ذهنیت مدرن، سلطه و میدان نابرابرِ دانش، منابع و استعداد: چالش‌های شکل‌گیری علوم انسانیِ پزشکی در ایران

شکل‌گیری و بسط علوم انسانی پزشکی، چالش معرفت‌شناختی مهمی در جهان است. در این مقاله چالش‌های پیش روی علوم انسانی پزشکی از منظر صاحب‌نظران علوم انسانی در ایران واکاوی شده است. مطالعه‌ای کیفی در سطح ملی در سال 1398 انجام شد. با در نظر گرفتن معیار اشباع، داده‌ها با 22 مصاحبۀ نیمه‌‌ساختاریافته و دو پرسش‌ باز جمع‌آوری و تحلیل مضمون شدند. ازنظر مشارکت‌کنندگان چالش‌های مهمی پیش روی شکل‌گیری علوم انسانی پزشکی وجود دارد که بخشی از آنها مفهومی و بخشی، کاربردی است. مهم‌ترین چالش، پزشکی (در اینجا منحصراً نهاد و رشتۀ پزشکی) به‌منزلۀ میدان معرفتی هژمونیک بود؛ با وجود این، مشارکت‌کنندگان دلایل دیگری را به‌منزلۀ چالش در این مسیر مطرح کردند. مهم‌ترین چالش‌ها در قالب چهار مضمون ذهنیت مدرن، سیاست، اجتماع و سازمان، سلطۀ زیست‌پزشکی و ناکارآمدی علوم انسانی مطرح است. اگرچه سلطۀ معرفت‌شناختی و نهادیِ زیست‌پزشکی که در نهاد پزشکی متمرکز است، چالش عمده‌ای است، در این سوی میدانِ دانش نیز ضعف و ناکارآمدی علوم انسانی مطرح است. همچنین ذهنیت مدرنِ متمرکز بر علوم سلامت در ایران و متمرکز بر نهاد پزشکی و نیز سیاستگذاری‌ها و خط‌مشی‌های نهادی از دیگر موانعی است که میدانی با توزیع نابرابر دانش، منابع و استعدادها را به وجود آورده است. تقویت نقش و کارکرد علوم انسانی و تعدیل سلطۀ زیست‌پزشکی در کنار اقدامات نهادی و سازمانی برای تحقق علوم انسانی پزشکی پیشنهاد می‌شود. توجه به انسان‌گرایی و سازنده‌گرایی در عرصۀ سیاست‌گذاری و نظری ضرورت دارد.

Modern Mentality, Domination, and the Unequal Field of Knowledge, Resources, and Talent: Challenges of the Formation of Medical Humanities in Iran

Introduction:Medicine is closely related to the humanities, and as Foucault points out, medicine has been the basis for the development of the modern humanities. Despite this, there is practically no connection between the humanities and biomedicine. Due to its necessity, medical humanities is a scientific discourse that has been discussed and researched in the last five decades. The formation and development of medical humanities is an important epistemological challenge in the world. It is also one of the essential subjects in the interdisciplinary field of science. The importance of the subject is mostly related to medicine itself and its role and place in the human life. That is why it can be said that the field of medical humanities is an important part of medical education. Given the role and importance of medical humanities in promoting health services and their effectiveness, there is a need for research in this area. There is a gap of knowledge in this domain in Iran. Therefore, the aim of the present study is to explore the challenges and obstacles to the formation of medical humanities in Iran.  Materials and Methods:This is a national wide qualitative study that was conducted in 2020 in Iran. Twentyfour faculty members of humanities departments who have relevant works with health were included in this study. Data were collected with semistructured interviews (22 participants) and openended questions with two participants. Data analysis was performed by the thematic analysis method. Discussion of Results and Conclusions:  From the participants’ point of view, there are important challenges facing the formation of medical humanities in Iran. The most important challenge is modern medicine as a hegemonic field of knowledge. The social field of science and related social capital is at the disposal of biomedicine. This is a serious obstacle to the formation of the medical humanities. In addition, other reasons were explored as challenges. Generally, four themes were explored: 1) modern mentality; 2) politics, society, and organization; 3) biomedical domination;  and 4) inefficiency of the humanities in Iran. The modern mentality is related to epistemological dualism and onedimensional science. The phrase ‘politics, society, and organization’ is related to scientific laws and regulations in the country that do not recognize interdisciplinary sciences and do not provide the space for such issues. Although the epistemological and institutional dominance of biomedicine, which focuses on the medical institution, is a major challenge, the weakness and inefficiency of the humanities is also another main challenge. The humanities departments generally do not have the high confidence to enter the medical field, and many of such departments are alien to the health sciences. Under the dominance of biomedicine unequal distribution of knowledge, resources and talents were formed in Iran. The political economy of biomedicine attracts all resources and talents. In addition, the structures of the scientific bureaucracy have prevented the formation of the medical humanities. In this law and regulation bureaucracy, no attention has been paid to the interdisciplinary approach of sciences, especially medical sciences. Therefore, different fields of science in Iran are operating as separate islands. This includes the humanities and medical sciences. Based on the findings of the present study, strengthening the role and function of the humanities as well as  modifying the domination of biomedicine are suggested. The field of humanities needs more connection to the medical sciences. Also, different fields of science in Iran need specific legal tools to support interdisciplinary sciences, and in particular, medical humanities. It is necessary to pay attention to humanism and constructivism in the field of policymaking and theory. Finally, the field of medical humanities is one of the necessities of medical sciences in Iran that needs serious attention.