health and medicine essay

health and medicine essay

The Intersection of Health and Medicine: Exploring Key Concepts and Contemporary Issues

1. Introduction to the Relationship Between Health and Medicine

As stated in a recent groundbreaking report from the Institute of Medicine, the scientific enterprise needs a robust initiative that weaves together the many disparate elements in the health sciences better than is currently the case. Such an initiative would both identify scientific opportunities and provide a basis for shaping future national and international research efforts. This will be a large undertaking—one that must involve the entire biomedical research community. Rather than being controlled by a central process, there will be good reason to work instead toward a more organic development that both recognizes and can adapt to the many ever-evolving changes across the health sciences enterprise. The goal of the emerging health sciences literature we have organized and surveyed has generally been to delineate new fields, trends, concepts, and opportunities in the health sciences related to human health. At the outset of our work, however, it will be useful to set some boundaries by defining the subject area in which we are working. Typically, the health sciences are defined officially in quasi-institutional contexts, although the choices made are not always consistent. Regardless of how official designations are made or ideas are enforced through funding or other incentives, there can be no question that the full complement of scientific disciplines engaged in health sciences continues to vary and grow rapidly and that, as a group, the disciplines are engaged in a wide and rapidly growing range of key scientific and public health problems.

Health rests on a rich foundation of biology, genetics, and environment that is the domain of medical science. By examining the relationship between health and medicine at the intersection of these two disciplines, our goal is to extract some important conceptual and practical guideposts for more effective cooperation between the scientific and medical communities, both nationally and internationally. As new population health sciences emerge, the distinction between health and health care will be increasingly blurred. Nevertheless, this distinction has been a fundamental feature of our approach, and it provides a very important underlying structure for our exploration of the intersection of health and medicine, as we take stock of the contemporary opportunities and challenges arising from the extraordinary success of modern medicine and biomedical science in their respective endeavors.

2. Historical Perspectives on the Evolution of Medical Practices

By the time of the ancient Greeks, incantators, oracles, and priest-healers still favored supernaturalism. However, rationalism increasingly contributed to the discovery of the real reasons for health and sickness thanks to the work by thinkers such as Hippocrates, Thales, and Pythagoras. Hippocrates is accepted as the father of rational medicine. His approach was to break with beliefs and put emphasis on observing the natural causes of diseases. However, he also attributes some diseases to the imbalances of the four humors. In this period, medical practices were mainly based on the answers to “what is” rather than “how to cure.” The curing practices were not institutionalized; they were rituals in sanctuaries or something done at the advice of priests or oracles. People began to distinguish and validate practices that could affect their health positively. In Egyptian culture, priests tried to read the will of Amun to diagnose the diseases. Treatments largely rested in persuasive symbols, such as written amulets and symbolic objects.

In the beginning, medical practices were closely linked to religious and supernatural beliefs. It was the religious clerics who were the healers or at least the ones who consoled the suffering patients. Eastern cultures had a different approach to medicine. They attributed the causes of diseases to several ancient theories. Chinese traditional medicine mainly relied on Confucian, Taoist, and Buddhist thoughts. Although in Mesopotamia there were spirits of sickness who caused the diseases, the god of Sun, Shamash, was considered contributory to therapy. Thus, religious prayers and sacred rituals were performed for health, and diseases were interpreted as sacred disease. The diseases that disappeared shortly were found to be natural diseases. However, it is still under debate as to what extent natural diseases turned into sacred diseases. According to Ibn Khaldun, who is accepted as the founder of sociology, in pre-Islam Arabia, only Jewish and Christian clergymen practiced medicine.

3. Contemporary Challenges in Healthcare Delivery and Access

The US healthcare system is also widely acknowledged as possessing less-than-desirable features, which include the fact that the nation’s health status overall is poor. A significant amount of ghetto-based, charity-treatment settings provide suboptimal care and have become over-congested. Costs have begun to literally “bankrupt” a number of healthcare plans and have closed some hospitals and clinics. The general economic instability of the Medicare and Medicaid healthcare financing programs, primarily having to do with rising costs and aging populations, also is affecting matters in areas way beyond healthcare providers and financial analysts. Finally, in time the healthcare industry as a whole will face numerous problems as it seeks to raise and allocate adequate capital to fund modernization.

