It’s undeniable that medicine and science have transformed our world. From novel therapeutics that combat various diseases, new technologies that allow us to better understand how our bodies function, to transformative surgical interventions. Yet, often, since we know that medicine and science “work”, we fail to interrogate and challenge the authority granted to it to understand and shape our world - for better and for worse.
As a historian of medicine, here are 3 reasons why I believe aspiring medical student should care about the history of medicine.
1. The history of medicine illuminates how the production of medical knowledge, and the practice of medicine can be biased.
While “science” and “medicine” are understood to be objective and neutral, it is critical to keep in mind that they are carried out by real people who operate in the social world - a social world that has radically shifted across time and geographies. As a result, it’s critical to consider the following questions: what sorts of research questions have been and continue to be asked and why? Why has data been analyzed this way and what are the implications? How have we chosen to apply scientific and medical knowledge? Ultimately, a historical investigation reveals that the answers to these questions are ultimately a reflection of broader sociopolitical, economic, cultural, and moral considerations. In other words, science and medicine shape our social world, and our social world affects the production of science and medicine.
2. The history of medicine helps us contextualize and respond to contemporary racial health disparities.
As is commonly reported, in the United States, Black, Indigenous, and non-white Hispanic people continue to have the worst outcomes on a majority of examined measures of health status, are more likely to be uninsured, face significant disparities in access to and utilization of care, and receive lower standards of care. While this data shows us that people of color continue to face significant disparities in the healthcare system, it fails to reveal its origins. Examining this history can help scientific and medical practitioners recognize that much of modern Western scientific and medical knowledge cannot be divorced from the historical contexts of slavery, colonialism, and global imperialism under which it was produced - a context that ultimately shaped racism and discrimination that we see in our society. The reality is that the medical enterprise has historically supported ideas about racial minorities “biologically based inferiority”. This has left them to racially biased scientific and medical discourses, unethical experimentation, and exploitation that manifests in contemporary racial discrimination and health disparities.
3. The history of medicine teaches valuable lessons in the domain of medical ethics.
While medicine has brought significant advances to our society it, at times, has come at a great cost, particularly to vulnerable populations. While it would be easy to say that “physicians in the past simply didn’t have a robust code of ethics”, an examination of the historical record reveals that could not be farther from the truth. The reality is physicians have consistently violated the ethical standards of their time in the name of medical advancement. Examining these histories - from 19th century experiments on enslaved women to 20th century experiments on prisoners and orphans - reveals the ways that medicine has caused harm and, hopefully, serves as lessons to future generations to interrogate the nature of their investigations.