Medical Humanities最新文献

The COVID-19 pandemic generated a distinctive body of narrative writing that sought to make sense of front-line medical experience under conditions of uncertainty and crisis. This article examines Emma Goldberg's Life on the Line: Young Doctors Come of Age in the Pandemic (2021) as a mediated, multivoiced account of early career physicians navigating professional, ethical and embodied transformation during COVID-19. Drawing on Narrative Medicine and Medical Humanities scholarship, the analysis introduces the concept of the 'third object' to examine how experience, memory and moral meaning are collaboratively reconstructed through interview-based story-telling rather than autobiographical memoir. In contrast to British COVID physician memoirs, such as Rachel Clarke's Breathtaking, which foreground first-person, retrospective self-narration within the institutional context of the National Health Service (NHS), Life on the Line operates through editorial mediation, creating a relational narrative space in which embodied knowledge and ethical reflection are collectively produced. Through close reading of Goldberg's six physician profiles, the article explores embodiment, memory, moral witnessing and professional formation under pandemic conditions. It argues that mediated story-telling functions as an ethical and epistemic intermediary during periods of epistemic collapse, extending Narrative Medicine beyond memoir-based models and contributing to ongoing debates in Medical Humanities about narrative form, care and meaning in crisis. This article finds that during COVID-19, narrative mediation did not merely record medical experience but became the primary mechanism through which clinicians reconstructed epistemic stability, ethical orientation and professional identity when clinical knowledge itself was unstable.

Migrants assuming caregiving roles for other migrants require care themselves. We report on how migrants in South Africa navigate the dual responsibilities of caregiving and self-care. 15 semistructured interviews were conducted with migrant caregivers between January and June 2023. Data were thematically analysed and interpreted through a narrative lens. Findings highlight the critical role migrant caregivers play in offering support to their communities. Despite systemic challenges, including language barriers, exclusion and personal trauma, they foster community cohesion and emotional well-being. At the heart of acts of care exists an ambivalence between identity management and the experience of trauma and exclusion.

Despite the longstanding presence in integrating the humanities into medical education, the term 'the humanities' remains inconsistently defined and operationalised across the literature. This scoping review investigates how the humanities are conceptualised, implemented and assessed across empirical studies within medical education. Using the Mak and Thomas (2022) methodological framework, we systematically searched three databases: ERIC, MEDLINE and Scopus. We identified 58 peer-reviewed studies featuring humanities-based interventions (HBIs). Through qualitative content analysis, we developed an operational framework that classifies HBIs into five conceptual categories: (1) ethical reasoning and moral education, (2) narrative and reflective practice, (3) aesthetic and expressive arts, (4) historical and cultural insight and (5) critique and power analysis. While HBIs were commonly used to foster empathy, ethical sensitivity, reflective thinking and professional identity, we observed substantial variability in disciplinary foundations, pedagogical goals and evaluative approaches. This conceptual pluralism, while generative, complicates comparative evaluation and obscures the specific contributions of different humanities traditions. Our findings offer a conceptual map of how the humanities are currently situated in medical education and provide a taxonomy to support greater clarity, coherence and intentionality in the design, implementation and assessment of HBIs across the literature.

Within the context of the eastward spread of Western learning during the late Ming and early Qing dynasties, the cross-cultural dissemination of medical knowledge exhibited complex characteristics of visual transformation. This study selects Taixi Renshen Shuogai (1623) and Zhenjiu Dacheng (1601) as research samples, employing a research method combining iconographic analysis and digital humanities to explore the different body concepts and their cultural connotations carried by Chinese and Western medical illustrations. The study constructs a three-dimensional analytical framework covering visual vocabulary, content expression and quantitative statistics to conduct an in-depth analysis of the cognitive differences in human body representation between the two medical traditions. The results show that the mechanistic view of the body advocated by Western anatomy and the organic view of the body upheld by traditional Chinese medicine form a sharp contrast at the image level; the former is characterised by precise analysis and structural reduction, while the latter centres on holistic grasp and functional correlation. This difference is not only reflected in visual elements such as composition patterns and expressive techniques, but more profoundly reflects the knowledge construction logic of different epistemological systems. The coexistence of two body cognition models during the Ming and Qing dynasties reveals the selective mechanism and creative transformation ability of Chinese culture in the process of knowledge acceptance, providing a new interpretive path for understanding the interaction model between traditional culture and foreign civilisations. This study expands the methodological boundaries of medical history research and provides a historical mirror for contemporary cross-cultural medical exchanges.

