Medical Reductionism

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During the 18th century around the time when bedside medicine shifted to hospital medicine and then consequently laboratory medicine, Nicholas Jewson wrote a paper that addresses the issue of how this shift affected the doctor-patient relationship, that ultimately the patient has disappeared in the equation. The tone of the paper suggested that the disappearance of the sick-man (as a catalyst that began the reductionism in medicine) would lead medicine in the wrong direction, somewhere undesirable. However, some of his claims are not very credible and some even questionable and so did the sick-man really disappear? And would this change to medicine as field actually happen for the worse?

To understand Jewson’s concerns we need to understand
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The nature of laboratory medicine was seen as unique at the time since it was researched based and a lot of the research was being done at the level of the cell. The idea that a big reductionism has occurred was understandable considering that the principles of laboratory medicine was vastly different compared to bedside medicine, because this shift happened in relatively short amount of time and it was a difficult concept to digest since the idea of humouralism was deeply ingrained in society’s perception of medicine. Therefore, when doctors narratives start becoming more reductive and significantly more scientific, it raises the concern that doctors seem to distance or dissociate themselves in relation to patients and their illnesses as seen in their reports of diagnosis; there were many works that argued this point such as Fissell’s patient narrative. It should also be noted that around this time, medicine as a field was gaining autonomy and this supported the idea of distant doctors since it seems that the social gap was increasing. To reiterate a point, just because a patients narrative was silenced it does not have to mean that their presence disappeared altogether, after all the doctor-patient relationship cannot exist when one is without the other. That is not to say that these worries are not valid, which they …show more content…
For example, medical training now includes elements such as effective health-care education, medical moral and ethics, proper palliative care and so on. The goal of medicine now conventionally being improving health and curing illnesses when possible and if not, providing options that best suit the patients needs in helping them manage their illness. Medical students have to comprehend and internalise these values over the course of their training in order to be a good doctor and in this case being a good doctor depends on their perceptiveness and attentiveness towards the patient. Medical practice also includes the history taking of a patient and that means the patients narrative is present. Along with diagnosing their signs and symptoms, doctors communicate with their patients about their medical history which compromises of a lot of factors, requiring real listening skills, and after that has been done feedback would be given. Generally, it can no longer be argued that the relationship is one sided or that the patient is silenced because both doctor and patient are now working together, that is in helping the patient in regards to their

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