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.     

Portrayals of Global Health Worker Migration in Canadian Print News Media: Domestic Concerns vs. Global Awareness

The global migration of physicians and nurses has implications for health human resources in both source and recipient countries. Of particular concern to academics and policy experts is the “brain drain” of health professionals from under-resourced nations to developed countries, which promote immigration of physicians and nurses to solve their own health worker shortages. How does the general public in these destination countries understand and respond to concerns over migration and immigration of health professionals? This understanding is likely to be influenced in large part by how the issues are portrayed in the news media. News media treatment of this issue was explored by surveying news articles; newspaper columns/editorials; and op-ed pieces; and letters to the editor published in four prominent Canadian newspapers between May 2004 and January 2009, a time frame that included two federal elections in which physician immigration was highlighted as a political issue. Despite the prominence among academics of concern over the brain drain of physicians and nurses from developing countries to Canada and other Western nations, this issue received little attention in print news media discussions, which focused on domestic physician shortages and the role of international medical graduates in filling Canadian needs. While recent federal elections brought concerns about immigrant physicians into the political spotlight in Canada, they did so by focusing on Canadians' health care provision needs to the exclusion of promoting a broader, global awareness that the immigration of health professionals to developed nations such as Canada exacerbates global health disparities.     

Pain Sensitivity: An Unnatural History from 1800 to 1965

Who was truly capable of experiencing pain? In this article, I explore ideas about the distribution of bodily sensitivity in patients from the early nineteenth century to 1965 in Anglo-American societies. While certain patients were regarded as “truly hurting,” other patients’ distress could be disparaged or not even registered as being “real pain.” Such judgments had major effects on regimes of pain-alleviation. Indeed, it took until the late twentieth century for the routine underestimation of the sufferings of certain groups of people to be deemed scandalous. Often the categorizations were contradictory. For instance, the humble status of workers and immigrants meant that they were said to be insensitive to noxious stimuli; the profound inferiority of these same patients meant that they were especially likely to respond with “exaggerated” sensitivity. How did physicians hold such positions simultaneously? Pain-assignation claimed to be based on natural hierarchical schemas, but the great Chain of Feeling was more fluid than it seemed.     

Nicknames of notorious American twentieth‐century deviants: The decline of the folk hero syndrome

This report examines the public use of personal nicknames for notorious American Twentieth Century Deviants. The analysis documents the frequency of nicknames by decade in the twentieth century, the category of the deviant act committed by the person nicknamed, and the connotations of the nicknames. The relationship between the use of nicknames for deviants, and deviants as folk heroes is explored. The data indicate that the public use of personal nicknames for deviants peaks in the 1920's and 1930's and has been declining ever since. This phenomenon parallels the decline in American's belief in the “rags to riches” type of folk hero.     

Part-Time Disabled Lesbian Passing on Roller Blades,or PMS,Prozac, and Essentializing Women's Ailments

Abstract

This paper discusses the role of the medical and psychiatric systems, as well as the pharmaceutical industry, in the social construction of women's hormonally-related ailments and their treatments. For some marginalised groups, passing as “normal” is a protection strategy against discrimination and maltreatment. Lesbians and invisibly disabled persons are examples of such groups. Given that the reproductive cycle and madness have been linked historically, women suffering from disabling cyclical conditions might also be stigmatised. In this context, the dilemma between seeking treatment versus being labelled psychologically ill is expounded.     

PERSONAL PARTICIPATION: Michael Polanyi, Eric Voegelin, and the Indispensability of Faith

In this paper I focus on the central role faith plays in the thought of Polanyi and Voegelin. I begin by indicating how both find the modern conception of scientific knowing seriously wanting. What Polanyi terms “objectivism” and Voegelin calls “scientism” is the modern tendency to reduce knowledge to only that which can be scientifically demonstrated. This errant view of knowledge does not occur in a vacuum, though, and both men draw a connection between this and the political pathologies of the twentieth century. I then show the complementary ways in which these two thinkers believe recovery is possible: an epistemological solution encompassed in Polanyi's personal knowledge and an ontological reorientation that is the core of Voegelin's insistence that we must recover an awareness of human participation in transcendent reality.     

Reflective thinking and medical students: some thoughtful distillations regarding John Dewey and Hannah Arendt

Reflective thought (critical thinking) is essential to the medical student who hopes to become an effective physician. John Dewey, one of America's foremost educators in the early twentieth century, revolutionized critical thinking and its role in education. In the mid twentieth century Hannah Arendt provided profound insights into the problem of diminishing human agency and political freedom. Taken together, Dewey's insight regarding reflective thought, and Arendt's view of action, speech, and power in the public realm, provide mentors and teachers of medical students guidance in the training of thought and the need for its effective projection at the patient's bedside and in the community.     

