The missing person: The outcome of the rule-based totalitarianism of too much contemporary healthcare.

OBJECTIVES: Medicine has an obsession with scientific progress and a misplaced belief in the perfectibility of the human body and mind and, as a result, there seems never to be time for the necessary backward glance. If we in healthcare are to learn any of the lessons of history, it seems important that we pay attention to those who have suffered at the sharp end of historical events.

METHODS AND RESULTS: This paper invokes thinkers and writers who lived lives scarred by totalitarian politics. Their testimony emphasises the importance of paying attention to the particularity of individual experience and demonstrates the importance of story, listening, seeing, imagination, and attention.

CONCLUSION: If we are to resist the secular totalitarianism of contemporary healthcare and reinstate the missing person at the centre of what we do, we as healthcare professionals must find the courage to disregard the rules.

PRACTICE IMPLICATIONS: In every consultation it is important to be aware of the wider historical, political and social context that may direct and constrain the choices available to both patients and professionals.