Kristin Zeiler reflects on features of the early field of medical humanities in Sweden, specifically focusing on Linköping University, and poses three questions for the field based on these features.
During recent years, calls have been made for an acknowledgement of diversity within medical humanities, as the field is recognized as increasingly global (Whitehead and Woods 2016). Even so, many accounts of the field’s development in the 70s and 80s (and before and after) centre on the situation in the UK or the USA (e.g. Bleakley 2015; Cole et al. 2015), and developments at the same time in other countries are more rarely explored. This piece starts from the view that differences and similarities in how medical humanities has developed, within and across different countries, contribute to the understanding of challenges and possibilities within the field. The piece centres on the development of the Department of Thematic Studies at Linköping University, and the division called Tema Hälsa och samhälle [Thematic Studies of Health and Society], while also discussing some more general features within the medical humanities scene in Sweden.
From its inception in 1981 to its closure in 2014, the research environment of Thematic Studies of Health and Society was intended to be thematically structured, and societal challenges related to health, illness, and health care practices, from predominantly humanities and social sciences perspectives, were among its main research foci. Of note, since medical humanities is sometimes differentiated from bioethics or medical ethics, the latter were integral parts of the Thematic Studies of Health and Society. Further, at Linköping University, researchers in, for example, Thematic Studies of Technology and Social Change and Thematic Gender Studies also contributed to this field, as did researchers in more disciplinarily structured divisions, such as history.
The dynamics of research and teaching at medical schools
In descriptions of its early development as a field, medical humanities has been described as offering a valuable contribution to the education of “humane physicians” through the cultivation of certain values and virtues deemed central to medicine, along with an emphasis on the richness and multitude of approaches within medical humanities (Cole et al. 2015). When focused on the USA, accounts commonly include descriptions of how medical schools reached out to Liberal Arts programmes, asking humanities and social sciences scholars to contribute to medical education (e.g. Brody 2011). I will term this a first “inception narrative.”
A second inception narrative can be told in medical humanities environments in universities without medical schools, where the absence of such education came to be described as part of what characterized and conditioned the local medical humanities work. However, yet a third kind of inception narrative, focused on the relation between research and teaching at medical schools, can be told via the case of Linköping University’s Thematic Studies of Health and Society. In this division, some of the researchers did teach at the medical school, among other programmes, but the main task was that of creating an interdisciplinary and thematically structured organization for research and postgraduate research training, focused on urgent societal challenges. This rendered the relationship between research and teaching at the medical school different compared to the two other inception narratives, thereby inviting reflection on the conditions for creating dynamic collaborations across medical humanities, as a research field, and medical and health care education.
At Linköping University, the task of creating a thematic and interdisciplinary research environment, and a programme for postgraduate research training, had been formulated by the Ministry of Education and Research, and recurred in the Government’s subsequent decision in 1975. The establishment of such a research environment was stated as the very reason why the Department of Thematic Studies, and all its divisions, were created. The Thematic Studies of Health and Society was one of these divisions, and from the early/mid-1980s, PhD candidates at this division received a PhD in Thematic Studies of Health and Society. This can be compared to the first PhD training program in the USA, initiated in Galveston Texas Medical Branch, where PhD candidates could receive doctorates in medical humanities from 1988. Further, medical students at Uppsala University had been able to choose to do the later part of their education in Linköping since 1969, and Linköping University’s full Medical School was inaugurated in 1986. In contrast to the inception narratives above, the development of the research field and the medical education in this third kind of inception narrative were independent, yet could benefit from each other.
On the one hand, repeated calls for a better integration of medical humanities into health care education have been made (and are continuously made) in Sweden (see Sachs and Krantz 1997; Ahlzén 2003), as in many other countries, and I see the value of medical humanities teaching in health care education programmes, medical schools included, as central. On the other hand, the Linköping example leads to my first question, which concerns how to enable collaboration across research and teaching in health care education: can a combined independence yet mutual gain between medical humanities research and health care education programmes foster a generous respect and collaboration between them, with both having shared and also different goals?
