Innovation Through Tradition: Rediscovering the “Humanist” in the Medical Humanities

Throughout its fifty-year history, the role of the medical humanist and even the name “medical humanities” has remained raw, dynamic and contested. What do we mean when we call ourselves “humanists” and our practice “medical humanities?” To address these questions, we turn to the concept of origin narratives. After explaining the value of these stories, we focus on one particularly rich origin narrative of the medical humanities by telling the story of how a group of educators, ethicists, and scholars struggling to define their relatively new field rediscovered the studia humanitatis, a Renaissance curriculum for learning and teaching. Our origin narrative is composed of two intertwined stories—the history of the studia humanitatis itself and the story of the scholars who rediscovered it. We argue that as an origin narrative the studia humanitatis grounds the medical humanities as both an engaged moral practice and pedagogical project. In the latter part of the paper, we use this origin narrative to show how medical humanists working in translational science can use their understanding of their historical roots to do meaningful work in the world.     

Reframing Medicine’s Publics: The Local as a Public of Vaccine Refusal

Although medical and public health practitioners aim for high rates of vaccination, parent vaccination concerns confound doctors and complicate doctor-patient interactions. Medical and public health researchers have studied and attempted to counter antivaccination sentiments, but recommended approaches to dispel vaccination concerns have failed to produce long-lasting effects. We use observations made during a small study in a rural area in a southeastern state to demonstrate how a shift away from analyzing vaccination skepticism as a national issue with a global remedy reveals the nuances in vaccination sentiments based on locality. Instead of seeing antivaccinationists as a distinct public based on statistical commonalities, we argue that examining vaccination beliefs and practices at the local level offers a fuller picture of the contextualized nature of vaccination decisions within the psychosocial spaces of families. A view of vaccination that emphasizes the local public, rather than a globally conceived antivaccination public, enables medical humanists and rhetoricians to offer important considerations for improving communications about vaccinations in clinical settings.     

Psychological knowledge in a colonial context: theories on the nature of the "native mind" in the former Dutch East Indies

This article analyzes the views of 3 Dutch physicians working in the former Dutch East Indies during the first part of the 20th century. These physicians based ideas about the nature of the normal indigenous psyche on both their analysis of Indonesian individuals suffering from mental illness and on casual observations that represented widely shared cultural stereotypes. On that basis, they advocated a psychological colonial policy, which was to be based on a scientific understanding of the psyche of the Indonesian people. Using these ideas, they advocated political repression, justified inequality and racism, and limited educational opportunities for Indonesians. Representatives of the Indonesian nationalist movement vigorously protested against these ideas.     

Toward a narrative conceptualization of stereotypes: contextualizing perceptions of public housing residents

Expansion of policies aimed at empowering disenfranchised groups, for example, resident/tenant participation in public housing, have been greeted with a great deal of enthusiasm. However, negative beliefs about the intelligence, ability, and morality of these groups, may interfere with the implementation of these policies. A greater understanding of social perceptions may lead to interventions that diminish interference. Traditional stereotyping research methods rely on trait conceptualizations that have been criticized as inadequate to fully describe social perceptions. This study examines the utility of a narrative approach to studying stereotypes about public housing residents. A group of college students (authors) wrote stories about a public housing resident and described the resident using trait objectives. Two readers, one given the story and the other the trait list, predicted how the author responded on various public housing belief and attitude instruments. Results indicate that stories and traits convey unique information not expressed by the other and offer preliminary support for the added usefulness, especially contextual information, of a narrative framework for studying stereotypes. The relevance of a narrative approach for understanding how stereotypes may undermine empowerment-based policies, in this case tenant participation in public housing, will also be explored. Copyright © 2000 John Wiley & Sons, Ltd.     

Sex Role Stereotypes and the American Physician

The potential influence of sex-role stereotypes on women medical patients is examined in this paper. It is argued that medical practice is, in part, a social enterprise, influenced by sex-role stereotypic notions held by both patients and physicians, and particularly by the interaction of women patients'behavior with physicians'expectations. Indirect evidence suggests that physicians tend to attribute symptoms presented by women to psychogenic rather than organic causes, but that women nonetheless receive more medical treatment than men in the form of unnecessary surgery and psychotropic drugs. The latter is viewed as part of a historical trend that the feminist self-help movement is attempting to counteract.     

