Health Humanities

Image of Da Vinci's Vitruvian Man of math

The common purpose of learning at The College of St. Scholastica is to serve and care for human beings, to promote human well-being, and to build a more humane world. That purpose is central to the Health Humanities Program, which was established in 2016 to integrate more fully the College's strengths in the liberal arts and in the health and human sciences. The program aims to provide a deeper understanding of the humanity of the diverse people whom our graduates serve: their patients, clients, and students; their colleagues; and themselves. The program's focus on human values reflects the College's commitment to excellence in Benedictine health care and human well-being.

Health humanities, also known as medical humanities, applies humanistic perspectives and liberal learning to health care and medicine. It is a rapidly growing, interdisciplinary field that explores questions of value and meaning in human health and in health care. In its current form the field started to take shape in the 1970s in major medical schools; the terms medical humanities and bioethics gained currency in the 1980s. In 1998 these interests converged professionally in the American Society for Bioethics and Humanities (ASBH), formed from three prior organizations: The Society for Health and Human Values (founded in 1969), the Society for Bioethics Consultation (founded in 1986), and the American Association for Bioethics (founded in 1994). Increasingly, "health humanities" is preferred as the broader, more inclusive term, though it has not displaced "medical humanities." Recently the field has begun to be offered as an undergraduate program, while retaining its place in medical and graduate school curricula.

Health humanities proceeds from the recognition that the humanities (communications, cultural and language studies, history, literature, philosophy, theology and religious studies, and the arts) are indispensable for humane health care, because they teach us about what it means to be human. They teach us about the human condition, about human experience, about human suffering and healing, about human well-being and flourishing. They teach us that human beings are persons or ends-in-themselves who ought never to be treated merely as means. They teach us about human dignity, or the intrinsic and insuperable value of being human. Further, the humanities teach us skills of observation, analysis, communication, critical thinking, discernment, empathy, and self-reflection—all of which are essential to humane health care and health promotion.

How medicine and the health professions conceive, represent, or see human beings—again, how they understand what it means to be human—decisively affects how patients are treated. It makes a difference whether the patient is seen mainly as a diseased or dysfunctional body, or as a whole person. The aim of health humanities is to provide humane care for the whole person, beyond biomedical knowledge (as important as that knowledge is).

Reducing medicine, health care, and public health to science and technology risks dehumanization. These dangers are real. At their worst, they led to the eugenics movements of the early twentieth century, to Nazi medicine, and to research exploiting vulnerable groups such as the US Public Health Service's "Tuskegee Study of Untreated Syphilis in the Negro Male" (1932-1972). Today, they lead to missing the social component of disability, to the social denial of death and its medicalization, and even to the medicalization of human life as a whole. To counter the dangers of biomedical reductionism, the health humanities strive for integrated, holistic, and ethical approaches. These approaches underpin primary and patient-centered health care. They better enable us to understand the social determinants of health and to learn from the voices of marginalized communities as well from individual experiences within them.

Human beings are persons: complex wholes of body, mind, and soul. In caring for persons, both the health sciences and health humanities are essential, but for different reasons. The natural sciences work with the physical world, with what can be empirically observed, measured, and tested. They study the impersonal, objective world of particles, atoms, molecules, cells, organisms, and bodies—the structures and laws of physical objects and events. It is clear that the health sciences have an indispensable role when it comes to the physical, bodily aspects of the human being. But we are not merely bodies. In fact our non-physical aspects are what make us distinctively human. This dimension of human being includes feeling, emotion, thought, meaning, value, and belief—the entire inner world of human experience, self-consciousness, and mind. Because it is internal and personal, human experience cannot be directly observed. Therefore, it is not accessible by natural scientific methods. It is the world of the humanities.

Though it cannot be observed, human experience can be understood—and understanding it is the task of the humanities, including the health humanities, which are specifically concerned with suffering and healing as human experiences (see the next section below). Humanistic understanding comes, at least most fully, from the word. Other animals are sentient and have experience, but human beings interpret their experiences and give them meaning. Human beings are creatures of meaning, not content in simply meeting physical needs. We have various forms of cultural expression, or ways of expressing meaning, but verbal communication is basic to human understanding. With narrative, we connect our experiences into meaningful wholes, in relationship to ourselves and others. Fundamentally, the humanities seek to understand human experience and meaning, and narrative is essential to their task (since human experience itself remains hidden, private, and unobservable). Narrative is the human way of knowing, the way persons understand themselves and each other. Such knowledge and understanding can in turn deepen our experience of reality and the meaning we find in it.

