Erik Larsen // “He is the object of information, never a subject in communication” (200). With this pithy formula, Foucault summarizes the prisoner’s situation within the panoptic prison. The prisoner is everywhere observed and monitored, made into an object of study and manipulation, while never communicating personally with their panoptic observer. Foucault’s description of modern impersonalism might pass as a maxim for the medical humanities. Indeed, if medical humanism’s origin lies in a response to biomedicine’s infamous dehumanization of the patient, one need only tweak Foucault’s statement minimally to justify this intervention: “the patient is the object of information and practical manipulation, never a subject in communication with the physician.” In response to this situation, the medical humanities introduce providers to the study of subjective expression, prompting physicians to engage the patient as subject, in addition to gathering necessary biomedical information. Put simply, the medical humanities reintroduce “the human” into a process characterized as exhaustively “dehumanizing.”
Nothing about this framing of the discipline should strike its practitioners as novel, even if some might object that the medical humanities have developed beyond a reactionary movement. While I concede this point, for those teaching medical humanities in hospitals and medical schools, the discipline continues to function in many respects as a response to biomedicine’s dehumanization of patient and provider. Although something of a cliché, and despite the efforts and successes of many compassionate providers, it seems correct still to describe contemporary medical practice as broadly impersonal. For this reason, I strongly support our attempts to “humanize” biomedicine with materials, methods, and concepts from the humanities. But I am disturbed by all that appears unthought in this well-intentioned response. Have we, for example, critically questioned the “humanity” implicit to our struggle with systemic dehumanization? What concept of “the human” informs the medical humanities? What does this notion function to contain and exclude?
These questions appear mostly unexplored in the field’s rapidly proliferating literature. And yet, “the human” seems the precondition for our conceptual and practical interventions into medicine. Like many a founding concept, “the human” assumes essential differences—in this case, between humans and other animals—that bespeak a normative or metaphysical distinction. Our attempts to “humanize” medicine may rely on a privative category—on the other defined by the humanity it lacks. Humanism, which undoubtedly shaped the modern humanities, may be a source for this conceptual background. We rightly value certain aspects of this tradition, but as Cary Wolfe indicates, problems arise from humanism’s implicit normativity: “most of us would probably agree that cruelty toward animals is a bad thing, or that people with disabilities deserve to be treated with respect and equality. But as we will see, the philosophical and theoretical frameworks used by humanism to try to make good on those commitments reproduce the very kind of normative subjectivity—a specific concept of the human—that grounds discrimination against nonhuman animals and the disabled in the first place” (xvii). In as much as it seeks, for sincere and ethical reasons, to bring “the human” back into medicine, will the medical humanities replicate norms that undermine its empathic prerogatives?
I can neither answer this question, nor furnish a superior paradigm. I aim, instead, only to prompt further discussion, and hopefully, more critical theorization of the medical humanities’ conceptual foundations. By doing so I intend neither to critique the idea of the medical humanities, nor to deny the need for a disciplinary response to medicine’s transformation of the patient into an “object of information.” Indeed, medicine needs to hear, understand, and respond to the patient as a “subject in communication.” But as we facilitate this transformation in medicine, we should ask ourselves a question: must this subject be “human”? We might begin to answer by identifying “the human”—the norm—underpinning our different approaches to the medical humanities. One might then consider who this norm designates as its non-human other.
Foucault, Michel. Discipline and Punish: The Birth of the Prison. New York: Vintage Books, 1995. Print.
Wolfe, Cary. What is Posthumanism? Minneapolis, MN: University of Minnesota Press, 2010. Print.
