Medical Humanities最新文献

{"title":"\"I have suffered something\": traumatic childbirth in 19th-century Britain.","authors":"Jessica Cox","doi":"10.1136/medhum-2023-012883","DOIUrl":"https://doi.org/10.1136/medhum-2023-012883","url":null,"abstract":"<p><p>In 1994, the American Psychiatric Association revised its definition of trauma in relation to post-traumatic stress disorder (PTSD), enabling the recognition of childbirth as a potentially traumatic event leading to the development of symptoms of PTSD. This article considers clinical definitions of postpartum PTSD in relation to 19th-century case histories of difficult childbirth, and posits that the circumstances of some of these births-particularly in the context of higher infant and maternal mortality-mean they were likely to have been experienced as highly traumatic events, which may have led to the onset of symptoms today associated with postpartum PTSD. While resisting problematic retrospective diagnoses of postpartum PTSD, the article highlights the presence of the now widely recognised risk factors for the disorder in the experiences of these women, and demonstrates that birth in 19th-century Britain had significant potential to be experienced as a traumatic event for mothers. In doing so, it seeks to contribute to a wider conversation around-and expand our understanding of-women's (physical and emotional) experiences of childbirth at this time, as well as some of the medical practices commonly employed in the birthing room, and the ethical questions which emerge from some of these. The article begins by outlining the risk factors now associated with postpartum PTSD, before exploring these in relation to 19th-century birth narratives. It draws on medical case notes (primarily the case studies of Dr Robert Lee) and women's own accounts of childbirth, as well as advice literature for women on the subject of childbirth. The discussion focuses in particular on three issues: women's knowledge around childbirth and agency within the birthing room (including issues of consent); the use of interventions in childbirth; and infant loss. The final part of the article briefly considers 19th-century discourses around puerperal insanity, and notes an association between difficult deliveries and the onset of puerperal insanity in some cases.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of science fiction in conceptualising the reproductive future: a linguistic and literary perspective.","authors":"Alexandra Krendel, Mike Ryder","doi":"10.1136/medhum-2024-013207","DOIUrl":"https://doi.org/10.1136/medhum-2024-013207","url":null,"abstract":"<p><p>In this paper, we explore how members of the public invoke science fiction tropes and references in response to the topic of complete ectogenesis (where the entire development of a fetus takes place outside of the human body in an artificial womb environment) and, to a lesser extent, genome editing. This paper addresses a critical research gap as fiction is central to how the public make sense of new technologies. This research is timely, as human clinical trials of artificial placenta and womb technology are expected to start within the next few years. We argue that gauging public opinion on this technology is a critical early step in understanding how the public might respond to such new technologies, should they become available in the near future and be presented in a particular fashion.Using corpus linguistic techniques, we analysed a large dataset of 15 548 YouTube comments (382 057 words) made in response to a video that depicts a fictional artificial womb facility, which went viral in December 2022 when some viewers believed it to be real. We identified several statistically significant trends, as commenters associated the video with science fiction, horror and dystopian fiction, while also making specific reference to <i>Aldous Huxley</i>, <i>Brave New World</i> and <i>Star Wars</i> (Clone Wars). These observations reveal how popular science fiction narratives serve as a key point of reference and that they stand as a powerful warning in the public imagination, and as a potential barrier to public acceptance of new reproductive technologies-despite the potential benefits for social justice and reproductive rights. Our findings therefore have implications for how scientific developments are communicated to the general public.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and making material histories of racialising violence in medicine.","authors":"Laura Elizabeth Smith","doi":"10.1136/medhum-2024-013103","DOIUrl":"https://doi.org/10.1136/medhum-2024-013103","url":null,"abstract":"<p><p>This article argues that gynaecology has historically understood Black women's reproductive organs as a site of resource extraction, not healing and that contemporary performance offers a way to make the power relations entailed in this abstract visible. The histories of the transatlantic slave trade and gynaecology are intertwined and inform how the medical system interacts with Black women today. 