One of the essential distinctions in health humanities is between disease as a physical condition and illness as a human experience. Disease can be understood in biomedical terms; illness and suffering cannot. In 1982 the New England Journal of Medicine published an influential article by Eric J. Cassel, M.D., "The Nature of Suffering and the Goals of Medicine." (In 1991 the article was expanded into an important book under the same title.) According to Cassel, "Suffering is experienced by persons, not merely bodies." He defined suffering as "the state of severe distress associated with events that threaten the intactness of the person." If the main obligation of the health professions is to relieve suffering and promote healing (the restoration of wholeness), then we need to understand persons and their experiences, not just bodies and their diseases and dysfunctions.

The health humanities approach illness, disability, suffering, healing, aging, and dying as human experiences, and they use narrative to better understand them. According to Dr. Rita Charon, Professor of Clinical Medicine and Director of the Program in Narrative Medicine at Columbia University: "Along with scientific ability, physicians need the ability to listen to the narratives of the patient, grasp and honor their meanings, and be moved to act on the patient's behalf. This is narrative competence, that is, the competence that human beings use to absorb, interpret, and respond to stories." This competence, she continues, "enables the physician to practice medicine with empathy, reflection, professionalism, and trustworthiness. Such a medicine can be called narrative medicine." (Rita Charon, "Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust," JAMA 286 (2001): 1897-1902.)

Narrative competence is closely related to other essential skills in health humanities, such as discernment, insight, and empathy. Since a person's experience of illness and of health is highly dependent on his or her culture, it is clear that cultural understanding is another critical area of health humanities. Narrative and cultural competence go hand-in-hand; both are necessary for effective, humane health care.

Human health is a comprehensive, multifaceted concept. The World Health Organization defines it as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." In its positive and fullest sense, health involves human well-being, human flourishing, and the realization of human potential. Paradoxically it is possible with disease and indeed with death, which are inescapable human realities. Any true conception of health and human well-being must accept these realities and be informed by their meanings—meanings which the health humanities seek to understand. Such a conception will integrate scientific knowledge, humanistic understanding, and spiritual wisdom, all of which together enable us to better appreciate the ends, meaning, and mystery of human life.

Minor: 20 credits
Major: 36 credits

The following five core courses (4 credits each) are required for both the minor and major:

  • HHU 2777 Proseminar in Health Humanities
  • HHU/PHL 2301 Health, Happiness, and Human Well-Being
  • HHU/ENG 3010 Trauma and Recovery: Medicine and Literature
  • HHU/GCL 3401 Health Care Across Cultures
  • HHU 4777/HIS 4402 Health, Disease, and Medicine in History

The five core courses satisfy the requirements for the minor. Majors will take 16 additional credits selected from the electives below (as listed in the catalog):

  • TRS 3310 Religious Perspectives on Living, Dying, and Grieving
  • TRS 3311 Religious Perspectives on Healthcare Ethics
  • PHL 4420 Philosophy of Science
  • SWK 3350 Understanding Systems of Privilege and Oppression (2 cr.)
  • SWK 3360 American Social Welfare Policy
  • SWK 3362 Human Behavior in the Social Environment
  • SWK 3395 Social Work and Healthcare
  • ECN 3335 Contemporary Healthcare Economic Systems
  • HSC/GER 2203 U.S. Healthcare System
  • PSY 2208 Lifespan Developmental Psychology 
  • PSY 3216 Personality (2 cr.)
  • PSY 3328 Behavior Management (2 cr.)
  • PSY 3363 Health Psychology (2 cr.)
  • PSY 3423 Abnormal Psychology
  • GER/PSY/SWK 3315 Psychosocial Aspects of Aging
  • GER 3316 Health and Functioning in Late Life
  • GER/PSY 3424 Mental Health and Aging (2 cr.) 

Additional elective courses for the major are possible, selected in consultation with the program director.

For the program schema (recommended plan of study), see http://publications.css.edu/advisor/17-18/pdf/MajorSchemes/HealthHumanities.pdf

Core Course Descriptions

HHU 2777 “Proseminar in Health Humanities” is an introduction to the interdisciplinary field of Health Humanities. It considers the unique contributions, approaches, and resources that the humanities and arts bring to health care. The course discusses basic methodological issues such as the differences between the health sciences and health humanities, fundamental concepts such as human dignity and personhood, and core philosophical questions such as materialism and biomedical reductionism, mind-body dualism, and the meaning and mystery of being human. The course introduces biomedical or healthcare ethics and its primary principles of autonomy, nonmaleficence, beneficence, and justice. Topics related to spirituality and illness are investigated, including the meaning of human suffering and mortality, end-of-life issues and ethical care of the dying, and hope. The course is concerned throughout to develop compassion and empathy as essential skills in humane health care.

