Medical Humanities最新文献

{"title":"Mental health treatments and the influence of culture: portrayals of hypnotherapy and electroconvulsive therapy in Singaporean television dramas.","authors":"Graham Matthews, Melissa Ho","doi":"10.1136/medhum-2023-012854","DOIUrl":"10.1136/medhum-2023-012854","url":null,"abstract":"<p><p>Stigma is one of the chief reasons for treatment-avoidant behaviour among people with mental health conditions. Stigmatising attitudes are spread through multiple determinants, including but not limited to: (i) individual beliefs; (ii) interpersonal influences; (iii) local cultural values and (iv) shared culture such as depictions in television shows. Our research indicates that popular television shows are currently understudied vectors for narratives that alternately reify or debunk assumptions and stereotypes about people with mental health conditions. Although such shows are fictional, they influence perception by normalising 'common sense' assumptions over extended periods of time. Consequently, representations of patients, psychiatrists and treatments influence knowledge and understanding of mental health and treatment-seeking behaviour. While storytelling about sickness can inspire possibilities and bestow meaning on traumatic experiences, fictional narratives written without sufficient care can have the inverse effect of curtailing horizons and limiting expectations. Problematic portrayals of patients, mental health professionals and psychological interventions are often reductive and may increase stigma and prevent treatment-seeking behaviour. This article analyses the representation of hypnotherapy and electroconvulsive therapy (ECT) in Singaporean television dramas that attract a wide, mainstream audience. Our diverse team investigated dramas in all four of the official languages of Singapore: English, Mandarin Chinese, Bahasa Melayu and Tamil. We found that depictions of hypnotherapy tend to produce problematic images of mental health professionals as manipulative, able to read minds, engaging in criminal behaviour, lacking in compassion and self-interested. Meanwhile, representations of ECT typically focus on the fear and distress of the patient, and it is primarily depicted as a disciplinary tool rather than a safe and effective medical procedure for patients whose condition is severe and refractory to pharmacotherapy and behavioural interventions. These depictions have the potential to discourage treatment-seeking behaviour-when early intervention has found to be crucial-among vulnerable populations.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"13-25"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591689","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":"Parental perspectives of trisomy 18: common threads of a life-limiting diagnosis.","authors":"Evelyn Armour, Melissa J MacPherson, Cheryl Mack, Michael van Manen","doi":"10.1136/medhum-2024-013188","DOIUrl":"https://doi.org/10.1136/medhum-2024-013188","url":null,"abstract":"<p><p>There is a narrative told among healthcare providers that the public stories of trisomy 18 do not reflect the experiences of the many families navigating this diagnosis. This is in the context of a recognised paradigm shift occurring in the treatment of children born with trisomy 18 from one focused solely on comfort to one that considers the potential of medical-surgical interventions to afford survival. This study aims to elicit and explore phenomenologically parents' narratives of trisomy 18. The focus is on the full spectrum of trisomy 18: whether it was diagnosed before or after birth, whether the child's life was of short or long duration and whether invasive or palliative care was sought. While trisomy 18 was not univocal of the children's stories, as a focus of this qualitative inquiry unified them. Healthcare providers may benefit from understanding how trisomy 18 may affect a particular diagnosis experience, whether made during pregnancy or the days after birth when parents are still getting to know their child. As parents live with this diagnosis, pregnancy and the life of their child may be shaped by an uncertainty of a life-limiting condition, whereby care is bounded by what is and is not possible. And, we may appreciate how trisomy 18 imparts meanings on ordinary and extraordinary moments for children and their families in a recognisable form. The understandings gained from this research may support healthcare professionals' reflective clinical practices as they care for children and their families affected by this diagnosis.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442422","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":"Prozac as medicine, metaphor and identity: reimagining recovery as a rhetorical process in Lauren Slater's <i>Prozac Diary</i>.","authors":"Swikriti Sanyal, Hemachandran Karah","doi":"10.1136/medhum-2024-012973","DOIUrl":"https://doi.org/10.1136/medhum-2024-012973","url":null,"abstract":"<p><p>This paper examines Lauren Slater's memoir, <i>Prozac Diary</i>, to understand the role of language in reimagining the notion of recovery. Written from the standpoint of a consumer of antidepressant drugs, <i>Prozac Diary</i> underlines the pervasiveness of professional psychiatry's pathologising practices and its psychopharmacological interventions in the 90s in the USA. Moreover, it unpacks the nuances of the relationship between the person and the pill at the intersections of myriad medical and socio-cultural discourses. Reading the memoir from the perspectives of disability studies scholars such as Kimberly E. Emmons and Lennard J. Davis, we argue that Slater's use of figurative language to critically engage with the Prozac discourse