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.