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This book explores the nature of decision making in one of the most crucial – yet also the most understudied – aspects of the regulatory system around biomedical research: research ethics committees. Every month, all over the UK, groups of people sit down and decide what kind of research should be carried out on patients within the National Health Service (NHS). These groups – Research Ethics Committees (RECs) – made up of doctors, nurses, researchers, and members of the general public, help shape the future of medicine, and play a crucial role in the regulation of a wide range of research from social science to epidemiology, vaccine and drugs trials, and surgery. Despite coming into existence in the late 1960s, and the considerable literature bemoaning the chilling effect such review has on biomedical research, we don’t know very much about how these bodies make decisions. This book provides one of the first empirical examinations of this kind of regulation, drawing on observational, interview, and archival data to give in-depth ethnographic insight into RECs, as they operate in the UK NHS. A key insight of this work is that, despite the trappings of a modern regulatory system – the operating procedures, guidance documents, and websites – NHS REC decision making revolves around very old-fashioned aspects of social life such as interpersonal trust, reputation, and the performance of character, and that an accurate understanding of this kind of regulation requires an acceptance of the inherently social nature of the processes involved.
Perception and analogy explores ways of seeing scientifically in the eighteenth century. It discusses literary, theological, and didactic texts alongside popular works on astronomy, optics, ophthalmology, and the body to demonstrate how readers are prompted to take on a range of perspectives in their acquisition of scientific knowledge. With reference to topics from colour perception to cataract surgery, the book examines how sensory experience was conceptualised during the eighteenth century. It argues that by paying attention to the period’s documentation of perception as an embodied phenomenon we can better understand the creative methods employed by disseminators of diverse natural philosophical ideas. This book argues for the central role of analogy in conceptualising and explaining new scientific ideas. It centres on religious and topographical poetry by writers including James Thomson, Richard Blackmore, Mark Akenside, Henry Brooke, David Mallet, Elizabeth Carter, and Christopher Smart. Together with its readings of popular educational dialogues on scientific topics, the book also addresses how this analogical approach is reflected in material culture through objects – such as orreries, camera obscuras, and Aeolian harps – that facilitate acts of perception and tactile engagement within polite spaces. The book shows how scientific concepts become intertwined with Christian discourse through reinterpretations of origins and signs, the scope of the created universe, and the limits of embodied knowledge.
Chapter 2 investigates the corrupting and corrosive effects of slavery. An association already exists between slavery and the rise of Gothic fiction through the West Indian connections of the major Gothic writers, Horace Walpole, William Beckford and Matthew Lewis. Mary Shelley’s new creation myth in Frankenstein draws not just on Prometheus and Adam but also, it will be argued, on the topical issue of the enslaved and the reluctance of many abolitionists to support the cause of immediate emancipation. Within this reading of Frankenstein as an allegory of slavery, the monster is considered as a demonised version of miscegenation and the fate of his female companion related to fears generated by rebel female slaves. Her resurrection in Whale’s Bride of Frankenstein (1935) demonstrates how surgery can be used for sexual purposes in creating a female creature, as indicated by the film title.
having anyone know. They did the surgery. I woke up from anaesthesia at home. It was prohibited to stay in the hospital [for long]. Father: We paid a big amount of money just to let him go into the hospital for one hour to
5.1 There would be little support today, even from the most paternalistic doctor, 1 for the proposition that a sick adult should be compelled to accept whatever treatment his doctor thought best. No one suggests that adults who stay away from dentists out of childlike fear and to the detriment of their dental and general health should be rounded up and marched to the nearest dental surgery for forcible treatment. Few would deny the right of the adult Jehovah’s Witness to refuse a blood transfusion, 2 even if in doing so she forfeits her life. Medical
techniques. … And thus during the storm of war a new science was born – War Orthopaedics. This science blurred the sharp division between orthopaedics and surgery and therefore these boundaries had to be re-configured once again. (Dr Fritz Lange, The Handbook of Orthopaedics, 1922)2 In August 1914 the Munich orthopaedist Fritz Lange was dispatched to Cambrai in the north of France to work in a Bavarian Army field hospital. On his railway journey, he was waylaid unexpectedly in Zweibrücken, where local doctors pleaded with him to treat the wounded soldiers who had been
‘image operations’ by applying the same strategy of combining virtual reality systems, 3D modelling, robotics and real-time imaging to surgery. The vision pursued at the HIT lab and several other research labs, including the Stanford Research Institute (SRI), the Johns Hopkins Institute for Information Enhanced Medicine, the Mayo Clinic and the MIT Artificial Intelligence Laboratory, was heavily nurtured by funds from DARPA, the NIH and NASA. Dr Richard Satava, who spearheaded the DARPA programme, aimed to develop ‘telepresence’ workstations that would allow surgeons
that time. Contrary to the suggestions of other authors that, from that time DS_C07.indd 157 11/15/11 4:44 PM 158 doubting sex on, only gonads defined a person’s true sex (and we have already seen how complex such a criterion was in practice), I want to argue that within my source material the sex of self emerged at the exact same time when clinical practice enabled gonadal tissue to be excised and microscopically examined thanks to anaesthesia and surgery. From the 1900s onwards, the rationale of the gonadal body started to conflict with a rationale of sex as
quality of surgeries and playing an active part in shaping a wider trend involving doctors moving to health centres and using government funds to improve premises. The surgeries that many South Asian doctors found themselves based in as a result of the discrimination that they faced were in areas where historically there had been little investment in general practice and the quality of practice premises left much to be desired.3 This does not mean that these conditions were simply passively accepted by medical migrants. Their recollections at times indicate an element
on her unfaithful husband, defies her maker by remaking herself anew, not just psychically but also through plastic surgery. 12 The use of surgery as an instrument of pacification rather than empowerment, demonstrated by the sexual surgery carried out by Isaac Baker Brown, was symptomatic of the war on women waged in the operating theatre. Bogus medical theory and practice underpin this