Medical Humanities最新文献

{"title":"Engineering organs, hopes and hybridity: considerations on the social potentialities of xenotransplantation.","authors":"Johannes Kögel, Peta S Cook, Nik Brown, Amy Clare, Megan H Glick, Kristofer Hansson, Markus Idvall, Susanne Lundin, Mike Michael, Sofie Á Rogvi, Lesley A Sharp","doi":"10.1136/medhum-2024-013061","DOIUrl":"10.1136/medhum-2024-013061","url":null,"abstract":"<p><p>The development of replacing human organs with those from genetically modified pigs holds immense potential for alleviating the shortage of organs necessary for patients in need of transplants. This medical advancement is also accompanied by significant social changes, including the emergence of a bioeconomy, new modes of biotechnology governance, altered human-animal relations and increased public engagement. Some aspects, such as the impact on the transplant allocation system, effects on clinical practice and healthcare provision, global trajectories and most importantly the consequences for patients and their families remain unpredictable. Given that xenotransplantation occurs within a societal context and its success or failure will not be confined to technical feasibility alone, it is essential to engage a social sciences perspective to highlight the social implications and emphasise the importance of social research in accompanying future developments.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":"51 1","pages":"180-184"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494197","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":"'Are you pregnant? If not, why not?': artificial reproductive technology and the trauma of infertility.","authors":"Soumya Kashyap, Priyanka Tripathi","doi":"10.1136/medhum-2023-012690","DOIUrl":"10.1136/medhum-2023-012690","url":null,"abstract":"<p><p>The article scrutinises Rohini S. Rajagopal's work, <i>what's a lemon squeezer doing in my vagina</i> (2021), to illustrate the escalating medicalisation of infertile bodies. In a cultural context where reproductive concerns are construed as medical disorders demanding treatment and surveillance, medical professionals and pharmaceutical companies exploit these sociocultural dynamics to provide infertile couples with immediate solutions through Assisted Reproductive Technologies. Consequently, the study contributes a critical perspective to the field of medical humanities, initiating a nuanced discourse that interrogates the impact of terms such as 'living laboratories', 'baby machine', 'mother machine' and 'hope technology' on our comprehension of future motherhood. Drawing on feminist critiques of medicalisation, the article argues that biotechnology perpetuates the eighteenth-century biomedical metaphor of the body as a machine with replaceable parts. Notably, contemporary advancements in reproductive medicine allow for the replacement of perceived 'flawed' body parts, further objectifying them within this framework.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"102-111"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366898","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":"Sociocultural aspects of the medicalisation of infertility: a comparative reading of two illness narratives.","authors":"Annie James, Manjusha G Warrier, Ann Treessa Benny","doi":"10.1136/medhum-2024-012977","DOIUrl":"10.1136/medhum-2024-012977","url":null,"abstract":"<p><p>This paper is a comparative reading of variations in the medicalisation of infertility caused by sociocultural aspects, in two illness narratives by patients: Elizabeth Katkin's <i>Conceivability</i> (2018), a story of navigating a fertility industry with polycystic ovarian syndrome and antiphospholipid syndrome in America and Rohini Rajagopal's <i>What's a Lemon Squeezer Doing in My Vagina</i> (2021), a discussion from India of a growing awareness of medicalisation in treatment of unexplained infertility. For this purpose, it first charts scholarship on illness narratives and medicalisation, noting a historical association. Following this, it shows how infertility, a physiological symptom of reproductive incapacity or failure to show clinical pregnancy, is generally medicalised. This paper reads the texts as showing hitherto unaddressed sociocultural aspects of infertility's medicalisation. At the same time, drawing from existing sociological and anthropological scholarship, it shows how a reading of sociocultural aspects in medicalised infertility nuances understanding of it's medicalisation. This comparative reading attends to sociocultural values and norms within the texts, including pronatalism, fetal personhood, kinship organisation, purity/pollution, individual reliance, sacred duty and so forth. It draws from scholarship on embodiment, rhetorical strategies and the language of medicine. It also shows how a patient's non-medicalised, affective history of 'deep' sickness caused by the biographical disruption of infertility is not that of a 'poor historian'. In laying out the particularisation of such sociocultural values and norms across America and India, medicalisation's migration from its origins to the margins reveals subjectivised, stratified reproduction in infertility illness narratives. This paper is part of a turn in scholarship away from understanding the medicalisation of infertility as naturalised and decontextualised.