There is a place where the human side of medicine is elevated, examined, and revered. Our Center for Medical Humanities, Compassionate Care and Bioethics, situated in the Department of Family, Population and Preventive Medicine in the School of Medicine, is devoted to training medical students and health professionals as well as conducting high impact research and scholarship in the three thematic components reflected in its name. While we maintain and develop curricula on these three themes with a primary focus on the medical school, we are also actively engaged in undergraduate and graduate teaching across the university. We maintain a productive research portfolio combining work in the traditional humanities including bioethics, narrative medicine, health care justice, health policy, and history; clinically-oriented scholarship centered on compassion, altruism, and palliative care; and NIH funded scientific research. Building on a rich legacy of four decades of exemplary medical humanism at the Stony Brook University School of Medicine, the Center was founded in August of 2008.
We are sometimes asked about our three-part name, The Center for Medical Humanities, Compassionate Care, and Bioethics. These are not three separate silos, but integrated concentric circles expanding outwards to form a trajectory for becoming effective humanistic physicians. The three elements have a natural order that helps students shape their professional identity while nurturing core values:
(1) Humanities and the Illness Experience (literature, film, the creative arts, poetry, narrative medicine) are intended to elevate student appreciation of the subjective experience of illness in the lives of patients, their families, and caregivers. Only by closely observing the illness experience can students begin to connect with patients as persons, replete with narratives of hope, anxiety, fear, love, loss, meaning, goals, culture, and treatment preferences. Student attentiveness to this narrative opens up the possibility of their encountering patients not just biologically, but as persons rather than mere puzzles. This awareness is at the very center of the art of medicine, of healing in any full sense of the word, and it naturally enlivens deeper empathic capacities.
(2) Virtues (empathy, attentive listening, humility, integrity, gratitude, self-care, benevolence, and loyalty) all unfold from the uptick in narrative consciousness made possible through detailed humanistic observation. For empathic care to be sustained over the course of a career the professional virtue of self-care is also important. The humanistic virtues build the secure relational foundation of trust that is needed for good communication with patients, and for effective ethical decision making.
(3) Clinical Ethics (communication, compassionate care, integrity, gratitude, self-care, equanimitas, respect for autonomy, confidentiality, and wisdom) is more than the application of a set of principles or procedures for approaching the challenging decisions that patients, families, and caregivers confront daily. Clinical ethics requires a close attentiveness to the humanistic as well the scientific details of each case, a skill that can be finely honed through the medical humanities. Empathic virtues as habits of daily clinical interaction create a safe space for meaningful dialogue with patients around their values, goals, and choices in which their autonomy is respected. These humanistic assets can be developed as workable communicative skill sets with both cognitive and affective dimensions. Clinical outcomes, patient satisfaction, and provider meaning and well-being are all enhanced when ethical decision making proceeds in the context of the humanistic virtues.
Our three concentric circles exist in a surrounding field of healthcare systems including the healthcare system and finance, health law and policy, justice and access to care, the science of compassionate care and posthumanism. Compassionate care drives clinicians and students toward concern for justice according to patient need. Martin Luther King, Jr., wrote famously of “the love that does justice.” Often patients are as stressed by navigating insurance and the healthcare system as they are by their illness itself. Clinicians committed to the good of patients are driven by compassion to advocate for access to needed medications and other necessary treatments, as well as ultimately to matters of population health.
This then is our philosophy, reflected in scholarship, research, cultural engagement, reflection rounds, Schwartz Rounds, clinical ethics, our thriving graduate degree program, and as embedded in our medical school educational structure. Our primary mission lies in building humanistic and ethical skill sets in our students and clinicians. We invite you to join in our work.–Stephen G. Post, PhD