Biomedicine Today: The Social Studies of (Bio)Medicine
(here in Word document format)
Professor Gareth Edel Email Office Office Hours
Description
What makes a doctor different than a plumber? Why do we treat medical knowledge differently than the skills that repair mechanical systems? Developing a social science perspective about medicine is based on seeing how shared beliefs about the world are part of the content of medical science and practice. Students are asked to identify power, category (race, class, gender), and politics in the shaping and present form of medicine, and to understand social processes at work in ‘making sense’ of medicine. The course introduces students to the social study of medicine emphasizing ongoing change and institutional forms.
We will ask how our understanding of the body and medicine have changed, and how these understandings have lasting impacts on how our society is organized. Using examples from the history of medicine to frame the multiple interpretations of the “body” and of “care” we look at how these understandings shape the practices, institutions and ideas we hold today.
The course is divided into sections focused on contemporary subjects in medical and health science research that students may have heard about in the mainstream media. Topics are used to demonstrate the social nature of medical knowledge and the difficulties of practice in a multicultural and uncertain world. Key issues framing the whole course include 1) recognition and evaluation of the increasing reliance on and visibility of technology in medicine, 2) the question of legitimacy of cultural relativism, and importance of cultural competency, 3) Evaluation of criticisms of Western medical care (i.e. commoditization, increasing specialization), and 4) the development of a robust foundation for ethical and epistemological evaluation of biomedicine.
Weekly readings focus on specific forms of controversial research and practice as understood through a broadly interdisciplinary social science lens. Drawing on literatures in Medical Anthropology, Sociology, as well as Science and Technology Studies (STS) the students are presented with a new case each week.
Weekly writing assignments require students to critically examine the role that ethical and technical decision making plays in innovation, while requiring that they evaluate different situations in light of multiple perspectives and theoretical frames. Grading will be based on participation, progress at gaining and applying core concepts, written work (weekly 2-3 page papers, media journals, and an individual paper 9-12 pages).
Expected Learning Outcomes:
Writing Skills- Students will develop writing skills through repetition and feedback, attention will be placed on clarity of communication and distinguishing between a personal voice (in weekly responses) and appropriate scholarly voice (in the iterations of the semester long research project).
Thinking like a Social Scientist - Students will improve their social science vocabulary and theoretical range (particularly the specific understanding of key concepts and theories from the interdisciplinary field of STS). Students will likewise be asked to develop a sensitivity to the distinctions between traditional disciplinary fields through the inclusion of multiple disciplinary readings.
Research Skills- Across the semester the students will be asked to work on a research project in order to develop skills at finding, evaluating, and using scholarly work. Initial problem framing and outlining are emphasized as tools to shape proper research, and their defined question or problem is used to frame individual research in the social studies of medicine.
COURSE REQUIREMENTS:
READING:
· Students are expected to complete all readings before the beginning of the class session date on which they appear on the syllabus below. Most readings will be available electronically (We will show you how to access them in the first class, and go over assignments in the first session).
· Students are responsible for all readings listed on this syllabus except where they are specifically noted as optional.
· Students will have the opportunity to earn extra credit by presenting in class on readings beyond those required.
WRITING:
· 6 brief (250-400 word) reading response papers are due on the day of reading discussion and must include specific references to the work discussed. Response papers are intended to enable discussion and encourage participation but also serve as a mechanism for faculty feedback, and evaluation. They will be given a grade of 0-4, and students may rewrite.
· A semester long research project will be assigned in three stages (preliminary proposal, first draft, final expanded draft) detailed in a class handout.
NOTES: Work is due on dates listed in the syllabus. All writing is required to be typed and to include citations from course material (at a minimum). Students will be asked to maintain a consistent citation style after in class discussion, to use a citation management system (such as Endnote, Zotero, or another of their choice), and to demonstrate improved thinking and skill in writing across the semester. All work is due in hardcopy at the start of class on the day it is to be turned in, and no work is accepted via email without prior approval.