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"76-85"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996638","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":"Implications of task shifting on power relations in healthcare: the case of clinical officers at public hospitals in Malawi.","authors":"Paliani Chinguwo","doi":"10.1136/medhum-2023-012867","DOIUrl":"10.1136/medhum-2023-012867","url":null,"abstract":"<p><p>In Malawi, there exists a group of medical professionals known as clinical officers (COs) who assume responsibilities typically carried out by doctors due to the current scarcity of the latter. This paper seeks to explain how the introduction of COs as part of implementing task shifting in healthcare, unintentionally became a terrain for the contestation of power between COs and physicians. The research from which this paper originates used a qualitative research approach. It was carried out in state-owned facilities, encompassing four district hospitals and one central hospital in Malawi. This paper develops a conceptual framework on power and then uses it to demonstrate that task shifting through the introduction of COs as substitutes for physicians, became a source of interprofessional conflicts. The paper argues that unequal power relations between COs and physicians in healthcare contribute to interprofessional conflicts. The paper further demonstrates that unequal power relations between COs and physicians are manifested through differences in educational backgrounds and work experiences as well as unequal responsibility and authority. The paper concludes that the interprofessional conflicts between COs and physicians arising from unequal power relations ultimately aggravate poor psychosocial well-being among COs.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"26-33"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724716","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":"Is there truth in fiction? Lessons from readers' responses to dementia fiction.","authors":"Jane Lugea, Carolina Fernandez-Quintanilla, Gemma Carney, Paula Devine","doi":"10.1136/medhum-2024-012976","DOIUrl":"10.1136/medhum-2024-012976","url":null,"abstract":"<p><p>This paper addresses the question 'is there truth in fiction?', by synthesising a range of disciplinary approaches to the issue, as well as drawing on empirical research carried out with readers of fiction about dementia (hereafter, dementia fiction). We argue that fiction-perhaps because of its fictional status and apparatus-invites readers to consider its truth value, to explore the possibilities of human experience and interrogate issues relative to their subjective experience, community or society. The findings have significant implications for the Medical Humanities' use of fictional texts to explore lived medical conditions and experiences, as well as claims made about the potential for fiction to affect real-world understandings, awareness and empathy around the conditions depicted. We show that the techniques used in fictional language may be artifice, but they simulate a truth that corresponds with reality.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"129-139"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781306","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":"Psychiatrists' experiences of involuntary care in South Africa: dilemmas for practice in challenging contexts.","authors":"Alex Morung Freeman, Laila Asmal, Leslie Swartz","doi":"10.1136/medhum-2024-012929","DOIUrl":"10.1136/medhum-2024-012929","url":null,"abstract":"<p><p>Providing for people with psychosocial conditions in crisis is a complex and controversial endeavour that has gained significant attention over the past decade. This increased focus is driven by global calls to reduce coercion, including by the United Nations Committee on the Rights of Persons with Disabilities, who interpret Article 12 of the United Nations Convention on the Rights of Persons with Disabilities in General Comment 1 to advocate for the replacement of substituted decision-making with supported decision-making. Psychiatrists occupy a central role in determining how to care for and respond to individuals with psychosocial conditions in crisis in the midst of these debates. They must protect the rights of people with psychosocial conditions in crisis and provide appropriate support within challenging and dynamic contexts. This responsibility includes promoting the autonomy of people with psychosocial condition while ensuring their long-term health, safety and well-being.In this study, we conducted a phenomenological analysis with a sample of nine psychiatrists in South Africa to explore their experiences with involuntary care and the complex dilemmas they face in delivering healthcare to individuals with mental health conditions. Our findings indicate that psychiatrists encounter significant challenges in preserving patient autonomy, particularly within the resource-limited context of South Africa. Pervasive stigma and insufficient support infrastructure complicate efforts to prioritise autonomy. At the same time, professionals must address the critical need to ensure the long-term safety and well-being of their patients. The absence of involuntary care can exacerbate a person's vulnerability to community stigma and inadequate community support, posing severe risks to their welfare. Balancing between protecting a person's autonomy and addressing the limitations of support structures creates a complex predicament for mental health professionals, often resulting in feelings of isolation and moral distress among psychiatrists.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"67-75"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005518","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":"Listening to face transplant patients and caregivers: how medical humanities approaches redefine surgical 'success'.","authors":"Fay Bound Alberti, Dallas Weins, Annalyn Bell Weins","doi":"10.1136/medhum-2024-013005","DOIUrl":"10.1136/medhum-2024-013005","url":null,"abstract":"<p><p>A recent review of face transplants argues that overall, they have been successful. But this verdict is based on surgical measures rather than patient-reported outcomes (PROMs), which for historical reasons are in their infancy. These measures are critical to understanding the nature of success in face transplants, and the evidence from mixed systems of healthcare, as in the USA, reveals that there are significant ethical and social concerns about the well-being of patients. Medical humanities research that focuses on the lived experience of patients and their caregivers can contribute significantly to the discussion by focusing on patient voices and the measures that matter outside of surgical contexts. This article builds on existing work and original interviews with face transplant recipients and their families from an emotion history perspective. It argues that surgical measures used in isolation can be misleading. We need a more holistic understanding of outcomes-financial, psychological and emotional as well as medical-that requires the insights drawn from the humanities and transforms the definition and measurement of 'success'.