Warner John Harley, Rizzolo Lawrence J
Section of the History of Medicine Yale University School of Medicine, New Haven, Connecticut 06520-8062, USA.
Clin Anat. 2006 Jul;19(5):403-14. doi: 10.1002/ca.20290.
For most of the 19th century, anatomists in the United States saw the affective, emotional aspects of human dissection as salient ingredients in professional formation. Professionalism (or "character") signified medical integrity and guaranteed correct professional conduct. As gross anatomy came under siege in the late-19th and early-20th centuries, crowded out of medical curricula by the new experimental sciences, medical educators rethought what it was that dissecting a human body stood to give medical students. As they embraced a new understanding of professionalism premised on an allegiance to science, anatomists celebrated the habits of mind and sensibility to scientific investigation that could be acquired at the dissecting table. One consequence was a deliberate distancing of gross anatomy from the "art of medicine," and with it a de facto suppression of attention to the affective components of human dissection. During this period in the opening decades of the 20th century, the norm of silence about the emotional dimensions of dissection was set in place. The confluence of various movements by the 1960s and 1970s both revived attention to the emotional experience of dissection and sparked a renewed discussion about the relationship between the affective components of learning anatomy and the professional formation of future healers. There is a need to balance the tension between the "affective" and "scientific" aspects of anatomy, and by extension the tension between the "art" and "science" of medical practice. One method is to use small-group "learning societies" as a means to cultivate and meld both dimensions of the professional ethic.
在19世纪的大部分时间里，美国的解剖学家将人体解剖中情感、情绪方面视为专业形成的重要因素。专业精神（或“品格”）意味着医学诚信，并保证正确的专业行为。19世纪末20世纪初，随着大体解剖学受到围攻，被新兴的实验科学挤出医学课程，医学教育工作者重新思考解剖人体能给医学生带来什么。当解剖学家接受了一种以对科学的忠诚为前提的新的专业精神理解时，他们颂扬了在解剖台上可以获得的科学调查的思维习惯和敏感性。结果之一是大体解剖学与“医学艺术”有意拉开距离，随之而来的是对人体解剖情感成分的关注实际上被压制。在20世纪初的这一时期，关于解剖情感层面保持沉默的规范得以确立。到了20世纪60年代和70年代，各种运动的交汇既重新唤起了对解剖情感体验的关注，也引发了关于学习解剖学的情感成分与未来医者专业形成之间关系的新讨论。有必要平衡解剖学“情感”和“科学”方面之间的紧张关系，进而平衡医学实践“艺术”和“科学”之间的紧张关系。一种方法是利用小组“学习社团”作为培养和融合职业道德这两个层面的手段。
