Medical Humanities最新文献

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.

In this paper, I show how humiliation, as a moral emotion, is a pervasive yet neglected dimension of medicine, health and ethics discourse. Although often conflated with shame, humiliation names a distinct self-conscious emotion: not an internalised sense of personal failure, but a relational harm imposed by others and institutions that undermines dignity and self-respect. Recently, medical humanities and ethics literature has attended extensively to shame and stigma, yet humiliation remains underexplored, despite its salience in patient accounts of dismissal, disrespect and degradation. I begin by explaining why it helps to have a conceptual distinction between humiliation and shame, showing how humiliation is an externally inflicted injury rather than a private moral lapse. Drawing on my ethnographic and phenomenological research in India and Zurich, in this conceptual paper, I illustrate how humiliation surfaces in healthcare encounters and spaces, where patients, especially those who are marginalised, are silenced or disregarded. I show that humiliation is diagnostic and has inherent moral insights and reveals injustice. Thus, in this paper, I argue that reclaiming humiliation as a moral and phenomenological category opens new ethical and analytical possibilities: it calls for reimagining medicine as a relational practice grounded in dignity, recognition and justice-one that acknowledges those once humiliated not as passive sufferers but as moral agents whose emotions reveal the truth of injustice.

Interest in epigenetics continues to grow, with the field often framed as relevant to health. Congruent with this, mediatisations of epigenetics exist that can be expected to help shape perspectives about its applications. Yet, while scholars have researched public framings of epigenetics within texts (eg, newspapers), there has been little attention to how it is communicated through audio-visual media-despite the clear significance of this genre internationally. Accordingly, this paper examines how creators of popular YouTube videos depict epigenetics. We report on a critical, thematic analysis of 10 highly viewed videos on epigenetics, attending to how these explain the field, present knowledge from it as 'empowering' and apportion personal responsibility. We explore how the purported novelty of epigenetics is narrated in the process, and how these configurations of epigenetic novelty reaffirm responsibilisation. Videos within our sample depict epigenetics as a new, important and relevant field. Audiences are urged to make active choices relating to epigenetic knowledge, out of both a responsibility to avoid detrimental impacts to oneself and others, and to realise personal and transgenerational benefits. However, the videos tend to omit qualifications of the promise and implications of epigenetics, nor do they signal the challenges of individual choice-making within unequal societies. Consequently, the popular YouTube videos in our sample serve to reproduce longstanding logics of responsibilisation even while insights from epigenetics are presented as novel, different and potentially empowering. Configurations of novelty can, then, be regarded as one means through which such dominant discourses are reaffirmed.

Interdiscursivity refers to the blending of multiple discourses, genres, or styles within a single communicative event. This study investigates the interdiscursivity of Chinese public health risk communication letters issued during major health crises over the past two decades, including SARS, H1N1, COVID-19 and seasonal influenza. It examines how multiple discourse types-advice-giving, scientific, literary, authoritative, affective and informal-are interwoven and strategically adapted across different crises to guide public behaviour, mobilise communities and foster trust. Using qualitative document analysis combined with thematic analysis, the study traces the historical evolution of these interdiscursive patterns and situates them within China's broader public health documentary heritage. The findings demonstrate that these letters not only translate abstract risks into actionable guidance but also serve as instruments for documenting sociocultural shifts and governance practices, and for supporting collective memory and institutionalised learning. By linking the diachronic evolution of interdiscursive strategies to the social and documentary functions of public health communication, this study highlights the dual role of risk communication letters as both practical tools and enduring public health documents, offering insights for future communication strategies in health crises.

Studying patient experience has become increasingly important for providing alternative perspectives on healthcare and quality improvement. Understanding these experiences contributes to improving quality of care and aligning healthcare delivery with patients' preferences and values. One method for exploring such experiences is the use of film. Examples such as Experience Based Co-Design (EBCD) and Database of Individual Patient Experiences exemplify how film can be employed to collect and present patient narratives. However, what remains largely absent in this work is the incorporation of cinematographic ideas and practices, an area that has been explored extensively within the field of visual anthropology. To demonstrate how visual anthropology can inform the use of film in healthcare research, particularly studies that focus on patient experience, this paper highlights three lessons. First, attention to the multimodal qualities of film enables researchers to explore how senses, emotions, images and actions interplay within lived experience. Second, film provides opportunities to experiment with and represent the movement of time through montage, emphasising both the intensity of particular moments and the subjective experience of time. Third, the open-endedness of film fosters a wide range of possibilities for collaborative sense-making. Meaning in film is never fixed but continually in a process of becoming, offering researcher and practitioners new ways to think and rethink common practices and approaches to healthcare improvement.