Session 7: What is Liberation Medicine? Brief History to the Present

Speaker: Dr. Lanny Smith


Readings:

Questions to consider for discussion:

1. The reading by Drs. Smith and Hilsbos reference a quote by Fr. Martin-Baro, "In our case more than anyone else's, the principle holds that the concern of the social scientist should not be so much to explain the world as to change it." One might argue that physicians inherently 'change' the world by providing medical treatment to patients, but in what ways to different physicians 'change' the world differently? For example: a subspecialist versus a generalist, a boutique doctor versus someone who cares for the uninsured. What does this mean in terms of our obligations as physicians (eg, to work in underserved areas, to see uninsured patients, etc)? 

2. Dr. Hilsbos describes three characteristics that are essential to the practice of Liberation Medicine, what are they? Can you think of examples where you or your colleagues have excelled or struggled with these?

3. Fr. Martin-Baro writes, "[p]sychology has believed that, were it not for unconscious mechanisms or conscious experiences holding them back from their existential goals and personal happiness, people would turn their lives toward a pursuit of those objectives they consider worthwhile." Do you see any parallels between this and medicine? Can you think of any of your patients that are 'held back' by their medical or psychiatric problems? 

4. How does Fr. Martin-Baro feel that psychology has improved or worsened our understanding of the relationship between personal estrangement and social oppression? What parallels can you draw to medicine or psychiatry? In what ways is uncontrolled diabetes or severe depression a medical and biochemical problem versus a reflection of greater social forces?

COPC

COPC Readings:

Questions to consider for discussion (COPC):

 1. While recounting Rakku's Story, Werner mentions a "chain of causes," what does he mean by this?

2. Think about a patient of yours that has had a bad outcome (eg, stroke, heart attack) and walk through the chain of causes you think led to this. Do you do this routinely? How might considering the chain of causes change your understanding of disease?

3. Much as Mann linked health and human rights, COPC seeks to link social and economic development with health care. In what ways do we do this at CHCC? In what ways could we do better?

4. COPC has never been proven in a clinical trial to improve health outcomes, yet it remains a model against which many health systems are compared. Do you believe that the tenets of COPC (eg, respect for autonomy, consideration of social/economic forces, distributive justice) are fundamental to any health care system? Or do they require study?