Abundance, Navajo Sand Painting

Religion and art are not subject to the reductionist and materialistic assumptions of modern science, the Kentucky farmer, poet, and essayist Wendell Berry argued.

The insights of the humanities cannot be contained within the boundaries of modern science nor understood by its explanations, Berry insisted. In Life Is A Miracle: An Essay Against Modern Superstition, he came close to capturing the complaint of the patient and others who experience the reductionistic and materialistic protocols of modern health care that too often become the foundation for public policy.

Berry's complaint is not new, however. The year 1965 was a turning point for the tension between modern medicine and the humanities. It became the starting date of the "medical humanities movement," which saw the emerging conversation between church and hospital move into the curricula of medical education. That year, funded by the Danforth Foundation, several chaplains, led by Dr. Ronald W. McNeur, met with prominent medical scientists about ways to overcome the increasing gulf between education for the physician and treatment of the patient. McNeur had long addressed the radical human implications of new developments in the practice of medicine coming out of university medical centers. In particular, he was concerned about the increasing tendency of medicine to disorient and destabilize patients by separating them from their religion and culture.

By 1965, the changes in health care delivery generated by the Second World War pervaded most sectors of the continent. The wartime taming of bacterial infection and the perfecting of care for the acutely injured were harbingers of the changes that science and technology would bring to health care. Governmental and philanthropic investments made research-based medicine available to the average citizen. With these changes came the myth, what Berry would call superstition, that disease and illness would be conquered, if not now, then later. A disease-free world became the promise to the believer. In the modern, cathedral-like hospital, the task of the physician shifted from care to cure. The role of the patient shifted from person to product.

The Danforth Consultation focused on such questions as:

• Can a unified view of medicine be developed in the student?
• Are medical schools going to offer serious study of ethical problems for doctors?
• Is medical education going to be divorced from the patient's problems?
• Are the student's motivations to service nurtured in medical education?
• What infringements on human rights are there in aggressive, bold research?
• Where in the curriculum are ethical questions to be raised, and by whom?
• What morality emerges from new knowledge?
• What happens to the awe of life in the complexity of reality?
• What is the influence of social values on medicine?

One participant in the Danforth Consultation was the newly-appointed founding dean of the Pennsylvania State University Milton S. Hershey Medical Center, Dr. George T. Harrell. Two years later, Harrell established the first academic unit in a medical school that addressed these questions. By 1972, there were eleven schools of medicine with human values programs; by 1974 there were nineteen; by 1976 there were twenty-nine; and by 1980, out of 125 accredited medical schools in the U.S., 117 had such programs.

During this unusually rapid adoption of new disciplines in medical school curricula, numerous symposia, workshops, and scholarly exchanges were organized. Major scholarly journals were launched, book series published, and professional associations formed. Perhaps the most telling impact of the medical humanities movement came when the questions of human values became part of standard questions for the national examination boards used for certifying and licensing health care professionals.

The impact of medical humanities was not confined to medical education. Faculties of nursing, social work, theology, and law began to engage in the conversations and consultations between health care providers and scholars in the humanities. Hospitals began to expect staff to consult with emerging specialists in ethics and law about unusual and difficult cases. The Park Ridge Center was founded to deepen the dialogue between faith, ethics, and health care. The American Hospital Association adopted a Patients' Bill of Rights. Congress established requirements for oversight of research involving human subjects and defined criteria for use of scarce medical resources.

These pervasive changes in health care reflected radical shifts in thinking in both popular culture and scientific discourse. Dr. McNeur's challenge, as he saw it, was to push theologians and scientists to converse with one another. He rejected the dictum of the time that the groups had nothing to say to each other. The fundamental problem, he argued, was the unexamined assumptions of the philosopher, Descartes, and the Cartesian school of thought that separated body and soul into distinct and separate entities. Cartesian philosophy encouraged a rationalism that became the basis for scientific and technological development. Human beings were treated as things; the soul as a thing. Whatever the distinctions, McNeur asserted, in a 1963 article published in The Christian Scholar, health care must come together at the bedside where the patient is treated as a whole person.

