Paul Macneill

The arts and medicine: a challenging relationship

This paper discusses various justifications for including medical humanities and art in healthcare education. It expresses concern about portrayals of the humanities and art as benign and servile in relation to medicine and the health professions. An alternative is for the humanities to take a more active role within medical education by challenging the assumptions and myths of the predominant biomedical model. Another is to challenge quiescent notions of the arts by examining examples of recent provocative work and, to this end, the paper considers the work of performance artists Stelarc and Orlan who have subjected their bodies to modifications and extensions. Their work challenges, and potentially undermines, conceptions of the body, medicine, and humanitys relationship with technology. Similarly, other artists, working with biological cultures, have raised controversial issues. Recent work of this kind defies easy understanding and resists being pressed into the service of medicine and other health professions for educational purposes by opening up topics for exploration and discussion without providing unitary explanatory frameworks. The paper goes on to discuss the implications for medical education if this is the approach to the arts and humanities in healthcare education. It suggests that there needs to be a shift in the foundational assumptions of medicine if the arts and humanities are to contribute more fully.

Globalisation, economics and professionalism

Abstract This paper presents an analysis of the effect of globalisation and attendant economic factors on the global practice of medicine, medical education, medical ethics and medical professionalism. The authors discuss the implications of these trends, citing case scenarios in the healthcare insurance, medical tourism, pharmaceutical industries, and the educational systems as well as in clinical practice, to illustrate the impact of globalisation and economics on professionalism. Globalisation, on the one hand, offers benefits for the global practice of medicine and for medical education. On the other, globalisation can have negative effects, particularly when the main driver is to maximise profitability across national boundaries rather than concern for human well-being. Appraising the effect of globalisation on professionalism involves assessing its effects at the intrapersonal, interpersonal, and institutional levels, and its effect on society at large.

Ethics and the Arts: A Critical Review of the New Moralisms

This chapter explores the nature of any relationship between ethics and the arts. At one time, the dominant position in the philosophy of art was that there was no relationship. Aesthetics and ethics were seen as autonomous spheres. The various ‘new moralists’ argue that, in some circumstances, there is a relationship. Noel Carroll and Berys Gaut, for example, argue that moral ‘flaws’ in some works of art may detract from the work’s aesthetic value, while others, such as Daniel Jacobson and Matthew Kieran, counter that a morally reprehensible quality in a work may contribute positively to its aesthetic value. Although the polarities are reversed, both of these positions accept that there is—or may be—a relationship between morality and aesthetics.

Presence in Performance: An Enigmatic Quality

During the twentieth-century there were significant challenges to the notion of ‘presence’ in theatre. At the beginning of the century, traditional repertory theatre had been under attack for being superficial and frivolous. These critiques were accompanied by significant shifts in ideas about the role of theatre, and changing notions about what constitutes good performance. There were a number of remarkable experiments in acting practices and in the training of actors to be more present: notably those of Konstantin Stanislavsky early in the century, and later, the work of Jerzy Grotowski. These made demands on trainees for a higher level of engagement in performing their role. However, following French philosopher Jacques Derrida’s critique of ‘presence’ in the 1960s, a ‘postmodern turn’ in theatre studies and practice de-substantiated notions of ‘presence’ and re-framed them as illusions and subterfuge. Derrida’s critique was powerful and led to changes in understanding of terms like ‘presence’ and the actor’s ‘self.’ In hindsight however, the reach of philosophy had been exaggerated in assuming that this significant element of performance was necessarily disempowered by a challenge to its metaphysical substantiality. An alternative perspective is that a non-substantive and more enigmatic understanding of ‘presence’ enriches, rather than undermines, theatrical possibilities.

Ethics and Performance: Enacting Presence

This chapter explores ‘presence’ in performance as a quality that is both aesthetic and morally relevant. The claim is that ‘presence’ is an important element in relating to others and relevant to relating ethically. Drawing on ‘the enactive process’ from perceptual and cognitive studies, ethics is conceived of as a process in which we humans ‘enact’ both the world, and ourselves as moral beings. Zarrilli applies this approach in working with actors to train them to bring an embodied sense and their full attention to their performance task. He relates this to ‘presence’ as it is experienced by the audience (although not as a quality that an actor should strive for). In parallel, ethics is conceived of as practices that involve bringing attention, acumen and skill to an interaction with another person. A review of a performance by Martina Abramovic is discussed as an example of a (potentially) transformative and ethically relevant power of ‘presence’ as so enacted. Also discussed is the place of affect in relation to ‘presence’ and the importance of affect in ethics. Woven together these threads present a conception of ethics as creative and retaining the aliveness of performance. It is an approach that opens to enacting moral ideals in life as contrasted with a more minimal approach of fulfilling one’s moral obligations.

Modern Painting and Morality

This chapter explores morality in relation to painting in three eras: early modern painting, painting in the twentieth-century, and painting from the end of the twentieth-century and through into this century. Two early modern painters (from the mid-1600s) are considered in comparison with two modern painters as a way of highlighting significant differences within and between early modern and modern eras. From the end of the nineteenth-century, modern painting was a closely associated with the avant-garde and its hopes for moral and social renewal led by artists. But, after two world wars, these hopes had reduced to despair and scepticism, and artists had turned to the absurd in Dada, and increasingly away from figurative or expressive work toward abstract painting, minimalism, and subsequently to Pop-art. There was little from any of these movements that engaged—with any seriousness—moral, social or political issues. There were moral issues raised by the relationship between money and art as an enterprise, but few prominent artists who expressed moral issues in their work. Nevertheless there were notable exceptions, and throughout the twentieth century some artists continued to work in figurative and expressive forms. Major artists, including Picasso and Diego Rivera, along with less prominent artists such as Ben Shahn, have painted works that expressed moral concern. Since the 1980s, figurative painting has regained its importance and this has brought attention to artists like Luc Tuymans and Marlene Dumas who raise—or at least allude to—subjects with moral overtones.

Introduction: Ethics and the Arts

This book sets out to explore many facets of a relationship between ethics and the arts in (almost) all the arts: literature, music, painting, photography, film and documentary, dance and theatre. There is a section dealing with the relationship between ethics and the arts from philosophical perspectives—and a chapter in that section considers the role of the media in framing ethical issues. Ethics and the arts are also explored in relation to bioart—a new mode of art that draws on the biological sciences and techniques for manipulating life forms. The final section considers uses of the arts in relation to science and medicine. In particular: the arts as they are employed within the medical humanities; rhetorical devices in supporting ‘medical progress’; and artists and their works in response to climate change.

Art’s Rich Contribution to Ethics

This book is a collection of invited essays on Ethics and the Arts. Most of the chapters were written without each author being familiar with other chapters and there is (unsurprisingly) a range of different approaches taken. Nevertheless, there is also a considerable degree of coherence between the chapters, which this concluding chapter addresses. The further aim is to examine the ways (in the particularities of each chapter) in which the arts can, and do, make a major contribution to ethics. The picture that emerges is of a two-way relationship between ethics and the arts. In this book, ethical concerns are discussed within the arts—but so too is ethics considered from the vantage point of the arts. In this chapter I take up this idea from both angles, in discussing the approaches taken by various authors toward ethics within their artform, as well as in drawing insights from the discussions of various ideas, art theories and practices, and a range of other disciplines, that may offer broader understandings of ethics. There are ethical issues that concern artists and a good many of them have been captured in chapters of this book.