CLASS PARTICIPATION:
· All students are expected to participate in seminar discussion, and to demonstrate engagement with topics through reference to course materials.
· Students are encouraged to disagree with the professor.
· Students are expected to use gender-neutral and culturally sensitive language.
· Each student will be permitted one unexplained absence, lateness and any further unapproved absences will be penalized in the semester grade if no official permission is provided. Each additional unacceptable absence is 1/3 of a letter grade removed from the final grade. Lateness is subtracted from the class participation section of the grade.
Boilerplate:
I have not included boilerplate requirements for academic honesty, ADA compliance, and other formalities that would be needed to reflect the institutional demands on Syllabus form and style.
Grading:
Research Presentation 10%
Term Research Paper 25%
Final Examination 25%
6 Weekly Response Papers on Readings 20%
Class Participation 20%
Required Texts:
An Anthropology of Biomedicine. Margaret Lock & Vinh-Kim Nguyen. 2010. Wiley-Blackwell
Genesis and Development of a Scientific Fact. Ludwik Fleck. [1935] 1979. U. of Chicago Press
Mutants: On Genetic Variety and the Human Body. Armand Marie Leroi. 2003. Viking
Course Outline and Readings:
WEEK 0- Meeting the class, Reviewing the Syllabus
Assignments:
Required Reading: Lock and Nguyen Chapter1
Required Reading: Begin reading Leroy Mutants For week 3
Suggested Reading:
Michel Foucault. 1994. The birth of the clinic. Vintage
WEEK 1 - Introduction -Making medicine and health
Assignments:
Required Reading: Lock and Nguyen Chapter 2
Required Reading: Continue reading Leroy Mutants For week 3
Submission:
Weekly Response Paper
WEEK 2- The Normal, Difference and Pathology
Assignments:
Required Reading: Lock and Nguyen Chapter 3
Required Reading: Continue reading Leroy Mutants For week 3
Suggested Reading:
Anne Fadiman. 1998. The Spirit Catches you and you fall down. Farrar, Straus & Giroux Pub.
Submission:
Weekly Response Paper
WEEK 3 Local Biology and Universality
Assignments:
Required Reading: Lock and Nguyen Chapter 4
Required reading: Have completed reading Leroy Mutants, whole book to be discussed in class.
Required Reading: Begin Reading Fleck due for week 5
Submission:
Weekly Response Paper
WEEK 4 Population, Standardization, and Medicine of scale.
Assignments:
Required Reading: Lock and Nguyen Chapter 5
Required Reading: Continue Reading Fleck due for week 5
Suggested Reading:
Steven Epstein. 2009. Inclusion: The politics of difference in medical research. Univ. of Chicago Press
Submission:
Weekly Response Paper
WEEK 5 Experimental Science and Evidence Based Medicine
Assignments:
Required Reading: Lock and Nguyen Chapter 7
Required Reading: Fleck, Whole Book to be discussed in class.
Submission:
Weekly Response Paper
WEEK 6 Mid Semester Review Session
Assignments:
Submission: Research Proposal for semester Project, proposal should be 3-5 pages, including bibliography, to include descriptive outline and at least 10 citations.
WEEK 7 The Body, owned and shaped
Assignments:
Required Reading: Lock and Nguyen Chapters 8 & 9
Required Reading:
Nikolas Rose "Introduction," Politics of Life Itself . Princeton University Press.2006., pp. 1‐7.
Fausto‐Sterling, Anne. (2000). “Dueling Dualisms,” from Sexing the Body: Gender Politics and the
Construction of Sexuality (pp. 1‐29). Boston:Basic Books.
Suggested Reading:
Dumit, Joseph. “Is it Me or My Brain? Depression and Neuroscientific Facts,” Journal of the
Medical Humanities Vol 24, Nos. 1/2 (Summer 2003): 35‐47.
