Empirical Bioethics and the Health 'Brain-Drain: a qualitative study of the experiential and ethical landscape of compulsory community service for a group of South African doctors
The health ‘brain drain’ (HBD) is an issue of significant global bioethical concern, resulting in severe maldistribution of healthcare workers (HCWs) and gross inequities in health service provision. The ethics of the HBD and its possible mitigation strategies are, however, complex and areas of active ongoing bioethical debate. South Africa faces a dire and worsening HBD crisis, and use a mitigation strategy of compulsory community service, or ‘comserve’, for most HCWs. While there is some literature on HCWs’ comserve experiences and the various ‘push and pull’ factors affecting th...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Gardiner, C. V. Tags: Original research Source Type: research
Meeting up in broken word/times: communication, temporality and pace in neuromixed writing
The article investigates letter writing as a way to explore neurodiverse collectives, neuromixed communication and neurodiverse research collaboration. From the perspective of neurodiversity studies and translation practice/studies, the article negotiates new perspectives of inherited images of neurological selves and others, such as the non-autistic as the ‘typical’ in contrast to the ‘atypical’ autistic person. Experimenting with autistic time, allowing different sensory modalities and different approaches to time, detail and narrative, the article challenges deficit approaches to autism. Through ...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Bertilsdotter Rosqvist, H., Hjorth, E., Nygren, A. Tags: Original research Source Type: research
"I am not alone with tears": embodying stigma and longing among youth living with perinatally acquired HIV in Tanzania through a collaborative arts-based approach
It is estimated that 4 million youth aged 15–24 years live with HIV globally, 85% of whom live in sub-Saharan Africa. For youth living with perinatally acquired HIV (YPHIV), stigma is frequently linked with negative health outcomes. YPHIV face distinct HIV stigma experiences across the lifespan, particularly because of the centrality of the family context in their HIV experience and the reality that they have lived with HIV since birth. Nevertheless, our understanding and measurement of stigma remains limited. One way to improve our understanding of HIV stigma for YPHIV is through in-depth exploration of embodied nar...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Hosaka, K. R. J., Mandewo, D., Mmbaga, B. T., Ngowi, H., Dow, D. E., Stewart, K. A., on behalf of the Sanaa ya Vijana Youth Collaborative Tags: Original research Source Type: research
Erosion of the 'ethical doctor-patient relationship and the rise of physician burn-out
This paper examines the topic of physician burn-out from a philosophical lens. We explore the question of how the rise of physician burn-out may be related to an underlying erosion of meaning in medicine, characterised by the breakdown of the intersubjective relationship between doctors and patients. We argue that while commonly cited strategies for addressing burnout—including promoting work-life integration, cultivating workplace community, and fostering resilience—are critical for enhancing physician well-being, the common thread linking these approaches is that each identifies the physician as the primary l...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Messinger, A., Das, S. Tags: Original research Source Type: research
Cracking open the eristic rhetoric of contralateral prophylactic mastectomy research or why surgeons should not be so certain about this controversial breast cancer treatment
Contralateral prophylactic mastectomy (CPM) is a controversial breast cancer treatment in which both breasts are removed when only one is affected by cancer. Rates of CPM have been rising since the late 1990s, despite surgeons’ strong agreement that the procedure should not be performed for average-risk women. This essay analyses that agreement as it is demonstrated in the surgical literature on CPM, arguing that it forms a ‘rhetoric of certainty’ built on the stark epistemological divide between objective and subjective forms of knowledge that operates in some areas of medicine. Further, the essay argues...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Pender, K. Tags: Original research Source Type: research
Understanding how college students characterise and cope with chronic pain: a thematic analysis of expressive writing samples
College students who experience chronic pain are a frequently overlooked population. This research attempts to provide insight into the language that college students use to describe their experiences with chronic pain, challenges they face and coping strategies they use. Over the course of 4 consecutive days, participants responded to an expressive writing prompt asking them to reflect on their emotions and thoughts related to being a college student with chronic pain. Writing samples were then analysed to identify themes pertaining to words with a positive or negative emotional valence, terms used to characterise pain, m...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Root, K., Nosek, S. Tags: Original research Source Type: research
'Why They Laugh At Us?: the functions and ethics of humour in Singaporean theatrical depictions of stigmatised illness
While humour in the context of illness might be perceived to be insensitive or inappropriate, it is used frequently in the medical setting and discussions of illness. This paper strives to answer why humour is used despite these feelings it might elicit, and attempts to outline conditions that inform the ethics of humour in an illness context.
