The Mechanical Patient: Finding a More Human Model of Health / Edition 1

by Sholom Glouberman

Overview

Healthcare is very much dependent on the model of the patient that is assumed by healthcare providers. The current model derives from a chemical/mechanical view of the patient body. Simply put: we are healthy if all of our mechanical parts are working properly and if all of the chemicals in our body are in the right proportions and have the appropriate reactions. This view is based on philosophical accounts of the body that go back to Paracelsus, Descartes, Boyle and others. It became the central basis of medical practice only in the late 19th Century after several hundred years of research and professional politics.

The Mechanical Patient traces the intellectual development of the chemical/mechanical model of the patient and its implementation. This book names the problem that we have with the mechanical patient and prepares us to respond to its exaggerated place in our society. It provides a historical and conceptual background and explains how the chemical/mechanical model of health gained such a strong hold over our thinking and took the place of the earlier Galenic humoral model. It sketches a promising outline of a more humanized model for understanding health and calls for help to fully articulate it. In that way, it joins a growing movement to go beyond our current chemical/mechanical orientation.

Product Details

ISBN-13:	9781138549944
Publisher:	Taylor & Francis
Publication date:	06/12/2018
Pages:	190
Product dimensions:	6.12(w) x 9.19(h) x (d)

About the Author

Sholom Glouberman is Philosopher in Residence at Baycrest Health Sciences in Toronto. He has a PhD in Philosophy from Cornell University. His early experience in healthcare was caring for his dying father. He was a planner and adviser at the McGill University Health Centre in Montreal, a Fellow at the King’s Fund in London England, the director of Health Policy for Canadian Policy Research Networks, the director of the International Health Management Program at McGill University and the founder of Patients Canada. He has been an adviser to many healthcare organizations in Canada and the UK. He has spoken before more than 25,000 people around the world. In the last few years he has worked extensively with patients and organizations to create patient partnerships and identify performance targets to humanize healthcare experiences.

Sholom Glouberman is Chairman of the Patient Advisory Board of the Registered Nurses Association of Ontario which has 42,000 members. In 2015 he underwent a major surgical procedure and was himself a patient. His direct experience and work with others has helped him see the disparity between the current medical model and patient concerns. He has written four books and many articles.

Table of Contents

Contents

List of Figures ..................................................................... xi

List of Tables .....................................................................xiii

Acknowledgments ............................................................. xv

Author ................................................................................ xix

1 Introduction .............................................................1

2 Aristotle and a Good Life ........................................7

Aristotle (384–322 BC) ........................................................ 7

How Aristotle’s Ideas Can Help Us Understand

More about Health .............................................................12

3 Galen’s Four Humors: The First Medical Model ....15

Galen (AD 129–c.210) .......................................................16

4 The Renaissance and Roots of the Mechanical

Patient ....................................................................25

Paracelsus (1493–1541) .....................................................26

Francis Bacon (1561–1626) .............................................. 28

William Harvey (1578–1657) ..............................................31

René Descartes (1596–1650) .............................................32

Pierre-Simon Laplace (1749–1827)......................................35

5 Robert Boyle: The First Mechanical Patient ..........37

Robert Boyle (1627–1691) .................................................37

Boyle and Samuel Hartlib .................................................40

Boyle and George Starkey (1628–1665) ...........................43

Boyle and William Petty (1623–1687) ...............................45

Boyle and John Wilkins (1614–1672) .............................. 46

Boyle and Thomas Willis (1621–1675) .............................47

Boyle and Robert Hooke (1635–1703) ............................ 48

Boyle and Thomas Hobbes (1588–1679) .........................51

Boyle and Arthur Coga (1631–1691) ................................53

Boyle and John Locke (1632–1704) ..................................53

Boyle and Isaac Newton (1642–1727) ..............................55

6 The Story of Scurvy and the First Failed

Controlled Trial .....................................................59

George Anson, 1st Baron Anson (1697–1762) .................60

James Lind (1716–1794) ....................................................61

James Cook (1728–1779) .................................................. 64

John Pringle (1707–1782) ..................................................65

Sir Gilbert Blane (1749–1834) ...........................................66

Almroth Wright (1861–1947) .............................................69

Axel Holst (1860–1931) and Theodor Frolich

(1870–1947) ........................................................................70

