We often hear people say, in a superficial way, a sort of vox popoli, that sickness and death are the maximum expression of democracy for a society, the great equalizers that strike everyone no matter who they are. We know, however, that this is far from true because it is obvious that environmental, social, economic and psychological conditions have a direct influence on the average life span and on the intrinsic quality of human existence. Not to mention the availability and accuracy of medical treatment. People today have an absolute requisite of wellbeing, and the sites and infrastructures devoted to healthcare thus acquire central importance, second only to medical skill in the strict sense. We have to bear in mind, although it is plain for all to see, that in the medical environment the emphasis of the scientific community is increasingly oriented toward diagnostics and prevention, which need to be widely available throughout the country on a vast scale (basic and local medicine available to all, everywhere), while the treatment of definite pathologies, especially those with a high level of complexity requires, on the contrary, a correspondingly and increasingly high level of specialization, as well as an operational capacity able to ensure that the hospital structures and universities are associated with the latest advances in research. We then require the two models to coexist, in micro and macro scale but, clearly, the intermediate dimension, that of the average hospital, does not provide the flexibility and responsiveness of the relationship between the citizens and the management of their health, or the demand for highly specialized services. The overall impact should be balanced in relation to the conditions observed, but some doubt remains that from the standpoint of healthcare facilities the architect is currently being asked to respond on a completely different scale. At the same time, it is the architect who has to combine the demands of flexibility and the continuous technological progress of the infrastructures with the need to build “solid”, safe, systemically reliable, and complex structures. We would add to this the importance of the psychological wellbeing of the patient as a real factor contributing to the healing process, and that this wellbeing is directly related to the quality of the spaces in which people are obliged to stay for their treatment. On the strategic and design plane, the architect has to focus on relieving the sensation of forced segregation and the obligation to live in an unnatural way, far from the domestic environment and familiar comforts, surrounded by people who suffer, treat, work, assist, study or perform research. In such a varied and hybrid setting, the models that we used to study, with regard to the distributive characteristics of the buildings, seem entirely unsuitable, and for this reason a thorough review from the architectural standpoint of the most advanced treatment facilities appears essential. It has become absolutely necessary to reflect in depth on hospital architecture in general, in light of modern needs.


Download cover
Download table of contents
Download introduction of Marco Casamonti