In the late twentieth century the impressive achievements of modern medicine are obvious, yet medicine seems to have failed to satisfy public expectation. Government regulation of hospitals and doctors is tightening in most Western countries and health funding is a divisive political issue. Medical complaints departments are increasingly busy. In the United States medical litigation has reached alarming levels, and a similar trend can be seen in other developed countries. Is there something wrong with medical research and practice? This book, written by a surgeon with more than thirty years experience of clinical medicine, examines what it is that doctors do, and what it is that patients expect of them. It finds that in the face of uncertainty, expectation and reality ofen often diverge. Starting from the communication difficulties that exist between doctors and patients, Humane Medicine explores the roles of science, ethics and the humanities in medical practice. It forcefully argues that more science cannot heal this rift, nor can better education in ethics.
To foster better communication, medical teachers must change their philosophy and methods, so that value-laden issues in clinical medicine are interwoven with the necessary science. Professor Little outlines some possible ways to achieve this. This important book will be of interest to medical students and their teachers, clinicians, health policy planners and other readers concerned about the direction of the medical profession.
"The author...encourages education, changes in medical curriculum and clinical paradigms, and a conscious change from a medical model which is biopositivist to one which is biohumane. He provides convincing evidence that the profession can remedy the communication problem between doctors and their patients. Thus, the author has achieved his objectives...Physician leaders and public policymakers will serve the citizenry and the medical profession better by studying this important work." David L. Nahrwold, Doody's Health Sciences Book Review Journal "...provides evocative content that will appeal to physicians and other providers, sociologists, ethnicists, philosophers, and anthropologists. Highly recommended." A.R. Davis, Choice "The beauty of Little's book is its lucidity. It is at once sophisticated and clearly written...Humane Medicine will increase one's understanding of the moral basis of medical practice...Little's book opens many avenues that will enhance physicians' philosophical and humanistic background..." William T. Branch, Jr., New England Journal of Medicine "This is not a book by a professional philosopher, but is nonetheless a valuable contribution in applied philosophy, specifically in the philosophy of medicine. Little is a Professor of Surgery, but one who is obviously widely read and aware of the contributions that philosophy and the other humanities, such as literature, make to medicine...The book...is not so much written as a textbook, but rather as a book in which a certain vision is put forward...The book is therefore a solid contribution to philosophy of medicine, and should be a standard reference book in all medical libraries." Keith Joseph, Philosophy in Review
1. Confronting the present: confronting the future; 2. The clinical process: a Popperean analysis; 3. Science and the epistemology of clinical medicine; 4. The impact of authority and medical research; 5. Probability: Master or servant; 6. Autonomy and a calculus; 7. Ethics and the definition of professionalism; 8. The bioethics committee; 9. Autonomy, logic, hermeneutics and informed consent; 10. Text, context and the medical history; 11. Towards a new medicine; 12. A summary.