'Father of gynaecology' and 19th-century American physician J. Marion Sims (1813-1883) was dependent on slavery in order to conduct experiments on enslaved Black women's reproductive organs-notably for developing a cure for vesicovaginal fistula that later benefitted wealthy white women. Turning to three recent performances, Black Youth Project 100's (BYP100) performance protests, Charly Evon Simpson's <i>Behind the Sheet</i> and Mojisola Adebayo's <i>Family Tree</i>, I analyse how performance can reveal medicine's history of using the bodies of Black women as the raw material to develop medical innovations that prolong white life. BYP100's performance protests at the statue of Sims in New York City made visible the racial violence he enacted on enslaved Black women's bodies. The play <i>Behind the Sheet</i> gives voice to the enslaved Black women omitted from the archive. The play <i>Family Tree</i> draws connections between Sims and instances of medical racism in the 20th and 21st centuries, including Henrietta Lacks (1920-1951), whose cervical cells were taken for medical research without her consent, and Black nurses who died during the COVID-19 pandemic working for the UK's National Health Service. Through performance, these three works draw attention to how the drive to read medical innovations as strictly positive 'advancements' often requires the erasure of coloniality's racialising function within the production of knowledge.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond medical xenophobia: Congolese and Somali refugees' struggles, perceptions and responses to the COVID-19 pandemic in South Africa.","authors":"Dostin Mulopo Lakika, Tackson Makandwa","doi":"10.1136/medhum-2024-013172","DOIUrl":"https://doi.org/10.1136/medhum-2024-013172","url":null,"abstract":"<p><p>The COVID-19 pandemic was an unprecedented crisis characterised by widespread disruption and significant loss of life. Governments worldwide responded with a myriad of containment measures aimed at curbing the spread of this deadly virus. In South Africa, a nation accommodating migrants from diverse backgrounds, COVID-19 mitigation protocols were authorised but met with criticism not limited to local citizens. Cross-border migrants decried these measures as manifestations of medical xenophobia and 'migrantcide', engendering reluctance among many, particularly migrants, to seek medical treatment from public healthcare facilities.This article delves into the perspectives and beliefs of Congolese and Somali asylum seekers and refugees living in South Africa, with a particular emphasis on their perceptions of COVID-19 within an immigration landscape often fraught with hostility. The central argument posits that animosity and state negligence in a time of socioeconomic difficulty exacerbated migrants' misconceptions regarding COVID-19, contributing to their hesitancy in using South African public healthcare facilities during the pandemic. The profound deficit in trust between refugees and healthcare practitioners, stemming from inadequate communication channels, further exacerbates existing tensions and mistrust.Based on extensive fieldwork conducted in 2021 among Congolese and Somali communities in Yeoville and Mayfair-two suburbs of Johannesburg, South Africa populated by migrants-this paper explores the various meanings, perceptions and beliefs surrounding the COVID-19 pandemic. It examines how these factors contributed to rising anxiety and fear, as well as the diverse responses adopted to address the deadly disease. The hesitancy of migrant groups to seek medical assistance from public healthcare facilities led them to explore alternative means of managing COVID-19 symptoms. While some of these approaches occasionally yielded positive outcomes, they often fell short of achieving the desired results, potentially resulting in an increased number of infections and fatalities that remained untested and unreported.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alder Hey's heart of gold: charity, cardiac surgery and the distortion of paediatric provision in a nationalised health service, 1948-91.","authors":"Michael Lambert","doi":"10.1136/medhum-2024-013133","DOIUrl":"https://doi.org/10.1136/medhum-2024-013133","url":null,"abstract":"<p><p>Liverpool is perceived as exceptional, a city apart from the nation, and its health services are no different. Alder Hey, the city's children's hospital, reaffirms this perspective. Its name is inseparable from the scandal surrounding the unlawful removal and retention of thousands of organs, mostly hearts, from children for research purposes over decades culminating in the 2001 Redfern report. This paper contextualises these events by reconstructing how paediatric cardiac surgery, as an emerging subspecialty, disproportionately shaped the development of children's hospital services for the city and its region. Such cumulative, compounding impacts are invisible in the historiography, focused on national trends and high politics. Recognising but eschewing established policy narratives, the paper