Revising,Correcting, and Transferring Genes

Abstract

The distinction between germline and somatic gene editing is fundamental to the ethics of human gene editing. Multiple conferences of scientists, ethicists, and policymakers, and multiple professional bodies, have called for moratoria on germline gene editing, and editing of human germline cells is considered to be an ethical “red line” that either never should be crossed, or should only be crossed with great caution and care. However, as research on germline gene editing has progressed, it has become clear that not all germline interventions are alike, and that these differences make a significant moral difference, when it comes to ethical questions about research, regulation, clinical application, and medical justification. In this paper, I argue that, rather than lumping all germline interventions together, we should distinguish between revising, correcting, and transferring genes, and I assess the consequences of this move for the ethics of gene editing.     

“SAFEGUARDING THE INTERESTS OF THE STATE” FROM DEFECTIVE DELINQUENT GIRLS

The 1911 mental classification, “defective delinquent,” was created as a temporary legal‐medical category in order to identify a peculiar class of delinquent girls in a specific institutional setting. The defective delinquent's alleged slight mental defect, combined with her appearance of normalcy, rendered her a “dangerous” and “incurable” citizen. At the intersection of institutional history and the history of ideas, this article explores the largely overlooked role of borderline mental classifications of near‐normalcy in the medicalization of intelligence and criminality during the first third of the twentieth‐century United States. Borderline classifications served as mechanisms of control over women's bodies through the criminalization of their minds, and the advent of psychometric tests legitimated and facilitated the spread of this classification beyond its original and intended context. The borderline case of the defective delinquent girl demonstrates the significance of marginal mental classifications to the policing of bodies through the medicalization of intellect.     

Christology and Anti‐Humanism

This article engages the current anti‐humanist or post‐human ethos from the point of view of Christology. Invoking Alain Badiou's claim that “the man of humanism has not survived the twentieth century”, it argues that the death of “the man of humanism” ushers in a situation in which the Christian proposal can be clarified in two crucial ways: (1) Christology is the core of Christian anthropology, and therefore must be the first and last word of the Church's formulation of her answer to the question that is every human life; (2) there is no neutral “human” ground in which the Church can carry on a discourse about “humanism” or “natural law”. The current situation thus forces a theological decision: either the death of man or the God‐Man.     

Animal experimentation: The legacy of Claude Bernard

Claude Bernard, the father of scientific physiology, believed that if medicine was to become truly scientific, it would have to be based on rigorous and controlled animal experiments. Bernard instituted a paradigm which has shaped physiological practice for most of the twentieth century. In this paper we examine how Bernard's commitment to hypothetico‐de‐ductivism and determinism led to (a) his rejection of the theory of evolution; (b) his minimalization of the role of clinical medicine and epidemiological studies; and (c) his conclusion that experiments on non‐human animals were, “entirely conclusive for the toxicology and hygiene of man”. We examine some negative consequences of Bernardianism for twentieth century medicine, and argue that physiology's continued adherence to Bernardianism has caused it to diverge from the other biological sciences which have become increasingly infused with evolutionary theory.     

From Global Expressivism to Global Pragmatism

In the twentieth century, questions of meaning and representation played a central role in the development of pragmatism and analytic philosophy. Present‐day neopragmatism, such as Huw Price's “global expressivism,” is often framed in terms of a nonrepresentationalist theory of meaning. While some neopragmatists, such as Robert Brandom, advocate a more local approach, this article argues for taking Price's global expressivism to its next logical step: global pragmatism. Global pragmatism prioritizes the behavior‐guiding function of language and redefines representation in operational terms. This operational approach (“o‐representation”) stresses the action and conduct‐guiding role of language use, highlights the connection between meaning and action, and addresses issues facing Price's global expressivism.     

The news media and psychological distress

Abstract

The twentieth century has been marked by advances in communications technology as well as mounting psychological distress. This study explored the premise that exposure to negative news via the media contributes to anxiety and depression. Levels of news media exposure, stress levels, irrational beliefs, optimism-pessimism, anxiety, and depression were assessed (n=239) and analyzed using multiple regression techniques. Negative stress was directly related to anxiety and depression. News media exposure and anxiety were positively related at low levels of irrationality. News media exposure was predictive of trait anxiety at low levels of optimism. However, media exposure was not predictive of depression. The implications of the findings for understanding how the news media impacts stress and the cognitive factors that effect this relationship are discussed.     

V. M. BEKHTEREV IN RUSSIAN CHILD SCIENCE, 1900S–1920S: “OBJECTIVE PSYCHOLOGY”/“REFLEXOLOGY” AS A SCIENTIFIC MOVEMENT

In the early 20^th century the child population became a major focus of scientific, professional and public interest. This led to the crystallization of a dynamic field of child science, encompassing developmental and educational psychology, child psychiatry and special education, school hygiene and mental testing, juvenile criminology and the anthropology of childhood. This article discusses the role played in child science by the eminent Russian neurologist and psychiatrist Vladimir Mikhailovich Bekhterev. The latter's name is associated with a distinctive program for transforming the human sciences in general and psychology in particular that he in the 1900s labelled “objective psychology” and from the 1910s renamed “reflexology.” The article examines the equivocal place that Bekhterev's “objective psychology” and “reflexology” occupied in Russian/Soviet child science in the first three decades of the 20^th century. While Bekhterev's prominence in this field is beyond doubt, analysis shows that “objective psychology” and “reflexology” had much less success in mobilizing support within it than certain other movements in this arena (for example, “experimental pedagogy” in the pre‐revolutionary era); it also found it difficult to compete with the variety of rival programs that arose within Soviet “pedology” during the 1920s. However, this article also demonstrates that the study of child development played a pivotal role in Bekhterev's program for the transformation of the human sciences: it was especially important to his efforts to ground in empirical phenomena and in concrete research practices a new ontology of the psychological, which, the article argues, underpinned “objective psychology”/“reflexology” as a transformative scientific movement.     

