Activism in Medicine: History, Literature, and Contemporary Issues and Movements - PowerPoint PPT Presentation

Loading...

PPT – Activism in Medicine: History, Literature, and Contemporary Issues and Movements PowerPoint presentation | free to download - id: 53f61f-YjA3Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Activism in Medicine: History, Literature, and Contemporary Issues and Movements

Description:

Title: Slide 1 Author: Self Last modified by: Owner Created Date: 7/21/2008 10:20:30 AM Document presentation format: On-screen Show (4:3) Company – PowerPoint PPT presentation

Number of Views:159
Avg rating:3.0/5.0
Slides: 115
Provided by: self5
Learn more at: http://phsj.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Activism in Medicine: History, Literature, and Contemporary Issues and Movements


1
  • Activism in Medicine History, Literature, and
    Contemporary Issues and Movements
  • Martin Donohoe

2
Overview
  • Background
  • Issues
  • History
  • Literature
  • Quotes and Photos
  • Education, the media, and democracy
  • What you can do

3
Portland, Oregon Mount Hood
4
Multnomah Falls, Oregon
5
Am I Stoned?
  • A 1999 Utah anti-drug pamphlet warns
  • Danger signs that your child may be smoking
    marijuana include excessive preoccupation with
    social causes, race relations, and environmental
    issues

6
Harvey Cushing
  • A physician is obligated to consider more than
    a diseased organ, more even than the whole man.
    He must view the man in his world.

7
Medicine and Public Health
  • Schism between the fields
  • Witnessed victims vs. statistical victims
  • Precautionary Principle

8
Important Contributions of Public Health
  • Water and food safety
  • Sanitation
  • Vaccination
  • Fluoridation
  • Iodine supplementation of table salt
  • Seat belts, air bags
  • Bed nets for malaria prevention
  • Barriers to decrease bridge suicides

9
Important Historical Figures in Medicine/Public
Health and Social Justice
  • Florence Nightingale
  • Clara Barton
  • Margaret Sanger
  • Thomas Hodgkin
  • Albert Schweitzer

10
Important Historical Figures in Medicine/Public
Health and Social Justice
  • Charles Dickens
  • Anton Chekhov
  • Upton Sinclair
  • George Orwell
  • William Carlos Williams

11
Rudolph Virchow
  • Founder of modern pathology
  • Thrombosis, pulmonary embolism, leukocytosis,
    leukemia
  • Member of state and local government for over 30
    years
  • Founded journal Medical Reform

12
Rudolph Virchow
  • Argued that many diseases result from the
    unequal distribution of civilizations
    advantages
  • Advocated public provision of medical care for
    the indigent
  • Promoted universal education

13
Rudolph Virchow
  • Worked to outlaw child labor
  • Improved water distribution and sewage system
  • Enhanced food inspection process
  • Published study of skull volumes to dispute myth
    of larger Aryan brains

14
Rudolph Virchow
  • Passed hygiene standards for public schools
  • Set new standards of training for nurses
  • Improved local hospital system

15
Rudolph Virchow
  • Doctors are natural attorneys for the poor If
    medicine is to really accomplish its great task,
    it must intervene in political and social life

16
Issues
  • Access to care
  • Boutique medicine
  • Racial, sexual and SES discrepancies in outcomes
  • Homelessness
  • Effects of poverty on health
  • Hunger

17
U.S. Health Care
  • Per capita expenditure on health care
  • U.S. 8,160
  • Typical poor African/Asian country 5-50
  • Even so, U.S. has 46 million uninsured, ranks
    24th worldwide in overall population health as
    judged by disability-adjusted life expectancy

18
Headline from The Onion
  • Uninsured Man Hopes His Symptoms Diagnosed This
    Week On House

19
Racial Disparities in Health Care African-America
ns
  • Higher maternal and infant mortality
  • Higher death rates for most diseases
  • Shorter life expectancies
  • Less health insurance
  • Undergo fewer diagnostic tests / therapeutic
    procedures

20
Racial Disparities in Health Care African-America
ns
  • Equalizing the mortality rates of whites and
    African-Americans would have averted 686,202
    deaths between 1991 and 2000
  • Whereas medical advances averted 176,633 deaths
  • AJPH 2004942078-2081

