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Lecture 12

HMED 3075 Lecture Notes - Lecture 12: Reproductive Health, Orphan Drug Act Of 1983, National Institutes Of Health

History of Medicine
Course Code
HMED 3075
Tobbell D

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HMED 3075 Lecture Notes 10/26 Technology and Patient Identity
Le cture : The Patient in 20th ce ntury America n Me dicine
Re a d in g : Shelley McKellar, “Limitations Exposed: Willem J. Kolff and his Contentious Pursuit of a
Mechanical Heart.
Th e p a tie n t in 19th Ce n tu ry America
Physicians expe cte d patients to be complia nt
The y re lie d on pa tie nts de scription of his /her s ymptoms
o Depended on the physician’s ability to listen to the patient
o The y could dia gnose a nd tre a t through the mail
o Ta ilored treatme nts individually to the pa tie nts
Middle cla ss a mericans with chronic illne s ses could be come very knowle dge able about their
o “Expert patient” would question the physician and consider changing caretaker if they
didn’t like the treatment
Th e p a tie n t a t the turn of th e 20th century
New diagnostic techs diminished importance of patient’s self-reported symptoms
Increasing gap between physician’s technical knowledge and patients knowledge
Physicians expe cte d greater de fe re nce and complia nce
o Patie nts continue d to ask que s tions a nd compla in.
o Sought a lte rna tive he ale rs ex. home opa ths , chiropra ctors , a nd midwive s .
Ch ildbirth in the e a rly 20th c e n tury ho s pita l
19th ce ntury childbirth
o Home birth with midwives. Woma n controlled.
o Pain, s uffe ring, a nd dangerous . Minimal role for physicia ns .
By e a rly 20th ce ntury, ne w technologie s and te chnique s
o Ane s the s ia , force ps , s te rile techniques, and surgica l intervention
o Provided by the mode rn hospital
Childbirth moves to the hos pital (by choice of mothe rs)
o Women sought relie f from pa in, suffe ring and da nge rs
o Phys icia n-controlle d; childbirth is medicalized
o Los s of pa tient autonomy
Th e American P a tient at Mid -Ce n tu ry
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