Historically, medicine has been one of the most humanistic sciences, but with the rapid development of modern medical technology, people are enjoying the services provided by medical technology, but are increasingly critical of the dehumanizing tendencies of medicine.
The article argues that the rise of technological maximalism in the context of rapid development of medical technology is the main reason for the break in the humanistic tradition of medicine.
The article argues that the rise of technological maximalism in the context of the rapid development of medical technology is the main reason for the break in the humanistic tradition of medicine
However, with the changes in the spectrum of diseases and the transformation of the medical paradigm, the call for humanistic care in medicine has
begun to be taken seriously by the medical profession. However, people should also realize that medical technology and humanistic care can neither be
or lack nor replace each other, but need to maintain a balance and the necessary tension.
Keywords: medicine; humanism
The advances in medical technology in the 20th century have greatly promoted human health care. Modern medicine has become a huge comprehensive system that encompasses the exploration of the mysteries of life, the prevention and treatment of disease, the promotion of health, and the alleviation of pain and suffering. However, it is ironic that while human beings are enjoying the ever-increasing health care services provided by modern medical technology, people are puzzled by the dehumanizing tendency of medicine and have raised more and more criticisms, calling for a reexamination of the purpose and value of medicine, and looking forward to the revival of the tradition of humanistic care in medicine.
It has been a long time since medicine was first introduced to the world, but it is still a long time since it was introduced to the world.
I. Medical Humanism: A Break in the Tradition
Since the purpose of medicine is to save patients who are struggling with illnesses and suffering from physical ailments and mental pain,
the doctor, in addition to possessing useful and necessary knowledge, "should have all the qualities of a good philosopher: altruism, zeal, humility, calmness, and a sense of humor. , zeal, modesty, cool judgment, composure, decisiveness, and lack of superstition." Since ancient times, medicine has been recognized
as a discipline with the most humanistic tradition, and doctors as the most humane profession. In ancient China, medicine was called
"the art of benevolence," and doctors were known as "men of benevolence," and practicing medicine to cure the sick and administering medicines to help others was considered one of the ideal ways to show benevolence to others. In the West, the ancient Greek medical doctor Hippocrates believed that "medicine is the most beautiful and noble of all techniques
". Emphasizing the wholeness of the human body, the harmony and unity of the human body and nature is the ancient medical thinking of the East and the West *** with the same characteristics,
Ancient doctors in the process of healing is not confined to the treatment of diseased parts of the treatment, but rather advocate a holistic recovery of the organism.
They believed that "the human body is composed of coherent and communicating perceptual rings of its own parts, and when any one of them
is attacked, the whole body may be affected. ...... Thus even when a very small part of a person is injured, the whole body feels
pain, because the parts are interconnected." Therefore, doctors should not only pay attention to the treatment of diseased parts, but also
should care for their patients. The patient's physical discomfort often also leads to mental pain, not to mention that the disease is sometimes regarded as the upper
Cang's punishment for human bad behavior, the patient thus suffers from both physical and mental torture, so the doctor to relieve the patient
People's mental stress is also conducive to the recovery of physical disease. Ancient doctors emphasized the close connection between their love for medical technology and their love for their patients, partly because they believed that the purpose of medical practice was to relieve the patient's pain, or
at least to alleviate it. On the other hand, it is because they lacked effective means of treatment and relief, so
they tried their best to seek treatment and relief measures for the patient at the same time, pay more attention to the treatment of the patient's attitude and behavior
style, through the patient's sympathy, care, comfort and so on, to give the patient's emotional care.
The tradition of medical humanism continues not only in the therapeutic activities of doctors, but also condenses into the medical establishment - the hospital - that solidly embodies the spirit of charity and fraternity
. In the history of medicine, no matter in China or abroad, the rise of hospitals is always related to charity, care and concern
Wai. Ancient Rome, a philanthropist, in order to care for the poor and sick patients, sold his own property, founded
the first hospital. Su Shi, a writer in the Northern Song Dynasty, founded the "Anle Disease Workshop" to care for homeless patients during an epidemic. There were also "monastery hospitals" in medieval Europe and "
general hospitals" during the French Revolution, all of which took care of and treated the poor as their own responsibility, and were full of humanitarian love and care.
