This paper examines anesthesiologist Henry K. Beecher's funding relationship with pharmaceutical manufacturer Edward Mallinckrodt, Jr. Beecher is a familiar figure to both medical ethicists and historians of medicine for his role in the bioethics revolution of the 1960s and 1970s. In particular, his 1966 article "Ethics and Clinical Research" is widely considered a turning point in the post-World War II debate about informed consent. We argue that Beecher's scientific interests should be understood in the context of his funding relationship with Mallinckrodt and that this relationship shaped the direction of his work in important ways. We also argue that Beecher's views on research ethics reflected his assumption that collaboration with industry was a normal part of how academic science is conducted. In the conclusion of the paper we suggest that Beecher's failure to consider his relationship with Mallinckrodt as worthy of ethical deliberation has important lessons for academic researchers who collaborate with industry today.
本文考察了麻醉师Henry K. Beecher与制药商Edward Mallinckrodt, Jr.的资助关系。Beecher是医学伦理学家和医学历史学家所熟悉的人物,因为他在20世纪60年代和70年代的生物伦理学革命中发挥了作用。特别是,他1966年的文章《伦理与临床研究》被广泛认为是二战后关于知情同意的辩论的转折点。我们认为,比彻的科学兴趣应该在他与马林克罗特的资助关系的背景下理解,这种关系在重要方面塑造了他的工作方向。我们还认为,比彻关于研究伦理的观点反映了他的假设,即与工业界的合作是学术科学开展的正常部分。在论文的结论中,我们认为比彻没有考虑到他与马林克罗特的关系值得进行伦理审议,这对今天与工业界合作的学术研究人员有重要的借鉴意义。
{"title":"\"The Warmth of His Continuing Interest\": Henry K. Beecher, the Bioethics Revolution, and Pharmaceutical Industry Funding of Academic Medical Science in Cold War America.","authors":"Joseph M Gabriel, Sukumar P Desai","doi":"10.1093/jhmas/jrad011","DOIUrl":"https://doi.org/10.1093/jhmas/jrad011","url":null,"abstract":"<p><p>This paper examines anesthesiologist Henry K. Beecher's funding relationship with pharmaceutical manufacturer Edward Mallinckrodt, Jr. Beecher is a familiar figure to both medical ethicists and historians of medicine for his role in the bioethics revolution of the 1960s and 1970s. In particular, his 1966 article \"Ethics and Clinical Research\" is widely considered a turning point in the post-World War II debate about informed consent. We argue that Beecher's scientific interests should be understood in the context of his funding relationship with Mallinckrodt and that this relationship shaped the direction of his work in important ways. We also argue that Beecher's views on research ethics reflected his assumption that collaboration with industry was a normal part of how academic science is conducted. In the conclusion of the paper we suggest that Beecher's failure to consider his relationship with Mallinckrodt as worthy of ethical deliberation has important lessons for academic researchers who collaborate with industry today.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Talking Therapy: Knowledge and Power in American Psychiatric Nursing. Kylie Smith","authors":"Mical Raz","doi":"10.1093/jhmas/jrad017","DOIUrl":"https://doi.org/10.1093/jhmas/jrad017","url":null,"abstract":"","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46355265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"At the Limits of Cure. Bharat Jayram Venkat","authors":"Catriona Ellis","doi":"10.1093/jhmas/jrad014","DOIUrl":"https://doi.org/10.1093/jhmas/jrad014","url":null,"abstract":"","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47661552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Transformation of American Sex Education: Mary Calderone and the Fight for Sexual Health. Ellen S. More","authors":"D. Drucker","doi":"10.1093/jhmas/jrad016","DOIUrl":"https://doi.org/10.1093/jhmas/jrad016","url":null,"abstract":"","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46193370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Empire Transformed: Remolding Bodies and Landscapes in the Restoration Atlantic. Kate Luce Mulry","authors":"Keith D. Pluymers","doi":"10.1093/jhmas/jrad013","DOIUrl":"https://doi.org/10.1093/jhmas/jrad013","url":null,"abstract":"","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44839527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aimed at clinical educators, this article reports on the use of a single skill-based session that introduces learners in Health Professions Education (HPE) to basic techniques from the discipline of history. The premise of the teaching method is a correspondence between medicine's social determinants of health (SDH) and categories of analysis commonly used by historians. At the center are eight categories, or "tools": social, cultural, intellectual, technological, political, economic, racial/ethnic, and gendered. Like the direct and specific implications of many diagnostic signs, each of these adjectives indicate to historians specific types of factors, or determinants. The intervention employs the demonstration-performance teaching method (explanation, demonstration, supervised practice, and evaluation). After the session, learners are able to: use "history's toolbox" as a systematic method for evaluating socio-cultural phenomena inherent in SDH; differentiate eight types of determinants in a historical case study that represents socio-cultural complexity; recognize how categorization simultaneously enhances some determinants while obscuring others, and how the use of constructed social categories in medicine can function to help and harm patients and populations. The intervention described is rooted in scholarship and theoretical questions belonging to the discipline of history, but these are not discussed. Neither the historical content nor the teaching method described here is appropriate for research or teaching in the discipline of history.
{"title":"History's Toolbox in Health Professions Education: One Skill-Based Session on Social Determinants of Health.","authors":"Susan Lamb","doi":"10.1093/jhmas/jrac040","DOIUrl":"https://doi.org/10.1093/jhmas/jrac040","url":null,"abstract":"<p><p>Aimed at clinical educators, this article reports on the use of a single skill-based session that introduces learners in Health Professions Education (HPE) to basic techniques from the discipline of history. The premise of the teaching method is a correspondence between medicine's social determinants of health (SDH) and categories of analysis commonly used by historians. At the center are eight categories, or \"tools\": social, cultural, intellectual, technological, political, economic, racial/ethnic, and gendered. Like the direct and specific implications of many diagnostic signs, each of these adjectives indicate to historians specific types of factors, or determinants. The intervention employs the demonstration-performance teaching method (explanation, demonstration, supervised practice, and evaluation). After the session, learners are able to: use \"history's toolbox\" as a systematic method for evaluating socio-cultural phenomena inherent in SDH; differentiate eight types of determinants in a historical case study that represents socio-cultural complexity; recognize how categorization simultaneously enhances some determinants while obscuring others, and how the use of constructed social categories in medicine can function to help and harm patients and populations. The intervention described is rooted in scholarship and theoretical questions belonging to the discipline of history, but these are not discussed. Neither the historical content nor the teaching method described here is appropriate for research or teaching in the discipline of history.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9493383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Drawing on my experience working as a postdoctoral research and engagement fellow on the Wellcome Trust-funded project, Surgery & Emotion, this article reflects on this innovative model of historical research and professional engagement, explores the challenges posed by crossing disciplinary boundaries, and interrogates the practical and theoretical utility of bringing historical research into the operating theatre. How do surgeons specifically engage with the history of their profession? What can the history of emotions offer to the training of medical students and surgeons? What obstacles interfere in this type of cross-disciplinary engagement? What peculiar opportunities and challenges do the United Kingdom higher education system and National Health Service pose to the teaching of medical history in clinical settings? Bringing Clio into the operating theatre provides surgeons with an alternative narrative to that which they have come to expect about the emotions they ought to feel and express in their work. It allows them to explore the high feelings of their professional lives at a remove and offers an array of possible solutions to the current emotional health crisis in British medicine. History allows surgeons to imagine an alternative world: one where the pervasive and persistent models of emotional detachment - damaging to both patient experience and professional wellbeing - dissolve.