21
Issues
  • Excessive pharmaceutical company influence,
    dubious marketing practices
  • Womens rights issues
  • Violence against women
  • Access to reproductive health care
  • Female genital cutting
  • Political, legal, and educational marginalization

22
Status of Women
  • Economic discrimination
  • Women do 67 of the worlds work
  • Receive 10 of global income
  • Own 1 of all property
  • A woman in a developing country walks an average
    of 6 km/day to obtain water

23
Issues
  • Environmental degradation
  • Overpopulation
  • Air and water pollution
  • Toxins
  • Deforestation
  • Global warming

24
Issues
  • Environmental degradation
  • Unsustainable agricultural and fishing practices
  • Famine
  • Commodification of worlds food and water supply
    by corporations
  • Species loss

25
Poverty Worldwide
  • 1.1 billion people lack access to safe, clean
    drinking water
  • 1.8 million child deaths/year
  • 2 billion have no electricity
  • 2.6 billion do not have adequate sanitation
    services
  • Hunger kills 18,000 people per day, most under
    age 5

26
Consequences of Pollution
  • Air pollution causes approximately 60,000 -
    75,000 premature deaths/yr. in U.S., 1.8 million
    worldwide
  • NAS Pesticides in food could cause up to 1
    million cancers in the current generation of
    Americans

27
Air Pollution
28
Air Pollution
29
Toxic Exposures
  • 13,000-15,000 deaths per day worldwide from
    water-related diseases
  • In developing countries, 90-95 of sewage and 70
    of industrial wastes are dumped untreated into
    the local water supply
  • 1 in 4 U.S. citizens lives within 4 miles of a
    Superfund site
  • Lead and mercury exposure multi-billion dollar
    problems

30
Water Pollution BathtubToiletSource of
Drinking Water
31
Toxins Minimata Disease - W Eugene Smith
32
Deforestation
33
Greenlands Ice Cap Melting 1992
34
Greenlands Ice Cap Melting 2002
35
Greenlands Ice Cap Melting 2005
36
Climate Change Drought
37
Famine
38
Factory Farms
  • 1 polluters of American waterways
  • Agriculture accounts for 70 of U.S. antibiotic
    use
  • 1 contributor to food-borne, antibiotic-resistant
    infections (CDC)
  • Source of MRSA, other resistant bacteria

39
Factory Farming
40
Overfishing Factory Trawlers
41
Dynamite Reef Fishing
42
Species Loss Lost Pharmacopoeia
  • Drugs from plants and native peoples health
    knowledge
  • More than 1/2 of the top 150 prescription drugs
    contain an active compound derived from or
    patterned after natural products -e.g. digoxin,
    vincristine, paralytic agents, etc.
  • Of the more than 250,000 known flowering species,
    lt0.5 have been surveyed for medicinal value

43
A Cure for Cancer?
44
Social Justice Issues
  • Maldistribution of wealth
  • Overconsumption (affluenza)
  • Rise of the corporation
  • 53 of the worlds 100 largest economies are
    private corporations 47 are countries
  • Minimum wage ? Living wage
  • Third World debt crisis
  • Human rights abuses

45
Maldistribution of Wealth
  • U.S Richest 1 of the population owns 50 of
    the countrys wealth poorest 90 own 30
  • Widest gap of any industrialized nation

46
Maldistribution of Wealth
  • Less than 4 of the combined wealth of the 225
    richest individuals in the world would pay for
    ongoing access to basic education, health care,
    adequate food, safe water, and adequate
    sanitation for all humans (UNDP)

47
Overconsumption (Affluenza)
  • U.S. 6.3 of worlds population
  • Owns 50 of the worlds wealth
  • U.S. responsible for
  • 25 of worlds energy consumption
  • 33 of paper use
  • 72 of hazardous waste production

48
George Orwell
  • Some people are more equal than others

49
Hudson River, 2009
50
Voltaire
  • The comfort of the rich rests upon an abundance
    of the poor

51
(No Transcript)
52
(No Transcript)
53
Primo Levi
  • A country is considered the more civilized the
    more the wisdom and efficiency of its laws hinder
    a weak man from becoming too weak or a powerful
    one too powerful.

