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Paper and Poster Abstracts American Association for the History of Medicine 89th Annual Meeting April 28-May 1, 2016 Minneapolis, MN Paper and Poster Abstracts Paper abstracts in alphabetical order by author last name pages 4-180 Posters abstracts in alphabetical order by author last name pages 181-179 Joint AAHM/AOS sessions pages 2-3 1 Session: H5 Medical History in the Medical Education: New (and Old Solutions to an Old Problem. A Panal Discussion for the American Association for the History of Medicine and the American Osler Society AAHM/AOS Joint Session 1 Medical History in the Medical Education: New (and Old Solutions to an Old Problem. A Panal Discussion for the American Association for the History of Medicine and the American Osler Society Speakers: Jacalyn Duffin, Queens University; John Harley Warner, Yale University; David Jones, Harvard University; and Kenneth Ludmerer, Washington University in St. Louis. Chair: Jeremy Greene, Johns Hopkins University Abstract: Many members of both the American Association for the History of Medicine and the American Osler Society teach medical students and trainees, and they share a strong interest in the role of history in medical education. This joint session will consider the evolving history of justifications and methods for bringing history into medical education, present recent collaborative efforts by historians to articulate the utility of history in medicine (such as the Clio Project), and invite discussion regarding how to advance these goals. History can complement the aim to instill professionalism and other competencies, as they have been promoted by organizations like the Association of American Medical Colleges and the Royal College of Physicians and Surgeons of Canada. Objectives: The main objective of this session is to stimulate enduring discussion and ongoing strategizing among members of both groups about how to promote this agenda within our own schools, hospitals, medical systems, and nations. Session: I5 The Origins and Evolution of Informed Consent: A Half-Century of Deliberation. A Panel Discussion for the American Association for the History of Medicine and the American Osler Society ◊◊◊◊ AAHM/AOS Joint Session 2 The Origins and Evolution of Informed Consent: A Half-Century of Deliberation. A Panel Discussion for the American Association for the History of Medicine and the American Osler Society Speakers: Susan Lederer, University of Wisconsin; Laura Stark, Vanderbilt University Chair: Sarah Tracy, University of Oklahoma Abstract: Many members of both the American Association for the History of Medicine and the American Osler Society teach students about the ethics of clinical research. Some conduct research that involves human subjects. Most are aware of the canonical status of Henry K. Beecher’s 1966 New England Journal of Medicine article “Ethics and Clinical Research” in this 2 field. This joint session offers two fresh perspectives on Beecher’s seminal article. Susan Lederer considers the 28 cases left out of Beecher’s NEJM 1966 essay, which originally contained 50 rather than 22 cases. Lederer discusses what was lost through these editorial cuts and why they were made. Laura Stark examines the initial, often critical, responses to “Ethics and Clinical Research,” and the process through which Beecher’s essay became a part of the canon of clinical research ethics. She also explores the ways in which regulatory policies over the decades to come pushed beyond and even against Beecher's original agenda. Objectives: The main objective of this session is to revisit Beecher’s important NEJM article on the occasion of its 50th anniversary to consider both its origins and evolution as a canonical publication in clinical research ethics. ◊◊◊◊ Session: G1 Race, Civil Rights, and Health Care in the 20th-Century United States Adler, Jessica Florida International University, Miami, FL I never did feel quite well again: African American veterans and health care in the Great War era Abstract: This paper examines how African American soldiers and veterans experienced federally sponsored health care during and after the Great War, and how plans for both military and civilian hospitals were complicated by questions about race. At the outset of war, army policy prioritized efficiency, and dictated that black soldiers (approximately nine percent of those serving in the wartime army) would be treated alongside their white counterparts according to ailment. But, in the face of rising social tensions, there were plenty of exceptions to the rule, and segregation was regularly practiced in military hospitals. After the war, many African American veterans faced insurmountable barriers as they attempted to access government sponsored care, which could foster deep feelings of