B09: Tutorial 2 – Brief Summary

In future weeks, summaries will be less detailed as you have more opportunities to form connections with peers in the class and develop resources together (and my ability to type things out each week will differ). As a reminder, collaborative note taking and study groups are things I consider toward styles of participation and engagement.

Outline for tutorials:

  • Admin things
    • Light sensitivity: some have written to me that they are light sensitive or otherwise find the room too bright. Unfortunately, there is only one switch in the room and it controls all the lights, so my plan to have only some lights on (or designate lower light areas of the room) is unsuccessful. If you have suggestions on how we can manage this, please let me know
    • Strike: monitor front page for updates as I get them.
    • Readings: there is a lot of content in many of the chapters we’ve had assigned, and not all of it is required for this course. My suggestion: try skimming the assigned material before lecture, and then use the lecture and slides to inform your focus for a closer and more careful reading of the most important parts of the texts. This will help you manage time better, and get a better sense of what to focus on, and will usually help answer some of your questions about the slides (since what’s written on the slides are usually briefer forms of what is also said in the text)
    • Assignments: Lots of questions about assignments: I don’t have info about these yet. Once I do we’ll start developing resources. Ask the prof for any questions in the meanwhile.
    • Office hours: I’ll send out a survey later this week now that I have access to your email addresses, to decide when/how to hold office hours.
  • Summary: I provided a brief summary of Thursday’s lecture/content.
  • Discussion sheets: The following sub-bullets include the text from the discussion sheets.
    • This sheet is meant to guide and prompt discussion together. You don’t need to hand it in if you don’t want. You don’t need to write all answers. You can use it to fidget, doodle, read your thoughts from, whatever. You can write on the back, sides, extra paper, wherever. C has extra pens if you need to borrow one.
    • Today’s questions focus on about what “health” could mean. The questions are broad to encourage different ways of thinking and understanding and approaching the questions. This will support and complicate our readings and conversations over the term, and will set us on the path toward our final course topic: what is disease? Biomedical ethics is applied ethics, so this also helps us explore the context of application for the theories we will learn in the next few weeks.
    • #1 Reflect: What does the word or idea of “health” mean to you? (Or: what is your relationship to the idea of health?)
    • #2 Evaluate: The World Health Organization (WHO) has defined human health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Is this different from your own thoughts on what health is? Are there any issues with the WHO account?
    • #3 Connect: What could thinking about how to understand “health” teach us about how we should think or act in medicine, public or global health, or bioethics? About what is “right” or “wrong” to do?
  • Closing remarks: We wrapped up from small group discussions with opportunities for class-wide comments. C then offered some closing comments around the WHO definition to get us thinking further, drawing from broader critical health conversations that have been had. Some rough examples of things mentioned include:
    • Is health a state, or also a process or activity? Something we have or do?
    • What does “well-being” mean? How is this any different from just saying “health” again? (Physical health, mental health, social health).
    • Can anyone ever have complete well-being, enough to be healthy on this definition? Consider: most people have had Chickenpox (vericella), which is a strand of Herpes (varicella zoster virus or VSV). VSV remains in our systems and can re-emerge as shingles (herpes zoster). If more people have herpes (and cold sores are also often caused by herpes strands like HSV1 and HSV2) and a majority of people have other persistent viral infections (most people have or will have one of more than 170 strands of human papillomavirus (HPV), which can be communicated through sexual interactions and pregnancy), then are any of us ever fully healthy? What about those of old age whose bodies are variously deteriorating? Or those with congenital (means present at birth) or chronic (ongoing or lifelong) illnesses, disorders, disabilities, or diseases?
    • Can this translate to policy and action? How can this inform healthcare?
    • What about other aspects of things that seem to inform health, like environmental well-being, spiritual well-being? What about wealth and social and material capital? (Think of Chemical Valley in Ontario, of correlations between “fertility” and air pollution, of the cost of healthcare in Canada and abroad, of spiritual understandings of the self within and beyond Western Judeo-Christian theologies…)
    • [mentions of racism, sexism, ableism (and slur mention), violence, medical abuse, sexual assault] What does “social well-being” mean in relation to social norms, when norms of what social well-being might look like are often informed by systems of domination or oppression? For example, the ways that enslaved people’s low-energy or attempts to escape were medicalized as drapetomania or dysaesthesia aethiopica against social norms (to be “treated” or “cured” with whippings); how Black political protestors were diagnosed with schizophrenia in Ionia Michigan (or вялотекущая шизофрения or slow progressive schizophrenia for political dissenters in Russia) because of their potentially “violent” ideas or actions; how women’s dissent against patriarchal home and political systems was often medicalized as hysteria to be treated with institutional sexual assault and confinement (and how the term is still used as a pejorative adjective today); how those with learning disabilities and developmental disorders were diagnosed as morons, imbeciles, idiots, (later replaced with mental retardation after those original terms were deemed too awful and stigmatized, despite our willingness to still use them today) and how this posed grounds for involuntary sterilization (including in Canada until only a few decades ago)?
    • And how do we reconcile these worries about how vague definitions can enable medical violence, with the feeling that maybe we can’t actually be fully healthy under oppression (both metaphorically as human health and personal flourishing, and literally due to social determinants of health like stigmatization, risk of violence and abuse, microaggressions, socioeconomic determinants of health)?
    • Where do we fit things like intergenerational trauma’s impacts on health in this definition?
    • Should we think of “healthy” or “standards of health” as different for different places and cultures? What does this mean when we think of global or international health, and international aid initiatives and international medical research ethics? Whose “healthy” should we abide by? Whose norms of diagnoses?
    • How does health as normal or desirable inform the ways we think about those with less access to health resources, those with congenital and chronic conditions, living as disabled or disfigured? What kinds of health and treatments are prioritized here?
    • (How) does this treat humans as distinct from other kinds of things or creatures?
    • A few other quotes I shared: (may be rephrased from original)
      • Rene Leriche (~1936): Health is “life lived in the silence of the organs”
      • HansGeorg Gadamer (~1993): “Health is not something that is revealed through investigation but rather something that manifests itself precisely by virtue of escaping our attention [… It] belongs to that miraculous capacity we have to forget ourselves”
      • Eli Clare (2017): Lots of good discussions in his book Brilliant Imperfection that challenges, complicates, and explores the idea of “cure” and the “normal”
      • Robert Crawford (1980): Credited with coining the term “healthism”, which is used to describe ideologies around health as morally good, desirable, a personal responsibility, and focuses on the roles of individuals’ responsibilities for health behaviours in ways that obscure broader systems’ impacts on the ability or desirability to pursue those activities (the term is found most often in academic fat studies and disability studies, and used differently by different people)

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