HHU/PHL 2301 “Health, Happiness, and Human Well-Being” is the program’s core course in philosophy. It examines concepts like health and illness, ability and disability, and happiness and well-being from a philosophical perspective. It explores the philosophical aspects of some of the central questions in medicine and health care: What is health? What is health in relation to happiness and human well-being? What are suffering and healing? What are the goals of medicine and what is the purpose of health care? To what extent are health, disease, and illness biological realities or social constructions? How have concepts of health, disease, and illness been used to harm people? What is mental health and illness, why are their meanings contested, and how has psychiatry been abused? Further, the course considers such issues as the different types of knowledge in health care, medical knowledge and power, human rights and health care, ethical principles and practices in health care, and current ethical dilemmas and controversies in the field.

HHU/ENG 3010 “Trauma and Recovery: Medicine and Literature” is the program’s core course in literature and narrative medicine. If we know that trauma cannot be told without a witness who encourages the tale by offering words and gestures of sympathy, we also know that to bear witness to trauma is to share its burden. Disciplined objectivity and reducing the patient to his illness have traditionally protected clinicians in the health care fields from experiencing the trauma of “caring too much” for their patients. But practitioners in the Health Humanities argue for the recovery of humanity in health care. They argue that encouraging the stories of both patients and family members invites all sufferers to find meaning in their pain, and to work towards emotional, if not always physical, healing. The field of Health Humanities positions the literature classroom — with its emphasis upon close reading, attention to semiotics, analysis of gesture, the mending of fractured narratives, and the adoption of alien points of view — as a safe place to learn to listen to trauma. And, while reading literature enables students to practice authentic listening, reflective writing shared in groups enables students to make meaning from their own trauma and to begin this rich process of storytelling. In this course we will closely read and analyze the narratives of wounded patients, healers, and family witnesses while we write and share our own.

HHU/GCL 3401 “Health Care Across Cultures” is the program’s core course in cultural competency. It proceeds from the premise that since a person’s experience of health and illness is highly dependent on his or her culture, cultural understanding is essential for humane health care in today’s multicultural societies. This course aims to help students achieve cultural competency, with particular attention to the development of culturally competent communication skills. It analyzes the influence of culture on human experiences of health and illness, and on health beliefs, values, and healthcare practices. Through interactive exercises, case studies, interviews, role plays, guest speakers, reflection papers, research and literature, the course investigates the increasingly complex intersection between healthcare delivery and culture. Students also examine the value assumptions of their own health beliefs in an effort to increase their effectiveness in intercultural healthcare settings.

HHU 4777/HIS 4402 “Health, Disease, and Medicine in History” is the program’s capstone course in the history of medicine, the first health humanities discipline. The history of medicine was founded in the late nineteenth century to help prepare more liberally educated and humane physicians. This course will cover the impact of disease on human history, together with human responses to disease, first of all medicine itself. The focus is the western world and western medicine, beginning with the Greek and Roman eras (Hippocrates and Galen) and continuing through the Middle Ages and Renaissance, the Scientific Revolution and Enlightenment, and the modern era. The course will trace the development of medical knowledge, including theories and conceptions of disease, from ancient humoral theory to bacteriology (germ theory), modern pathology, and genetics. It will also recount the history of medical practice, treatment, and technology to cure and prevent disease, to heal people, and to promote health. Specific topics include disease as both a pathological reality and social construct; the social history of medicine, especially the social and economic conditions (notably poverty) of disease; the societal and cultural impact of epidemics such as the plague; health disparities and the effects of power, wealth, race, class, and sex on public health and healthcare; the medical exploitation of (and unethical experimentation on) vulnerable populations, e.g., the infamous Tuskegee study; and the dangers of biomedical reductionism in forms such as “scientific” racism, the eugenics movement, and Nazi medicine. At a philosophical level the course will ask what the history of medicine tells us about ourselves as human beings.

Pamela Bjorklund (Ph.D., University of Minnesota) is Professor in the Department of Graduate Nursing, School of Nursing, at the College of St. Scholastica. She helped found the College's Health Humanities Program. Her research interests take her to the points of nexus between Psychiatry, Nursing, Sociology, Philosophy, Ethics, Technology, and Women's Studies. For additional information and recent publications, see http://www.css.edu/academics/school-of-nursing/about/faculty-and-staff.html.

