Medical Humanities Blog

Call for Papers: Medical Sociology Online

Medical Sociology Online (MSo) invites submissions of papers for publication.

Papers which are within the scope of medical sociology or sociology of health and illness will be considered for publication.

For further details for authors, or to view copies of previous issues of Medical Sociology Online (MSo) please view the MSo website:
http://www.medicalsociologyonline.org/index.html

The e-mail address to submit papers or communicate with the editorial team is:  MSo@liv.ac.uk

(h/t MEDSOC listserv)

On Visible Embryos

The fantastic Morbid Anatomy Blog has a great post on a new online exhibition at the University of Cambridge, organized and produced by Nick Hopwood and Tatjana Burklijas with funding from (who else?) the Wellcome Trust.  Excerpt:

The "Making Visible Embryos" web exhibit approaches a complex, wide-spanning subject engagingly and clearly without ever oversimplifying the subject matter. It is well-designed with heavily (and beautifully) illustrated pages (see above; visit the website to find out more about each image.)

The exhibit deftly explores the changes in metaphor, imagery, and understanding of the mysterious and centuries-hidden embryo, from speculative, religiously influenced illustrations of the 1300s to the modern day ultrasound. It also touches on popular debates about embryology, uses of the embryo in the fine arts, the history of (and uses of) illustration and modeling of the embryo, and contemporary controversies surrounding the embryo in the 21st century.

FYI, Buklijas has a wonderful article on corpse supply and anatomical practices in late 19th century Vienna in the most recent Bulletin of the History of Medicine.  The article, the online exhibition, and the blog post are all highly recommended. 

Call for Proposals: Jane Eyre and Disability

The Madwoman and the Blindman: Jane Eyre and Disability Edited by David Bolt, Julia Miele Rodas, and Elizabeth J. Donaldson

This book is the first to examine Charlotte Brontë’s Jane Eyre from a disability studies approach. Offering an appreciation and analysis of the ways in which disability, disfigurement, mental illness, cognitive alterity, addiction, and related ideas figure in this classic text, the aim of The Madwoman and the Blindman is to collect substantial essays by literary and cultural scholars to contribute to the growing discipline of disability studies. In order to achieve this aim, the proposed book will draw on theory and criticism in literary, cultural, gender, Victorian, film, and disability studies, bringing together essays that offer fresh insights into Brontë’s classic nineteenth-century novel.

Rationale. With an undisputed place in the English literary canon and as an established landmark of feminist literature, Jane Eyre has garnered the attention of literary critics and of cultural and political theorists for generations. The discourse initiated, or at least perpetuated by Gilbert and Gubar’s The Madwoman in the Attic has considered gender, ethnicity, and class extensively, but this taxonomy is deficient without the inclusion of disability, a cultural and political identity of increasing stature. Although few novels have received the same intense critical attention as Jane Eyre, until now, no single volume has focused on analyzing and theorizing the role of disability. In fact, the most visible aspects of disability have traditionally been understood in rather transparent symbolic
terms: the blindness of Rochester and the “madness” of Bertha apparently standing in for other aspects of identity. But now that recent scholarly interest in the representation of disability has led to a richer and more complex framework for understanding disability in literature, as well as creating new political, social, and aesthetic inroads into the appreciation of fiction, it has become necessary to fill this gap in Brontë scholarship. For the first time, a scholarly book on Brontë’s Jane Eyre invites readers to investigate the text through the lens of disability, providing a critical appreciation of the ways in which disability is depicted in the novel.

Prospective authors should send a proposal (500-700 words) and a 
biographical note to the editors on or before 1 January, 2009.  
Selected authors will be required to submit completed essays on or before 1 January, 2010. Editors: David Bolt (bolt@talktalk.net); Julia Miele Rodas (Julia.Rodas@bcc.cuny.edu); and Elizabeth J. Donaldson (edonalds@nyit.edu).

(h/t H-DISABILITY listserv)

On the Death of Jay Katz

Jay Katz died on Monday, November 17, 2008.  Though the first edition of his seminal book, The Silent World of Doctor and Patient, was published in 1982, in the earlier days of bioethics, I have no hesitation in declaring it one of the best and most important books at the intersection of ethics, law, medicine, and research of the last 25 years.

If anything, in my view, its importance is underestimated, and it is therefore worth pausing for a moment to reflect on Katz's life and on some of his substantive views in context of the medical humanities.

