Medical Humanities: research for our times

22 April 2020
Elizabeth Stephens and Karin Sellberg
Associate Professor Elizabeth Stephens and Dr Karin Sellberg

In late November 2019, IASH members Associate Professor Elizabeth Stephens and Emeritus Professor Peter Cryle, together with Dr Karin Sellberg from UQ's School of Historical and Philosophical Inquiry and colleagues at the University of Exeter, Dr Jana Funke (Dept. of English and Film) and Professor Kate Fisher (Dept. of History) were awarded a QUEX Accelerator Grant for their project, Medical Humanities' approaches to Healthy Ageing and the Life Course. The project is led in collaboration with Kazuki Yamada, a QUEX PhD student researching how the Western sciences of sex and ageing conceptualised later life sexuality from the mid-nineteenth century onwards.

The QUEX grant is just one project in an exciting program of research in Medical Humanities that aims to increase our understanding of health and ageing. While drawing on historical records, their research is more relevant than ever and demonstrates the important contributions that humanities scholarship can make to contemporary and pressing needs. 

Elizabeth, Peter, and Karin graciously agreed to be 'interviewed' about their work via email. We started with the QUEX project.

Q: I think many people would agree that ageing is a social process, not just a biological one. Why is it important that this be recognised in modern medical practice? Or do you think that is it already recognised?

Modern medical practice is definitely more interested in the role of social and cultural factors in the ageing process, and yet medical research itself remains largely, and necessarily, focused on the biological and clinical. This is why the medical humanities are so important: collaborative approaches are needed that draw on the special expertise of both humanities scholars, who study the impact of the social, and colleagues in the medical sciences.

A special focus of this [QUEX] project will be to examine historical theories about healthy ageing, which have sometimes changed dramatically over time. Where medical knowledge is often understood as scientific and therefore impartial, our project is interested in the larger cultural assumptions and intellectual traditions of which medical ideas about ageing are a part.

Q: Your project description states that “understandings of health and ageing are neither timeless nor universal and have always been shaped by shifting cultural contexts and social contexts.” Can you explain and give an example of how understandings of ageing have changed over time?
Age and the aging process were always considered central factors (alongside gender and individual disposition) in the calculation of a healthy lifestyle in the Western medical tradition, at least as far back as Hippocrates and the Ancient Greeks. On the whole, this tradition was more concerned with the maintenance of health than the battle against disease. However, around the beginning of the 19th century, this focus changed, and ageing increasingly became categorized as a form of disease (that needed to be cured). The European medical profession sought means of eradicating ageing, rather than maintaining a healthy life in old age.

In Europe at the end of the nineteenth century there was a strong sense that a whole civilisation was ageing, so that ageing itself took on historical significance, while at the same time being diagnosed as a literal, medical phenomenon. Europe and Europeans were seen to lack vigour by comparison with “younger” countries like the US. There was a concern with “degeneration” as a hereditary disorder, whereby children were burdened from the outset with the congenital effects of ageing.
Q: One of the things that your project explores is the deployment of statistical modes of analysis of large data sets. The Australian Government proposes to use its recently-introduced My Health Record to collect de-identified data for research purposes. What do you see as the benefits, or perhaps disadvantages, of this kind of data collection and research?

The collection and use of large data sets and health records has been extremely controversial in Australia. Resistance to the implementation of My Health Record saw many in Australia opt out of this system.

The current public health crisis caused by the COVID-19 pandemic is likely to change this. In other countries, such as Singapore, the equivalent of the My Health record system has been used as an effective containment strategy: residents are obliged to record their temperature twice a day, and this determines their mobility. Similarly, quarantine conditions have been monitored using residents’ phone data and GPS positioning (to different extents) in many parts of Europe and Asia. That has happened even in countries such as the UK and the Scandinavian countries, that are usually very resistant to such breeches of individual privacy.

Australians, if recent history is any indication, would be extremely resistant to any such use of data surveillance in the health sector. It seems very likely, however, that greatly increased health data monitoring is in our near future. In the everyday politics of dealing with a pandemic, people who act in radically individual or libertarian ways are likely to be seen as a danger to those around them.

Q: We’ve heard a bit in the media recently (at least before COVID-19) about how research predicated on a male subject does not necessarily produce the best outcomes for non-male patients. Can you elaborate on how gender and gender assumptions play out in the fields of ageing and aged care?

As mentioned above, both gender difference and ageing were considered important factors in the understanding of health in pre-modern and early modern Europe. It was understood that the gender, age and individual disposition of each person called for different health strategies. In contemporary medical practice, such differences are often not considered to the same extent, as most evidence-based medical research is conducted on young male subjects (as non-male, non-normal and ageing bodies are considered less reliable as a base for research). Numerous recent health sociology and medical anthropology studies have shown that this results in less successful outcomes for non-male patients, but it also produces less successful outcomes for the ageing population as a whole.

This is one of the areas in which the medical humanities may make an important contribution, adding nuance to the understanding of the human body, and countering the problematic assumptions abroad in the homogenisation and generalisation of medical research bases.
Q: The recent restrictions on travel and physical distancing requirements have no doubt had an effect on the progress of your project as it has for many others. Could you describe the work that you have covered to date and any interesting findings you maybe weren’t expecting?

We have begun discussions with a group of Exeter colleagues who are working on the history of sexology. IASH colleagues are aware of archival materials of various kinds that have not been examined by our colleagues, and we have begun to write about it so that it can be shared in the absence of face-to-face meetings, but our work is still at an early stage.

We are, furthermore, building a Australasian medical humanities research network, and a series of collaborations in Australia, including a collaboration with the Museum of Applied Sciences and Arts in Sydney, and the Harry Brookes Allen Museum of Anatomy and Pathology at the University of Melbourne, tentatively entitled “Public Health Education in the Cultural Sector: New Approaches from the Medical Humanities”, considering the use of anatomical displays, graphics and schematics in Australian history, and during the current COVID-19 pandemic.


Banner image: "Ageing of the human face" GBdeZeeuw / CC BY-SA (