Ancel Keys (1904–2004) ....................................................71

7 Surgery and the Mechanical Patient ......................73

John Hunter (1728–1793) ..................................................74

Fanny Burney (1772–1840) ...............................................75

Ignaz Semmelweis (1818–1865) ....................................... 77

Joseph Lister (1827–1912) .................................................81

Wilhelm Röntgen (1845–1923) ..........................................82

Abraham Flexner (1866–1959) ......................................... 84

The Mechanical Patient in the Modern Hospital ..............85

Nurses in the Modern Hospital ........................................ 86

Lili Elbe (1882–1931) .........................................................87

Christiaan Barnard (1922–2001) ....................................... 88

Surgical Techniques ...................................................... 90

PROMs ........................................................................... 90

8 Medicine and the Chemical Patient .......................93

Lady Mary Wortley Montagu (1689–1762) ........................93

Edward Jenner (1749–1823) ..............................................95

Louis Pasteur (1822–1895) ................................................ 96

Robert Koch (1843–1910), Ferdinand Cohn

(1829–1898), and Maurice Hilleman (1919–2005) ............. 98

Mary Mallon (Typhoid Mary) (1869–1938) ....................... 99

Charles Best (1899–1978), Sir Frederick Banting

(1891–1941), and James Collip (1892–1965) ..................101

The Tuskegee Syphilis Study (1932–1972) and Ethics ...101

Gerhard Domagk (1895–1964) ........................................102

Alexander Fleming (1881–1955), Howard Florey

(1898–1968), and Ernst Chain (1906–1979) ......................103

Henrietta Lacks (1920–1951) ...........................................104

Ali Maow Maalin (1954–2013) ..........................................106

Sam Wagstaff (1921–1987) and Robert Mapplethorpe

(1946–1989) .......................................................................106

WHO Atlas .......................................................................107

Brenda Zimmermann (1956–2014) .................................. 110

9 Genetics and the Return of Individualized

Medicine ..............................................................113

Charles Darwin (1809–1882) ........................................... 114

An Aside on the Evolution of Human Consciousness ... 115

Francis Galton (1822–1911) .............................................. 115

Wilhelm Beiglböck (1905–1963), Karl Brandt

(1904–1948), and Josef Mengele (1911–1979) ................... 116

Rosalind Franklin (1920–1958), Francis Crick

(1916–2004), and James Watson (1928–) ......................... 118

Herbert Boyer (1936–) and Stanley Cohen (1935–) ......... 118

Charles DeLisi (1941–), Pete Domenici (1932–),

and Craig Venter (1946–) ................................................. 119

Angelina Jolie (1975–) ......................................................120

Emmanuelle Charpentier (1968–) and Jennifer

Doudna (1964–) ................................................................120

10 The Great Mortality Shift ....................................123

Edwin Chadwick (1800–1890) ........................................124

John Snow (1813–1858) ..................................................126

Joseph Bazalgette (1818–1891) .......................................127

John Simon (1816–1876) .................................................127

Aneurin Bevan (1897–1960) ............................................128

Rachel Carson (1907–1964) .............................................130

Thomas McKeown (1912–1988) ......................................131

Hubert Laframboise (1924–1991) and

Marc Lalonde (1929–) .......................................................132

11 Humanizing Health: The Social/Relational

Person ..................................................................139

The Great Chain of Being ............................................... 141

Voltaire (1694–1778), Rousseau (1712–1778),

Diderot (1713–1784), and Hume (1711–1776)...................142

The Enlightenment and Reform ..................................142

James Edward Oglethorpe (1696–1785) .........................143

Jeremy Bentham (1748–1832) and John Stuart Mill

(1806–1873) .......................................................................144

Richard Wilkinson (1943–) ..............................................146

Michael Marmot (1945–) .................................................. 147

Amartya Sen (1933–) ....................................................... 150

Thomas Piketty (1971–) ................................................... 151

Finding a More Human Model of Health .................... 151

Bibliography ............................................................... 157

Index ..........................................................................163