1. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Medicine and power The role of medical education Angelo Stefanini Centre for International Health University of Bologna

2. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna “Medicine, like science, is a mode of power" “Medicine, as science tout court, is not neutral, it is not pure cognitive activity, it is not the result of a disinterested investigation of reality, but it is at the service of capital. Its very beginning is in response to a need expressed by the capital and its future development will be instrumental to the preservation and reproduction of the latter.” G.A. Maccacaro (1924-1977) A. Stefanini - Unibo

3. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Current medical education Largely irrelevant Focused on the biology of the body Undervaluing those disciplines that link with the social context Split between “scientific” (“hard”) and the “less scientific” (“soft”, humanities) disciplines A. Stefanini - Unibo

4. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Resulting in… Shielding future doctors from the social reality Obscuring the social determinants of disease Ruling class/political system not accountable for social production of disease Health professionals distant from social reality conformed with the logic of for profit / market- oriented health care A. Stefanini - Unibo

5. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna The medicine capitalism needs Human being as part of the physical nature Nature as the enemy of man Social causes of disease easily ignored Tb = mycobacterium Koch Blocking the journey back along the etiological chain A. Stefanini - Unibo

6. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna University as a “factory of consent" Provides information, or rather notions, completely detached from the real context Discourages any critical attitude Creates myth of neutrality of pure science as unquestionable objectivity “…systematic concealment of how the organization of work and social life leads to suffering and disease." (F. Ongaro Basaglia 1982) A. Stefanini - Unibo

7. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Rudolf Virchow’s “Medicine is a social science and politics is medicine on a large scale “ = “Normalization" and "legitimisation" role of medicine within social organization A. Stefanini - Unibo

8. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Two medicines Either intrinsically political, i.e. challenging situations and structures potentially pathogenic Or the mere job of repairing body failures A. Stefanini - Unibo

9. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Changing medical education Cannot be separated from social reality Objectives of transformation defined by students/faculty AND community Universities not to replace but support the community to take control of its own health A. Stefanini - Unibo

10. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna www.csiunibo.org A trans-disciplinary, multi-professional, participative unit dedicated to teaching, research and practice in the field of “social determination of disease” (CSI)

11. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna Lessons we are learning 1.Cross-contamination 2.Different and innovative perspective 3.Activists’ attitude A. Stefanini - Unibo

12. Centro Studi e Ricerche in Salute Internazionale e Interculturale DIMEC - Università di Bologna A. Stefanini - Unibo “An upside-down faculty of medicine” (Maccacaro 1977)