Healthcare delivery systems in the United States today display many strengths, while at the same time they face many challenges. Healthcare is one of the country’s largest industries and provides jobs with attendant benefits for millions of individuals. Overall, the nation offers good-quality care to those people who happen to be sick and wealthy, with modern equipment and medications, and the latest in technological excellence. On the other hand, the current healthcare system suffers from major service inadequacies, to the point of denying access to millions of Americans. The costs of providing services are escalating at rates that threaten both public and private budgets, and the mix of services needed is politically extraordinarily difficult to generate. More critically, the existing delivery system is simply not organized to provide care and support to individuals with chronic or catastrophic illnesses, diseases that are characteristic of an aging population.

4. Innovations and Technologies Shaping the Future of Medicine

Health situations around the world fluctuate, with different countries and regions experiencing different health challenges. In 2013, communicable diseases were the sixth leading cause of death and disability in high-income regions, harming those countries less than deaths and disability resulting from diabetes, stroke, and heart disease. However, in low-income regions, deaths and disability from infectious, maternal, and perinatal disease were still the leading health risk – a pattern that changed in low-income regions only in 2007. Of the leading causes of “health burden” – essentially a measure of “healthy life expectancy” – in 1990, only one of the top ten leading causes was not a communicable disease. Yet in 2010, four of the leading ten causes of health burden in low-income countries are non-communicable conditions. As countries move up the “health ladder” of economic development, some aspects of the health situation significantly improve, while other aspects do not.

Amid growing concerns that medicine was losing sight of its fundamental mission of caring for the health of people, a small group of physicians laid the foundation for a new field they called “preventive medicine.” In just over 200 years, preventive medicine succeeded in substantially lengthening life expectancy, revolutionizing the way we think about health and well-being in a population, and laying the foundation for disciplines including public health. After centuries of emphasis on infectious diseases, preventive medicine laid the framework for understanding and working to prevent and control chronic conditions, helping people to face and manage the challenges and opportunities of an aging society. Today, a diverse and wide array of both medical and public health practitioners are playing a key role in helping individuals and populations enjoy healthier and longer lives.

5. Ethical Considerations and Debates in Healthcare

Resolving ethical disputes also requires negotiation and ethical compromise, moving beyond the breaking of deadlocks. Rationing debates often generate particularly controversial ethical considerations, as they frequently involve what philosophers of healthcare call fundamental questions about the nature of healthcare and the values we attribute to various individuals or treatments within the realm of healthcare. In the early 21st century context, new ethical considerations and challenges are being posed to the healthcare community by several elements including advancements in environmental health, personalized genomic medicine, information technology, and the changing nature of healthcare regulation. Each of these elements calls for new responses to longstanding ethical debates and to ever-present questions of just inclusion, resource allocation and prized distributions, particularly in the domain of drug innovations. As part of an ever-evolving process, healthcare professionals and bioethicists in the modern age have also shown particular concern for the need to ensure restraint to power, and to create mechanisms promoting transparency and accountability.

The field of healthcare is replete with ethical considerations and debates, and the implications of these discussions for both health and healthcare are crucial. The four principles, endorsed by bioethicists and healthcare professionals, provide an excellent foundation for conducting ethical reflection in healthcare. They can be seen as action-guiding rules or as higher-order principles to which more specific moral rules can be disaggregated. The four principles are often understood as sitting uneasily with one another, occasionally creating conflicts between them, and thus leading to dilemmas in moral decision-making in healthcare. As specific moral theories and approaches don’t always lead to solving these dilemmas, healthcare professionals rely on their own professional and personal moral frameworks instead – an approach known as meandering in ethics and some have critiqued.

Ethical considerations and debates in healthcare