21A.215 | Spring 2012 | Undergraduate

Disease and Health: Culture, Society, and Ethics

Assignments

There are three written assignments, two required rewrites, and one optional revision.

Paper 1 – Due Session 10

Many authors we’re reading in this course deal with the concept of disease as culturally constructed or socially produced… Read more

Paper 2 – Due Session 16

Write a paper on some feature of biomedicine that has recently changed (during the last 30 years) in a significant way… Read more

Paper 3 – Due Session 24

Choose a topic in the field of international health and write about it… Read more

Paper 3 Oral Presentations – Due Sessions 25 & 26

Projects will be presented during the final two class sessions.

Here are some pointers on class presentations… Read more

Sweeping Assertions

In your papers, watch unsupported assertions.

A phrase like “condition X is not found in other cultures where the body is seen differently” will have to be documented. This is a pretty tall order if you say “in other cultures”! If you introduce other cultures you will need to provide evidence. So I would say something like “in some other cultures” and choose one or two specific cultures and show the contrast. Sweeping, unsupported assertions weaken your argument.

Databases

Databases provide searchable collections or resources.

A good anthropology source (a searchable collection of articles from the top journals) is:

  • JSTOR.com
  • JSTOR will not supply the most recent journal issues.
  • Lexis-Nexis for newspaper and magazine articles.
  • Sociological Abstracts for sociology, including medical sociology
  • You may also want to consult the Proquest General Reference database for both magazine articles and peer reviewed articles.

Late Paper Policy

Remember, papers must be handed in ON TIME unless an arrangement has been made for an extension at least 24 hours ahead of due date and the new deadline is specified.

Late papers lose a letter grade of credit each day.

No exceptions—you may not be able to meet a paper deadline, but you certainly are capable of writing me and arranging a new deadline, at least 24 hours ahead of time.

It’s very important to keep agreements, and a paper due date is precisely that. If you find you cannot keep an agreement, then re-negotiate it. Don’t just disappear without contacting me (or anyone you’re in a relationship with); it’s immature, rude, and puts you in a bad light—unnecessarily, as all you need to do is re-negotiate.

7+ typed pages

Session 8: Topics discussed in class

Session 10: paper due

Session 12: paper returned

Session 14: Revision due

Many authors we’re reading in this course deal with the concept of disease as culturally constructed or socially produced. These concepts are briefly described in Hahn, pp. 77–8:

The culture of a society constructs the way societal members think and feel about sickness and healing. That is to say, the members of a society are taught by others about different sicknesses and their names, their characteristic symptoms and courses, their causes and mitigating circumstances, their cosmological and moral significance, and appropriate responses.

The metaphor of construction suggests that reality is a structure of ideas built by society through social interaction that may include informal as well as formal education. The reality constructed by society makes sense of the experience of sickness and healing to its members.

The social production of disease refers to all the ways in which beliefs and patterned relationships produce events of sickness1.

Choose an example that illustrates either the cultural construction or social production of a specific disease. The verbs that illustrate the main contrast between cultural construction and social production in the above text have been bolded. Social production analyzes disease happenings, events, behavior. Cultural construction analyzes ideas, beliefs, values, representations of and about disease.

You may choose a current example or a historical example.

Also tell us why you find this particular example especially worthy of analysis and discussion.

In addition to your argument, tell us how your analysis fits with, or departs from, a conventional biomedical understanding of the disease.

All papers must cite at least three outside sources. These can be scholarly journals and books, or newspapers and magazines. If you use Internet sources, make sure the sites chosen provide reliable and objective (i.e., unbiased) information. You may cite class readings as well, in addition to the outside sources. Try to read critically; looking for bias, missing information, or evidence that people interviewed are simply taken at their word.

You must adequately reference your sources; see note on plagiarism in the syllabus. Proper, comprehensive citation most definitely includes sources on the Web. Any text you use that is not written by you must be cited, no matter what form it comes in. If you have any questions about how to do this, see or write me.

Examples of cultural construction can be found in the Supplementary Reading section under that heading. Articles about social production can be found in Supplementary Reading as well; however they are also found under other headings.

A general rule: late papers are automatically marked down unless arrangements are made at least 24 hours before due date. An extension will be granted if the 24+ hour deadline is met and if you indicate the new due date.

The description of cultural construction in the Hahn reading is exactly what the assignment asks for. However, his discussion of social production and mediation has proved too complicated for students to work with. The definition of social production above includes both of Hahn’s concepts. It is basically an expanded notion of epidemiology—all of the social factors that produce incidents of disease (“disease events”). You know what epidemiology is—the study of disease rates in populations (and their causes). Social production looks at the social factors, as opposed to the biological/geological/meteorological, etc. ones.

1 “Social production” here is not identical to Hahn’s definition.