Many of today's prominent humanities scholars are persons who picked up the challenge of bridging the historical separation of the humanities from the science and practice of medicine. Rather than the Cartesian separation of the patient into divisible parts, many of these scholars articulated grounds of thought that are common to both the humanities and science and that address the unity of person as patient. The foundations of the discourse between the humanities and the sciences became increasingly the grounds for conversation about public policy and the economics of resource allocation.

Despite the success of the medical humanities movement in seeking to be at the heart of health care education, much of the investment in medical research continued to follow the Cartesian model, not the least of which is the Human Genome Project. By picking apart human tissue at the molecular level, researchers began to express their motivation to find "the holy grail" of life in genetic matter.

It is risky to choose one author or book as representative of any strand of thought, but Edward O. Wilson's Consilience, published in 1998, warrants the risk. Speaking with all confidence about molecular biology as the dominating discipline of medical research, Wilson argued that the advance of scientific knowledge can now account for and subsume—perhaps consume?—all knowledge, including religion and the arts. Using some of the very arguments the humanists made a decade earlier, Wilson asserted that everything comes together in our genes and that culture, social relationships, and human values are determined in the paradigm of the genome.

The peoples of New Mexico, among whom I now live, move through life with their eyes, but not their hearts, on the competing claims for scientific truth, particularly what is declared as truth for living. If science has provided such an immensity of knowledge about life, so too has science provided an immensity of violence—their sacred grounds defiled by careless disposal of plutonium, their waters clouded by industrial wastes, their economies depressed by corporate greed. These peoples wonder whether, in fact, the efforts to find unifying thoughts and practices lead to anything more than the dominance of a few over the lives of the many. In no place in North America has research-based health care been so pervasively rejected as in New Mexico. The bearers of human values, the humanities, are often seen as co-opted by the industries of health care. Managed care, using the hard-won standards of ethics and law, is often experienced as withholding care.

Not long ago, a Nobel laureate asserted to a New Mexico audience that scientists would soon know all that is necessary to control life. He spoke of the great strides molecular biology is making in overcoming "the superstitions of the primitives." He said this to an audience many of whom could trace their lineage back through hundreds of years of competing claims of truth. Their memories and practices have been largely ignored by both the scholars of the university-based humanities and sciences. Are they lacking truth? Is their diversity too divisive in the world of public policy? Wendell Berry puts their perspective another way. Why should we trust those whose vision of the future is "a place where the most genetically favored and the most richly subsidized scientists determine the future by 'plunging ahead,' each isolated in his or her vision of 'new terrain,' and each cut off from any restraining affection for old terrain?"

It is the matter of trust, public trust, that will support or destroy the best-rationalized and -financed research, especially health care research; the most promoted clinical treatment; the most hyped religion. At a recent consultation sponsored by the National Science Foundation, participants agreed that one of the major challenges for science today is eroding public trust in scientific, and particularly medical, enterprise. The behaviors and the claims of many scientists and medical practitioners, with the aggressive and often destructive efforts to gain funding and profits, are undermining public trust, and not just among traditional peoples. What Berry and others argue is that the molecular biologists are taking us into yet another superstition that not only betrays us in what is promised but also robs us of our abilities to return to the cultural landmarks by which we reorient ourselves.

When the historical principles of the scientific method are followed—often they are not by scientific scholars—there is respect for what is known, for what is uncertain, for what is the exception. As important and imperative as discourse between the humanist and the scientist is, have those of us in the humanities been holding our colleagues to their principles? Or have we been co-opted into rationalizing new superstitions that deny the miracle of living? We need to take a second look.

Works Cited
Barker, Verlyn L. Health and Human Values. Columbus, Ohio: United Ministries in Education, 1987, 10-11.