Medicine before the 20th century had a very limited ability to diagnose and treat disease, and even in hospitals it was little more than
a regimented care procedure. In the 20th century, medicine changed dramatically. Modern hospitals are equipped with a wide range of
diagnostic instruments and equipment: from X-rays, electrocardiograms, electroscopes, endoscopes, tracers, and diagnostic ultrasound to automated biochemistry
analyzers, CT scans, positron emission tomography (PET), and magnetic **** vibration imaging (MRI). With these instruments, doctors can accurately, dynamically, and automatically diagnose and analyze the causes of disease and functional changes in the body. Kidney dialysis machines, heart-lung machines,
pacemakers, artificial organs, etc. play an important role in clinical treatment, chemical drugs, organ transplants, reproductive technology,
Interventional therapy provides a variety of effective means of treatment. The emergence of modern diagnostic and therapeutic technologies has drawn doctors' attention from focusing on the patient to searching for the causes of disease, analyzing data that deviate from normal values, and discovering structural
and functional changes in cells or molecules. In order to diagnose and treat diseases more accurately and efficiently, clinical specialties and subspecialties have been established that are categorized according to the location or type of disease, where the patient is reduced to a living machine that needs to be repaired and
replaced due to damage to or malfunctioning of a certain part of the body. In order to facilitate the management of modern hospitals, the names of patients were replaced by semi-military numbers
and the individuality of the patient was dissolved by the uniformity of the classification of diseases. The development of medical specialization has led to the disintegration of the health care process, in which the word patient in the vocabulary of modern medicine has been broken down into individual words such as etiology, pathogenesis, symptoms, signs, and so on
, and the suffering of the patient has been transformed into the values on the test forms and various kinds of image pictures. Thus, the patient as a whole
has been gradually dissolved in the process of modern medical treatment. Although the care of the patient is still mentioned,
that has been outside the scope of modern medical technology. The humanistic spirit in medicine has lost its luster under the wash of modern science and technology
.
Second, technological maximalism: the alienation of medicine
Prior to the twentieth century, the progress of medical technology was quite slow, and doctors were able to solve the problems of their patients to the best of their ability with a limited number of medicines and with the experience gained from practice
. In the 20th century, the situation changed more radically, as medicine
acquired not only the weapons to eradicate and control disease, but also the codes to manipulate life. With the rapid development of medical technology, "technological perfectionism" has locked people in the ambitious fantasy that medicine "can do, must do"
: human beings can eliminate all diseases and pains, and all human organs can be replaced like machine parts after they are damaged. all human organs can be replaced when they break like parts of a machine. New technologies have had a profound effect on doctors' behavior and on the doctor-patient relationship. The constant updating of diagnostic techniques has led doctors to spend more time in the laboratory than at the patient's bedside, listening to the patient's statement and talking to the patient. Doctors have become more concerned with
physical problems and have neglected the patient's emotions because physical problems can be measured, emotional problems cannot, and doctors
believe that if the physical problem is solved, all other problems will be solved. In short, modern medicine attempts to dismantle the nontechnical dimension of
medicine with technology.
