Based on their (...) writings, I introduce a conceptual framework for professionalism to address the crisis. In addition, I contend that to address the professionalism crisis adequately, medicine’s position within an evolving health care network must also be considered. To that end, I first discuss the genesis of the crisis in terms of the Flexner Report and especially Peabody’s response to it. Next, I explore how the crisis intensified during the twentieth century, particularly in terms of medicine’s ultimate scientification and eventual commercialization, and how Pellegrino reacted to this. I then propose a health care professionalism cycle and a care-competence cycle to provide a conceptual framework for addressing the crisis. I conclude that medicine’s position is no longer as the center of health care but rather as another node within a wider evolving health care network. And the resolution of medicine’s professionalism crisis depends on medicine’s positioning and defining itself in terms of the professionalism for each of the other professions within the health care network. (shrink)

Throughout its fifty-year history, the role of the medical humanist and even the name “medical humanities” has remained raw, dynamic and contested. What do we mean when we call ourselves “humanists” and our practice “medical humanities?” To address these questions, we turn to the concept of origin narratives. After explaining the value of these stories, we focus on one particularly rich origin narrative of the medical humanities by telling the story of how a group of educators, ethicists, and scholars struggling (...) to define their relatively new field rediscovered the studia humanitatis, a Renaissance curriculum for learning and teaching. Our origin narrative is composed of two intertwined stories—the history of the studia humanitatis itself and the story of the scholars who rediscovered it. We argue that as an origin narrative the studia humanitatis grounds the medical humanities as both an engaged moral practice and pedagogical project. In the latter part of the paper, we use this origin narrative to show how medical humanists working in translational science can use their understanding of their historical roots to do meaningful work in the world. (shrink)

This article examines J. G. Farrell’s depictions of colonial medicine as a means of analysing the historical reception of the further past and argues that the end-of-Empire context of the 1970s in which Farrell was writing informed his reappraisal of Imperial authority with particular regard to the limits of medical knowledge and treatment. The article illustrates how in The Siege of Krishnapur (1973), Farrell repeatedly sought to challenge the authority of medical and colonial history by making direct use of period (...) material in the construction of his fictional narrative; by using these sources with deliberate critical intent, Farrell directly engages with the received historical narrative of colonial India, that the British presence brought progress and development, particularly in matters relating to medicine and health. To support these assertions the paper examines how Farrell employed primary sources and period medical practices such as the nineteenth-century debate between miasma and waterborne Cholera transmission and the popularity of phrenology within his novels in order to cast doubt over and interrogate the British right to rule. Overall the paper will argue that Farrell’s critique of colonial medical practices, apparently based on science and reason, was shaped by the political context of the 1970s and used to question the wider moral position of Empire throughout his fiction. (shrink)