Beyond the Schools of Psychology 1: A Digital Analysis of Psychological Review, 1894–1903

Traditionally, American psychology at the turn of the twentieth century has been framed as a competition among a number of “schools”: structuralism, functionalism, behaviorism, etc. But this is only one way in which the “structure” of the discipline can be conceived. Most psychologists did not belong to a particular school, but they still worked within loose intellectual communities, and so their work was part of an implicit psychological “genre,” if not a formalized “school.” In this study, we began the process of discovering the underlying genres of American psychology at the turn of the twentieth century by taking the complete corpus of articles from the journal Psychological Review during the first decade of its publication and conducting a statistical analysis of the vocabularies they employed to see what clusters of articles naturally emerged. Although the traditional functionalist school was among the clusters we found, we also found distinct research traditions around the topics of color vision, spatial vision, philosophy/metatheory, and emotion. In addition, momentary clusters corresponding to important debates (e.g., the variability hypothesis) appeared during certain years, but not others.     

Artificial Intelligence and Medical Humanities

The use of artificial intelligence in healthcare has led to debates about the role of human clinicians in the increasingly technological contexts of medicine. Some researchers have argued that AI will augment the capacities of physicians and increase their availability to provide empathy and other uniquely human forms of care to their patients. The human vulnerabilities experienced in the healthcare context raise the stakes of new technologies such as AI, and the human dimensions of AI in healthcare have particular significance for research in the humanities. This article explains four key areas of concern relating to AI and the role that medical/health humanities research can play in addressing them: definition and regulation of “medical” versus “health” data and apps; social determinants of health; narrative medicine; and technological mediation of care. Issues include data privacy and trust, flawed datasets and algorithmic bias, racial discrimination, and the rhetoric of humanism and disability. Through a discussion of potential humanities contributions to these emerging intersections with AI, this article will suggest future scholarly directions for the field.

     

Race and the Feminized Popular in Nietzsche and Beyond

I distinguish between the nineteenth‐ to twentieth‐century (modernist) tendency to rehabilitate (white) femininity from the abject popular, and the twentieth‐ to twenty‐first‐century (postmodernist) tendency to rehabilitate the popular from abject white femininity. Careful attention to the role of nineteenth‐century racial politics in Nietzsche's Gay Science shows that his work uses racial nonwhiteness to counter the supposedly deleterious effects of (white) femininity (passivity, conformity, and so on). This move—using racial nonwhiteness to rescue pop culture from white femininity—is a common twentieth‐ and twenty‐first‐century practice. I use Nietzsche to track shifts from classical to neo‐liberal methods of appropriating “difference.” Hipness is one form of this neoliberal approach to difference, and it is exemplified by the approach to race, gender, and pop culture in Vincente Minnelli's film The Band Wagon. I expand upon Robert Gooding‐Williams's reading of this film, and argue that mid‐century white hipness dissociates the popular from femininity and whiteness, and values the popular when performed by white men “acting black.” Hipness instrumentalizes femininity and racial nonwhiteness so that any benefits that might come from them accrue only to white men, and not to the female and male artists of color whose works are appropriated.     

JUST WAR THEORY,HUMANITARIAN INTERVENTION,AND THE NEED FOR A DEMOCRATIC FEDERATION

The primary purpose of government is to secure public goods that cannot be achieved by free markets. The Coordination Principle tells us to consolidate sovereign power in a single institution to overcome collective action problems that otherwise prevent secure provision of the relevant public goods. There are several public goods that require such coordination at the global level, chief among them being basic human rights. The claim that human rights require global coordination is supported in three main steps. First, I consider Pogge's and Habermas's analyses as alternatives to Hobbesian conceptions of justice. Second, I consider the core conventions of international law, which are in tension with the primacy of state sovereignty in the UN system. Third, I argue that the just war tradition does not limit just causes for war to self‐defense; it supports saving innocent third parties from crimes against humanity as a just reason for war. While classical authors focused less on this issue, the point is especially clear in twentieth‐century just war theories, such as those offered by the American Catholic bishops, Jean Elshtain, Brian Orend, and Michael Walzer. Against Walzer, I argue that we add intractable military tyranny to the list of horrors meriting intervention if other ad bellum conditions are met. But these results require us to reexamine the “just authority” of first resort to govern such interventions. The Coordination Principle implies that we should create a transnational federation with consolidated powers in place of a treaty organization requiring near‐unanimity. But to be legitimate, such a global institution must also be directly answerable to the citizens of its member states. While the UN Security Council is inadequate on both counts, a federation of democracies with a directly elected executive and legislature could meet both conditions.