HEALING, WHOLE PERSON CARE AND INCLUSIVE MEDICINE

 

As we move into the 21st century there is a malaise, if not disenchantment with what has come to be known as modern medicine. While this has much to do with shrinking healthcare budgets, cuts in services, and the restructuring of healthcare over the last 30 years, it is also connected with an increasing awareness that modern biomedicine, despite its extraordinary scientific and technological accomplishments, has become increasingly detached if not divorced from healthcare practitioners and their patients. This has many manifestations, but is probably best represented by the way in which 'healing,' in concept and practice, has been systematically marginalized in contemporary medicine. Healing has at its core a collection of values that centre on re-asserting the primacy of the healthcare practitioner/patient relationship and its complex dynamics in both ordinary day-to-day interactions, and particularly in situations where patients may find themselves confronted with chronic or terminal illnesses. Building on over a decade of work accomplished at McGill Programs in Whole Person Care, and with the knowledge that similar initiatives were occurring globally, we put out a call for the first international conference on whole person care that would bring together colleagues, researchers, patients and others committed to rediscovering and opening up medicine to the arts and sciences of healing.

 

The First International Congress on Whole Person Care, held at McGill University in October 2013, brought together 250 clinicians and researchers from North America, Europe, the UK, Japan, Australia, and New Zealand with the expressed aim of exploring a new paradigm in healthcare that centred on healing. As can be discerned from the abstracts of the Congress that constitute this first issue of the International Journal of Whole Person Care, not only is wholeperson care alive and well -- indeed, thriving in some international contexts -- but is being practiced across a range of institutions and healthcare professions in diverse and complex ways. As made evident by the authors in this first issue of the journal, whole person care is being explored through a myriad of paradigms, methods, tools, and themes. These encompass mindful medical practice, creative writing, music and art therapy, inter-professionalism, narrative medicine, reflective practice, trans disciplinary, palliative care, evidence informed biomedicine, and qualitative research, to name a few. Although seemingly disparate, these themes (in seminars, workshops, and posters presented at Congress) were united by an underlying commitment to constructing a shared understanding of what whole person care (and healing) can mean in theory and practice. As with any emergent paradigm, we did not come to either a consensus or a clear-cut definition of whole person care. Rather, Congress participants were able to discern the possibilities of what healing might look like by drawing on their own knowledge, experiences and understanding.

 

In this respect the Congress achieved exactly what we had intended, which was to begin a conversation that bridged different geographical, social, cultural, professional and disciplinary boundaries, with the aim of formulating an approach within medicine that would include (and not, as it currently tends to, marginalize) the practices of healing. Although not drawn from a healthcare context, the following quote from the anthropologist Margaret Mead captures some of the elementary principles and values that might prefigure the ethos driving whole person care as we move forward:

 

"If we are to achieve a richer culture, rich in contrasting values, we must recognize the whole gamut of human potentialities, and so weave a less arbitrary social fabric, one in which each diverse human gift will find a fitting place."(1)

 

Importantly, whole person care is not simply about opening up niches within medicine in which it can be practiced. Rather, it represents a much broader and far more ambitious shift that aims at reconceptualising and reconstructing the entire edifice of the contemporary healthcare mandate. (2) It aims at what might be called an inclusive medicine, one which recognizes, practices, and appreciates contrasting values; including the vast complexity of human potentiality and the social fabric that constitutes it; and which ultimately re-asserts the centrality of the healthcare practitioner/patient relationship.

 

In 2014 whole person care remains on the margins of medicine. However, it is clear from the Congress and the abstracts found in this inaugural issue of the International Journal of Whole Person Care significant inroads and contributions are being made locally, nationally, and internationally, and that it is likely to grow and exert increasing influence over what is now considered to be "normal"or accepted medical practice in the years ahead. How and in what ways whole person care will emerge in the decades ahead is still an open question, depending as much on the vision and imagination of those who currently work in healthcare systems as it does on practitioners of healing themselves. We anticipate that this journal will become a forum for exploring such a vision and will thereby contribute to the evolution in theory, practice and policy of whole person care in the years ahead. We look forward to receiving your contributions.

 

REFERENCES

 

1. Mead M. Sex and temperament in three primitive societies. NewYork: W. Morrow; 1935. p. 322.

 

2. Hutchinson, TA, editor. Whole Person Care. A new paradigm for the 21st century. New York: Springer Science + Business Media, LLC; 2011.

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