Afterword: Elaborating Health and Medicine’s Publics

This essay argues that medical and health humanists interested in the rhetorical work of publics can extend their research by attending to embodiment and infrastructure. In addition to discussing how such strategies are illustrated in the essays appearing in this special issue, I relate them to the rhetorical study of personal health records (PHRs) as described in consumer-directed arguments. I conclude by posing two questions to health and medical humanists: “How do discursive constructions of publics and more specific instantiations of embodied experiences mutually shape each other?” and “What do the infrastructures of health and medical users look like and involve in their enactment?”     

消极刻板印象对老年人医疗决策的影响及归因偏差的作用

随着年龄的增长, 对老年人的消极刻板印象和医疗决策逐渐成为了与老年群体越来越相关的两个概念。在此背景下, 很有必要系统地探讨消极刻板印象对老年人医疗决策的效应及其机制。本研究以158名老年人为被试, 通过两个实验考察了消极刻板印象、归因偏差和老年人医疗决策质量间的关系。实验1结果发现, 消极刻板印象负向影响老年人的医疗决策质量, 同时, 归因偏差在刻板印象对老年人医疗决策质量的效应中起到中介作用。实验2结果表明, 减少归因偏差的干预控制可以有效降低刻板印象对医疗决策质量的消极效应。本研究对理解刻板印象效应机制、缓解刻板印象消极效应、以及改善老年人医疗决策质量具有一定的理论意义和实践价值。     

Prescribing Psychologists in Integrated Primary Care: Introduction to the Special Section

The authority to prescribe could differentiate psychologists from other non-physicians in primary care, achieving a significant step for the growth of our profession. Psychologists are currently prescribing in primary care settings in a number of public service venues, as well as medical school training facilities. In this Special Section of the Journal of Clinical Psychology in Medical Settings, results of a survey of physicians working with a prescribing psychologist indicate that the psychologist is highly valued and seen as a competent prescriber. A series of papers providing case examples demonstrate how psychologists are evolving in these new clinical roles, as well as participating in behavioral and psychopharmacology training of primary care physicians.     

From Pink Frilly Dresses to ‘One of the Boys’: A Social‐Cognitive Analysis of Gender Identity Development and Gender Bias

In middle childhood, many girls go through a curious metamorphosis, in which their earlier embrace of all‐things‐feminine appears to transform into an identity as a tomboy. We believe this striking shift, observed in girls but not boys, signifies a critical development in children’s socio‐cognitive functioning, with implications for their understanding of gender as it relates to their identity and their social relationships. In this article, we review the evidence for this identity shift and present a theoretical account that integrates ideas from social cognition and social development. We argue that this identity shift involves the emergence of public regard and status awareness, with concurrent increases in the complexity with which knowledge associated with gender categories is represented in the mind. We then posit that these changes have important implications for the developmental trajectory of implicit and explicit gender attitudes and stereotypes, and we present a set of predictions generated by our theoretical analysis.     

Das Image von Psychologen, Psychotherapeuten und Psychiatern in der Öffentlichkeit

This is a systematic review of studies about the public image of or attitudes toward mental health professionals, particularly psychologists, psychiatrists, and psychotherapists (including psychoanalysts) on the basis of computerized medical and psychological databases (PsycLIT, Pub Med, Google Scholar) and their cross-references with 43 new articles. It is an update of an older meta-content analysis of the same topic (N= 60 primary studies) which analyzed studies, published between 1948 and 1995. Data about their perceived social status, field of activity and clinical expertise, their sex/gender and physical appearance, personality and social interaction (especially those between therapists and clients), their work setting and about differential effects are presented. It becomes obvious that there exists a “shrink”-stereotype, which refers equally to psychologists, psychotherapists and psychiatrists, and which differs from the stereotype of physicians. The appearance of the “shrink” stereotype is male and psychoanalytically influenced (looking as Sigmund Freud in the setting “couch”). The stereotypes of “shrink’s” personality are partially idealisations (warm, intelligent, understanding parental figures) and partially very negative images (the neurotic; the dangerous, manipulative abuser). Public image of “shrinks”, research deficits, methodological problems, and sex/gender issues are critically discussed.     