54
Issues
  • War and Militarism
  • Diversion of economic resources and intellectual
    capital
  • Prejudice/hate crimes
  • Erosion of civil liberties
  • Weapons of mass destruction
  • Military worlds largest polluter

55
The Military Diversion of Resources Away from
Health Care
  • 3 hours world arms spending annual WHO budget
  • 1/2 day of world arms spending full childhood
    immunizations for all worlds children
  • 3 weeks of world arms spending/yr. primary
    health care for all in poor countries, incl. safe
    water and full immunizations
  • War on Terror creating enormous U.S. debt

56
War and Peace
  • World military budget 1,470 billion in 2008
  • 190X what the UN spends on peacekeeping
  • US
  • Largest military budget, largest arms supplier
  • Greatest debtor to UN peacekeeping fund

57
  • Every gun that is made, every warship launched,
    every rocket fired, signifies in the final sense
    a theft from those who hunger and are not fed,
    those who are cold and not clothed.
  • Dwight D. Eisenhower

58
  • The problem in defense spending is to figure out
    how far you should go without destroying from
    within what you are trying to defend from
    without.
  • Dwight D. Eisenhower

59
(No Transcript)
60
US Anti-Terrorism Spending, 2006
61
(No Transcript)
62
(No Transcript)
63
(No Transcript)
64
(No Transcript)
65
(No Transcript)
66
(No Transcript)
67
(No Transcript)
68
Kuwaiti Oil Fires Gulf War I
69
(No Transcript)
70
(No Transcript)
71
The Value of the History of Medicine
  • Provides context for contemporary practices
  • Promotes pride in our field and sense of mission
    to carry on work of our predecessors
  • Fosters humility regarding utility of novel
    technologies

72
Brigham and Womens Hospital
  • Established 1966 through merger of Peter Bent
    Brigham Hospital, Robert Breck Brigham Hospital,
    and Boston Hospital for Women
  • 1847 First administration of anesthesia in
    childbirth

73
Brigham and Womens Hospital History
  • 1913 Harvey Cushing named surgeon-in-chief
  • Father of modern neurosurgery
  • Used X-rays to diagnose brain tumors, electrical
    stimuli to study sensory cortex
  • Helped develop Bovie electrocautery
  • Discovered Cushings Disease

74
Brigham and Womens Hospital History
  • 1923 Elliott Cutler performs worlds first
    successful heart valve surgery
  • 1926 William Murphy, George Whipple, and George
    Minot discover that liver extracts cure
    pernicious anemia
  • Awarded Nobel Prize
  • 1939 Soma Weiss named physician-in-chief
    co-discoverer of Mallory-Weiss tears

75
Brigham and Womens Hospital History
  • 1949 first use of cortisone for rheumatoid
    arthritis
  • 1949 Carl Walter develops worlds first blood
    bank
  • 1954 Joseph Murray performs first successful
    human organ (kidney) transplant
  • Awarded Nobel Prize

76
Brigham and Womens Hospital History
  • 1962 D/C cardioversion used for first time to
    restore normal heart rhythm in A-fib
  • Home of first CCU
  • Today one of the largest non-university
    recipients of research funding from NIH
  • Contemporary leaders in medicine

77
The Role of Literature
  • Vicarious experience
  • Explore diverse philosophies
  • Promotes empathy, critical thinking, flexibility,
    non-dogmatism, self-knowledge
  • Encourages creative thinking
  • Allows for group discussion/debate

78
Why Use Literature
  • Encourage appreciation of non-medical literature
  • Develop reading, analytical, speaking and writing
    skills
  • Promote ethical thinking (narrative ethics)
  • Identification with doctor authors (e.g., Keats,
    Chekhov, Maugham, Williams)
  • Can be used in a variety of settings

79
Homelessness
  • Doris Lessing
  • An Old Woman and Her Cat
  • From the Doris Lessing Reader (New York Knopf,
    1988)

80
(No Transcript)
81
Race and Access to Care
  • Ernest J Gaines
  • The Sky is Gray
  • in Gray, Marion Secundy, ed. Trials,Tribulations,
    and Celebrations African American Perspectives
    on Health, Illness, Aging and Loss. Yarmouth,
    Maine Intercultural Press, 1992