The modern hospital environment also seems hardly conducive to valuing the spiritual. Daily routines are ruled by mechanical dialing,
buttons, and computers, all of whose operation is essential or even vital. The mechanization
, automation, and computerization of diagnostic treatments have kept doctors away from non-technical contact with their patients, leading to depersonalization, assembly
line, and supermarketization of medical procedures. Death is seen as the disintegration of molecules, and disease is seen as an abnormality in cellular or molecular structure and function
. Hospital operating procedures pay little attention to the patient's feelings, which is perhaps to be attributed to the fact that effective instruments have not yet been invented to test for fear, distress and dis
pleasure. Since time is money, then, in the name of efficiency, the amount of time given to the individual patient
is minimized. Under intense time pressure, medical
staff exhausted by the queues of patients outside waiting rooms are unlikely to be a source of sympathy. In addition, there are unanticipated consequences of medical advances themselves: an increase in medically and pharmacologically
induced illnesses - illnesses caused by drugs or diagnostic and therapeutic procedures. The emphasis on medication and the management of other aspects of disease
control has led people to place all their trust in relying on medication and surgical procedures, to the point where it has created the modern superstition that medication
guarantees health. It has been reported in the United States that 30 to 40 percent of all surgeries should not be done. Of the thousands of drugs
that are available, only 10% are effective, 30% are dispensable, and 60% are not effective at all. A similar study in Britain
shows that only 15 percent of drugs actually work. Blindly relying on diagnostic instrument data without comprehensively questioning and examining the patient has also led to
a rise in clinical misdiagnosis.
It is worth noting that the underlying motivation behind the promotion of technological maximalism is the pursuit of greater financial gain. There is no doubt
that high technology will lead to high profits, and here the medical profession shares *** the same joy as drug and biotech companies. The efficacy of gene therapy has been widely touted since clinical trials of gene therapy began a decade
ago, but of the hundreds of gene therapy
trials, none has yet unambiguously demonstrated clinical efficacy. While we must recognize that scientific inquiry
is not a straight path and requires hard work and even the price of failure, it is nonetheless important to be wary of the negative impacts of high technology
and of the negative effects that some unrealistic promises can have on all who are interested in the field and lead to decisions
that are contrary to the best interests of science, patients, and society. Disturbingly, this lack of objectivity due to conflicts of interest
involves not only individuals but also academic institutions. For example, in a 2000 issue of the American miscellany
Science
, an editorial was published titled "Gene Therapists, Cure Yourself First". The editorial was written by Leon E. Rosenberg, a professor of medicine at PrincetonUniversity and former president of the American Society of Human Genetics (ASHG), who was extremely concerned about recent widely
reported deaths in gene therapy trials and warned against the rush for quick results and the tendency to raise expectations for gene therapy. and warns against the tendency of gene therapy to induce the public to expect too much from gene therapy. While this is not a blanket rejection of gene therapy as a field of clinical medicine, it is a reminder that it should be viewed with greater scientific rigor.
We should also see that some of the "high technology" that is currently being promoted is neither smart nor efficient, but perhaps
just expensive. Lewis, the famous American medical doctor, called it "halfway technology" (halfway technology)
, such as coronary artery bypass grafting is often re-stenosis, the patient's quality of life is not high, coronary artery endoluminal angioplasty
(PICA
) is also
, and so is the intensive care unit.
(PICA
)
This is in addition to the dying patient in the intensive care unit (ICU), who is lying in a bed with an artificial respirator and tubes
. U.S. academics report that half of their health dollars are spent on saving patients who have only six months to live, while 40 million people, more than half of whom are children in particular, lack basic health care.
This shows that the cost of health care, while somewhat proportional to the length of life, is not necessarily effective in improving
quality of life and health status. Clinical medicine emphasizes that extensive and expensive treatments, while saving the lives of some critically ill patients
and delaying the process of death, do not fundamentally address health problems. As time progressed, people began to realize
that a purely unconditional reliance on medical technology to protect and prolong life was inadequate, and that this tendency to treat disease in isolation from the patient, to treat the patient as a "physical substance" or a "machine for life," could lead to the creation of a new kind of health care system, one in which the patient was treated as a "physical substance" or "machine for life.
This tendency to treat disease in isolation from the patient and to view the patient as a "physical substance" or a "machine for life" can lead to the deformity of health care and
the heavy financial burden it places on patients and society. The alienation of medicine is increasingly criticized: specialization dissolves the
holistic human being, technologization ignores the human psyche, and marketization disregards human emotions. How to solve the contradiction between the development of high technology and
appropriate technology; harmonize the contradiction between caring for the patient and treating the disease has become an urgent problem for modern society
.