follows enduring tensions between teaching and research, service and specialty, centre and periphery, managers and clinicians and patients and professional prestige, which remained unresolved from the inception of the National Health Service (NHS) in 1948 to the Royal Liverpool Children's Hospital becoming a self-governing trust in 1991. Using archival documents to reconstruct complex organisational and clinical decision-making within the shifting architecture of the NHS at national, regional and local levels over time, this paper shows how children's hospital services in Liverpool were distorted by another heart. One of gold: charity. Public appeals and philanthropic support for paediatric provision outweighed competing claims for compassionate giving in Liverpool. The availability of alternative funding to develop highly specialised paediatric cardiac surgery, and to lever further statutory resources at the expense of competing specialties, impacted the shape of nationalised health services in the city and its wider region. Ultimately, the paper demonstrates how children's care, clinicians and charity confounded efforts to organise universal, nationalised health services.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performing dissections: feminist performance as research methodology in the medical humanities.","authors":"Alex Mermikides","doi":"10.1136/medhum-2024-013049","DOIUrl":"https://doi.org/10.1136/medhum-2024-013049","url":null,"abstract":"<p><p>Over the past two years, I have been making a performance about human dissection, capitalising on my position as a performance researcher embedded in the medical school at King's College London. The performance seeks to capture and convey the affective culture of the dissection room and the uncanny materiality of the preserved and anatomised bodies within it, dwelling on the emotional, ethical and existential anxiety, the awe, wonder and morbid fascination they elicit. In this article, I demonstrate how the practice of feminist performance might be employed as a research methodology within medical education, and how it might challenge binary assumptions about how future doctors construct their professional identity, by deconstructing the bodies of deceased donors.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical retelling of dental ethics told through 'George Washington's Complete Denture'.","authors":"Eleanor Fleming, Patricia Neville","doi":"10.1136/medhum-2024-013151","DOIUrl":"https://doi.org/10.1136/medhum-2024-013151","url":null,"abstract":"<p><p>Dental ethics is a specialised branch of dentistry addressing ethical issues in dental practice. However, dental ethics and diversity are thought to be at odds within the practice of dentistry. Dentistry centres on ethical clinical practices which assume dental ethics are both value neutral and singular with no need for diverse perspectives. Dental ethics are thought to be static, and yet, they are dynamic and problematic in terms of values in dentistry: cosmetic dentistry and its aim for a white smile and the dentist as a clinician, businessperson when there are glaring oral health disparities in communities. In this paper, we use the artefact of George Washington's complete dentures to tell an alternative story of dentistry that demonstrates just how ethics and diversity are relevant to dentistry. As two dental educators and social scientists, we bring an interdisciplinary praxis to problematise dental ethics and reframe it through a diversity lens. Instead of having a monolithic discourse of dental ethics, we invite critical reflectivity to decentre white, Eurocentric bioethics. Using the implosion method, we deconstruct this dental object to connect it with global history, centring key ethical dilemmas often missed in dental ethics: settler colonialism, biopolitics, whiteness, power and racial capitalism. Every country has its own myth-making, and part of US oral health lore is this complete denture from the country's first president. The denture is problematic because it is possibly composed of teeth from enslaved African people. Unnamed African people are removed from history, and yet their teeth are national lore. As an object, the denture is not a mere artefact of history, but is celebrated to show a nation's founding father's connection to a profession. To celebrate the denture without appreciating these ethical dilemmas is to miss the importance of critically engaging history and context in both oral health practice and dental education.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative medicine intervention on the obstetric-gynaecological work floor to discuss social stigmas around heavy menstrual bleeding using cocreated site-specific poetry.","authors":"Heleen Eising, Elsemarijn Leijenaar, Ramsey Nasr, Renate van Leuken, Marlies Bongers, Megan Milota","doi":"10.1136/medhum-2024-013150","DOIUrl":"https://doi.org/10.1136/medhum-2024-013150","url":null,"abstract":"<p><strong>Purpose: </strong>Stigmatisation and lack of awareness about many women's health concerns constitute a major public health problem. This study analyses the impact of a narrative medicine (NM) intervention designed for obstetrical-gynaecological (OB-GYN) professionals and patients in a teaching hospital. It used a cocreated, site-specific poem based on patient and clinician lived experience narratives to stimulate meaningful discussions on taboo topics and provide an opportunity for participants to learn from each other's perspectives and experiences.