Most of the biographical information that follows comes from his obituary in the N.Y. Times:

Jacob Katz was born on Oct. 20, 1922, in Zwickan, Germany, one of two sons of Paul and Dora Ungar Katz. His father owned a department store. When Jacob was 11, the Nazis came to power and his family’s citizenship was revoked. His father managed to get him a Czech passport. At 16, on his own, Jacob went to Prague, and then, by way of Italy and England, made his way to New York, where he found work in an auto parts store. The rest of Jacob’s family followed in 1940.

Four years later, he graduated from the University of Vermont, and in 1949 he received his medical degree from Harvard. He then served as a captain in the Air Force.

Katz trained as a psychiatrist and a psychoanalyst, but for most of his career worked at Yale Law School, an interesting juxtaposition that Katz explores throughout his work.  From the obituary:

Dr. Katz had been hired as a physician by Yale in 1953 and soon became the chief resident of the outpatient clinic at the university’s medical school. He began teaching psychiatry at Yale in 1955 and three years later was appointed to the law school as an assistant professor of psychiatry and law. He retired in 1993, but taught until recently as an emeritus professor.

Given his background and upbringing, one should not be surprised that one of his primary areas of interest was unethical human subjects research.  And one of the reasons I find Katz's work so illuminating is that, in my view, he is much more closely aligned with the views of his contemporary Hans Jonas.  Both these giants were of German Jewish heritage, both escaped from the Nazis, and both were deeply concerned with the research imperative in the U.S.  Whereas there is little doubt that human subjects research is generally considered a good absent reasons to prevent or stop it, both Katz and Jonas began with the opposite presumption: that human subjects research should not be undertaken at all absent specific compelling reasons for that particular protocol.

Though I have no problem admitting I am much, much closer to Jonas and Katz's views on this issue, even those unpersuaded would do well to understand that the imperative to conduct research on humans can never be safely assumed, but must be justified.  And Katz continually pressed his contemporaries to do so in a variety of fora and ways.

In addition, Katz's analysis of the reasons for the poor communication between doctor and patient is as deep and as incisive an analysis as exists.  Physicians are no doubt tired of hearing that the #1 complaint patients make regarding physicians is that physicians do not listen well, generally because this has been the case for years if not decades.  But simply instructing physicians that they ought to listen better is less helpful, if only because the factors that tend to produce the silence are so deeply ingrained into clinical practice in the West.  Katz's analysis is fundamental in unpacking this, and I highly recommend it.

Finally, one can apprehend the importance of both of the above points in Katz's analysis of the current state of breast cancer treatments, a theme he returns to throughout the book.  I share Katz's view that breast cancer is a particularly revealing frame for thinking about issues related both to the research imperative and to silence, and also centers on the question of uncertainty in health and illness.

Katz's contributions to ethics & the medical humanities are, IMO, immense, and merit multiple readings and discussions.

Thoughts?

On Contested Illnesses

The L.A. Times reported this week on the release of a 450-page report produced by the Research Advisory Committee on Gulf War Veterans' Illnesses.  According to the article, the Committee "was chartered by Congress because many members thought that veterans were not receiving adequate care. On the 15-member committee appointed in 2002, scientists made up about two-thirds and the rest were veterans."

I have not yet had the chance to do anything other than skim the report, but the Times article notes a number of points of interest for a medical humanities audience. 

First, Gulf War Syndrome has been the subject of vigorous contest, across academic, policy, and grass-roots discourse.  Its status as a contested illness has proven a rich source of fodder for all manner of scholars, but such status has very real consequences for all manner of suffering people and caregivers (who ought always remain central in a medical humanities analysis, IMO).  The Article notes that

The report broke with most earlier studies by concluding that two chemical exposures were direct causes of the disorder: the drug pyridostigmine bromide, given to troops to protect against nerve gas, and pesticides that were widely used -- and often overused -- to protect against sand flies and other pests.

Second, policy discourse among scientific bodies and committees is also a fascinating and significant subject of inquiry in thinking about the ways in which contested issues related to health and illness are framed, negotiatied, and acted upon.  The article notes:

Several reports had already been issued by the prestigious Institute of Medicine, an arm of the National Academy of Sciences, blaming stress and other unknown causes for the soldiers' symptoms.

"There's something about going to the Gulf and serving in the Gulf that has caused something bad and persistent and real, but we have not found any evidence for a specific cause," said Dr. Harold C. Sox, chairman of a 2000 institute study and editor of the journal Annals of Internal Medicine.