Submission:
Weekly Response Paper
WEEK 8 The Lived Body
Assignments:
Required Reading: Lock and Nguyen Chapter 11
Required Reading:
Turner, Bryan. 2008. “Missing Bodies – Towards a sociology of embodiment”, Sociology of Health
and Illness. Vol 13:2, p 265-273
Submission:
Weekly Response Paper
WEEK 9 Genetics, Genomics and the power of an idea
Assignments:
Required Reading: Lock and Nguyen Chapter 12 & 13
Required Reading:
Stephen J Gould. 1996. section titled: ” The allure of numbers” The Mismeasure of Man. WW Norton. Pages 105 – 113
Ruth Hubbard and Elijah Wald. 1999. Exploding the Gene Myth. Beacon. Pages 1-6 “The Role of Genetics in our Lives” and 163- 185 “Afterword”
Suggested Reading:
Carol Tavris. 1993. The Mismeasure of Woman. Touchstone.
Evelyn Fox Keller. 2002. The Century of the Gene. Harvard University Press.
Submission:
Student Presentations Week 1
WEEK 10 – Policy, Policing, and Surveillance
Assignments:
Required Reading: Lock and Nguyen Chapter 14
Required Reading:
Lopez, R. Income inequality and self-rated health in US metropolitan areas: A multi-level analysis,
Social Science and Medicine 2004; 59:2409-2419
Issacs, S.L. and S.A. Schroeder. Class-The Ignored Determinants of Nation’s Health, New England
Journal of Medicine 2004; 351:1137-1142
Fiscella, K., P. Franks, M.R. Gold and C.M. Clancy. Inequality in quality: addressing socioeconomic,
racial and ethnic disparities in health care, Journal of American Medical Association 2000;
283(19): 2579-2584
Suggested Readings:
Kleinman, D. L. & Kinchy, A J. (2007). Against the neoliberal steamroller? The Biosafety Protocol and the social regulation of agricultural biotechnologies. Agriculture and Human Values, 24, 195-206.
Submission:
Student Presentations Week 2
WEEK 11: Final Exam Review
Assignments:
Submission:
Term Research Paper Due at start of class
Description
What makes a doctor different than a plumber? Why do we treat medical knowledge differently than the skills that repair mechanical systems? Developing a social science perspective about medicine is based on seeing how shared beliefs about the world are part of the content of medical science and practice. Students are asked to identify power, category (race, class, gender), and politics in the shaping and present form of medicine, and to understand social processes at work in ‘making sense’ of medicine. The course introduces students to the social study of medicine emphasizing ongoing change and institutional forms.
We will ask how our understanding of the body and medicine have changed, and how these understandings have lasting impacts on how our society is organized. Using examples from the history of medicine to frame the multiple interpretations of the “body” and of “care” we look at how these understandings shape the practices, institutions and ideas we hold today.
The course is divided into sections focused on contemporary subjects in medical and health science research that students may have heard about in the mainstream media. Topics are used to demonstrate the social nature of medical knowledge and the difficulties of practice in a multicultural and uncertain world. Key issues framing the whole course include 1) recognition and evaluation of the increasing reliance on and visibility of technology in medicine, 2) the question of legitimacy of cultural relativism, and importance of cultural competency, 3) Evaluation of criticisms of Western medical care (i.e. commoditization, increasing specialization), and 4) the development of a robust foundation for ethical and epistemological evaluation of biomedicine.
Weekly readings focus on specific forms of controversial research and practice as understood through a broadly interdisciplinary social science lens. Drawing on literatures in Medical Anthropology, Sociology, as well as Science and Technology Studies (STS) the students are presented with a new case each week.
Weekly writing assignments require students to critically examine the role that ethical and technical decision making plays in innovation, while requiring that they evaluate different situations in light of multiple perspectives and theoretical frames. Grading will be based on participation, progress at gaining and applying core concepts, written work (weekly 2-3 page papers, media journals, and an individual paper 9-12 pages).