Healthcare and religion are deeply intertwined facets of human experience. Each has existed as long as the other, and influences between them are accordingly protean. This is true globally and especially in the USA, one of the most religiously diverse industrialised nations but, ironically, also one plagued by a paucity of religious literacy (RL). This paper will argue that US healthcare settings are particularly treacherous areas regarding the lack of RL. Although recent decades have witnessed increased awareness of the importance of religion/spirituality (R/S) for patients, the ability of healthcare providers to incorporate R/S in the care of their patients is lacking, due largely to a lack of RL. This paper will examine how work in this area has been limited by a lack of agreement on how to define RL, by several barriers to the religiously literate provision of spiritual care, and by the lack of a quantitative instrument with which to measure RL. Reviewing four prominent notions of RL-based on (1) Knowledge, (2) Understanding, (3) Faith and (4) Practice-this paper will further argue that one of these (understanding) is most amenable to application to healthcare but is informed in important ways by the other three, which function better together with the one.

Each year, nearly 60 million people need palliative care to relieve suffering associated with serious illness or trauma, yet it is rarely accessible in low-income and middle-income countries (LMICs). Thus, implementation of palliative care in LMICs is both imperative and urgent. But the assumption that palliative care as practised in Western countries is the only 'enlightened' way to care for the seriously ill risks bad consequences. Chinua Achebe's novel Things Fall Apart depicts the harm that results when one culture arrogantly imposes itself on another, although with best intentions. The novel therefore can serve as a guide to culturally sensitive implementation of palliative care in non-Western cultures. While universal access to Western scientific medicine for relief of pain and other types of physical and psychological suffering is imperative, it must be recognised that scientific medicine is itself a culture and that there are fundamental differences between cultures in the meanings of health and healthcare, illness and suffering and death and afterlife. Optimum palliative care requires the recognition that people often think and suffer differently in different cultural and socioeconomic contexts. It requires the tolerance of and openness to others that is missing from the colonisers in Achebe's novel but found in the colonised.

This article introduces 'sonic life writing' as a new methodological approach to sharing bodily knowledge about illness experience through non-lexical sound and music. Drawing on autoethnographic research conducted during treatment for HER2+breast cancer, I argue that sonic approaches can complement existing counter-narratives by offering non-lexical modes that bypass certain constraints of dominant cancer discourse, such as metaphors of warfare. The conceptual framework of 'corporeal acoustemology' extends Steven Feld's work on ways of knowing through sound into medical and corporeal territories, proposing that bodily processes and treatment experiences can be made audible through compositional practice. This methodology moves beyond data sonification to what I term 'artistic sonation'-qualitative sonic expression that captures the temporal, relational, emotional, and embodied dimensions of illness that can resist lexical representation. Three original compositions demonstrate this approach: TCH-P transforms chemotherapy experience into rhythmic testimony using South Indian konnakol vocal techniques; KRANKENHAUSFUNK and the extrinsic death receptor pathway reimagines hospital radio by broadcasting the cellular process of apoptosis through repurposed infusion pumps; and Anuvāram Jugalbandī explores the disrupted temporalities of illness and care through intercultural musical dialogue. Theoretically, the article proposes 'reparative listening' as a framework for engaging with sonic illness narratives, drawing on Eve Kosofsky Sedgwick's work on reparative reading and recent scholarship on acoustic justice. This approach creates conditions for witnessing experiences that fall outside conventional narrative structures while challenging the medical emphasis on visual over auditory engagement with bodies. This article and practice-based research positions music and sound not as therapeutic intervention but as testimonial practice and knowledge transmission, contributing to growing intersections between sound studies and health humanities. Sonic life writing offers new possibilities for sharing the complexities of illness experience while expanding our understanding of embodied ways of knowing in medical contexts.

