centro studi e ricerche in salute internazionale e interculturale dimec - università di bologna...

Centro Studi e Ricerche inSalute Internazionale e Interculturale

DIMEC - Università di Bologna

Medicine and power The role of medical education

Angelo StefaniniCentre for International Health

University of Bologna



“Medicine, like science, is a mode of power"

“Medicine, as science tout court, is not neutral, it is not pure cognitive activity, it is not the result of a disinterested investigation of reality, but it is at the service of capital. Its very beginning is in response to a need expressed by the capital and its future development will be instrumental to the preservation and reproduction of the latter.”

G.A. Maccacaro (1924-1977)

A. Stefanini - Unibo



Current medical education

• Largely irrelevant

• Focused on the biology of the body

• Undervaluing those disciplines that link with the social context

• Split between “scientific” (“hard”) and the “less scientific” (“soft”, humanities) disciplines




Resulting in…

• Shielding future doctors from the social reality

• Obscuring the social determinants of disease

• Ruling class/political system not accountable for social production of disease

• Health professionals

• distant from social reality

• conformed with the logic of for profit / market-oriented health care




The medicine capitalism needs

• Human being as part of the physical nature

• Nature as the enemy of man

• Social causes of disease easily ignored

• Tb = mycobacterium Koch

• Blocking the journey back along the etiological chain




University as a “factory of consent"

• Provides information, or rather notions, completely detached from the real context

• Discourages any critical attitude

• Creates myth of neutrality of pure science as unquestionable objectivity

“…systematic concealment of how the organization of work and social life leads to suffering and disease." (F. Ongaro Basaglia 1982)




Rudolf Virchow’s “Medicine is a social science and politics is medicine on a large scale “

=

“Normalization" and "legitimisation" role of medicine within social organization




Two medicines

• Either intrinsically political, i.e. challenging situations and structures potentially pathogenic

• Or the mere job of repairing body failures




Changing medical education

• Cannot be separated from social reality

• Objectives of transformation defined by students/faculty AND community

• Universities not to replace but support the community to take control of its own health




www.csiunibo.orgwww.csiunibo.org

A trans-disciplinary, multi-professional, participative unit dedicated to teaching, research and practice in the

field of “social determination of disease”

(CSI)



Lessons we are learning

1. Cross-contamination

2. Different and innovative perspective

3. Activists’ attitude





“An upside-down faculty of medicine” (Maccacaro 1977)

centro studi e ricerche in salute internazionale e interculturale dimec - università di bologna...

Documents

centro studi e ricerche

bologna university

bologna medicine

stefanini unibo slide

pure science

myth of neutrality

critical attitude

organization of work