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Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis a difficult and rarely uniform task. Currently, ASD is behaviorally diagnosed based on criteria defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Recently, a change was made in the criteria from more lenient criteria in DSM-IV-TR, to more narrow criteria laid out by the DSM-V, which supersedes the DSM-IV-TR. This drastic change raised many questions and debates about which set of criteria are better. The more lenient criteria offers a more inclusive diagnosis giving greater access to therapies; while the narrow diagnostic criteria excludes some individuals, creating a more uniform diagnosis that's easier to use in research. This thesis analyzes the change in diagnostic criteria from the DSM-IV-TR to the DSM-V and the effects of these changes on the practices of diagnosis. In addition, it explores the implications of this change for the families of children with autism and for those involved in autism research, examining their respective opinions and interests pertaining to narrow verses broad diagnostic criteria. Building on this analysis, the thesis offers recommendations about diagnostic criteria should be set. It argues that the wellbeing of patients takes priority over the interests of researchers, and thus diagnosis should be done in a way that offers the best prognosis for all children who suffer from autistic symptoms.
ContributorsBremer, Michelle Nichole (Author) / Hurlbut, Ben (Thesis director) / Robert, Jason (Committee member) / Brian, Jennifer (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
The concept of “good” research is concrete in terms of technique, but complex in theory. As technology advances, the complexity of problems we must solve also grows. Research is facing an ethical dilemma—which projects, applied or basic, should be funded. Research is no longer an isolated sector in society, and the decisions made inside of the laboratory are affecting the general public more directly than ever before. While there is no correct answer to what the future of research should be, it is clear that good research can no longer be only defined by the current classification system, which is rooted in antiquated, yet ingrained, social status distinctions.
Differences between basic and applied research were explored through a wet-lab case study. Vaccinia virus (VACV) infections are a prime model of the competition between a virus and its host. VACV contains a gene that is highly evasive of the host immune system, gene E3L. The protein encoded by E3L is E3, which contains two highly conserved regions, a C-terminus, and a N-terminus. While the C-terminus is well-understood, the mechanism by which the N-terminus grants IFN resistance was previously unknown. This project demonstrated that the N-terminus prevents the initiation of programmed necrosis through host-encoded cellular proteins RIP3 and DAI. These findings provide insight into the function of the N-terminus of E3, as well as the unique functions of induced programmed necrosis.
This project was an example of “basic” research. However, it highlights the interconnectivity of basic and applied research and the danger in isolating both projects and perspectives. It points to the difficult decisions that must be made in science, and the need for a better research classification system that considers what makes science “good” outside of antiquated social class ideologies that have shaped science since ancient Greece. While there are no easy answers to determine what makes research “good,” thinking critically about the types of research projects that will be pursued, and the effects that research has on both science and society, will raise awareness, initiate new conversations, and encourage more dialogue about science in the 21st century.
Differences between basic and applied research were explored through a wet-lab case study. Vaccinia virus (VACV) infections are a prime model of the competition between a virus and its host. VACV contains a gene that is highly evasive of the host immune system, gene E3L. The protein encoded by E3L is E3, which contains two highly conserved regions, a C-terminus, and a N-terminus. While the C-terminus is well-understood, the mechanism by which the N-terminus grants IFN resistance was previously unknown. This project demonstrated that the N-terminus prevents the initiation of programmed necrosis through host-encoded cellular proteins RIP3 and DAI. These findings provide insight into the function of the N-terminus of E3, as well as the unique functions of induced programmed necrosis.
This project was an example of “basic” research. However, it highlights the interconnectivity of basic and applied research and the danger in isolating both projects and perspectives. It points to the difficult decisions that must be made in science, and the need for a better research classification system that considers what makes science “good” outside of antiquated social class ideologies that have shaped science since ancient Greece. While there are no easy answers to determine what makes research “good,” thinking critically about the types of research projects that will be pursued, and the effects that research has on both science and society, will raise awareness, initiate new conversations, and encourage more dialogue about science in the 21st century.
ContributorsSnyder, Caroline Jane (Author) / Jacobs, Bertram (Thesis director) / Hurlbut, Ben (Committee member) / Mateusz, Szczerba (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation experiments ranging from 1944 to 1974. The goal of this thesis is to analyze the ways in which that committee formed moral evaluations and the extent to which its strategies related to a broader historical and philosophical discourse. Here I attempt to describe two specific techniques of simplification the committee deploys in order to make a retrospective moral analysis possible. Although the techniques comprise specific problems, frameworks, subjective perspectives, and conceptual links, their unifying principle is the field of choices the techniques produce. In the first technique I outline, I argue that by focusing on the problem of historical relativism, the committee gains a platform through which it would be granted flexibility in making a distinction between moral wrongdoing and blameworthiness. In the second technique of simplification I outline, I argue that the committee's incorporation of a principle to reduce uncertainty as an ethical aim allow it to establish new ways to reconcile scientific aims with moral responsibility. In addition to describing the structure of these techniques, I also demonstrate how they relate to the specific experiments the analysts aim to evaluate, using both the ACHRE experiments as well as the Nuremberg Trial experiments as my examples. My hope is not to show why a given committee made a particular moral evaluation, or to say whether a decision was right or wrong, but rather to illustrate how certain techniques open up a field of choices that allow moral analysts to form retrospective moral judgments.
ContributorsCirjan, Cristian (Author) / Hurlbut, Ben (Thesis director) / Humphrey, Ted (Committee member) / Zachary, Gregg (Committee member) / Barrett, The Honors College (Contributor)
Created2015-05