Expected Learning Outcomes:
Writing Skills- Students will develop writing skills through repetition and feedback, attention will be placed on clarity of communication and distinguishing between a personal voice (in weekly responses) and appropriate scholarly voice (in the iterations of the semester long research project).
Thinking like a Social Scientist - Students will improve their social science vocabulary and theoretical range (particularly the specific understanding of key concepts and theories from the interdisciplinary field of STS). Students will likewise be asked to develop a sensitivity to the distinctions between traditional disciplinary fields through the inclusion of multiple disciplinary readings.
Research Skills- Across the semester the students will be asked to work on a research project in order to develop skills at finding, evaluating, and using scholarly work. Initial problem framing and outlining are emphasized as tools to shape proper research, and their defined question or problem is used to frame individual research in the social studies of medicine.
COURSE REQUIREMENTS:
READING:
· Students are expected to complete all readings before the beginning of the class session date on which they appear on the syllabus below. Most readings will be available electronically (We will show you how to access them in the first class, and go over assignments in the first session).
· Students are responsible for all readings listed on this syllabus except where they are specifically noted as optional.
· Students will have the opportunity to earn extra credit by presenting in class on readings beyond those required.
WRITING:
· 6 brief (250-400 word) reading response papers are due on the day of reading discussion and must include specific references to the work discussed. Response papers are intended to enable discussion and encourage participation but also serve as a mechanism for faculty feedback, and evaluation. They will be given a grade of 0-4, and students may rewrite.
· A semester long research project will be assigned in three stages (preliminary proposal, first draft, final expanded draft) detailed in a class handout.
NOTES: Work is due on dates listed in the syllabus. All writing is required to be typed and to include citations from course material (at a minimum). Students will be asked to maintain a consistent citation style after in class discussion, to use a citation management system (such as Endnote, Zotero, or another of their choice), and to demonstrate improved thinking and skill in writing across the semester. All work is due in hardcopy at the start of class on the day it is to be turned in, and no work is accepted via email without prior approval.
CLASS PARTICIPATION:
· All students are expected to participate in seminar discussion, and to demonstrate engagement with topics through reference to course materials.
· Students are encouraged to disagree with the professor.
· Students are expected to use gender-neutral and culturally sensitive language.
· Each student will be permitted one unexplained absence, lateness and any further unapproved absences will be penalized in the semester grade if no official permission is provided. Each additional unacceptable absence is 1/3 of a letter grade removed from the final grade. Lateness is subtracted from the class participation section of the grade.
Boilerplate:
I have not included boilerplate requirements for academic honesty, ADA compliance, and other formalities that would be needed to reflect the institutional demands on Syllabus form and style.
Grading:
Research Presentation 10%
Term Research Paper 25%
Final Examination 25%
6 Weekly Response Papers on Readings 20%
Class Participation 20%
Required Texts:
An Anthropology of Biomedicine. Margaret Lock & Vinh-Kim Nguyen. 2010. Wiley-Blackwell
Genesis and Development of a Scientific Fact. Ludwik Fleck. [1935] 1979. U. of Chicago Press
Mutants: On Genetic Variety and the Human Body. Armand Marie Leroi. 2003. Viking
Course Outline and Readings:
WEEK 0- Meeting the class, Reviewing the Syllabus
Assignments:
Required Reading: Lock and Nguyen Chapter1
Required Reading: Begin reading Leroy Mutants For week 3
Suggested Reading:
Michel Foucault. 1994. The birth of the clinic. Vintage
WEEK 1 - Introduction -Making medicine and health
Assignments:
Required Reading: Lock and Nguyen Chapter 2
Required Reading: Continue reading Leroy Mutants For week 3
Submission:
Weekly Response Paper
WEEK 2- The Normal, Difference and Pathology
Assignments:
Required Reading: Lock and Nguyen Chapter 3
Required Reading: Continue reading Leroy Mutants For week 3
Suggested Reading:
Anne Fadiman. 1998. The Spirit Catches you and you fall down. Farrar, Straus & Giroux Pub.