Healthcare education is increasingly moving beyond the biomedical paradigm to incorporate medical humanities, highlighting a person-centred approach. Integrative medicine encompasses biomedical sciences as well as social and cultural factors to treat the whole person, focusing on optimal health and healing. These shifts are evident in the rise of competency-based frameworks that aim to integrate ethical values, cultural sensitivity and interdisciplinary knowledge. Despite these developments, limited research has examined how such frameworks differ across countries and health professions based on distinct academic traditions and conceptual emphases. To address this research gap, this study conducted a comparative analysis of seven national-level health professional competency frameworks for six countries: the UK, the USA, Canada, Australia, South Korea and China. Using Mayring's structured content analysis method, documents were analysed across four categories: competency domains, keyword mapping, structural features and sociocultural characteristics. To support interpretive depth, the Health Systems Science (HSS) framework was applied as a lens for understanding conceptual convergence and divergence in the person-centred approach. While all seven frameworks highlighted core areas such as communication, professionalism and patient-centred care, their structures and value orientations varied. The frameworks for the UK and Australia focused on moral accountability, while those for the USA and Canada emphasised functional and systems-based competencies. Frameworks for China and South Korea reflected traditional philosophies and professional identity formation. The HSS framework offered a valuable structure for aligning both topic-based domains and personal attributes across diverse educational systems, especially highlighting a person-centred approach to consolidate integrative medicine. The findings suggest that while each framework has distinct strengths, gaps remain-particularly in addressing social competencies, such as advocacy and cultural sensitivity. These areas warrant further integration, education and validation to support socially accountable and systems-oriented professional development.

In this epistolary paper, we draw on the work of an interdisciplinary, psychosocial study of the relationship between time and care, Waiting Times, to explore the significance of a book of letters as a waiting object. Words in Pain, a collection of letters by Olga Jacoby (1874-1913) to her doctor and family written in the shadow of her early death, was published posthumously in 1919 as the nation emerged from World War I and the Great Flu Pandemic; while a new edition was published in 2019 just before the COVID-19 pandemic forced the relationship between waiting, care, vulnerability and interdependence into consciousness. We argue that Jacoby's passionate reflections on her children and her imminent death show her working out how to live well in the face of a loss that is to come, while using her letters to take care of the future: a future that includes her children and the future generations to whom her letters have come down. We also explore how Jacoby's first editor in 1919, who published the book anonymously, perhaps to protect the identity of her well-known doctors, and her 2019 editors, who restored Jacoby's place in time, each performed an act of care, for both the past and the future. The act of writing and reading, but also that of editing, thus provides a container of time and care, while the letter becomes a waiting object that offers to reanimate a relationship to a future into which the writer knows she cannot endure.

Medical professionalism is a core component of medical education, yet it remains conceptually ambiguous and inconsistently articulated across institutions, cultures and training contexts. Although students are expected to demonstrate professionalism as part of professional identity formation, the meanings and expectations associated with professionalism are often implicit, variable and shaped by both formal curricula and the hidden curriculum. This qualitative study examined how medical students articulate and make sense of professionalism during undergraduate medical training using a discourse-informed analytical approach. All students (M1-M4) at a single US medical school were invited to participate, and recruitment concluded after 44 students volunteered. Data were collected through 20 individual semistructured interviews and four focus groups, and transcripts were analysed inductively to identify recurring ways professionalism was articulated in students' accounts. Analysis revealed three recurring ways professionalism circulated in student discourse: (1) definable and actionable, in which professionalism was described through observable behaviours such as punctuality, dress and communication; (2) inherently subjective, where professionalism was framed as situational, relational and shaped by cultural or interpersonal expectations; and (3) uncertain and confusing, characterised by difficulty articulating a coherent understanding and by the expansion of professionalism into broader expectations of self-presentation and image management. Across these accounts, students most often articulated professionalism in physician-centred terms, emphasising self-regulation, appearance, composure and evaluability, reflecting the institutional and assessment contexts of early medical training. This study demonstrates that medical students encounter professionalism through multiple coexisting ways of understanding that circulate within medical education and are variably taken up as students navigate professional expectations. By shifting analytical attention away from defining what professionalism should be and toward examining how professionalism is articulated and taken up in practice, a discourse-informed approach offers a productive framework for understanding professional identity formation in contemporary medical education.