The Patient As a Person : An Integrated and Systemic Approach to Patient and Disease

In the current era, evidence-based medicine and various supporting technologies dominate everyday clinical practice, according to a disease-centred, as opposed to patient-centred, approach. They have obviously improved the clinical management of diseases and it is therefore unreasonable to think of a medicine in which they are not considered fundamental. In fact, the strength of the new medicine should be to adapt scientific knowledge to a specific clinical case. This book therefore looks at the prospect of a new 'person' centred medicine, which stands alongside the 'disease' and 'patient' centred medicine, which pays special attention to the subjectivity of scientific knowledge and the relationship between doctor and patient. It is important to emphasise that this book is written by several hands, i.e. by experts from different fields, doctors, philosophers, architects, sociologists, art critics, physicists and engineers. This is with the intention of providing as broad a perspective as possible on the doctor-patient relationship. Due to its translational and multicultural approach to the subject, the book will be of interest to a wide readership, from medical experts to students, psychologists, philosophers and institutional actors. Preface Contents Part I: Between the Doctor and the Patient Chapter 1: Between the Doctor and the Patient: History of the Relationship Introduction Prehistoric Times and Early Medicine Mesopotamia and Egypt Greeks and Romans From Medieval Europe to 1800 The Development of a Patient-Centred Medicine Conclusions References Chapter 2: The Relationship Between the Doctor and the Patient: The Ancient Conceptions of Philosophy as Medicine Philosophy as Medicine The Quadripartite Model of Medicine and the Therapeutic Goals of the Philosopher-Doctor Treatment Methods and the Relationship Between Doctor and Patient References Chapter 3: Between the Doctor and the Patient: Origins of an Intermediate World Plato’s Prisoners Damasio and the Self That Comes to Mind Put Yourself in the Place of Another and Yourself Play and Change The Multiple Realities and the Intermediate Worlds The Copy and the Substitute Multiple Realities and In-Between Worlds References Chapter 4: A Systemic Approach to Health and Disease: The Interaction of Individuals, Medicines, Cultures and Environments Introduction The Systemic Approach The Biomedical Model of Health The Eclipse of the Universal Subject and the Emergence of the Situated Subject Micromacro and Macromicro A Sociology of Chemical Processes? The Organization of Work and Circadian Rhythms Which Health Model? A Few Proposals Conclusion References Chapter 5: The Ward as a Scene Naturalisation of Roles: That of Doctor and Patient in the Ward Sympathy Empathic Imagination Bibliography Chapter 6: Between the Doctor and the Patient: The Role of the Unconscious in the Relationship Introduction Interpersonal Communication Skills and Relationship Contexts Models of Doctor-Patient Relationship The Role of Unconscious in the Doctor-Patient Relationship Social Cognition: Theory of Mind Social Cognition: Empathy Brain Areas Involved in the Response to the Needs of the Patient Conclusions and Future Directions References Chapter 7: The Medical Doing on the Person Bibliography Siteography Chapter 8: Consent and Trust in the Doctor Patient Relationship References Chapter 9: Big Data and Precision Medicine References Chapter 10: Rehabilitation After a Disease: What Is “Normality” After an Invalidating Disease? Suggested Reading Part II: The Patient as a Person and the Disease Chapter 11: Toward Patient Care: Integrative and Complementary Approaches Introduction History and Definitions Self-Management and Patient Empowerment Complementary Health Approaches: An Intermingled Connection Between Mind, Body, and Spirituality Discussion References Chapter 12: Human Complexity: A Symphony of Vital Rhythms Introduction The Subconscious Mind Self-Organization of Rhythms Crucial Events Three Forms of Complexity and 1/f Noise Complex Rhythms Autonomic Neuropathy Meditation Top-Down or Bottom-Up Approach to Consciousness? Caring Versus Curing Therapies for Both Parkinson and Alzheimer Conclusions Group Mind Einstein’s Legacy A New Approach to Quantum Mechanics Bounded Rationality Autopoiesis References Chapter 13: Spirituality in Medicine: A New Dimension in the Light of a Millennial Tradition Introduction Spirituality, Contemplative Practices and Science The Illness, the Treatment, the Death, the Compassion in the Buddhist Tradition The New Dimension of Spirituality in the Relationship of Cure The Institutional Context The Individual Context Conclusions References Chapter 14: The Body of Descartes and Humanism in Medicine The Body and the Mechanistic Theory of Nature The Body and Soul of Descartes Reduction of Complexity Cartesian Distinction Between Machines, Animals and Men Language and Reason Outside the Body The Language The Mind and Language Excluded from Corporeality Biomedical Model and Its Evolution Humanistic Medicine in the Context of a Model of New Medicine Conclusion References Chapter 15: The History of Narrative Medicine: A Way to Know the Patient Dimension Between Apollonian and Dionysian The Here and Now The Patient Dimension The Mythos and Reinforcement of Human Qualities in Pandemic Ages References Chapter 16: To Care for a Patient as a Person: Emotional Architecture of the Environment Hospital as a Social Architecture Quality of Spaces and Soft Qualities Finishing Materials and Furniture Wayfinding and Orientation Green Spaces and Healing Gardens Users’ Comfort and Indoor Air Quality (IAQ) Design for All New Perspectives for Increasingly Healing Hospitals References Chapter 17: Beauty Saves. Culture Cures Classical vs Conceptual Art: From Aesthetic Perceptive Experiences to Ecstatic Sharing The Historical Avant-Gardes: Anti-Beauty That Generates Pleasure Present-Day Museology: Include, Empower, Cure, and Spread a Sense of Well-Being Curing the Soul: Museotherapy and the Search of Self Chapter 18: An Integrated and Systemic Approach to the Patient: Beyond Evidence Based Medicine Healthcare and Patient Centeredness My Personal Experience of Relationships with Sick People References Chapter 19: Medicine: The Science In-Between References Chapter 20: A Dialogue Between a Philosopher and a Doctor Pingitore Iacono Pingitore Iacono Pingitore Iacono Pingitore Iacono Pingitore Iacono Pingitore Iacono Conclusion Bibliography