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Friday, March 24, 2006
Harvard (Re)discovers Patients' Narratives
The Boston Globe recently reported that Harvard Medical School is reconfiguring its curriculum in an effort to train physicians to understand the experience of illness, and the bewildering complexities of the health care system, from the patient's perspective. There's an intriguing historical footnote to this news. Much of what Harvard and its hospitals are now implementing - placing students in clinical situations where they will be intensely involved with the whole person, not merely with that person's disease, and closely supervising students to provide feedback on their interactions with patients and families - is at the heart of Clinical Pastoral Education (CPE), the clinical training completed by many theological students and clergy in preparing for working as professional chaplains or for other ministry to patients and families. The CPE movement began in 1925, at . . . Harvard Medical School, when Richard C. Cabot, a professor of medicine and philosophy and the author of Adventures on the Borderland of Ethics (1926) called for a "clinical year for theological students," similar to medical students' third year. The most influential early CPE center was Massachusetts General Hospital, where Harvard's "new" medical-education curriculum is now being rolled out. Perhaps Professor Cabot would describe this innovation as "a theological year for medical students"?
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The Luxurious Growth
David Brooks, NY Times
“There seems to be a general feeling, as a Hastings Center working group put it, that ‘behavioral genetics will never explain as much of human behavior as was once promised.’”
Mind-Altering Drugs and the Problem Child
Claudia Meininger Gold, Boston Globe
“If we can listen differently to parents of young children who have ‘behavior problems,’ we can intervene early, before there is even a question of medication, and may be able to change these developing brains.”
Cash for Kidneys? Scheme Won't Work
Art Caplan, MSNBC
“A default donation plan could bring a boost in organs for transplant without creating the headaches, fears and misdistribution of a financial market.”
'Blade Runner' ruling subverts nature of sport
Art Caplan, MSNBC
“It may be fascinating to see who can go the fastest on rocket-powered legs or throw a heavy weight the farthest using performance-enhancing drugs, or genetically engineered muscles. But what you have then is an exhibition or a show, not a sport.”
A Phony 'War on Science'
Michael Gerson, Washington Post
“In their talk of a Republican war on science, liberals may be blinding themselves to a very different kind of modern war in which their own ideals are deeply implicated: a war on equality.”
It’s Not Immoral to Want to be Immortal
Arthur Caplan, MSNBC
“Despite a lot of hand-wringing and finger-pointing, it is not obvious that wanting to live a lot longer is evil or immoral.”
Science Is Leading Us to More Answers, but It's Also Misleading Us
David A. Shaywitz, Washington Post
“Consumers of scientific information must balance the hope we place in global biology with the skepticism this field has surely earned.”
Taking the Scary out of Breast Cancer Stats
Carol Tavris and Avrum Bluming, LA Times
“The media understand how deeply women fear breast cancer, and the result is that every study that seems to find a link between some new risk factor and the disease makes headlines everywhere.”
Dollars to Doughnuts Diagnosis
Albert Fuchs, LA Times
“Insurance doesn't make routine care affordable; it makes it more expensive by adding a middleman.”
Tainted Medicine
Jerome P. Kassirer, LA Times
“Disclosure of financial ties may give a scientist or researcher a clean conscience, but that doesn't erase the possibility of a conflict.”
Children's health can't be left to faith alone
Arthur Caplan, MSNBC
“Parents do not have the right to watch a child wither away while they pray.”
Transplant List Numbers Raise Doubts
Arthur Caplan, MSNBC
“The American people have a right to expect absolute honesty about the number of people waiting for a transplant at any time.”
An Epidemic No One Wants to Talk About
Robert E. Fullilove et al., Washington Post
“Simply put, we will never rid the United States of HIV and other STDs if our only weapon is medical treatment.”
Making Cells Like Computers
Erik Parens, Boston Globe
“Conceivably, we are on the verge of installing synthetic genomes in bacterial cells to create products we want. But we are still a long, long way from doing what most people mean by ‘synthesizing life.’”
Miracle Workers?
David Rieff, New York Times Magazine
“Even today, the oldest of all relations between patient and physician — that of supplicant to shaman — continues to exert its authority.”
Overselling Overmedication
Judith Warner, NYTimes.com
“Most of the critics decrying the over-medicalization of the American mind rest their arguments upon the bedrock assumption that people who have nothing wrong with them are being medicated for largely fictitious concerns.”
Ads Spur Urge for Drugs
David Lazarus, LA Times
“DTC advertising has turned prescription drugs into just another gotta-have-it consumer product.”
As a double major working toward a masters of pastoral ministry and a doctorate in health care ethics, I found the clinical internships required by both programs invaluable. I have recently graduated with a Doctor of Health Care Ethics degree where I completed four clinical internships at area hospitals. I have also completed one of two required CPE's for my ministry degree. That experience was one of the most profound. I engaged in the CPE over the summer of 2005. By that time I was nearing the end of my doctoral study, so I entered the clinical pastoral education experience with a considerable amount of clinical time under my belt. I was faced with situations where I had to adjust my focus and purpose for engaging the patient, family, or staff member. I found it to be an enlightening and rewarding experience. I have received letters of appreciation and inspiration from patients or family members with whom I spent precious time. During my summer internship I was faced with two particular situations where I had to make use of both my pastoral and ethics training to help the patient and family navigate difficult situations. The experience only strengthened my resolve that all of us who have chosen a health care profession of any sort must seek out educational and training experiences that will equip us all to address the "patient as person" by considering the physical, psychological, social, and spiritual needs of that particular patient, family, or co-worker.
- Jessica A. Moore