Kimberly Lakhan (DHSc, A.T. Still University) is Assistant Professor of Physician Assistant Studies in the School of Health Sciences at the College of St. Scholastica. She practices as an Otolaryngology (ENT) PA and is a distinguished fellow of the American Academy of PAs (AAPA). In health humanities, her research interests include global health, health care ethics and economics, and interdisciplinary health care. For additional information, see http://www.css.edu/graduate/masters-doctoral-and-professional-programs/areas-of-study/ms-physician-assistant/faculty-and-staff.html.

Brian Volck (M.D., Washington University) is Assistant Professor of Pediatrics in the Division of Hospital Medicine at Cincinnati Children's Hospital Medical Center. His practice and research interests include global child health, Native American child health, medical education, cross-cultural medicine, medical ethics, and the intersection of poverty, justice and health. He is a nationally prominent figure in the field of health humanities: http://www.brianvolck.com/bio/.

Kirk C. Allison (Ph.D., University of Minnesota) is an adjunct faculty member with responsibility for online course development in the Health Humanities Program at the College of St. Scholastica. From 2006 to 2016 he was director of the Program in Human Rights and Health, School of Public Health, University of Minnesota. His dissertation research on Gottfried Benn’s Medical Exotics: Proximities in Literature, the Body and Ethos, combined archival work (Marbach and Berlin) and practical explorations (medical school anatomy course; medical examiner’s office rotation). Internationally he studied at the Universities of Erlangen-Nuremberg, Munich (Fulbright Fellow), and Bochum, and was Gastlektor at the University of Salzburg. His undergraduate degrees are in Computer Science (BS) and German (BA, followed by an MA) from the University of Kansas. He also holds an MS in Health Services Research, Policy and Administration with a Bioethics minor from the University of Minnesota. His teaching has addressed health and human rights; global health, relief, development, and NGOs; the history of eugenics, medical lethality, and dignity-violating research; research ethics; and humanitarian response. His publications concerning health, society and ethics address the history of eugenics; human security, disability, and social exclusion; science in the Third Reich; hospital affiliation and high-risk infant outcomes; assisted suicide, vulnerabilities, and public health ethics; public consultation for science policy formation; the Human Genome Project; rhetoric and the concept of rationing; execution, organ harvesting and transplantation in China and related international institutional responses; and paternal religious affiliation and practice in Lithuania. He has also chaired the American Public Health Association’s Ethics Special Primary Interest Group (now Ethics Section).

Program Outcomes

Graduates of the College's Health Humanities Program should be able to:

  • Understand humanistic perspectives, human values, and their health applications.
  • Deploy a comprehensive and multifaceted understanding of human health as human well-being and flourishing, encompassing the physical, mental, emotional, social, intellectual, and spiritual dimensions of human life and experience.
  • Use skills that are essential for humane health care, health promotion, and health stewardship: observation, analysis, communication, critical thinking, discernment, empathy, and self-reflection.
  • Demonstrate interdisciplinary preparation for humane health care through a deeper understanding of (and empathy for) impairment, illness, suffering, healing, aging, and dying as human experiences on an individual level and in community.
  • Understand the influence of social, cultural, and economic contexts on the manifestation of disease and the experience of illness.
  • Reflect upon and act appropriately as neighbor to the person who is suffering (Luke 10:25-37).
  • Counter the main sources of dehumanization in modern medicine, health care, and public health, including biomedical reductionism, misuse of technology, commercialization, and stigma.   
  • Employ knowledge of the main concepts, principles, applications, and controversies in biomedical and public health ethics.
  • Show familiarity with humanities concepts that are part of the Medical College Admissions Test (MCAT).

Careers

Students who successfully complete a Health Humanities major or minor, along with required science courses outside the program, will be well-prepared for admission to medical school, to Physician Assistant programs, and to other health science graduate programs.
The program is also ideal for students who have an interest in law school, in earning a graduate degree in public health, or in pursuing an administrative career in healthcare.

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Randall Poole, Ph.D., Professor of History and Director, Health Humanities Program

The College of St. Scholastica
School of Arts & Letters
Tower Hall, Room 4150F
1200 Kenwood Avenue
Duluth, MN 55811

Phone: (218) 723-6468 
Email: rpoole@css.edu