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In Britain interest in “medical humanities” has emerged only recently, whereas in the United States it has been developing over the past thirty years. What then has generated this concern and why now? The answer seems to be that it is a second generational response to the shortcomings of a medical culture dominated by scientific, technical and managerial approaches. The first response came in the 1960s and 1970s and led in Britain to the emergence of medical sociology, social history of medicine and medical ethics as academically respectable subdisciplines. The current response can then be seen as a new phase in which medical humanities is making its first appearance in Britain, and is also taking a new and related direction in North America.
Within this overall picture two main formulations of medical humanities are apparent. The first is concerned with complementing medical science and technology through the contrasting perspective of the arts and humanities, but without either side impinging on the other. The second aims to refocus the whole of medicine in relation to an understanding of what it is to be fully human; the reuniting of technical and humanistic knowledge and practice is central to this enterprise. We have described these two approaches to medical humanities as “additive” and “integrated” respectively1 and Richard Smith summed them up as follows:
“The additive view is that medicine can be ‘softened’ by exposing its practitioners to the humanities; the integrated view is more ambitious, aiming to shape the ‘nature, goals and knowledge base' of medicine itself’.”2
In reality there is a wide spectrum of literature emerging which lies on a continuum between these …