Patient vs. disease in medicine: Historical perspectives and contemporary concerns.
Subjectivity and objectivity are central dimensions or perspectives in medicine. During modern times, the "history of the disease" (objectivity) has more and more re-placed the "history of the patient" (subjectivity). But if medicine wants to be human, the physician's and patient's subjectivity and ethics cannot be ignored. During the Middle Ages, the concepts of health and disease are seen from a transcendental point of view, subjectivity was given an objective or spiritual meaning. Processes of secularization, naturalization and individualization deeply influenced medicine in Modern Times. The positivist 19th century laid the foundations of successful scientific medicine; the concept of disease became objective, the length and the quality of life were increased, at the same time, however, medicine witnessed anthropological losses. The 20th century stressed anew the patient's subjectivity and ethics against the scientific objectivity. Integrating psychology and sociology is a similar initiative in this anthropological perspective. The anthropological and ethical permeation of medicine is essential. Disease is not just a physical phenomenon, it is also a psychic, social, and spiritual one. Medical science behaving as human medicine should always and above all see the ill and suffering person.
von Engelhardt
Dietrich
D
Institute of Medicine and History of Science, Lübeck, Germany.
D015510:Clinical Medicine / Q000266:history*; D004992:Ethics, Medical / Q000266:history; D005858:Germany; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049691:History, Medieval; D006801:Humans; D010361:Patients / Q000266:history*