Healing relationships and the existential philosophy of Martin Buber |
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Authors: | John G Scott Rebecca G Scott William L Miller Kurt C Stange Benjamin F Crabtree |
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Institution: | (1) Department of Family Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, One Worlds Fair Drive, Somerset, NJ 08873, USA;(2) Department of Family Medicine, Center for Research in Family Practice and Primary Care, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA;(3) Department of Philosophy, Loyola University, 1032 West Sheridan Road, 60660 Chicago, Illinois, USA;(4) Department of Family Medicine, Lehigh Valley Health Network, 17th and Chew Street, Allentown, PA 18104, USA;(5) Departments of Family Medicine, Epidemiology & Biostatistics, and Sociology, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA;(6) Case Comprehensive Cancer Center, 11100 Euclid Avenue #6, Cleveland, Ohio 44106, USA;(7) Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA |
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Abstract: | The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views
the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper
is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians
and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then
by connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical
healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews
of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient
relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be
sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components
of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians
as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused
on healing, with I-Thou relationships at its core. |
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