Three, medical humanism: an urgent call
Despite the brilliant achievements of medicine in the 20th century, people's response to the advancement of medical technology nowadays
is that "the better we do, the worse we feel". After the 1970s, there was no longer blind optimism about the success of medical technology
. costs and inequitable distribution of health resources. In this context, there is a sense of disillusionment with the promise of developing medical technology to enhance
and improve health and quality of life, and skepticism about the efficacy and fairness of the modern health care system.
. It has been noted that "medicine sometimes seems to be led by elites interested primarily in developing its technical capabilities,
with little regard for its social purposes and values, let alone the suffering of individual patients." There are also scholars who feel that, "
Just as we don't believe that the purpose of the arms industry is to defend national security, we have difficulty believing that the pharmaceutical and health care industries
are intended to promote human health." They criticize the modern health care system for having evolved into a "medical-industrial complex," and the free-market economic system in which "high-tech-high-cost <
High-tech-high-cost-high-benefit" has become the goal of the "medical-industrial complex" in a free market economy. It is not surprising, therefore, that since the 1970s, the public has become increasingly antipathetic to the "medical-industrial complex," preferring traditional medicine or naturopathy that treats them more humanely.
To this end, the medical profession and society as a whole are urgently calling for a new turn in medicine, a redefinition of its purpose, and a focus on humanism. The emergence of the patients' rights movement, the self
health care movement, the naturopathy movement, and the holistic medicine movement in Western countries in the 1970s, the birth and development of bioethics, as well as the introduction of the
biopsychosocial medicine model in the late 1970s, have all fully demonstrated that medicine has begun to
take a new turn, i.e., to move from the perspective of a medical doctor to a medical doctor. There is a new turn, that is, from the tendency to explore the causes and treatments of diseases in terms of
biological factors, to a three-dimensional, networked, multi-dimensional examination of health
and disease problems. At the same time, with the deepening of life science research, people more clearly recognize the limitations of biological
mechanisms and the overall organic connection of human beings. The medical profession is surging with the thought of returning to human beings, society and humanities
, emphasizing that the purpose of medicine is human-centered, and that medicine is not only the treatment of disease (cure), but also the care and attention of the sick
persons.
However, it is not easy to reverse the mindset formed by the long-standing biomedical model. Even now, many
doctors do not fully recognize the limitations of the biomedical model and do not understand the nature and value of medicine. In a technological society
that emphasizes quantitative information from the hard sciences and shuns ambiguity and pluralism, people are embarrassed by philosophical
scientific questions about the value of life and the meaning of disease. But in the case of medicine, which is constantly confronted with sickness and death, the consequences are unimaginable if doctors ignore the value of their patients
and fail to explore the meaning of life and the purpose of medicine.
A good doctor is one who is committed to practicing the best possible health care for his or her patients. The challenge for the modern physician is to maintain a balance between scientific and technological knowledge and
humanistic literacy. The most important step in addressing this issue is to emphasize that becoming a doctor requires knowledge not only of the natural
sciences but also of the humanities and social sciences. Hippocrates, the ancient Greek medical doctor, said
that the best way you can treat people is by your love for them and your interest in their affairs. The famous American medical doctor and humanist
ist W. Osler pointed out that "as a doctor you need to constantly remind yourself that when you see a patient, you should sit down
even if it's just for 30 seconds, and the patient will be relaxed as a result, and it will be easier to exchange ideas, or at least to feel that the doctor is willing to take the time to
take an interest in his patient. interest. This is the basic philosophy of the physician." At present, countries in Europe and the United States have y recognized the need to strengthen the medical human
literacy and social science knowledge education, many universities' medical schools and clinical hospitals have set up corresponding courses and practical
practical training to promote the combination of medical science and humanism.
