Medical Humanities最新文献

Artificial intelligence (AI) is transforming clinical practice while simultaneously raising concerns about trust. Drawing on complexity theory, this paper argues that the crisis of trust in medical AI is rooted in multiple forms of uncertainty, including non-causal statistical relations, system-level complexity and the irreducibility of clinical judgement. It introduces a 'U-map' (Uncertainty Map), a conceptual tool that links specific forms of uncertainty to role-appropriate clinical uses such as screening, triage or deliberation aid. Using this map, the paper calibrates model claims against distinct clinical epistemic roles and develops a multidimensional account of trust that spans technological reliability, institutional governance and cultural-emotional orientations. On this basis, the paper sketches a posthuman model of care in which human-machine collaboration and distributed accountability offer a more adequate response to the normative and epistemic challenges posed by medical AI.

Family members, relatives and friends are all affected when someone is hospitalised with a life-threatening illness. However, they often feel neglected and sometimes ignored by healthcare professionals. To address this, the reading of literature has been used in various clinical contexts in an attempt to humanise the care of patients and their relatives. Reading fiction enables healthcare professionals to imaginatively enter relatives' perspectives, fostering a deeper understanding of their experiences, which may in turn enhance family-centred care in clinical practice. However, research on how healthcare professionals engage with the reading of literary texts and what they discuss in such contexts has not yet been explored. This article presents findings from a qualitative study exploring a reading group for nurses at a hospital ward in Denmark, where literature on kinship was read and discussed. We examined the following specific research question: What takes place when nurses join a reading group in a clinical context to read and discuss literature on kinship?Based on a hermeneutical analysis of four audio-recorded reading group sessions, we identified the following three themes: (1) awareness of kinship and the negotiation of norms, (2) engagement with various perspectives and (3) acknowledgement of emotions when caring for family members. These themes are discussed in light of Felski's concept of recognition as knowing and acknowledgement. Additionally, by applying Meretoja's theory of narrative agency, we demonstrate how reading literature in a clinical setting can foster narrative agency, enabling nurses to expand and clarify their understandings and assumptions of kinship based on their ability to navigate and influence what Meretoja terms their 'narrative environment' in a clinical context.

Ferdowsi's Shahnameh, composed around 1000 CE, contains a remarkable narrative of the birth of the Persian hero Rostam, which describes a procedure resembling a caesarean section, termed 'Rostam-zad' or 'Rostamina'. This account, predating Roman associations with the procedure, offers insights into ancient Persian medical practices, including surgical techniques, anaesthetic methods and postoperative care. The story details a lateral incision, the use of a cannabis and camphor concoction for pain management and suturing with a healing salve, culminating in maternal survival-a rare outcome in ancient surgical births. By analysing this narrative, this paper explores the intersection of myth and medicine, highlighting the sophistication of Persian medical knowledge and challenging Eurocentric narratives in the history of medicine. The Shahnameh's depiction not only reflects empirical surgical and pharmacological practices but also underscores the role of epic literature in preserving medical history, offering valuable perspectives on the cultural and scientific heritage of ancient Persia. This article also draws on contemporary scholarship, offering a comparative exploration of this cultural and medical tradition alongside Greco-Roman, Indian and Islamic medical texts. Additionally, the article clarifies that Ferdowsi's purpose in composing the Shahnameh was primarily to preserve the Persian language and mythohistorical identity, not to record medical procedures. The present study treats the narrative of Rostam's birth as a 'mytho-medical' episode, a symbolic story that nevertheless preserves empirical medical knowledge embedded in Persian cultural memory.

This article examines how kisses and knocks in Marcel Proust's The Way By Swann's and Samuel Beckett's Molloy serve as coping mechanisms to combat fear-driven insomnia. Since childhood, the Proustian narrator endures insomnia, finding solace either in his mother's tender kiss or its cherished memories. In contrast, the adult eponymous protagonist in Samuel Beckett's Molloy develops child-like anxiety about embodying his old mother's neurodegenerative afflictions by sleeping in her bed. Molloy's fear not only shapes the dynamics of his relationship with his mother but also the general maternal figure-son bond. This becomes evident when he absconds from Lousse's home and rejects her care when she replaces her dead dog with Molloy. Although the Proustian narrator and Molloy have profoundly different relationships with their mothers, it is evident that fear underlies the emotional complexities of their mother-son bond. While the former is afraid of being abandoned by his mother, the latter is scared of mirroring his old mother's neurodegenerative illness by sleeping in her bed. The fear-oriented mother-son relationship impacts their quality of sleep. Hence, the Proustian narrator uses his mother's kiss as an antidote to insomnia. On the other hand, Molloy knocks on his sleeping mother's head, emphasising the transactional nature of their relationship, thereby rejecting their genetic relationship as he is scared of inheriting her illness. Here, Mary Ainsworth's pioneering research on developmental psychology helps us delve deeper into the emotional intricacies of the mother-son relationship that cause sleep disorders experienced by the Proustian narrator and Molloy. This paper aims to bridge gaps in the existing scholarship on Proust and Beckett by examining the impact of mother-son relationship on the protagonists' quality of sleep and their coping mechanisms to combat insomnia.