Submission:
Weekly Response Paper
WEEK 3 Local Biology and Universality
Assignments:
Required Reading: Lock and Nguyen Chapter 4
Required reading: Have completed reading Leroy Mutants, whole book to be discussed in class.
Required Reading: Begin Reading Fleck due for week 5
Submission:
Weekly Response Paper
WEEK 4 Population, Standardization, and Medicine of scale.
Assignments:
Required Reading: Lock and Nguyen Chapter 5
Required Reading: Continue Reading Fleck due for week 5
Suggested Reading:
Steven Epstein. 2009. Inclusion: The politics of difference in medical research. Univ. of Chicago Press
Submission:
Weekly Response Paper
WEEK 5 Experimental Science and Evidence Based Medicine
Assignments:
Required Reading: Lock and Nguyen Chapter 7
Required Reading: Fleck, Whole Book to be discussed in class.
Submission:
Weekly Response Paper
WEEK 6 Mid Semester Review Session
Assignments:
Submission: Research Proposal for semester Project, proposal should be 3-5 pages, including bibliography, to include descriptive outline and at least 10 citations.
WEEK 7 The Body, owned and shaped
Assignments:
Required Reading: Lock and Nguyen Chapters 8 & 9
Required Reading:
Nikolas Rose "Introduction," Politics of Life Itself . Princeton University Press.2006., pp. 1‐7.
Fausto‐Sterling, Anne. (2000). “Dueling Dualisms,” from Sexing the Body: Gender Politics and the
Construction of Sexuality (pp. 1‐29). Boston:Basic Books.
Suggested Reading:
Dumit, Joseph. “Is it Me or My Brain? Depression and Neuroscientific Facts,” Journal of the
Medical Humanities Vol 24, Nos. 1/2 (Summer 2003): 35‐47.
Submission:
Weekly Response Paper
WEEK 8 The Lived Body
Assignments:
Required Reading: Lock and Nguyen Chapter 11
Required Reading:
Turner, Bryan. 2008. “Missing Bodies – Towards a sociology of embodiment”, Sociology of Health
and Illness. Vol 13:2, p 265-273
Submission:
Weekly Response Paper
WEEK 9 Genetics, Genomics and the power of an idea
Assignments:
Required Reading: Lock and Nguyen Chapter 12 & 13
Required Reading:
Stephen J Gould. 1996. section titled: ” The allure of numbers” The Mismeasure of Man. WW Norton. Pages 105 – 113
Ruth Hubbard and Elijah Wald. 1999. Exploding the Gene Myth. Beacon. Pages 1-6 “The Role of Genetics in our Lives” and 163- 185 “Afterword”
Suggested Reading:
Carol Tavris. 1993. The Mismeasure of Woman. Touchstone.
Evelyn Fox Keller. 2002. The Century of the Gene. Harvard University Press.
Submission:
Student Presentations Week 1
WEEK 10 – Policy, Policing, and Surveillance
Assignments:
Required Reading: Lock and Nguyen Chapter 14
Required Reading:
Lopez, R. Income inequality and self-rated health in US metropolitan areas: A multi-level analysis,
Social Science and Medicine 2004; 59:2409-2419
Issacs, S.L. and S.A. Schroeder. Class-The Ignored Determinants of Nation’s Health, New England
Journal of Medicine 2004; 351:1137-1142
Fiscella, K., P. Franks, M.R. Gold and C.M. Clancy. Inequality in quality: addressing socioeconomic,
racial and ethnic disparities in health care, Journal of American Medical Association 2000;
283(19): 2579-2584
Suggested Readings:
Kleinman, D. L. & Kinchy, A J. (2007). Against the neoliberal steamroller? The Biosafety Protocol and the social regulation of agricultural biotechnologies. Agriculture and Human Values, 24, 195-206.
Submission:
Student Presentations Week 2
WEEK 11: Final Exam Review
Assignments:
Submission:
Term Research Paper Due at start of class