Medicine as a Means to What End? Foundations and Fragments in Healing Narratives
Ryan Gillespie, PhD, Lecturer, University of California, Los Angeles
If a—or the—goal of medicine is to restore health, a major burden is placed on the theoretical formulation and implementation of what it means to be healthy. Answering the question of what it means to be healthy requires, I argue, a healing narrative, and healing narratives in our era are varied and sometimes in tension with one another. One popular healing narrative of holistic care is illustrative: some definitions include the spiritual alongside the physical, psychological, and social, and some (perhaps most famously, the WHO’s) do not. This paper offers three things: (1) an articulation of what, generally, a healing narrative is, both as a heuristic and as a theoretically-informed analytical tool; (2) an account of flourishing as a potential end of medicine in a holistic account of health, with holistic meaning not the treatment of all parts of the human equally but rather requiring, in a contested though extant line of reasoning from Aristotelian eudaimonia, placing special emphasis on the spiritual and divine; and (3) a case study, steeped in fieldwork, of a potential model for a healing narrative of flourishing, CURE Children’s Hospital of Uganda (a faith-based pediatric neurosurgical specialty hospital in Mbale), that combines the spiritual, bodily, psychological, and social in a practical theology of health and human flourishing. Flourishing as a conceptual end for medicine provides a basis on which philosophy, theology, religious practices, and medicine can engage one another. Aristotelian-ish flourishing in the context of medical practice in the Galenic system provided a unifying framework for nearly a millennium across the Abrahamic faiths, and such sourcing, though hardly free from lacunae and tensions, might prove similarly fruitful under contemporary conditions of neoliberal imperatives of autonomy and efficiency in medicine, and the realities of ethically pluralistic and otherwise morally fragmented societies more generally. (A portion of this work was funded by the Templeton Foundation).
If a—or the—goal of medicine is to restore health, a major burden is placed on the theoretical formulation and implementation of what it means to be healthy. Answering the question of what it means to be healthy requires, I argue, a healing narrative, and healing narratives in our era are varied and sometimes in tension with one another. One popular healing narrative of holistic care is illustrative: some definitions include the spiritual alongside the physical, psychological, and social, and some (perhaps most famously, the WHO’s) do not. This paper offers three things: (1) an articulation of what, generally, a healing narrative is, both as a heuristic and as a theoretically-informed analytical tool; (2) an account of flourishing as a potential end of medicine in a holistic account of health, with holistic meaning not the treatment of all parts of the human equally but rather requiring, in a contested though extant line of reasoning from Aristotelian eudaimonia, placing special emphasis on the spiritual and divine; and (3) a case study, steeped in fieldwork, of a potential model for a healing narrative of flourishing, CURE Children’s Hospital of Uganda (a faith-based pediatric neurosurgical specialty hospital in Mbale), that combines the spiritual, bodily, psychological, and social in a practical theology of health and human flourishing. Flourishing as a conceptual end for medicine provides a basis on which philosophy, theology, religious practices, and medicine can engage one another. Aristotelian-ish flourishing in the context of medical practice in the Galenic system provided a unifying framework for nearly a millennium across the Abrahamic faiths, and such sourcing, though hardly free from lacunae and tensions, might prove similarly fruitful under contemporary conditions of neoliberal imperatives of autonomy and efficiency in medicine, and the realities of ethically pluralistic and otherwise morally fragmented societies more generally. (A portion of this work was funded by the Templeton Foundation).