</p><p><strong>Method: </strong>This qualitative study employed a thematic analysis of 36 written reflections collected in three 1-hour NM sessions, along with follow-up interviews with 14 participants (aged≥18 years, fluently Dutch speaking).</p><p><strong>Results: </strong>Analysis of the anonymous written reflections and interviews indicates that OB-GYN professionals and patients valued the commissioned poem as an unexpected and engaging source of inspiration for exploring patients' perspectives. Participants were also deemed NM an appropriate approach to support multidisciplinary discussion. The written responses and interviews also highlighted valuable focus areas for a subsequent NM training.</p><p><strong>Conclusions: </strong>This study contributes to the field of NM teaching by showing that such interventions can be used in continuing education interventions in the workplace. Our site-specific artwork for a Dutch OB-GYN department encourages meaningful discussions between healthcare providers and patients. Poetry, in this case a cocreated, site-specific work, can reveal new facets of patients' perspectives and needs.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evoking Brecht's <i>A Worker's Speech to a Doctor</i>: developing clinical skills, deepening understanding and promoting action on living and working conditions, or mobilisation for system reform or transformation?","authors":"Humairaa Karodia, William MacGregor, Dennis Raphael","doi":"10.1136/medhum-2024-013159","DOIUrl":"https://doi.org/10.1136/medhum-2024-013159","url":null,"abstract":"<p><p>Bertolt Brecht's 1938 poem 'A Worker's Speech to a Doctor' has been used by health educators to direct attention to the health-threatening effects of adverse living and working conditions. However, to date there has not been a systematic analysis of these evocations and their goals (eg, develop clinical skills through promotion of empathy, encourage action to improve living and working conditions, and/or calls for broad societal mobilisation for systemic reform or even replacement). Of particular concern and relevance is the context in which this poem is mentioned, how it was applied, and whether it is presented in fragments or its entirety, thereby leaving intact Brecht's critique of the capitalist economic system and its role in creating illness as well as the Doctor's complicity in this same system. This investigation revealed that while most of the 56 instances found in books, book chapters, journal articles, presentations, and blogs did draw attention to how living and working conditions shape health and in many cases their public policy antecedents, most did not include the entire poem, leaving out Brecht's critique and blunting his message. We suggest 'A Worker's Speech' and other Brecht's poems as a rich source for reflection, discussion, and action to promote health by health and social services workers, researchers, community activists, and the public.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negotiating uncertainties: care-seeking in an algorithmic society.","authors":"Rui Liu, Susanne Lundin, Emma Eleonorasdotter","doi":"10.1136/medhum-2024-012921","DOIUrl":"https://doi.org/10.1136/medhum-2024-012921","url":null,"abstract":"<p><p>This article examines how different layers of health-related uncertainties emerge and intersect in an algorithmic society. We aim to understand how people's self-care practices co-evolve with digitalised health systems. Sweden stands out among Western countries due to the population's high digital consumption of medical and health products. We conceptualise health-related uncertainties as inherent in care-seeking. The uncertainties are embedded in an algorithmic society and hinge on what we term algorithmised medicine. Methods used are open-ended questionnaires and semistructured interviews with Swedish residents. We identify: First, people are aware of algorithm-embedded digital infrastructure and its impact on information access in everyday life. Second, people oscillate on a trust-distrust nexus in different contexts. And third, lived experiences of the body compete with medical advice and online information. We conclude that while formal health systems strive to be robust, access to medicines remains an uncertain practice at the interplay of medicine, algorithms and bodily experiences of sickness. This study contributes to the field of medical humanities by showing that the digital arena is a porous and emergent entity, with inseparable links to people's lived experiences.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}