Medical humanities: contributing to medicine and studies of medicine
As a general description, a large bulk of the humanities and social sciences analyses of health, illnesses, mortality, health care etc. in Sweden from the mid-1970s to the mid-1990s may be seen as predominantly sub-disciplinary or multidisciplinary (see examples in further reading section), while examples of larger interdisciplinary work – where scholars worked intensely together – can be found, primarily, from the later parts of the 1990s onwards (see e.g. Lundin and Åkesson 1999). However, when reflecting on the development of this field in Sweden during the 1990s, Roger Qvarsell and Ulrika Torell (2000) identify two approaches: medical humanities as a contributor to medicine, in a complementary way, and medical humanities as a study of medicine.
The former approach, they suggest, emphasized insights from the humanities and social sciences as a “complement” to a medical focus on biology and pathology, seeking a “broader and more multidisciplinary picture of the human being in all her complexity,” with the aim of both broadening and deepening the understanding of illnesses, their causes and methods for treatment and prevention (Qvarsell and Torell 2000, 16, my translation from Swedish). The latter approach underlined that the medical knowledge production and health care were the object of study, centring on, for example, “knowledge, representations, attitudes and emotions” about and in relation to the body of the human being, their illnesses, and how these are shaped in relation to the contemporary socio-cultural context (Qvarsell and Torell 2000, 17, my translation).
These approaches may resonate with tendencies in present-day medical humanities. Analyses of lived experiences of illness, for example, may qualify as an example of the former approach, if the aim is to contribute to a better understanding of a particular condition, as lived and co-constituted and co-constitutive of a distinct socio-cultural and medical context. Further, the emphasis on studying medical science and health care as “a social and cultural field” (Qvarsell and Torell 2000, 17) may be seen as resonating with recent calls for medical humanities to “address not only the meaning and historico-cultural contexts of health and illness” but also “their very production, concrescence and dispersal” across societies (Viney et al. 2015; see also Whitehead and Woods 2016) – as when the focus of such inquiry is a critical examination of the medical knowledge production, as situated, and co-produced with the societal.
The two approaches (medical humanities analyses as contributions to medicine and as studies of medicine) arguably are often combined and benefit from being combined, as, for example, studies of lived experience of an illness can entail a thorough questioning of certain biomedical framings of that illness. A second question I carry with me, therefore, is this: did, and if so how did, these two tendencies recur also in other countries, in this period of the field and in the present? Further, as I mainly see the analytic gains with holding them together as productive dual aspects, rather than seeing them as opposed, I wonder if, at certain periods of time and in certain contexts, there is a value of differentiating between them, underlining their (slightly) different overarching aims.
Languages and terminology
In 2020, three medical humanities centres were inaugurated in Sweden: the Birgit Rausing Centre for Medial Humanities at Lund University, the Centre for Medical Humanities and Bioethics at Linköping University, and the Centre for Medical Humanities at Uppsala University. All centres use the term “medical humanities” in their names. This is noteworthy, as other terms were more common in the early stages of the field in Sweden, and the question of terminology is entangled with that of languages. On the one hand, English has increasingly become the lingua franca among scholars in medical humanities in Sweden (even though, as noted by Tynan et al. (2024), some Nordic networks have tended to be linguistically either Anglophone or Scandinavian). On the other hand, analyses and discussions about the role of Swedish vs. English in teaching and writing at Swedish universities are ongoing (e.g. Malmström and Pecorari 2022).
The choice of “medical humanities” in the names of the three new centres was not the result of a joint discussions and strategy. Instead, it can be understood in the light of the growing dominance of English as the language of academic writing: the term “medical humanities” has been a common (though also debated) term in the English-language scholarship. However, returning to the early days of the field in Sweden, other terms than “medical humanities” were used. Swedish, wider Scandinavian, and Nordic networks within this field organized workshops on themes such as Humanistisk Sundhetsforskning (a Danish term that may be translated as “humanities health research”). In 1995, Nätverket för humanistisk hälsoforskning – which can be translated as the Network for Humanities Health Research (or Humanities-based Health Research) – was launched (see Qvarsell and Torell 2000). A few years later, Nordiskt nätverk för humanitisk och samhällsvetenskaplig hälsoforskning [The Nordic Network for Humanities and Social Sciences Health Research] was established.
