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Public Health and Social Justice: Linking Sciences and Humanities

Explore the intersection of public health and social justice, addressing issues such as access to care, poverty's impact, pharmaceutical industry influence, women's rights, homelessness, medical mistakes, human subject experimentation, environmental degradation, and social inequality.

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Public Health and Social Justice: Linking Sciences and Humanities

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  1. Public Health and Social Justice:Linking the Sciences and Humanities Martin Donohoe, MD, FACP

  2. Overview • Issues • Literature and Public Health • Quotes • Photos • Education, the media, and democracy • Time Permitting • Case Study in Institutional Ethics: • GE – NY Presbyterian Hospital agreement

  3. Portland, OregonMount Hood

  4. Multnomah Falls, Oregon

  5. Am I Stoned? A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues”

  6. Martin Luther King “Injustice anywhere is a threat to justice everywhere”

  7. Harvey Cushing “A physician is obligated to consider more than a diseased organ, more even than the whole man. He must view the man in his world.”

  8. Medicine and Public Health • Schism between the fields • Witnessed victims vs. “statistical” victims • Medical ethics / public health ethics • Activism

  9. Important Historical Figures in Medicine/Public Health and Social Justice • Florence Nightingale • Clara Barton • Margaret Sanger • Thomas Hodgkin • Albert Schweitzer

  10. Important Historical Figures in Medicine/Public Health and Social Justice • Charles Dickens • Anton Chekhov • Upton Sinclair • George Orwell • William Carlos Williams

  11. Rudolph Virchow • Founder of modern pathology • Thrombosis, pulmonary embolism, leukocytosis, leukemia • Member of state and local government for over 30 years • Founded journal Medical Reform

  12. Rudolph Virchow • Argued that many diseases result from “the unequal distribution of civilization’s advantages” • Advocated public provision of medical care for the indigent • Promoted universal education

  13. Rudolph Virchow • Worked to outlaw child labor • Improved water distribution and sewage system • Enhanced food inspection process • Published study of skull volumes to dispute myth of larger Aryan brains

  14. Rudolph Virchow • Passed hygiene standards for public schools • Set new standards of training for nurses • Improved local hospital system

  15. Rudolph Virchow “Doctors are natural attorneys for the poor … If medicine is to really accomplish its great task, it must intervene in political and social life…”

  16. Issues • Access to care • Racial, sexual and SES discrepancies in outcomes • The effects of poverty on health

  17. Issues • Corporatization of academic and clinical medicine • Boutique Medicine • Outsourcing of medical care • Developing world brain drain

  18. Issues • The role of the pharmaceutical industry • Drug promotion and advertising • Drug pricing • Conflicts of interest • Balancing responsibilities to self, patients, insurers, colleagues, and community

  19. Issues • Women’s rights issues: • Violence against women • Teen pregnancy • Female genital mutilation • Political, legal, and educational marginalization • Sexual harassment

  20. Issues • Homelessness • Substance abuse • Tobacco industry • Privacy: • Genetic testing • Drug testing

  21. Issues • Medical mistakes • Impaired providers • Health care fraud

  22. Issues • Human subject experimentation • Nazis, Japan’s Unit 731 • Tuskegee Syphilis Study • Willowbrook Hepatitis Experiments • Henry Beecher • U.S. government-sponsored radiation experiments • Nuremberg Code, Helsinki Conventions

  23. Issues • Human Subject Experimentation - Contemporary Issues: • Special populations (e.g., prisoners, cultural minorities, the mentally ill) • Internationalization of research • Use of placebo controls • The role of for-profit IRBs • cloning

  24. Issues • Environmental degradation • Overpopulation • Air and water pollution • Toxins • Deforestation • Global warming • Unsustainable agricultural and fishing practices • Famine • GMOs, biopharming, and rBGH

  25. Air Pollution

  26. Air Pollution

  27. Air Pollution

  28. Water Pollution:Bathtub=Toilet=Source of Drinking Water

  29. Deforestation:Clear Cutting with Corridors

  30. Minimata DiseaseW Eugene Smith

  31. Greenland’s Ice Cap Melting: 1992

  32. Greenland’s Ice Cap Melting: 2002

  33. Greenland’s Ice Cap Melting: 2005

  34. Glaciers Calving

  35. Drought

  36. Factory Farming

  37. Factory Farming

  38. Overfishing:Factory Trawlers

  39. Dynamite Reef Fishing

  40. Issues • Environmental degradation – social justice contributors: • Species loss • Third World debt crisis • Human rights abuses

  41. Polar Bears Stranded / Dying Off

  42. A Cure for Cancer?

  43. Wallace Stegner “We simply need … wild country available to us, even if we never do more than drive to its edge and look in. For it can be a means of reassuring ourselves of our sanity as creatures, a part of the geography of hope”

  44. Issues • Social justice: • Overconsumption (“affluenza”) • Maldistribution of wealth • Rise of the corporation

  45. George Orwell “Some people are more equal than others”

  46. Voltaire “The comfort of the rich rests upon an abundance of the poor”

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