China's traditional medicine is humanities-led medicine, with rich resources of humanism. For example, it attaches great importance to the ethical value of medical practice, emphasizes that medical activities are centered on the patient rather than the disease, regards the patient as a whole person rather than a damaged machine, carries through the idea of respecting and caring for the patient in the process of diagnosis and treatment, advocates the establishment of a cooperative relationship between doctors and patients, and regards "medicine is a benevolent art" as the principle of medical science and humanism. The humanistic legacy of medicine is still alive and well in the world. These invaluable heritage of medical humanism has shone with attractive light in
modern society. Regrettably, under the influence of western medical technology, China's medical profession has shown a similar phenomenon of emphasizing technology over humanism, and the tendency of neglecting humanistic care has appeared even in the clinical practice of traditional medicine.
How to rebuild scientific medicine in modern society? How to re-establish the balance between scientific medicine and humanistic medicine in modern society is also a difficult problem for the Chinese medical profession
.
Why is the importance of humanistic issues in medicine talked about so much and changed so little? It may be due to the lack of appropriate tests
of humanistic education in medicine. The nature of "soft disciplines" is difficult to measure, especially since training a doctor who is both scientifically minded and
full of humanistic spirit requires a long period of practice, and is not as immediately effective as learning a specialized skill, not to mention the fact that humanistic spirit is not simply knowledge learned from books, but is mainly learned from life experience and clinical process.
What is more, humanism is not simply knowledge learned from books, but mainly from the experience of life and clinical process
understanding and experience.
Fourth, medical humanism: the response of science
With the development of medicine, people are more and more y aware of the overall connection between various medical disciplines as well as medical technology and humanities and social sciences
and make it clearer that the development of medical technology and humanistic care are inseparable. As Planck, the famous German physicist and Nobel laureate, pointed out, "Science is an inner whole, which is broken down into separate whole
Bodies do not depend on the nature of things, but on the limitations of human understanding of things. There is in fact a continuous chain from physics to chemistry
and through biology and anthropology to the social sciences, a chain that cannot be broken anywhere.
"
Under the influence of mechanical materialism, modern medicine has gone from the art of conversation to the technology of silence. Many doctors believe that in
diagnosing a disease, objective indications, such as finding a lesion and detecting an abnormality are more important than the subjective feelings of the patient, and that X-rays, electrocardiograms
graphs, laboratory tests, of the results of the hormones, chemotherapy, antidepressants, and CTs are highly effective tools that do not require more than words
words. Doctors see little value in language in the fight against disease and have become accustomed to not using language as a therapeutic tool.
The general public also believed in the technical devices. Although some doctors do recognize to some extent that their words have a therapeutic effect on some
patients, they have never thought of it as a scientific thing, nor have they wanted to use language as a therapeutic tool.
Modern scientific research suggests that the therapeutic value of discourse, especially talking to patients in diagnostic treatment, should be taken seriously by clinicians
. Clinicians should be aware of the value of using language as a therapeutic tool and avoid its side effects, which are sometimes
toxic.
As early as Homer's time, there were applications of language to benefit the patient: e.g., benedictions, in which the speaker encouraged the patient and provided
humanitarian support; prayers to God pleading to intervene in ailments; and magical incantations, to ward off demons. Aristotle believed that catharsis of repressed
emotions was therapeutic. In China's ancient medical classic, the Spiritual Pivot? Shi Chuan", the therapeutic effect of language is also eloquently
discussed: "The feelings of human beings, all are not evil to death but happy to live, tell them of their failures, speak to them of their goodness, guide them to what they want to do, and open them
to the pain they suffer, even though there are people who have no way of doing things, and there are people who are wicked enough not to listen to them." With modern advances in neuroscience, immunology, and endocrinology
many studies have addressed the effects of emotional states on the production of certain chemicals and the secretion of certain hormones. For example
, brain endorphins are endogenous morphine-like substances whose products or secretion may in fact be influenced by a variety of external factors. People
have gained a deeper
understanding of the holistic nature of the human body and the organic connection between the body's functional state and its ability to resist disease through the realization of the interconnections and interactions between the immune system, the nervous system, and the endocrine system. As a result, the doctor's use of
language as therapy became scientifically easy to understand because he knew how to influence the patient's emotional
state in an appropriate way. Here again, science brings us some new concepts and a reasonable
explanation of the therapeutic significance of the physician's speech.