As can be seen from these examples, and from the name of the Thematic Studies: Health and Society, formulations in this period typically contained the term hälsa [health] in the very name of the field, at a time when this was not yet common in the English-language literature. This can also be contrasted with present-day debates where calls for “health humanities” as a broader term than “medical humanities” have been made in the English-language literature, without such calls having fed into the titles of the newly created centres in Sweden. Given the legacy of humanistisk hälsoforskning in the Swedish context, a possible reason for this may be an almost taken-for-granted understanding that even if we use the English term of “medical humanities,” the field has always been about more than medicine – and included analyses of, for example, health and well-being. The question of how language opens up or closes avenues for conversation and collaboration is the third question that I carry with me: how can medical humanities make room for conversations in its current, main international language – English – without losing the richness that comes with different languages? This question, which is not new for non-native English speakers in this field, is becoming increasingly recognized as vital in the context of a more global understanding of medical and health humanities.
Acknowledgements
When writing this piece, I had the pleasure of talking to some of the scholars who were active in the early days of this field: Lennart Nordenfelt, Jan Sundin, Sonja Olin Lauritzen, Susanne Lundin, and Rolf Ahlzén. Thank you for sharing your experiences. The above, however, are my reflections on this time period. I also thank the colleagues at the seminar at the Centre for Medical Humanities and Bioethics for comments on a previous version of this piece, and Ylva Söderfeldt, the Centre for Medical Humanities, Uppsala University, and Katarina Bernhardsson, the Birgit Rausing Centre for Medical Humanities, Lund University.
About the author
Kristin Zeiler is Professor at the Department of Thematic Studies of Technology and Social Change, and Director of the Centre for Medical Humanities and Bioethics, Linköping University. As an interdisciplinary scholar in medical humanities, rooted in philosophy of medicine and medical ethics, she works with qualitative critical phenomenology, i.e. combining qualitative research and critical phenomenology, and combines philosophy of medicine with feminist technoscience studies (e.g. Käll and Zeiler. 2025. Intersections of Feminist Technoscience and Phenomenology: Subjectivity, Embodiment, and Agency. Routledge). Currently, she is the PI of the project Biomedicine, Clinical Knowledge, and the Humanities in Collaboration: A Novel Epistemology for Radically Interdisciplinary Health Research and Policy-Work on Post-Covid-19 Syndrome. You can find her on LinkedIn: Kristin Zeiler.
References
Ahlzén, Rolf. 2003. “The Humanistic Medicine Program at the Karolinska Institute, Stockholm, Sweden.” Academic Medicine 78 (10): 1039–42. https://doi.org/10.1097/00001888-200310000-00021.
Bleakley, Alan. 2015. Medical Humanities and Medical Education. How the Medical Humanities Can Shape Better Doctors. Routledge.
Brody, Howard. 2011. “Defining the Medical Humanities: Three Conceptions and Three Narratives.” Journal of Medical Humanities 32: 1–7. https://doi.org/10.1007/s10912-009-9094-4.
Cole, Thomas R., Nathan S. Carlin, and Ronald A. Carson. 2015. “Introducing Medical Humanities.” In Medical Humanities. An Introduction, edited by Thomas R. Cole, Nathan S. Carlin, Ronald A. Carson, 1–17. Cambridge University Press.
Lundin, Susanne, and Lynn Åkesson. 1999. “GenEtnologi. Om tvärvetenskapens vedermödor och belöningar.” Kulturella Perspektiv 2: 23–32. https://doi.org/10.54807/kp.v8.31546.
Malmström, Hans, and Diane Pecorari. 2022. Språkval och internationalisering: Svenskans och engelskans roll inom forskning och högre utbildning. Rapport från Språkrådet 19. Språkrådet. https://www.isof.se/utforska/publikationer/publikationer/2022-02-01-sprakval-och-internationalisering.