Veterans blame the institute's reports for the difficulties they've faced in getting treatment for their problems.

The lack of identifiable causes is a familiar bugaboo for those familiar with the literature on contested diseases, which, IMO, highlights the importance of diseasecausalityin assessing social and cultural conceptions of illness and health.

Third, I have already suggestedthe close links between state military activity and human subjects experimentation.  In a prior post, I observed Goodman, McElligot, and Marks's claim that

the history of unethical research is primarily a history of the ways in which unuseful bodies are made useful to the state.  My initial response to this thesis was to doubt that state involvement is really either necessary or sufficient for unethical research to occur.  But the further one delves into the history of unethical research, the more and more plausible this claim begins to seem.

In this context, it is worth noting that

The major causes of the disorder appear to be self-inflicted. Pyridostigmine bromide was given to as many as half of the troops in the fear that the Iraqis would unleash chemical warfare against them.

According to the report, at least 64 pesticides containing 37 active ingredients were used during the war. They were sprayed not only around living and dining areas, but also on tents and uniforms, White said.

The full report is available for download here.  Look for a future Medical Humanities Bibliography on Contested Illnesses. 

Call for Papers: Neuroscience & Subjectivity

CALL FOR PAPERS

Special issue of Subjectivity on
‘NEUROSCIENCE AND SUBJECTIVITY’

Edited by:
John Cromby
Tim Newton
Simon Williams

The 1990’s ‘decade of the brain’ saw the beginning of a massive expansion of research into and publicity about neuroscience. New imaging techniques, capable of producing arresting pictorial images of patterns of brain activation, proliferated through the mass media, and evocatively named subdisciplines (social neuroscience, neuropsychoanalysis) grabbed the attention of many scholars.

In response, some social scientists working within the ambit of science and technology studies launched programmes of research into the intimate workings of the new neurosciences. Others explored the linkages between neuroscience and emergent political and cultural formations, charting regimes of governance and power in relation to the politics of ‘life itself’. Yet others have taken up elements of neuroscience in their own writings: in social theory, cultural studies, critical psychology, economics, politics and elsewhere, tropes and theories from contemporary neuroscience are now sometimes invoked to add weight, authority and grounding to arguments. But it nevertheless seems fair to say that, for the most part, social science and neuroscience continue to remain distinctively separate from, and often wary of, each other.

In this special issue, we invite contributors from both disciplines to explore the potentials of neuroscience with relation to the notion of subjectivity. Subjectivity is a term that potentially embraces the various phenomena indexed by terms such as consciousness, self and being. It refers to the way in which our being-in-the-world, our experience, our acquired ways of interpreting, feeling and acting, are already bound up with both the flux of social relations and the bodies that enact them.

Exploring the potentials of neuroscience with relation to subjectivity therefore means a joint emphasis on the body and the social, on the interpenetration and co-constitution of brain and culture. It is not that one can simply be the adjunct to the other, nor that one can always be subordinate or foundational to the other. Rather, what we seem to need is a nuanced exploration of the relative contribution of each in relation to the various moments, events and phenomena that constitute a life.

Subjectivity is a concept with a broad range of convenience and a presence in numerous disciplines, so we expect its coupling with relevant work in contemporary neuroscience to yield many interesting possibilities for scholarship. Such work will require potential contributors to consider very seriously just what it might mean to take theories and evidence from neuroscience and social science jointly together. With this in mind, and without being prescriptive, here are some questions that we feel contributors might usefully orient towards:

• To what extent do social science concepts and terminology that appear to bridge the divide between the body and the social (e.g. somatechnics, performativity) actually do so in this context?
• Conversely, how adequate are biological concepts (e.g. autopoiesis, lifelines) as the basis for a thorough integration of the social and the neural?
• Does work in neuroscience illustrate the possibility of applying similar, if not uniform, epistemological frameworks across the natural and social sciences? Or does it merely confirm the impossibility of such an exercise?'
• In the kind of interdisciplinary moves that any integration between social science and neuroscience might rest upon, what gets lost? Which issues and questions get obscured or elided, and which, conversely, come to seem ‘naturally’ demanding of attention?
• What are the potentials of specific branches of neuroscience (e.g. social, affective) for our understandings of subjectivity?
• To what extent do findings within neuroscience qualify or undercut appeals to consciousness or intentionality as explanations of behaviour?
• What are the implications of contemporary neuroscientific findings for the theories and concepts of psychoanalysis?
• To what extent does recent work in affective neuroscience illuminate the putative ‘turn to affect’ in the social sciences? Conversely, in what ways might work within the ‘turn to affect’ extend neuroscientific understandings?
• What methodological challenges might be encountered, by both social science and neuroscience, in any attempt to jointly explore subjectivity?