82
Poverty
  • Orwell, George. How the Poor Die. In Sonia Orwell
    and Ian Angus, eds. The Collected Essays,
    Journalism and Letter of George Orwell, IV In
    Front of Your Nose, 1945-1950. New York
    Harcourt, Brace and World, Inc pp.223-233.
  • Checkhov, Anton. Letter to AF Koni, January 26,
    1891, Letter to AS Survivor, March 9, 1890. In
    Norman Cousins, ed. The Physician in Literature
    Philadelphia WB Saunders, 1982.

83
(No Transcript)
84
Impediments to Public Health and Social Justice
  • Political climate
  • Scientific Ignorance
  • Pseudoscience
  • Damaged educational system
  • The corporate media
  • All lead to the decline of democracy

85
Bush Administration
  • Key administrators/committee members/regulators
    former industry representatives and/or lobbyists
  • Privatization of public services
  • Corporate profit before public good
  • Unsound/distorted/suppressed science

86
Bush Administration
  • Rollbacks of key environmental laws
  • Lax enforcement of existing laws
  • Huge tax cuts primarily benefit wealthy
  • Federal and state government deficits
    astronomical
  • Program and funding cuts
  • Increased trade deficit
  • Obama ?change?

87
(No Transcript)
88
Would You Sign a Petition to Ban Dihydrogen
Monoxide?
  • 1. It can cause excessive sweating and
    vomiting 2. It is a major component in acid
    rain 3. It can cause severe burns in its gaseous
    state 4. It can kill you if accidentally
    inhaled 5. It contributes to erosion 6. It
    decreases effectiveness of automobile brakes 7.
    It has been found in tumors of terminal cancer
    patients

89
Environmental and Geographic Ignorance
  • A majority of Americans believe that electricity
    in the U.S. is produced in nonpolluting ways
  • 25 knew that majority (70) comes from oil,
    coal and wood
  • Percent of US teens unable to locate the
    following on a map
  • United States 11
  • Pacific Ocean 29
  • Japan 58

90
Pseudoscientific Beliefs
  • Percentage of Americans who believe at least to
    some degree in these phenomena
  • 1997 1976
  • Astrology 37 17
  • UFOs 30 24
  • Reincarnation 25 9
  • Fortune-Telling 14 4

91
Obfuscating Influence of Religion
  • Onion Headline

92
Greenwash
  • Public relations / ad campaigns
  • Chevrons People Do Campaign,
    butterflies/refinery
  • Grants to a few scientists who challenge
    environmental warnings
  • Tobacco ads in 1950s

93
Astroturf
  • Artificially-created grassroots coalitions
  • Corporate front groups
  • The American Council on Science and Health
  • National Wilderness Institute
  • The Foundation for Clean Air Progress

94
Corporate-sponsored environmental education
materials (examples)
  • Exxons Energy Cube
  • -Gasoline is simply solar power hidden in
    decayed matter
  • -Offshore drilling creates reefs for fish
  • Pacific Lumber Company
  • -The Great American Forest is. . . renewable
    forever

95
Sponsored Environmental Education Materials
(Examples)
  • International Paper
  • -Clearcutting promotes growth of trees that
    require full sunlight and allows efficient site
    preparation for the next crop
  • American Nuclear Societys Activities with the
    Atoms Family
  • Dows Chemipalooza

96
Advertising
  • Doubt is our product
  • Brown and Williamson Tobacco Company Memo, 1960s

97
Advertising
  • Record 570 billion spent on advertising in 2005
  • 11X greater than in 1950
  • Half in US
  • 481 billion in 2008
  • The average American can recognize over 1,000
    corporate logos, but fewer than 10 plants and
    animals native to his/her locality

98
Television
  • The average American youth spends 900 hrs/yr in
    school, 1,500 hrs/yr watching TV
  • By age 65, the average American will have spent 9
    yrs watching TV
  • Contributor to obesity epidemic

99
Public Education in Disarray
  • U.S. Schools ranked lowest among western nations
  • ? funding, infrastructure decaying
  • 1/4 of U.S. Schools have no library