Medical tourism in india: perceptions of physicians in tertiary care hospitals

Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical issues emerging out of that and the need for understanding the linkages between public and private sectors for a more effective intervention for an equitable medical care policy.     

Competencies of Process: Toward a Relational Framework for Integrated Care

As integrated care (IC) has gained more traction within both the psychosocial and medical fields, the need to train medical family therapy students and established professionals in this care typology has increased in tandem. To address this stated need, there is a large body of literature pertaining to models of care, typologies of intervention, clinical and financial effectiveness, and now a burgeoning discussion related to the academic and practice-based competencies necessary for IC practice. While the ability of the medical family therapist as behavioral health provider (MedFT/BHP) to practice in integrated settings may rely on an understanding of population-based medicine, disease etiology, medication and psychopharmacology, as well as augmentations to patient conceptualization and practice, all of the specifics related to that care are ultimately leveraged on the relationships formed by the MedFT/BHP with their healthcare colleagues. What this means is while we have attempted to distill the gestalt of integrated care into its major practice-based parts (e.g., model development and implementation, competencies, financial viability, efficacy/effectiveness, mechanisms of activation, and marketing), we have not adequately described the competencies necessary to set the stage for these types of close working relationships: relationships that make integration, of any kind, a possibility. The following paper was written to discuss three competencies related to the relational process of integration: (a) conceptual flexibility, (b) understanding and acceptance, and (c) acknowledgment and appreciation, as well as how these competencies provide the backdrop against which integrated care, as a practice, can emerge.     

Still a Hetero-Gendered World: A Content Analysis of Gender Stereotypes and Romantic Ideals in Chinese Boy Love Stories

Boy’s Love (BL) stories are a fictional fantasy textual story that describes a romantic relationship between men. Previous qualitative studies claimed that BL stories have depicted androgynous characters and egalitarian love relationships. The current study undertook a quantitative content analysis of 87 randomly sampled popular Chinese BL stories. Our coding system for coding both the masculinity and femininity of each main character in the selected BL stories was developed based on several previous studies. Gay male characters in BL stories were depicted as either similar to traditional masculine men (i.e., scoring high in masculinity and low in femininity) or similar to traditional feminine women (i.e., scoring high in femininity and low in masculinity). In the romantic relationships, BL stories typically paired a masculine character with a feminine character. In addition, heterosexual romantic ideals were prevalent in BL stories. Such an analysis challenges the previous analysis of BL stories. It suggests that heteronormative gender stereotypes exist in BL stories, even if these stories depict gay male characters and romantic relationships. These findings have important implications for understanding media effects in stereotypes toward gay men in contemporary Chinese society. It also encourages further research on alternative explanations for women’s motivation in reading and writing BL stories.     

Challenge your stereotypes! Human Library and its impact on prejudice in Poland

Human Library is a public event aimed at reducing stereotypes and prejudices, in the form of an interactive, contact‐based intervention. It employs the logic of a regular library yet with readers “borrowing” Living Books, which are real people representing various minority groups. Readers engage in 30‐min conversations, during which they can challenge their stereotypes and widen their scope of knowledge and understanding. This pre‐post intervention study examined the effectiveness of the Human Library (held in Wroc?aw, Poland) in reducing social distance towards Roma, Muslims, dark‐skinned, and transgender people, as well as in decreasing homonegativity. Also, we measured whether participation in the Human Library changes individual attitudes towards diverse workgroups. We found that the Human Library decreased social distance towards Muslims. Also, the more Living Books that the participants “read,” the bigger the shift in their social distance towards Muslims. Furthermore, we observed an increase in positive affective attitude towards working in diversified groups, as a result of participation in the event. The study serves as partial support for the effectiveness of the Human Library in altering one's attitude towards minority groups and diversity. The intervention is discussed as a promising but not yet entirely understood tool to improve intergroup relations.     

Medical ethicists, human curiosities, and the new media midway

Medical ethicists have assumed a role in justifying public voyeurism of human "curiosities." This role has precedent in how scientists and natural philosophers once legitimized the marketing of museums of "human curiosities." At the beginning of the twentieth century, physicians dissociated themselves from entrepreneurial displays of persons with anomalies, and such commercial exhibits went into decline. Today, news media, principally on television, promote news features about persons that closely resemble the nineteenth century exhibits of human curiosities. Reporters solicit medical ethicists for soundbites to affirm the newsworthiness and propriety of public voyeurism of these medical stories. Ethicists' soundbites are usually ambiguous or self-evident and rarely enable viewers to morally engage the issues. The precedent of early twentieth century physicians disengaging from such exploitive public shows is a useful example for medical ethics.     