We want to emphasise that these questions are meant to be neither obligatory nor exhaustive: we look forward to receiving papers addressing these or any other relevant topics.

Contributions are welcome from any area of neuroscience and from any area of social science. We’re especially interested to consider multi-authored collaborations across these disciplines, or single-authored papers that try to engage constructively with relevant aspects of both.

Potential contributors should email an abstract to us by 27th March 2009. Abstracts should be no more than 300 words in length, and contain a title and full contact details of authors. Once all of the abstracts have been received, we will select those for which we would like to consider a full-length submission. Authors will be notified by the end of May 2009.

This special issue of Subjectivity will be published in summer 2011, and finished papers must be received by 8th January 2010. Papers must be submitted using the journal’s online manuscript system, and clearly marked for inclusion in this special issue. Go to:
http://sub.msubmit.net/cgi-bin/main.plex
Further information about the journal, including some free access, can be found at:
http://www.palgrave-journals.com/sub/index.html

Contact:
Dr. John Cromby, Loughborough UK: J.Cromby@lboro.ac.uk
Prof. Tim Newton, Exeter UK: t.j.newton@exeter.ac.uk
Prof. Simon Williams, Warwick UK: S.J.Williams@warwick.ac.uk

_______________________________________

Though this call specifically addresses social science and neuroscience, I want to suggest that the medical humanities might permit some important and novel frames and insights to bear on issues at the center of neuroscience and subjectivity (I surely hope so, because in a very real sense, my dissertation is an account of subjectivity and neuroscience, in context of pain).

(h/t NEURO-L listerv)

Call for Applications: Wellcome Trust Centre

The Wellcome Trust Centre for the History of Medicine at University College - London is inviting applications for M.Phil/Ph.D studentships in the history of medicine for Fall 2009.  Applications are due by January 12, 2009, and full details, including information about financial support, are available here.

The Wellcome Trust Centre is unquestionably one of the preeminent institutions for studying the history of medicine, so this is a wonderful opportunity for those inclined.

Caution (from the web site): "Students from outside the EU are encouraged to apply but should arrange to discuss the impact of 'overseas' students fees being charged."

Medical Humanities Bibliography: Health and Social Justice

Patrick S. O'Donnell, guest-blogger and bibliographic-making machine, has produced another extensive bibliography and graciously permitted me to make it available here on MH Blog for download:

Download health_and_social_justice_bibliography.doc

Bless you, Patrick!

On the Downsides of Technical Innovation

Given the recent discussion here and elsewhere on the role -- or lack thereof -- of technical innovation in producing health comes the results of a study in the latest Health Affairs documenting significantly expanded use of medical imaging techniques without solid evidence of improved health outcomes.  Here is the Abstract:

The availability of computed tomography (CT) and magnetic resonance imaging (MRI) scanning has grown rapidly, but the value of increased availability is not clear. We document the relationship between CT and MRI availability and use, and we consider potentially important sources of benefits. We discuss key questions that need to be addressed if value is to be well understood. In an example we study, expanded imaging may be valuable because it provides quicker access to more precise diagnostic information, although evidence for improved health outcomes is limited. This may be a common situation; thus, a particularly important question is how non-health-outcome benefits of imaging can be quantified.

The full-text is available for download free of charge.  In addition, this issue features a number of articles discussing different aspects of health policy and medical imaging, many of which seem promising at first glance.

In my view, the role of imaging techniques in constructing notions of health and illness cannot be understated.  I am biased, as a significant portion of my dissertation on pain involves assessment of the power of the visible both in Western culture in general, and in the cultures of biomedicine and science in the U.S. in particular.  Nevertheless, understanding the appeal of imaging techniques seems to require some understanding of the role of images of the inner body in U.S. society.  For an excellent and timely exposition of this subject, see Kelly Joyce's recent monograph entitled "Magnetic Appeal: MRI and the Myth of Transparency."*  There are a number of additional sources I can recommend for those interested.

*Sidebar: For a variety of reasons, I do not like the term "myth" as used to refer to a community's beliefs about health and illness.  Still, Joyce's perspective is important and informative, in my view.