is a rhetorical act of self-care. Furthermore, we contend that by normalising illness and challenging the ableist assumptions of normalcy, Slater also invests in rhetorical care of the collective self/bodymind.This paper demonstrates how through a metaphorical representation of Prozac, Slater questions the predominant mental health discourses that construct the meanings of 'illness' and 'health' and shape illness and health-based identities. Simultaneously, through her dialogical negotiations with the Prozac discourse to reconstitute a complex health identity, she raises fundamental questions about the existence of a 'core', 'authentic', 'healthy', pre-Prozac selfhood that the drug claims to restore. Therefore, by unravelling the intrapersonal, socio-cultural and discursive ramifications of recovery, as opposed to psychiatry's perfunctory understanding of biological cure as a restoration of a socially desirable state of 'normalcy', she is able to reclaim the lived experience of recovery. We argue that in <i>Prozac Diary</i>, recovery does not merely imply a passive internalisation of psychiatry's biological determinism and its psychopharmaceutical approaches. Instead, it is a rhetorical process that enables the medicalised individuals to actively engage with the mental health system and interrogate the possibility of critically responding to its normative frameworks as agentic subjects.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392299","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":"Finland's New Children's Hospital and resurgent charity in a Nordic post-welfare state.","authors":"Henni Alava, Janette Lindroos, Arvi Pihlman","doi":"10.1136/medhum-2024-013128","DOIUrl":"https://doi.org/10.1136/medhum-2024-013128","url":null,"abstract":"<p><p>Finland's New Children's Hospital (NCH) opened in 2018 after a high-profile charity campaign. Through an analysis of the campaign, we illustrate how debates about children's hospitals and charities are simultaneously shaped by universal debates over the ownership and funding of healthcare services, and by the particularities of historical context and local institutional arrangements. Such debates also draw from and contribute to shaping cultural repertoires, particularly shared beliefs and values concerning children, the state and charity. In Finland, the NCH marked a break from an established model of publicly funded hospitals, and a return to the pre-welfare state era when charities played a role in healthcare. The campaign thus generated substantial public debate, in which we identify three core claims: (1) Hospitals must be built with public funding and oversight. (2) Children are suffering because politicians have failed, and a new model is needed. (3) The NCH further strengthens Finland's excellence in paediatric healthcare and promotes health technology exports. Over the course of the campaign, critique faded away, and the second and third lines of argument came to dominate public debate. Through a reflection on the historically changing relations between state, charity and children that shaped what we conceptualise as the NCH assemblage, we show how clichéd cultural tropes naturalised the political shift toward a post-welfare state that is embedded in the NCH campaign. As citizens without voter rights, children are exceptionally easy for politicians to sidestep when allocating funds. Yet, as what Sara Ahmed describes as 'objects of feeling', children are also exceptionally potent targets for charity, who, in the NCH case, came to serve as tools for the neoliberal disassembling and reassembling of healthcare services in Finland.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374632","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":"On the consequences of childbirth: obstetrics/gynaecology, comparative anatomy and racial theories in 19th century France and Brazil.","authors":"Maria Helena Pereira Toledo Machado","doi":"10.1136/medhum-2024-013097","DOIUrl":"10.1136/medhum-2024-013097","url":null,"abstract":"<p><p>The following paper is centred on an analysis of comparative studies of the human pelvis developed over the 19th century by mostly French natural scientists, physical anthropologists, students of the human anatomy and doctors engaged in the initial stages of the emerging fields of gynaecology and obstetrics. As this paper will argue, there was considerable overlap between these specialisations, producing a fundamentally masculine, Eurocentric and racialised knowledge that had an enormous impact in establishing racially informed gynaecological and obstetric practices. This paper argues that comparative pelvic anatomy studies originated from the belief that African and Black women had specifically different pelves and genitalia and served to stratify women of different races and promoted racially oriented obstetric and gynaecological treatments. Despite their European origins, these French publications had profound repercussions across various regions of the Atlantic world and directly influenced the medical care provided to women of African descent in both slave and postemancipation societies, particularly in Brazil. In 1887, a doctoral candidate from the Rio de Janeiro Medical School (Brazil) wrote a dissertation in which he advocated and justified the racialised treatments offered to enslaved, free and soon-to-be-free women of African descendent who delivered their offspring at the medical school's maternity ward. In his advocacy for such practices, the author drew connections between the prevailing methods at Rio de Janeiro's Medical School to a long lineage of French medical thought on the racialised comparative anatomy of women's pelvises throughout the 19th century.