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":"51 1","pages":"154-160"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494198","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":"'Finally making sense': graphic medicine and ADHD diagnosis in adulthood.","authors":"Sathyaraj Venkatesan, Prerna Tolani","doi":"10.1136/medhum-2024-012991","DOIUrl":"10.1136/medhum-2024-012991","url":null,"abstract":"<p><p>This article aims to examine the lived experiences of attention-deficit/hyperactivity disorder (ADHD) diagnosis in adulthood, emphasising its revelatory nature and diverse emotional responses it provokes. The diagnosis serves as a pivotal moment of self-discovery, often evoking feelings of validation and identity affirmation. However, it also triggers a complex array of emotions, including grieving for the childhood self, frustration with society's failure to recognise the legitimate challenges and evolving self-concept post diagnosis. Through a close reading of digitally published comics by Laura Balcerek, Amber Lewis and Juliette Yu-Ming Lizeray, this article studies how the graphic medium conveys these nuanced experiences. By dissecting narrative and visual elements inherent in the comics, the article studies the affordances of the comic medium to capture the lived experiences of ADHD diagnosis in adulthood. Ultimately, this article intends to deepen understanding of the diverse lived realities and underscores the expressive potential of graphic narratives of neurodivergence.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"172-179"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899130","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":"Mpox in the news: social representations, identity, stigma and coping.","authors":"Brigitte Nerlich, Rusi Jaspal","doi":"10.1136/medhum-2023-012786","DOIUrl":"10.1136/medhum-2023-012786","url":null,"abstract":"<p><p>In May 2022, when the COVID-19 pandemic began to recede from public view, another infectious disease surprised the world-mpox (formerly monkeypox). It appeared to disproportionately affect gay, bisexual and other men who have sex with men (GBMSM). Using qualitative thematic analysis and social representations theory, we analysed a corpus of 91 items from a variety of news outlets that included GBMSM community members' personal accounts of living through an mpox outbreak. The aim was to study the various ways in which members of a marginalised group created social representations of mpox and to ascertain whether these challenged older representations related to HIV and AIDS and newer ones related to COVID-19. Commentators anchored mpox to known, culturally accessible phenomena to render this previously unfamiliar disease familiar; objectified aspects of mpox, especially pain, through emotive language, making it 'real' and psychologically tangible; personified it by linking it to accounts of celebrity activists; and ontologised it through visually vivid descriptions. Challenging stigma was a cross-cutting theme in people's accounts. In contrast to the stigmatising imagery of health issues affecting GBMSM, these accounts contribute to the development of social representations designed to challenge such stigmatisation, which, in the contexts of HIV and AIDS and COVID-19, has hindered effective medical interventions, promoted misinformation and fuelled denigration.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"161-171"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787389","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":"Patients as knowledge partners in the context of complex chronic conditions.","authors":"Vox Jo Hsu, Megan Moodie, Abigail A Dumes, Emily Lim Rogers, Chelsey Carter, Emma Broder, Daisy Couture, Ilana Löwy, Emily Mendenhall","doi":"10.1136/medhum-2024-012957","DOIUrl":"10.1136/medhum-2024-012957","url":null,"abstract":"<p><p>This article conveys how taking patient knowledge seriously can improve patient experience and further medical science. In clinical contexts related to infection-associated chronic conditions and other complex chronic illnesses, patient knowledge is often undervalued, even when clinicians have limited training in diagnosing and treating a particular condition. Despite growing acknowledgement of the importance of patients as 'stakeholders', clinicians and medical researchers have yet to fully develop ways to evaluate and, when appropriate, meaningfully incorporate patient knowledge-experiential, scientific, social scientific, historical or otherwise-into clinical practice and research. We argue that there are opportunities for clinicians and researchers to collaborate with patients and colleagues from the social sciences and humanities. We use two examples to demonstrate why patient knowledge should inform medical engagement with chronic and complex conditions. The first comes from a disability studies scholar who describes the social biases that can sideline patient expertise, and the second is from an anthropologist whose reading in medical humanities led to an effective treatment for her recovery. Rather than merely acknowledging 'lived experience', clinical and research teams should include patients with complex chronic conditions as 'knowledge partners'. These patients occupy unique and valuable epistemological positions, and their knowledge should be considered with as much openness and rigour as other forms of medical knowledge. As more medical schools, residency programmes and hospitals emphasise the need for 'deep listening' and patient input, we encourage meaningful engagement with patients whose insights can provide crucial knowledge for clinical and scientific advancement.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"34-38"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724717","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}