100
Education in Disarray
  • National HS graduation rate 65-70
  • College tuition costs rising
  • Increasingly marginalizes poor, minorities

101
Ignorance vs. Democracy
  • Information is the currency of democracy
  • Thomas Jefferson

102
The Media
  • Most media organizations owned by multinational,
    multi-billion dollar corporations that are
    involved in a number of businesses apart from the
    media, such as forestry, pulp and paper mills,
    defense, real estate, oil wells, agriculture,
    steel production, railways, and water and power
    utilities

103
Global Warming Controversial?
  • Of 928 articles in peer-reviewed scientific
    journals, 0 were in doubt as to the existence or
    cause of global warming
  • Of 636 articles in the popular press (NY Times,
    Washington Post, LA Times, WSJ), 53 expressed
    doubt as to the existence (and primary cause) of
    global warming
  • Science 20043061686-7
  • (Study covers 1993-2003)

104
Global Warming
  • Causes estimated 160,000 deaths and 5.5 million
    disability-adjusted life years lost per year
  • WHO, UN Environment Program

105
Lobbying
  • Almost 15,000 full-time lobbyists
  • Estimates of return on lobbying range from 28 to
    100 for every 1 spent
  • Pharmaceutical lobby spent 1.3 billion on
    lobbying between 1998 and 2007
  • More than any other industry

106
Lobbying
  • Lobbying groups spent 3.3 billion in 2008
    (record)
  • All single issue ideological groups combined
    (e.g., pro-choice, anti-abortion, feminist and
    consumer organizations, senior citizens, etc.)
    spent well-under 100 million

107
The Benefits of Sterility-Causing Chemicals in
the Workplace?
  • 12 September 1977
  • Dr. Eula Bingham, Assistant Secretary for
    Occupational Safety and Health Regarding
    worker exposure to DBCP. While involuntary
    sterility caused by a manufactured chemical may
    be bad, it is not necessarily so. After all,
    there are many people who are now paying to have
    themselves sterilized to assure they will no
    longer be able to become parents... If possible
    sterility is the main problem, couldnt workers
    who were old enough that they no longer wanted to
    have children accept such positions voluntarily?
    Orsome workers might volunteer for such
    workposts as an alternative to planned surgery
    for a vasectomy or tubal ligation, or as a means
    of getting around religious bans on birth
    control when they want no more children?
  • Sincerely,
  • Robert K. Phillips, National Peach Council

108
The Decline of Democracy
  • True democracy demands an informed citizenry
    (education), freedom of the press (media), and
    involvement (will, time, money)

109
What you can do
  • Explore the history of medicine
  • Respect
  • Question dogma The least questioned assumptions
    are often the most questionable Paul Broca
  • Read great literature
  • Patients illnesses are stories
  • Take patients perspective
  • Develop a public health-oriented perspective in
    care of patients
  • Find your passion

110
What you can do
  • Become active in an organization
  • Educate yourself
  • Educate your students and your patients
  • Use the media
  • Volunteer, do pro bono work
  • Satisfies your debt to society
  • Feeds your soul

111
Contemporary Activist Organizations
  • Amnesty International, Oxfam
  • Partners in Health
  • PNHP
  • HCWH, NRDC, ED, Greenpeace, Sierra Club, No Dirty
    Gold, PANNA
  • Union of Concerned Scientists, Public Citizens
    Health Research Group
  • NARAL, Planned Parenthood
  • Physicians for Social Responsibility, Physicians
    for Human Rights
  • Others

112
Anita Roddick
  • "If you think you are too small to have an
    impact, try going to bed with a mosquito in your
    tent"

113
First they came for the Jews by Pastor Niemoller
  • First they came for the Jews, and I did not
    speak up, for I was not a Jew.
  • Then they came for the communists, and I did not
    speak up for I was not a communist.
  • Then they came for the trade unionists, and I did
    not speak up, for I was not a trade unionist.
  • Then they came for me, and there was no one left
    to speak up for me.

114
Contact Information
  • Public Health and Social Justice Website
  • http//www.phsj.org
  • martindonohoe_at_phsj.org
About PowerShow.com