betrayal and lead to negative health outcomes. The story of African Americans’ experiences in army and veterans’ hospitals showcases the complexity of managing the health fallout of war. More specifically, it highlights the challenges and paradoxes inherent in offering veterans’ entitlements in the era of Jim Crow. Analyses of complaints filed with the Army Inspector General, federal agencies, and African American advocacy organizations, as well as congressional testimony, government reports, and articles from African American newspapers reveal how military and federal policies have been interpreted, adapted, implemented, and experienced – and how seemingly universal entitlements may, in fact, be conditional and limited. The paper focuses on an important moment in the history of health policy. The establishment of the Veterans’ Bureau and the first veterans’ hospitals in 1921 serves not only as an often overlooked symbol of the mass acceptance of hospitals as ideal sites of care, but also as the initiation of what has become the largest integrated health care system in the United States. All veterans in the early 1920s ostensibly had access to new and diverse entitlements. The struggles of black veterans highlight how one sect of a larger cadre of former service members 3 vigorously demanded that the government fulfill its increasingly expansive health care obligations. Keywords: Hospitals, health policy, health care, war, veterans, African Americans Objectives: 1. Develop an historically informed sensitivity to the diversity of patients (including appreciation of class, gender, socio-economic status, ethnicity, cultural, spiritual orientations). 2. Acquire a historically nuanced understanding of the organization of the U.S. healthcare system, and of other national health care systems. 3. Recognize the dynamic interrelationship between medicine and society through history. ◊◊◊◊ Session: A1 Doctors Beyond Borders: Immigrant MDs in North America in the 20th Century Alam, Eram University of Pennsylvania, Philadelphia, PA First Contact: Foreign Medical Graduates Enter the American Healthcare System Abstract: In 1965, facing a major doctor shortage in the wake of Medicare and Medicaid expansions, Congress passed legislation to expedite the migration of skilled professionals to the US. Foreign Medical Graduates (FMGs), from predominantly postcolonial Asian nations, were amongst the largest groups of immigrants to enter. This “exceptionally” qualified medical workforce was granted legal citizenship in exchange for medical labor and comprised a third to a half of the practicing physicians in the US during the 1960s and 1970s. Drawing from oral histories and published medical literature, I use the clinical space as a site to explore how a South Asian physician in a white coat complicates normative constructions of expertise, credibility, and authority. Although FMGs held a privileged position due to their professional skills, there remained strong discriminatory attitudes towards these “snake charming” physicians, which affected their daily practice and professional prospects. For FMGs, two sets of social interactions were particularly salient: their dealings with their colleagues and their contact with patients. Despite holding the same professional status as their US educated counterparts, FMGs self-reported on the need to outperform in all metrics of clinical knowledge and practice in order to simply receive satisfactory evaluations. And during clinical encounters, FMGs developed particular strategies and techniques to navigate their American cultural naiveté, while maintaining their medical authority and professionalism. In spite of these hardships, FMGs acquired clinical skills and knowledge that allowed them to leverage their training into economic, spatial, and symbolic mobility. I argue that the possibilities afforded FMGs are related to the whitening power of expertise, and it is this process that has allowed South Asian physicians to lose their foreignness and become part of a positive cultural trope in contemporary American society. These non-white elite laborers provide a unique vantage point to explore professionalization as an important axis of racial formation in the United States. 4 Objectives: 1. Develop the capacity for critical thinking about the nature, ends and limits of medicine. 2. Understand the dynamic history of medical ideas and practices, their implications for patients and health care providers, and the need for lifelong learning. 3. Recognize the dynamic interrelationship between medicine and society through history. ◊◊◊◊ Session: A4 Negotiating Medical Knowledge: Midwives' Tales Amster, Ellen McMaster University, Ontario, Canada The Muslim Midwife: Birth as Medical Knowledge, Mediation, and the Constitution
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