Battered Women

SUMMARY

This review of research findings on woman battering reveals how research has played a major role in changing social policy and challenging common myths and stereotypes. The earliest literature contained the ideas of a few psychotherapists who viewed woman battering as a rare phenomenon that involved masochistic women and sadistic men, which led to the myth of psychopathology as the mediating factor. Research following the birth of the battered women's movement destroyed this and some subsequent myths. It led to changes in medical practitioners' attitudes toward battered women patients and law enforcement's reaction to battering victims and their abusers. It also revealed important facts about the courts' handling of abusers and their victims and about violent relationships that result in homicide. The myth that children living in violent households are unharmed has been soundly discredited, yet despite these findings, many battered women continue to face serious difficulties when they attempt to divorce their abusers and obtain custody of their children. Other myths have been exposed by researchers on the basis of their findings. However, once ideas gain popular public acceptance, they tend to continue to exert influence. Nevertheless, positive changes have occurred in the entire spectrum of medical, legal, and social services with which battered women must interface. The research findings reviewed here help highlight current needs and suggest future directions.     

Compassionate stereotyping of elderly patients by physicians: revising the social contact hypothesis

Departing from previous research on age stereotypes, this study examined degree of contact with elderly patients as a factor affecting age stereotyping by physicians. Included are measures of behavioral intentions as well as more traditional attitudinal measures. A total of 63 rheumatologists completed a brief questionnaire on which they rated a 53- or an 83-year-old target patient on a number of dimensions including psychological adjustment and need for support and information. Patients' age and physicians' degree of contact with elderly patients had few direct effects on physicians' ratings; their interaction, however, yielded a strong and consistent finding: The elderly patient was rated as less adjusted, autonomous, and instrumental and in greater need of support and information by high-contact physicians. These findings suggest that although negative age stereotypes are less prevalent than has previously been indicated, rheumatologists, particularly those who treat elderly patients, may draw on compassionate stereotypes in their care of elderly patients.     

Medical Ethicists,Human Curiosities,and the New Media Midway

Abstract

Medical ethicists have assumed a role in justifying public voyeurism of human “curiosities.” This role has precedent in how scientists and natural philosophers once legitimized the marketing of museums of “human curiosities.” At the beginning of the twentieth century, physicians dissociated themselves from entrepreneurial displays of persons with anomalies, and such commercial exhibits went into decline. Today, news media, principally on television, promote news features about persons that closely resemble the nineteenth century exhibits of human curiosities. Reporters solicit medical ethicists for soundbites to affirm the newsworthiness and propriety of public voyeurism of these medical stories. Ethicists' soundbites are usually ambiguous or self-evident and rarely enable viewers to morally engage the issues. The precedent of early twentieth century physicians disengaging from such exploitive public shows is a useful example for medical ethics.     

L’internalisation des stéréotypes chez les « petits » fonctionnaires : impact du contact avec le public et du prestige perçu

This paper focuses on the internalization of stereotypes among French office workers in the lower category (category C). More precisely, we investigated the impact of two independent factors on this internalization of stereotypes: the perceived external prestige and public contact. Results obtained using questionnaires completed by 175 office workers have mainly showed that, in accordance with previous studies, the external prestige perceived influence significantly the internalization of stereotypes. But, contrary to previous studies, the frequency of contacts with the public has no impact on the internalization of stereotypes in our sample. Our results invite furter work on this population of office employees who is, paradoxically, increasingly confronted with stereotypes but subject of very few studies.     

Medical students' predictions of public opinion regarding role performance of doctors

Role performance in others is evaluated as part of the interaction process but the results may not always be clearly perceived. One might assume that students being trained to be physicians would be attuned to patient evaluation of doctors' role performance, but the results of a study of the predictions made by fourth-year medical students concerning the public evaluation of doctors' role performance shows that doctors in training do not have an accurate picture of public opinion.