In fact, many highly qualified physicians have experience in this area. Bernie Lown, a Harvard cardiologist, says the most
important therapeutic start may be when a doctor meets a heart attack patient in the emergency room and tells him that everything is under
control and that he will be fine. In this case, language is used in therapy as a relationship of trust. Studies of placebos
also suggest that a trusting connection between doctor and patient can ease pain or reduce the need for painkillers. Patients who have the courage to face their cancer have been shown to have better outcomes in cancer treatment
than those with negative attitudes. This is not to suggest that
doctors should acquire the skills of faith healers or to expect the magic of discourse therapy, but rather to emphasize the importance of maintaining an appropriate balance between the enormous power of science and technology in the hands of the physician and the humanistic aspects of treatment. Physicians' medical practice must be grounded
in a scientific foundation, but they can learn a therapeutic emotion that seems to be possessed only by unorthodox physicians. Discourse therapy needs to be
explored and researched so that it can become an integrated part of the medical sciences and arts, and become even more alluring in the 21st century.
V. Medical technology and humanism: the necessary tension
Since medicine is a science directly related to human life, medical technology is the art of promoting health and reducing diseases, and
health care is a cause related to human happiness, medicine should be the best combination of science and technology and humanistic care
. "Heaven and man are one", the penetration and integration of science and technology and humanism is the ideal goal of modern medicine. However, in
practice, people have found that it is not easy to realize this ideal integration, and there is still a long way to go. People have to
recognize that we will still face the constant conflict between science and technology and humanism for quite some time.
With the development of society and the improvement of living standards, human beings' demand for health care is increasing, and the development of medical technology
provides a guarantee to meet the growing demand for health care, so the direction of the development of medical technology and the fundamental
purpose of human beings is the same. However, we should also see that the rapid development of medical technology will continue to challenge the spiritual life of mankind
and traditional moral norms. We have already encountered the heavy economic burden that the uncontrolled application of modern medical technology has brought to individuals, families
and society, and we will also face the unpredictable potential impact of human cloning and artificial brains on human society. With life support systems blurring the boundaries between life and death, and transgenic animal organ transplants breaking through the
Interspecies barrier, when Stephen Hawking, "the man with only his head left," is confronted with babies born from in vitro fertilization of sperm and eggs cultivated in rats and then transplanted into
embryos, he may be tempted to write a "brief history of life. "A Brief History of Life."
On the one hand, human beings need to vigorously develop medical technology to safeguard and promote their own health, and have to break through the traditional concepts
and rebuild values and morals, such as the quality of life concept, the value of life, the concept of brain death, which fully reflects that the human
human society has to build up a new set of value system to. On the other hand, mankind is also alert to the adverse effects of high technology
and seeks to ensure that it serves the interests of mankind, to avoid its negative effects. Recognizing that medical technology is a double-edged sword that can benefit mankind
as well as cause disasters for mankind, maintaining this tension between medical technology and humanism will be conducive to the harmonious development of
medical technology and social culture. Here, it is very
important to ensure the legitimacy of the application of technology with humanism. Scientific medicine guides what is proper and effective treatment, and humanistic medicine guides what is good treatment. In this
case, the doctor will say to the patient, I have the knowledge and I will use my best knowledge to provide you with the best
service you need.
Medicine in the 21st century is no longer just a complex system of science and technology, but it has also become a huge
social service system. The integration of medical science and humanism implies not only the care of the individual patient, but also
the care of the group: to ensure that every citizen can share in the achievements of medical technology. Although limited in providing medical
health services to all citizens, it embodies the pursuit of the principle of equity in health care for all and the minimum social conscience
to ensure that medical technology advances along the path of benefiting all mankind. Therefore, the promotion of humanistic care in medicine is the main theme of medical
development in the 21st century, which is not only the requirements of doctors, but also the expectations of the entire health care service.