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041545","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":"Deaf futurity: designing and innovating hearing aids.","authors":"Jaipreet Virdi","doi":"10.1136/medhum-2024-013011","DOIUrl":"10.1136/medhum-2024-013011","url":null,"abstract":"<p><p>One of the tenets of a posthuman vision is the eradication of disability through technology. Within this site of 'no future', as Alison Kafer describes, the disabled body is merged with artificial intelligence technology or transformed into a prosthetic superhuman. These imaginative possibilities are materialised in a future-oriented mindset in contemporary technological innovation, including hearing aids and other devices-such as vibrating vests to 'feel sounds' or sign language gloves, what design critic Liz Jackson defines as 'disability dongles'-designed to bypass deafness that simultaneously provide a 'cure' and create a 'post-deaf reality'. Bringing together material culture with crip futurity, history of science, medicine and technology (HSTM), this paper investigates how hearing devices for deaf people have embodied futurity through design and technological features. While mid-20th century analogue hearing aids incorporated fashion through colour and style, 21st century digital hearing aids favour a sleek, industrial aesthetic borrowed from modern architecture, jewellery and automotive design. Yet discretion remains a persistent and common design feature, meant to diminish obvious symptoms of deafness. Applying what I refer to as the 'disabled gaze'-an autonomous claiming of identity that draws attention to, rather than camouflages, disability-this paper attempts to understand how expanding the breadth of hearing aid design beyond discretion will open possibilities for imagining deaf futurity to radically disintegrate ableist stereotypes and transform how disabled people are represented in society.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"678-684"},"PeriodicalIF":1.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"That's me at my best\": perspectives of older adults on involvement in technology research.","authors":"Susanna E Martin, Cindy C Zhang, Mallorie T Tam, Julie M Robillard","doi":"10.1136/medhum-2024-013030","DOIUrl":"10.1136/medhum-2024-013030","url":null,"abstract":"<p><p>Creating assistive technology for older adults requires a deep understanding of their needs, values and preferences. Human-centred approaches can be used to engage older adults in technology research to help ensure that end solutions are ethically aligned, relevant and responsive to their priorities. However, the value of cocreation is not universally acknowledged. Older adults continue to receive negative stereotyping and are limited from engaging in research. With the growing demand for assistive technologies that effectively meet end-user needs, it is important that we deepen our knowledge about engagement and promote inclusion of older adults in technology research. To learn more, we asked members of a research advisory group for assistive technologies, specifically social robots, to tell us about their experiences of engagement and the impact it has on their lives, to speculate whether participation in research may promote human flourishing. Our findings reveal that engagement is more than knowledge exchange: it is a multifaceted, dynamic process that creates rich and meaningful experiences for older adults. Experiences of engagement dovetail with interpretations of flourishing and improved well-being, which include outcomes related to empowerment, autonomy and connectedness to self and others. Older adults also report finding purpose and satisfaction in knowing that their contributions to research may be used to develop technologies that can benefit others. This work amplifies the voice of lived experiences to deepen our understanding of the impacts of participation and prompts us to reimagine how older adults may be meaningfully engaged in technology research.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"648-656"},"PeriodicalIF":1.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability, digital technologies and the ambivalent allure of posthumanist/transhumanist futures.","authors":"Margrit Shildrick","doi":"10.1136/medhum-2024-013020","DOIUrl":"10.1136/medhum-2024-013020","url":null,"abstract":"<p><p>Technologies, both simple and sophisticated, have always played a major role in the negotiation of a range of disabilities that are assumed to impede the expression of autonomous selfhood. Whether deployed as mechanical aides to ideally normalise physical differences, as organic-and often internal-supplements to bolster the performance of body and mind, or as digital enhancements that override the supposed shortcomings of neurodiversity, the widely accepted claim is that such technologies have a clear therapeutic value. It conjures the illusion of an unproblematised sequence of more complex technologies leading to increasingly enhanced function and the advent of superior selfhood. Those who identify as having disabilities, either physical or cognitive, are assured of a better future in which anomalies are sufficiently offset to the extent that they no longer attract disvalue.My paper offers a less conventional perspective that leaves behind the desire for individual autonomy and opens up the question of the transhuman and the posthuman. Rather than focusing on the bounded self at the centre of humanist thought, I ask what is at stake when human embodiment becomes intricately entangled with non-human materialities and digital coding. It is likely that the major developments in such 'prosthetic' technologies will strongly impact the field of disability. Beyond a merely functional usage, which is likely to dominate in the short term, urgent questions arise about the extent to which the category of the human can or should be sustained as the anchor of continuing life. In exploring the practical, philosophical and bioethical implications of newly emerging technologies, I distinguish between the motivation of transhumanism, which focuses on self-perfectibility and mastery, and a posthumanism that in seeking to radically decentre the very notion of human privilege and hierarchical distinctions offers an optimistic view of disability futures.