Medical Humanities Bibliography: Social Inequalities on Health

Though this is (sadly) not one of Patrick S. O'Donnell's bibs, this helpful list of texts on social inequalities in health was compiled by a participant on the Spirit of 1848 listserv, so I thought I'd reproduce it here for MH Blog readers.  No claims that it is exhaustive, of course:

• Heyman, J., Hertzman, C., Barer, M. L., & Evans, R. G. (2006). Healthier Societies. From Analysis to Action. New York: NY, Oxford University press.
• Amick, B. J., Levine, S., Tarlov, A. R., & Chapman Walsh, D. (1995). Society and health. New York, N Y : Oxford University Press.
• Evans, R.G., Barer, M. L., & Marmor, T.R. (1994). Why are some people healthy and others not? New York : Walter de Gruyter Inc.
• Oakes, J.M., & Kaufman, J.S. (2006). Methods in social epidemiology. San Francisco, CA : Jossey-Bass.
• Galea, S. (2007). Macrosocial determinants of population health.
• Dying For Growth: Global Inequality and the Health of the Poor, by Jim Yong Kim
• Health and Social Justice: Politics, Ideology, and Inequity in the Distribution of Disease-A Public Health Reader--edited volume (Richard Hofrichter) Jossey-Bass Press.
• The impact of inequality (wilkinson)
• The status syndrome (marmot)
• Ses and health in industrial nations (adler et al)
• Hilary Graham, Unequal Lives: Health and Socioeconomic Inequalities (Open University Press, 2007).
• Judith Green and Ronald Labonte (eds) Critical Perspectives in Public Health (NY: Routledge, 2008)
• Amy Shulz and Leith Mullings (eds) Gender, Race, Class, and Health: Intersectoral Approaches (SF: Jossey-Bass, 2006)
• Sandro Galea (ed.) Macrosocial Determinants of Population Health. (Secaucus, NJ: Springer, 2007).
• Richard Hofrichter & Rajiv Bhatia, Tackling Health Inequities through Public Health Practice: Theory to Action (Oxford University Press, fall 2009).
• Social Injustice and Public Health by Barry Levy and Victor Sidel, 2006
• Race, Ethnicity and Health by Thomas LaVeist, 2002.
• unhealthy health policy: a critical anthropological examination, arachu castro and merrill singer editors.
• The Society and Population Health Reader: Income Inequality and Health, Kawachi, Kennedy and Wilkinson, (eds.), The New Press, New York, 1999
• Poverty, Inequality and Health: An International Perspective, Leon and Walt (eds.), Oxford University Press, New York, 2001
• Social determinants of health, 2nd ed. eds. Marmot & Wilkinson, Oxford Univ Press. 2006.
• Kawachi and Kennedy's book, The Health of Nations
• Bartley, M. (2003). Understanding Health Inequalities. Oxford UK: Polity Press.
• Davey Smith, G. (Ed.). (2003). Inequalities in Health: Life Course Perspectives. Bristol UK: Policy Press.
• Raphael, D. (Ed.). (2004). Social Determinants of Health: Canadian Perspectives. Toronto: Canadian Scholars Press.
• Marone, J. & Jacobs, L. (2005). Healthy, Wealthy, & Fair: Health Care and the Good Society.
• Kawachi/Berkman et al Neighborhoods and Health
• Thomas LaVeist. Minority Populations And Health : An Introduction To Health Disparities In The United States 2005
• Leiyu Shi and LaVeist et al's Vulnerable Populations in the United States 2005
• Challenging Inequities in Health: From Ethics to Action Evans, Whitehead, Diderichson, Bhuiya, Wirth (2001)
• Davey Smith, G. (Ed.). (2003). Inequalities in Health: Life Course Perspectives. Bristol UK: Policy Press.
• Navarro, V. (Ed.). (2002). The Political Economy of Social Inequalities: Consequences for Health and Quality of Life. Amityville, NY: Baywood Press.
• Navarro, V. (Ed.). (2007). Neoliberalism, Globalization, and Inequalities: Consequences for Health and Quality of Life. Amityville NY: Baywood Press.
• Navarro, V., & Muntaner, C. (Eds.). (2004). Political and Economic Determinants of Population Health and Well-being: Controversies and Developments. Amityville NY: Baywood Press.
• Julie Cwikel. Social Epidemiology - Strategies for Public Health Activism. Columbia University Press.