Qvarsell, Roger, and Ulrika Torell. 2000. “Humanistisk hälsoforskning. Ett växande forskningsfält.” In Humanistisk hälsoforskning. En forskningsöversikt, edited by Roger Qvarsell and Ulrika Torell, 9–22. Linköpings universitet.
Sachs, Lisbeth, and Ingela Krantz. 1997. “Interdisciplinary Health Research – A Symposium.” Social Science and Medicine 44 (8): 1209–10.
Tynan, Avril, Anna Ovaska, and Åsa Slotte. 2024. “Humanistinen lääketiede, lääketieteellinen humanismi, medicinsk humaniora: Medical Humanities in Finland.” The Polyphony, January 23, 2024. https://thepolyphony.org/2024/01/23/medical-humanities-finland.
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Further reading from the time period in Sweden
Broberg, Gunnar, and Mattias Tydén. 1991. Oönskade i folkhemmet. Rashygien och sterilisering i Sverige. Gidlunds.
Drakos, George. 1993. “Spetälska, det onda och den grekisk-ortodoxa kyrkan.” In Ondskans etnografi, edited by L. Gerholm and T. Gerholm, 87–102. Carlsson Bokförlag.
Frykman, Jonas. 1994. “Kroppens förvandlingar: Hälsa, medicin och kulturell förändring i 1900-talets samhälle.” Kulturella Perspektiv – Svensk Etnologisk Tidskrift 3 (2): 48–59.
Johannisson, Karin. 1974. “Magnetisörernas tid. Den animala magnetismen i Sverige.” PhD diss., Uppsala University. Almqvist & Wiksell.
Johannisson, Karin. 1994. “The People’s Health: Public Health Policies in Sweden.” In The History of Public Health and the Modern State, edited by Dorothy Porter, 165–82. Brill.
Johannisson, Karin. 1997. Kroppens tunna skal. Sex essäer om Kropp, historia och kultur. Norstedts.
Lindahl, B. Ingemar. 1995. “Medical History of: Europe.” In Encyclopedia of Bioethics, edited by Warren. T. Reich, 1589–95. MacMillan, Simon & Schuster, and Prentice Hall International.
Liss, Per-Erik. 1990. Health Care Needs: Meaning and Measurement. PhD diss., Linköping University.
Nordenfelt, Lennart. 1979. Till sjukdomsbegreppets semantik: en begreppsanalytisk studie. Akademilitt.
Nordenfelt, Lennart. 1984. Health, Disease, and Causal Explanations in Medicine. Springer.
Nordenfelt, Lennart, and Per-Anders Tengland, eds. 1996. The Goals and Limits of Medicine. Almqvist & Wiksell.
Olin Lauritzen, Sonja. 1990. “Hälsovård som rutin eller relation: Svensk mödra- och barnhälsovård möter invandrarfamiljer.” PhD diss., Stockholm University.
Sachs, Lisbeth. 1983. Onda ögat eller bakterier. Turkiska invandrarkvinnors möte med svensk sjukvård. Liber Förlag.
Sachs, Lisbeth. 1995. “Is there a pathology of prevention? The implications of visualizing the invisible in screening programs.” Culture, Medicine and Psychiatry 19: 503–25.
Salomonsson, Anders, ed. 1987. Mera än mat. Carlssons Bokförlag.
Sundin, Jan. 1995. “Culture, Class, and Infant Mortality during the Swedish Mortality Transition, 1750-1850.” Social Science History 19 (1):117–45.
Sundström, Per. 1987. “Icons of disease. A philosophical inquiry into the semantics, phenomenology and ontology of the clinical conceptions of disease.” PhD diss., Linköping University.
Weimarck, Torsten. 1992. “Medaljongen och dess baksida. Reflexioner över det mekaniserade avbildandet och döden.” Artes (1). https://lup.lub.lu.se/record/539454.
