Foucault’s “fearless speech” and the transformation and mentoring of medical students

Thomas J Papadimos and Stuart J Murray

AbstractIn his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developedthe theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derivedfrom the ancient Greek word parrhesia, Foucault’s analysis of free speech is relevant to thementoring of medical students. This is especially true given the educational and social need totransform future physicians into able citizens who practice a fearless freedom of expression onbehalf of their patients, the public, the medical profession, and themselves in the public and politicalarena. In this paper, we argue that Foucault’s understanding of free speech, or parrhesia, should beread as an ethical response to the American Medical Association’s recent educational effort,Initiative to Transform Medical Education (ITME): Recommendations for change in the system of medicaleducation (2007). In this document, the American Medical Association identifies gaps in medicaleducation, emphasizing the need to enhance health system safety and quality, to improve educationin training institutions, and to address the inadequacy of physician preparedness in new contentareas. These gaps, and their relationship to the ITME goal of promoting excellence in patient careby implementing reform in the US system of medical education, call for a serious consideration anduse of Foucault’s parrhesia in the way that medical students are trained and mentored.

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