{"title":"Clio in the Operating Theatre: Historical Research, Emotional Health, and Surgical Training in Contemporary Britain.","authors":"Agnes Arnold-Forster","doi":"10.1093/jhmas/jrac045","DOIUrl":"https://doi.org/10.1093/jhmas/jrac045","url":null,"abstract":"<p><p>Drawing on my experience working as a postdoctoral research and engagement fellow on the Wellcome Trust-funded project, Surgery & Emotion, this article reflects on this innovative model of historical research and professional engagement, explores the challenges posed by crossing disciplinary boundaries, and interrogates the practical and theoretical utility of bringing historical research into the operating theatre. How do surgeons specifically engage with the history of their profession? What can the history of emotions offer to the training of medical students and surgeons? What obstacles interfere in this type of cross-disciplinary engagement? What peculiar opportunities and challenges do the United Kingdom higher education system and National Health Service pose to the teaching of medical history in clinical settings? Bringing Clio into the operating theatre provides surgeons with an alternative narrative to that which they have come to expect about the emotions they ought to feel and express in their work. It allows them to explore the high feelings of their professional lives at a remove and offers an array of possible solutions to the current emotional health crisis in British medicine. History allows surgeons to imagine an alternative world: one where the pervasive and persistent models of emotional detachment - damaging to both patient experience and professional wellbeing - dissolve.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9169005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tequilla Manning, Walter N Ingram, Christopher Crenner
The University of Kansas School of Medicine recently confronted challenging questions about commemorative naming. Every year, the school assigns the incoming medical students to advising groups, called academic societies. There are six societies, each bearing the name of a prominent physician from the school's history. Over the years, as students learned about the society namesakes, controversy developed over the naming of the Wahl Society. In 1938, Dr. Harry Wahl led an effort to preserve the racial segregation of the medical school. He fought hard, though unsuccessfully, to defend the established practice of barring the few Black students admitted to the school from continuing into the third and fourth year of the program and graduating. In 2017, with this history in mind, a well-organized coalition of medical students submitted a request to change the name of the Wahl Society. The society is now named the Cates Society, honoring Dr. Marjorie Cates, the first Black woman to graduate from the medical school. In this paper, we offer observations on how medical students' involvement with historical inquiry -- as well as their caution about it limits -- helped to navigate the challenging process of renaming.
{"title":"Commemorative Naming, Renaming, and the Role of Medical History in Academic Medicine.","authors":"Tequilla Manning, Walter N Ingram, Christopher Crenner","doi":"10.1093/jhmas/jrac047","DOIUrl":"https://doi.org/10.1093/jhmas/jrac047","url":null,"abstract":"<p><p>The University of Kansas School of Medicine recently confronted challenging questions about commemorative naming. Every year, the school assigns the incoming medical students to advising groups, called academic societies. There are six societies, each bearing the name of a prominent physician from the school's history. Over the years, as students learned about the society namesakes, controversy developed over the naming of the Wahl Society. In 1938, Dr. Harry Wahl led an effort to preserve the racial segregation of the medical school. He fought hard, though unsuccessfully, to defend the established practice of barring the few Black students admitted to the school from continuing into the third and fourth year of the program and graduating. In 2017, with this history in mind, a well-organized coalition of medical students submitted a request to change the name of the Wahl Society. The society is now named the Cates Society, honoring Dr. Marjorie Cates, the first Black woman to graduate from the medical school. In this paper, we offer observations on how medical students' involvement with historical inquiry -- as well as their caution about it limits -- helped to navigate the challenging process of renaming.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9531583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Questions of how to sustain interest in the history of medicine and broader health sciences (HOM/HS) in a changing institutional environment, and how to collaborate with stakeholders to offer activities to do so, are on the radar for many academic health sciences centers and their libraries. This essay is an initial exploratory study of non-curricular HOM/HS efforts at United States medical schools ranked in the top thirty in primary care or research. In 2019, we collected public information pertinent to any presence of an on-campus HOM/HS community and the group's structure, including funding, activities, and the library's involvement with the group. Seventeen of forty-five institutions in the sample presented information about an institutional HOM/HS group. All posted a mission statement. Their funding varied in nature; some collected fees from members, while others relied on university support. Half were student-led. Most groups hosted regular lecture series, with fifteen groups hosting at least one annually. Six groups sponsored publications or awards. These findings indicate that several institutions with active programs offer potential models and lessons for sustaining HOM/HS communities. Beyond providing a physical or digital space in which HOM/HS groups connect, libraries play an active role in fostering some of these communities.
