James Giordano^1,2 and Wayne Jonas^2,3

¹Center for Clinical Bioethics, and Division of Palliative Medicine, Georgetown University Medical Center, Washington, D.C. 20057, U.S.A. ²Samueli Institute, Alexandria, VA 22314, U.S.A. ³Uniformed Services University of Health Sciences, Bethesda, MD.

Abstract: In this essay, we posit that modern medicine, in its Asclepian focus, has subordinated the need and importance of Hygieian healing and caring, and in so doing has lost a quality that is essential to medicine, and fundamental to its lasting moral value. We argue that an integrative medicine must be based upon a core philosophical foundation that re-enjoins Asclepian and Hygieian approaches in true conceptual and practical dialectic, such that integration represents a synthesis of these orientations in epistemic, humanitarian and ethical domains. While we assert that a core philosophy is critical to the development and sustainability of an integrative medicine, such claims remain vacant in the absence of some meaningful attempt to put these concepts into action. We believe that to apply such philosophical foundations, an approach is necessary that simultaneously engages education, research, practice and policy. This involves not simply studying and co-opting new (or older, more ancient) modalities in a curative paradigm, but represents a paradigm shift that requires and is based upon understanding of, and skills for the application(s) of the most appropriate types of treatment(s) to affect disease, illness and health in a patient-centered model of care.