Is Medicine an Art or a Science?
by: osam
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The Inhumanity of Medicine - Is Medicine an Art or a Science?
I. Introduction
Is medicine an art or a science? This question which has been asked several times in history gained a new significance towards the end of the twentieth century. The twentieth century ended with myriad questions; it also ended with endless possibilities. The reason for this is not far-fetched: the ICT revolution had brought down more barriers and restrictions than any other factor or event. For the first time in history, the idea of a global village had become a real possibility. Massive strides had been made in information and communication, and individuals became more empowered than ever before. Long standing centers of power were demystified and old barriers were rendered useless. Political and geographical boundaries were no longer as intimidating. In the wake of these tremendous changes, philosophical concepts of space, time and even personhood had changed. Intellectual disciplines therefore needed to reassess their tools and methodologies; not one was left out - not even the ancient discipline of medicine.
Given the new perceptions, what seems to be standard medical practice now appears to be beastly. The physician is now scrutinized not only by his medical community but by his patients, the press, the judiciary and even by the Church. The impersonal nature of medical practice is becoming more visible. Of course, there have been a lot of changes and improvements designed to give medical practice a human face, but I shall argue that much more needs to be done.
II. Conceptual Clarification
In its broadest sense, the word science is derived from the latin word, scientia, which means knowledge. It therefore refers to any systematic knowledge or organized body of knowledge. In its more usual restricted sense, science refers to a system of acquiring knowledge based on the scientific research method as well as to the organized body of knowledge gained through such research.
The scientific method seeks to explain the events of nature and make predictions based on observed regularities in nature. Through observation of natural phenomena, and/or through experimentation science seeks to understand natural phenomena and therefore provide the impetus for man to find solutions to problems in a number of scientific and technological fields.
Given this understanding of science, is medicine a science? Yes, of course. If medical practice did not observe the nature of disease, carry out experiments and prolonged tests, medical practice would have still been in its most primitive state and many diseases would have remained undefeated.
What is an art? What is an art? Traditionally the term art was used to refer to any skill or mastery. Although today the word art usually refers to the visual arts, the concept of what art is has continuously changed over centuries. Perhaps the most concise definition is its broadest—art refers to all creative human endeavors. Art is simply a generic term for any product of the creative impulse, out of which sprang all other human pursuits — such as science via alchemy, and religion via shamanism.
Generally art is a (product of) human activity, made with the intention of stimulating the human senses as well as the human mind; by transmitting emotions and/or ideas. Beyond this description, there is no general agreed-upon definition of art.
A precise definition of the arts can be contentious, but the following points should be noted:
- it is a human activity
- it involves the mastery of a skill
- it is a cultural and creative activity
- it involves the transmission of emotions and stimulation of the human senses
- it seeks to understand man in a wider cultural setting
The question we need to ask now is, is medicine an art? Yes, of course. If medicine requires the mastery of a skill, if it involves creativity, if it must understand man in a wide cultural setting; if it involves handling human emotions, then it is an art.
The term medicine is derived from the Latin ars medicina meaning the art of healing. Going by the etymology of the word, it seems that the word medicine began as an art. What art? The art of healing. It was an art which in ancient times involved rituals, appeasement of the gods and performing some sacred rites. In the modern era, with the rise of science, medicine began to embrace more of the scientific observation and shed its humanism. It became strictly speaking, “the science of diagnosing, treating, or preventing disease and other damage to the body or mind.”
III. The Problem
This definition glosses over many silent cultural issues. It gives the impression that the physician’s business is with the disease and not with the patient. The patient is only a means through which his practice can be done, and in many cases, the patient is the means through whose disease knowledge of medicine can be gained and the field of medicine could be advanced. Therefore the patient was an experiment in the hands of the doctor. He didn’t even need to tell the patient what was wrong with him. He didn’t need to involve the active participation of the patient in the cure. In other words, the wider human issues involved in medical practice were never given a chance. These are the issues that are raising their heads today.
Without doubt, the scientific method is indispensable. Medicine can only develop through scientific experiments. The problem however is that the development of medicine as a science in recent history is at the expense of its art form. The result is that medical practice has developed as a very inhuman discipline. I will illustrate this in three areas:
1. Consultation: During consultation, the physician hardly asks anything about the patient’s lifestyle. Emphasis is placed on the symptoms. The conversation with the physician is usually about diseased body parts and not really about the whole person - the patient's symptoms, concerns and values. In the end, the physician examines the patient, interprets the symptoms, and formulates a diagnosis to explain the symptoms and then proposes a treatment.
2. The Concept of Medicine: The procedure described above is as a result of the concept of medicine which defines it as “the science of diagnosing, treating, or preventing disease…” From this point of view, two points of emphasis emerge very clearly:
(1) that it is a science
(2) that it is about disease
What this perspective does not include is that:
- Medicine involves a physician and a patient
- The physician is a real human person with emotions and prejudices
- The patient is a real human being whose condition is not unconnected with his lifestyle and history
- The practice of medicine involves a relationship between the physician and patient which transcends the administration of drugs. Effective healing takes place not only the disease is cured, but also when the lifestyle of the patient is changed.
3. Medical Research: So much is going on in medical research today that is raising eyebrows. To be fair, medical knowledge cannot grow without experiments and sometimes it is better to experiment with human beings. There are however cases where the full implications of the experiments or the drugs being tested may not be known by either the scientists or the volunteers. Through the course of the twentieth century, healthcare providers focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development was a more mechanistic, detached practice, with the perception of an attendant loss of patient-focused care.
Today, frontier research such as research on stem cells and its implications, to many people, are another demonstration of the inhumanity of the discipline.
IV. Conclusion
The tide is however turning very fast. There is a real demand for medicine to submit itself to scrutiny, not from members of the scientific community but from members of the wider human community. I wish to suggest that as part of the medical encounter, the healthcare should engage the physician, the patient and the patient’s community or social group in a relationship. Emphasis should be placed on community support, nutrition, lifestyle and healthy habits. This definitely takes the practice of medicine outside narrow hospital corridors and operating theaters to the community. This process is both an art and a science.
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About the Author
Osam Osam-Edim Temple is a Professor of Philosophy at the American University of Nigeria. He has travelled widely, teaching philosophy in various institutions in different parts of the world.
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