This paper analyses two Singaporean theatrical depictions of chronic and stigmatised illnesses: Haresh Sharma’s Off Centre (1993), which is about schizophrenia and depression, and Paddy Chew’s monologue Completely With/Out Character (1999), on HIV and AIDS. In these plays...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Hyder, S. Tags: Original research Source Type: research
Reversing the medical humanities
The paper offers the concept of reversing the medical humanities. In agreement with the call from Kristeva et al to recognise the bidirectionality of the medical humanities, I propose moving beyond debates of attitude and aptitude in the application and engagement (either friendly or critical) of humanities to/in medicine, by considering a reversal of the directions of epistemic movement (a reversal of the flow of knowledge). I situate my proposal within existing articulations of the field found in the medical humanities meta-literature, pointing to a gap in the current terrain. I then develop the proposal by unfolding thr...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Scott-Fordsmand, H. Tags: Original research Source Type: research
The use of an object: exploring physician burnout through object relations theory
The crisis of physician burnout has been widely and repeatedly reported across the mainstream press and medical journals around the world, in the closing years of the second decade of the 21st century. Despite multiple systematic reviews and commentary on the scale of this ‘global epidemic’, understandings of both the phenomenon and the most effective interventions remain limited. Practice-based medical humanities represents the collaborative sharing of conceptual tools for understanding illness and clinical practice and the shouldering of responsibility for mapping the shape of care, in all its local, national...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Winning, J. Tags: Open access Original research Source Type: research
Human-centred design, disability and bioethics
Human-centred design methodologies provide a means to align bioethical advocacy with the needs and desires of disabled people. As a method, human-centred design seeks to locate points of friction in an individual’s experience of everyday interactions, specifically in relation to technologies, but potentially in relation to processes and institutions. By focusing on disabled persons and their experiences of institutional organisation, human-centred design practices serve to create a foundation for a bioethical practice that addresses idiosyncratic needs and desires while providing support for disabled persons and thei...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Wolf-Meyer, M. Tags: Current controversy Source Type: research
Ethics and medical specimens
On 1 August, it was announced that the family of Henrietta Lacks reached a settlement with the biotech company over non-consensual use of her cells. Most of us know the story very well already; Lacks died of cervical cancer in 1951; while still living, tissue from her body was taken without consent, and has since been used to create a cell line that reproduces itself outside the body (known as the HeLa cells). These have been used to develop everything from cancer treatments to vaccines, stem cell studies and genetic research. The case has exposed something that has been true of medicine since it’s infancy: vulnerabl...
Source: Medical Humanities - August 24, 2023 Category: International Medicine & Public Health Authors: Schillace, B. Tags: Editorial Source Type: research
Where past meets present: Indigenous vaccine hesitancy in Saskatchewan
In Canada, colonisation, both historic and ongoing, increases Indigenous vaccine hesitancy and the threat posed by infectious diseases. This research investigated Indigenous vaccine hesitancy in a First Nation community in Saskatchewan, ways it can be overcome, and the influence of a colonial history as well as modernity. Research followed Indigenous research methodologies, a community-based participatory research design, and used mixed methods. Social media posts (interventions) were piloted on a community Facebook page in January and February (2022). These interventions tested different messaging techniques in a search f...
Source: Medical Humanities - July 11, 2023 Category: International Medicine & Public Health Authors: Sullivan, P., Starr, V., Dubois, E., Starr, A., Acharibasam, J. B., McIlduff, C. Tags: Open access, COVID-19 Original research Source Type: research
Understanding the value of art prompts in an online narrative medicine workshop: an exploratory-descriptive focus group study
Narrative medicine is an interdisciplinary field that complements and expands on conventional healthcare training by supporting narrative competence skills and creativity derived from the arts and humanities domains to address the needs of healthcare providers and receivers. With the COVID-19 pandemic having had a profound impact on the healthcare workforce with an already high burn-out rate, multimodal arts interventions may help address the holistic dimensions of well-being. While empirical evidence supports the use of arts-based interventions in promoting healthcare workers’ well-being and personal growth, art pro...
Source: Medical Humanities - July 11, 2023 Category: International Medicine & Public Health Authors: Choe, N. S. Tags: Original research Source Type: research
Contributions of Hippocratic medicine and Plato to todays debate over health, social determinants and the authority of biomedicine
By exploring a competition for authority on health and human nature between Plato and Hippocratic medicine, this paper offers a fresh perspective on an overarching debate today involving health and the role of healthcare in its safeguarding. Economically and politically, healthcare continues to dominate the USA’s handling of health, construed biophysically as the absence of disease. Yet, notoriously, in major health outcomes, the USA fares worse than other countries in the Organisation for Economic Co-operation and Development (OECD). Clearly, in giving pre-eminence to healthcare, the USA is doing far less than it co...
Source: Medical Humanities - July 11, 2023 Category: International Medicine & Public Health Authors: Levin, S. B. Tags: Original research Source Type: research
The production of medicoethical misconduct: medical ethics and vivisection in Wilkie Collinss Heart and Science
Even as Wilkie Collins’s Heart and Science continues in the tradition of cautionary tales of medicine and science, it also integrates nineteenth-century discussions of medical ethics, vivisection and women, further building on earlier criticisms of scientific hubris. By indicting a fictional medical doctor and his methodology, Heart and Science depicts the extremes of good and bad, ethical and unethical medicine—whether the doctor can care, and not simply solve the medical enigma—in light of a changing medical field that prized objectivity and distance from the subject over the old holistic way of listeni...
Source: Medical Humanities - July 11, 2023 Category: International Medicine & Public Health Authors: Cole, T. G. Tags: Original research Source Type: research