In an era of technological acceleration, clinical evaluation is increasingly governed by digital diagnostics, algorithmic protocols and standardised efficiency. While these advances improve precision, they risk reducing the clinical encounter to an impersonal transaction-undermining the clinician's role as an ethical witness to suffering. This review essay proposes the concept of sacred attention as a necessary complement to the biomedical gaze: a cultivated, ethically attuned mode of presence that reclaims the human depth of clinical care.Drawing on the Indian literary and philosophical traditions of Rabindranath Tagore and Adi Shankaracharya, we reframe clinical empathy not as an affective impulse but as a contemplative practice. Tagore's vision of ananda dhara (the eternal stream of bliss) evokes a poetic theology of dignity, inviting clinicians to perceive the sacred within the mundane. Shankaracharya's affirmation chidananda rupah shivoham ('I am of the nature of blissful consciousness') offers a non-dualist ontology that critiques hierarchical detachment and affirms relational reciprocity in care.This framework has specific clinical and pedagogical relevance. We explore how sacred attention can recontextualise the physical examination as an embodied ritual, transforming it from procedural touch to ethical presence. We also examine how medical education can integrate literary-philosophical traditions to cultivate inner stillness, reflective awareness and relational depth in future physicians.By positioning sacred attention as a pedagogy of perception, this essay contributes to the medical humanities discourse on empathy, presence and rehumanised care. Healing, we argue, requires not only technical knowledge-but the moral clarity to truly see.

This paper proposes an approach to designing equitable decentralised clinical trials (DCTs) to address ongoing structural disparities in clinical research. Continuing historical legacies of exploitation in clinical trials, such as unethical medical experimentation on vulnerable populations, combined with global power asymmetries, has resulted in global access gaps where over two billion people lack essential medicines and vaccines often developed through these very trials. Guidelines such as International Council for Harmonisation of Good Clinical Practice uphold ethical compliance for the protection of the rights, safety and well-being of human participants involved in clinical trials. Despite this critical role, these guidelines remain inadequate for confronting the deeper legacies of structural harm. DCTs offer a potential paradigm shift to expand participation by integrating digital health technologies and local networks. However, without deliberate attention to a justice-oriented design, they risk reproducing the same inequities they seek to overcome. We, therefore, draw on futures thinking and design justice to propose three interdependent strategies: (1) anticipatory justice, (2) institutionalising reciprocity and (3) relational accountability. Such an approach invites a shift in how innovation is imagined and enacted in clinical research, one that anticipates future challenges, foregrounds local voices and offers a pathway toward more just and equitable global healthcare systems. When grounded in equity and co-creation, DCTs could evolve from methodological innovation into a moral infrastructure: one that redistributes power, protects against duress and reimagines clinical research as a practice of solidarity and shared flourishing.

This article examines how composing and interpreting comics in a narrative medicine classroom can improve medical students' capacity to tolerate uncertainty. The study, conducted in The Ohio State University course From Page to Bedside: Literature for Physicians, invited students to read Julia Wertz's Impossible People: A Completely Average Recovery Story and then respond in both written and comic form. Twenty-four medical students participated. Their written and visual responses were analysed qualitatively for patterns in affective engagement, self-reflection and interpretive openness. Students reported that comics released them from perfectionist tendencies and invited experimentation that was not possible in their other coursework. While the findings are limited in scope, the study suggests that comics complement narrative medicine's goal of helping practitioners recognise the partiality and contingency of clinical understanding to see their picture of a patient is a picture forever incomplete.

Vaccine hesitancy is a major contemporary threat to global health leading to the delay or refusal of vaccines. Quantitative studies on vaccination attitudes generally state that vaccine hesitancy is higher among immigrants. However, qualitative studies show a spectrum of vaccine-related attitudes and behaviours among immigrant parents, from refusal over delay to acceptance of all childhood vaccines. This paper is based on a 2020 qualitative study among Serbian parents living in the Netherlands. It discusses childhood vaccine compliance, focusing on parents with at least one fully vaccinated child. In general, the Serbian parents interviewed made decisions relating to vaccination based on their sociocultural background (ie, viewing vaccines as a part of 'traditional' upbringing), intersubjective norms (ie, they trust the state, vaccines, health officials, peers) or they lack sufficient language proficiency or information regarding vaccines. More importantly, the results also show that some participants exhibit vaccine hesitancy because they do not trust the vaccines, the government, health officials or pharmaceutical companies. The intriguing results confirm that vaccine hesitancy does occur among both the highly educated and lower educated, informed and uninformed, as well as users of complementary medicine and the religious (here, Serbian Orthodox Christian) and non-religious. Thus, this study interprets contemporary vaccine hesitancy as a rational response among vaccine-accepting parents to live in a post-trust world burdened by regulatory scandals, scientific pluralism and the availability of alternative information. Consequently, the study indicates that contemporary vaccine hesitancy requires understanding as a contemporary 'risk management strategy' outside of contextual, individual/group and vaccine-related factors.

Medical humanities scholarship has long emphasised the role of narrative in clinical practice, where it is valued for humanising medicine and revealing the subjective dimensions of illness. This focus has shaped the dominant view of the role of narrative in public health, where it is typically positioned as a means to render abstract data more ethically resonant, amplify marginalised voices, and support moral or political engagement. While this framing has enabled important forms of interdisciplinary collaboration, it also narrows how narrative is understood, construing it as a tool for communication rather than as a mode of explanation. This paper argues that such a view overlooks the role narrative reasoning already plays within population health science itself. Drawing on work in philosophy of science and population health, it shows that key explanatory practices-especially those concerned with temporally extended, socially embedded and structurally conditioned outcomes-require narrative forms of reasoning. Recognising narrative's role in population health explanation repositions medical humanities from a communicative adjunct to an epistemic collaborator, capable of analysing the forms of reasoning on which population health science depends. In doing so, it expands the field's methodological contributions and opens new possibilities for interdisciplinary research on structural inequality and health.