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"685-693"},"PeriodicalIF":1.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630291","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":"Edges of perception: balancing sensory loss and potential in assistive technology.","authors":"Femke Krijger","doi":"10.1136/medhum-2024-013023","DOIUrl":"10.1136/medhum-2024-013023","url":null,"abstract":"<p><p>Being deafblind means my perception differs profoundly from those who are conventionally sighted and have non-impaired hearing. A lot of hidden knowledge is to be found in the disparity between these differing experiences that could be of great value in developing assistive technologies that have a broad scope to engage with both disabled and non-disabled users. This article explores the balancing act between sensory loss and the potential inherent in all of us and how this should be part of the design process of haptic assistive technology.Facing the true impact of my sensory loss, I realised it held the unexpected gift of a-literally-different perspective. I am losing sights and sounds, but the world still reveals itself to me in many ways. Exploring my sensory potential, I combine daily life experiences and theoretical knowledge to better understand how to get the most out of my sensory processing systems. The goal is not to compensate what is lost, but stay connected in a way that enables me to live my life to the fullest.I undertake sensory life hacks based on the brain's unmatched capacity to adjust to circumstances and work with <i>any</i> kind of input. Both predicting processing and neuroplasticity offer an operating system of highly evolved flexibility that allows and even encourages creative solutions. I adjust my coping strategies to align them with these processes shaping my perceptual experience, balancing sensory loss and sensory gain.I believe there is great potential to enrich daily life experiences with haptic assistive technology, building on the natural sensory abilities we have as human beings, co-creating life. However, this comes with challenges: researchers who are not sensorily impaired should consider through experience that we all have limited perception in a way. At the edges of the familiar, you have to face your perceptual limits, pushing you out of your comfort zone and in doing so space is being created for growth; researchers used to the dominance of sight and hearing are less used to consciously experiencing the power of sensory proximity, such as touch and proprioception. These bodily tactile senses, however, are grounding senses in all of us and display a broad scope of sensations to be experienced.The hereditary disease that causes deafblindness forced me to explore the edges of my perception, and instead of devastating loss I discovered a richness of sensory abilities. This article is a plea to dive into this, using my lived experience and critical knowledge. Realising this potential can mean that inclusive research on assistive technologies might really do what it promises, co-creating technologies to enhance life experiences.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"601-609"},"PeriodicalIF":1.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839793","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":"Deaf-led alarm design: technology and disability in home, work and parenthood.","authors":"Gretchen Von Koenig","doi":"10.1136/medhum-2024-013029","DOIUrl":"10.1136/medhum-2024-013029","url":null,"abstract":"<p><p>Domestic alarms are highly personal technological appendages that help us achieve an individual sense of safety and familial well-being-like baby monitors that help us care for children and alarm clocks that ensure a daily routine and help us get to work on time. Alarms can be understood as technologies that extend our eyes, ears, and memory to monitor our homes and ourselves in various ways beyond typical human capacity. The designs of domestic alarms tend to favour audible forms of alerting, and disabled users and inventors have hacked and redesigned alarms to fit their own families' needs. Alarm design can tell us what type of domestic futures designers and technologists have imagined, casting visions about who is fit for parenthood and who is a reliable worker, and what types of futures disabled users imagined for themselves. As the future of these technologies becomes subsumed into smartphones and other IoT devices, a look into their predigital material forms uncovers episodes of disability agencies that assert a right to disability futures of domestic bliss and safety. Through the archives of The Deaf American and other deaf community publications, this research reviews the postwar alarm designs of Emerson Romero, a Cuban-American deaf activist and engineer, to show how deaf-led alarm designs are forms of material rhetoric that assert a right to a domestic future for disabled parents and workers.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"639-647"},"PeriodicalIF":1.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773537","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}