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Some pointers on class presentations:

  1. Work on PRESENTING your paper, rather than reading it to the class.
  2. Arrange one or two dress rehearsals, preferably with friends who can give you suggestions. If this is not possible, practice in front of a mirror, and set the timer.
  3. These are timed presentations and YOU WILL BE CUT OFF at 10 minutes. Students often don’t think running over will be a problem, but it often is—they tend to spend time at the beginning getting going, and then lose track of the time. Over the years I have seen many, many students say something like, “but I’ve only covered half of what I need to say!” If you want the person minding the stopwatch to alert you when you have 5 minutes, 2 minutes left, you can request this.
  4. It is fine to take less time—everyone appreciates a well-planned presentation that doesn’t waste anyone’s time.
  5. You do need to provide a COMPREHENSIVE PRESENTATION of your paper: describe the topic, discuss the materials you worked with, and present your findings. If you want to talk about why you chose the topic, fine. If you want to present a personal anecdote as an illustration, fine. But the bulk of the presentation should be about the issues and what you learned from reading your sources.
  6. Don’t cite the titles of your authors’ essays or books—first and last names (at first mention, thereafter only last name) are enough.
  7. Don’t adopt an “aw shucks,” purposely shy or humble manner, as your audience will not appreciate it. An overly informal style will weaken your impact, as it suggests a lack of preparation or that you’re not taking the task very seriously. Work on adopting a more formal style than you ordinarily use in your interactions. Wearing more formal clothes than you usually wear, while not a requirement, helps you get into the right frame of mind. Again, the best way to figure out your own formal style is to practice, preferably in front of one or two friends. One of them should keep time and cut you off at 10 minutes.

Most MIT students have not had much experience giving oral presentations. No matter what you do in life, you will be making presentations of one kind or another. Most of us, no matter how verbal we are in conversations, experience a bit of stage fright when we find ourselves actually facing an audience, even of our peers. Stage fright can be brought under control with practice. See this part of the CI-H requirement as an opportunity rather than something scary you’d just as soon not have to do.

You can give an oral presentation, an oral presentation with overhead slides, or a PowerPoint presentation.

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7+ typed pages

Session 16: paper due

Session 18: paper handed back

Session 20: revision due

Write a paper on some feature of biomedicine that has recently changed (during the last 30 years) in a significant way. Part of your analysis should involve the institutional context within which the change occurred/is occurring. You should at least touch on the following questions:

  • What are the causes of the change?
  • Are these causes mostly internal to biomedicine, or external?
  • Who are the actors most involved (both inside and outside of biomedicine)? (Keep in mind that actors can be both individual people and institutions.)
  • What is at stake for those actors most involved in the change?
  • At what sites are the changes occurring (e.g., private practice? medical schools? U.S. Congress?)?
  • What non-medical interests and institutions are involved in this change in a major way?
  • What moral and ethical issues are involved?
  • What major values are involved?
  • What are the likely consequences (the most significant ones) if the change becomes permanent?

One possible way to organize your essay is to analyze how this change is occurring in two countries.

Providing some history of the change is not required but very welcome.

Optional (and to be clearly differentiated from the analysis): your own opinion of this change, at the end of the paper.

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7–10 pages

Session 19: Topics discussed in class

Session 20: Optional draft due

Session 22: Optional draft handed back

Session 24: Paper due

Choose a topic in the field of international health and write about it. Describe the medical aspects of your topic, using technical language sparingly—write for a general audience (Uncle Joe). Then describe the main social, cultural, political, and economic factors that constitute its context.

As always, if you have opinions, you may write briefly about them, drawing a clear distinction between any advocacy language and your descriptive/analytical writing. It’s best to put opinions at the end of your paper if feasible.

The topic you choose should be amenable to a 7–10 page treatment. I can help you narrow or broaden it.

The way to go about choosing a topic (which is an integral part of the assignment) is to think about what interests you (guaranteed, SOMETHING in international health interests you). If you’re stumped, think about our readings. If you’re still stumped, browse through the topics in the “Supplementary Reading” section of the class website.

Papers may be about contemporary issues or historical ones.

Examples:

  • The introduction of some aspect of biomedicine in another country
  • International development efforts to improve public health in a country, or that country’s own efforts (e.g., improve nutrition, increase the number of hospital beds, teach about boiling water, supply clean water to an area suffering from water-borne diseases)
  • International health agencies like the World Health Organization
  • A Non-Governmental Organization—e.g., Doctors Without Borders, Partners in Health, The Smile Train
  • A Ministry of Health in another country
  • International pharmaceutical companies’ impact in an area of the world
  • Other health-related multinationals
  • A case involving a clash between biomedicine and local traditional healing systems
  • Campaigns to reduce incidence of or eradicate diseases, for example, yaws, smallpox, malaria, HIV/AIDS
  • A vaccination campaign

Any topic concerned with health in the international context is a possibility.

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Spring 2012
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