{"title":"Characterizing History of Health Sciences Organizations at Academic Health Sciences Centers.","authors":"Kristine M Alpi, Jordan R Johnson, Meg E Langford","doi":"10.1093/jhmas/jrac041","DOIUrl":"https://doi.org/10.1093/jhmas/jrac041","url":null,"abstract":"<p><p>Questions of how to sustain interest in the history of medicine and broader health sciences (HOM/HS) in a changing institutional environment, and how to collaborate with stakeholders to offer activities to do so, are on the radar for many academic health sciences centers and their libraries. This essay is an initial exploratory study of non-curricular HOM/HS efforts at United States medical schools ranked in the top thirty in primary care or research. In 2019, we collected public information pertinent to any presence of an on-campus HOM/HS community and the group's structure, including funding, activities, and the library's involvement with the group. Seventeen of forty-five institutions in the sample presented information about an institutional HOM/HS group. All posted a mission statement. Their funding varied in nature; some collected fees from members, while others relied on university support. Half were student-led. Most groups hosted regular lecture series, with fifteen groups hosting at least one annually. Six groups sponsored publications or awards. These findings indicate that several institutions with active programs offer potential models and lessons for sustaining HOM/HS communities. Beyond providing a physical or digital space in which HOM/HS groups connect, libraries play an active role in fostering some of these communities.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The history of medicine has only unevenly been integrated into medical education. Previous attempts to incorporate the subject have focused either on the first year, with its already over-subscribed curriculum, or the fourth year in the form of electives that reach a small minority of students. Duke University provides an alternative model for other universities to consider. At our institution we have overcome many of the curricular limitations by including history during the mandatory third year clerkships. Reaching 100% of the medical school class, these sessions align with clinical disciplines, providing students a longitudinal perspective on what they are seeing and doing on the hospital wards. They are taught in conjunction with a medical history librarian and rely heavily on the utilization and interpretation of physical artifacts and archival manuscripts. The surgery, obstetrics/gynecology, and pediatrics rotations now feature successful and popular history of medicine sessions. Describing our lesson plans and featuring a list of both physical and online resources, we provide a model others can implement to increase the use, the framing, and the accessibility of history in their medical schools.
{"title":"History of Medicine in the Clerkships: A Novel Model for Integrating Medicine and History.","authors":"Justin Barr, Rachel Ingold, Jeffrey P Baker","doi":"10.1093/jhmas/jrac042","DOIUrl":"https://doi.org/10.1093/jhmas/jrac042","url":null,"abstract":"<p><p>The history of medicine has only unevenly been integrated into medical education. Previous attempts to incorporate the subject have focused either on the first year, with its already over-subscribed curriculum, or the fourth year in the form of electives that reach a small minority of students. Duke University provides an alternative model for other universities to consider. At our institution we have overcome many of the curricular limitations by including history during the mandatory third year clerkships. Reaching 100% of the medical school class, these sessions align with clinical disciplines, providing students a longitudinal perspective on what they are seeing and doing on the hospital wards. They are taught in conjunction with a medical history librarian and rely heavily on the utilization and interpretation of physical artifacts and archival manuscripts. The surgery, obstetrics/gynecology, and pediatrics rotations now feature successful and popular history of medicine sessions. Describing our lesson plans and featuring a list of both physical and online resources, we provide a model others can implement to increase the use, the framing, and the accessibility of history in their medical schools.</p>","PeriodicalId":49998,"journal":{"name":"Journal of the History of Medicine and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9161837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}