Review - Medicine of the Person
Faith, Science and Values in Health Care Provision
by John Cox, Alastair Campbell and Bill Fullford (Editors)
Jessica Kingsley, 2009
Review by Tony O'Brien RN, MPhil.
Dec 1st 2009 (Volume 13, Issue 49)
Paul Tournier was a French physician who in the mid 20th century initiated a movement called "medicine of the person". Tournier was a Christian who sought to integrate Christianity and Biblical reflection into the practice of medicine, and in so doing to place considerations of the person at the heart of medical care. In Medicine of the Person a group of theologians, doctors and academics take up Tournier's challenge to consider what medicine of the person might mean in the 21st century. Not all of the fourteen chapters directly address Tournier's work, but all focus on some aspect of medicine with a view to showing how it might benefit from broader perspectives based on culture, ethnicity and faith. There are three sections to the book. The first examines Tournier's writings and the movement of medicine of the person, the second covers non-Christian faith perspectives and the third focuses on contemporary practice. Overall, readers gain an introduction to the ideas of Paul Tournier and of Christian medical practice, and an overview of some of the issues in the relationship between medicine and religious spirituality.
I found the sections on Paul Tournier the most interesting. Tournier was certainly an remarkable and energetic individual whose ideas seem consistent with much of the postwar philosophical movement towards re-establishing the centrality of meaning in human experience. I was reminded of Viktor Frankl, and his very different approach to exploring human potential. Like Frankl, Tournier was a visionary, rather driven in pursuit of his ideals, and radical in some of his practices. For example he would invite patients to his house for evening chats following consultations, where he would talk issues through with them, encouraging them to explore the deeper meaning of the complaints they brought to his surgery. It is hard to imagine a doctor adopting such a practice these days, and not only because of pressure of time. Questions would be asked about the propriety of it, not to mention of the proper boundaries of medicine. But as with much of the novel psychotherapy of the mid-century, a lot was accepted on the basis of the good intent of the practitioner. We live in more skeptical times.
Christian medical practice is a strong theme within this book. This is taken up in theoretical explorations of how Christian practice is different to secular ideas of values based medicine, and in relation to a variety of clinical contexts, including public health, home health care and neuroscience. The focus is not limited to Christianity, however, and there is a chapter on how English mental health policy is expanding to include considerations of spirituality. For non-Christians the emphasis on Christianity might seem to have limited importance as it is not something that can be adopted like a new clinical intervention. Commitment to a personal relationship with God, especially one mediated through a singular historical figure, is an individual matter and the idea of medicine and the person therefore raises issues of who can participate in such a movement. Tournier was apparently catholic in his spiritual beliefs, but there is no question that medicine of the person is a Christian movement.
The four chapters of the middle section of the book extend the discussion to different faiths, with an initial chapter on theology of diversity followed by chapters on the Jewish, Islamic and Hindu faiths. I found these chapters rather basic, important as it is to recognize multiple faiths. Within the limitations of space the authors were able to do little more than provide an introductory overview, with fairly straightforward examples of religious practices that require openness and tolerance from health professionals. This section wasn't strongly related to Tournier's work. I had reservations, too about other chapters, such as the one on neuroscience, which made extensive use of italics in a rather didactic style.
Overall Medicine of the Person is an interesting book, especially for bringing to light a rather obscure figure. As part of a more general exploration of the place of spirituality in health care the book contributes to a growing recognition that health problems should not be seen in isolation. With emotional and social life having been accepted as part of "the person", and with the place of culture and ethnicity widely acknowledged, it is time for spirituality to come in from the cold.
© 2009 Tony O'Brien
Tony O'Brien RN, MPhil., Senior Lecturer, Mental Health Nursing, University of Auckland, New Zealand, a.obrien@auckland.ac.nz