SCIENCE IN HUMAN CULTURE PROGRAM

Thesis Archive

SHC Senior Thesis Completed in 2016:

ERIK BAKER
"Ex Africa Semper Aliquid Novi: Consensus, Credibility, and Concern in the History of HIV/AIDS Origins Research"
Faculty Adviser: Steve Epstein, Sociology

Abstract: Since the beginning of the observed AIDS epidemic in the early 1980s, practically every community with a stake in understanding the disease has engaged in speculation, storytelling, rigorous investigation, and controversy about its origins. In this work, I investigate the history of scientific theorizing about the genesis of HIV, from the time of the discovery of the virus in the mid-1980s to the twenty-first-century emergence of an articulated consensus about how it arrived in human beings. Drawing on literature in science and technology studies about the closure of scientific controversies, “boundary work” and “boundary objects,” and the distinction between “matters of fact” and “matters of concern,” I analyze several major book-length treatments of the origins of HIV and their reception in both the scientific and popular press. I argue that the central event driving the emergence of a consensus was the 1999 publication of a book called The River by British journalist Edward Hooper, which argued that HIV was initially introduced to humans through oral polio vaccination campaigns in the Belgian Congo in the late 1950s. By showing how the scientific consensus on HIV origins arose as a result of mainstream scientists encountering and attempting to refute Hooper’s claims, I argue for the importance of acknowledging that “social” factors like struggles over credibility are constitutive of, rather than incidental to, scientific practice, and conclude that the scientific “facts of the matter” about the origins of HIV are thus inextricable from the network of human concerns in which they are embedded.

SHC Senior Thesis Completed in 2015:

ANNA CASSELL
“‘Something is Really Wrong’: Evaluating Concussions and Early Retirement in Women’s Collegiate Soccer”
Faculty Adviser: Mark Sheldon, Philosophy and Helen Schwartzman, Anthropology

Abstract: The topic of concussions has captured the attention of the American public. While most of the media discourse on concussions focuses on football, it is not the only major sport where concussions are both common and their effects devastating; women’s soccer is another sport in which concussions have become an increasingly problematic health concern. Indeed, countless female soccer players have suffered concussions, and growing number of women have had to leave the sport due to these injuries. Although concussions have become an increasingly common injury, there remains a great deal of uncertainty with regard to their diagnosis, treatment, and prognosis. Additionally, the way that scientific and medical information regarding concussions is communicated to players is wrought with ambiguity, which can make players’ medical decision-making especially challenging. My research brings an anthropological lens to the study of concussions sustained in women’s collegiate soccer. I do this by combining ethnographic research, specifically focused on the narratives of players who have had to medically retire from soccer, with an in depth evaluation of the NCAA’s “Sport-Related Concussion Guidelines, which are assessed in light of the most recent and relevant scientific and educational literature on this topic. My research suggests that there is a major lack of understanding about the long-term impacts of concussions at all levels, and when this is combined with player narratives, which indicate that players often do not report their concussions and continue to play or they lie about their symptoms in order to be cleared to play, it is obvious that “something is really wrong.” However, despite the severity of persistence of some of these long-term symptoms that can result from concussions, participation in collegiate soccer—and indeed all levels of soccer—has tremendous value for women and girls. The value of athletic participation that remains in spite of these injury risks compels this ultimate paper’s recommendations relating to improvements in the management of concussions in women's collegiate soccer.

SHC Senior Theses Completed in 2014:

Abstract: Following a revision of the FDA broadcast advertising regulations in 1997, the pharmaceutical industry turned its focus to advertising efforts that directly communicated with the patient. This focus on the patient had a significant impact on the clinical relationship as various political, economic, and medical actors debated whether this was in the patients’ best interest. I content analyzed congressional hearings from the 1970s to the late 2000s on the topic of direct-to-consumer advertising (DTCA), to examine how each of these parties exerted their credibility in the political arena. One of the most significant shifts in the debate was the decline in concern for the physician as the consumer and a rise in concern for the patient as the consumer. Along with this shift, there was a consistent discussion of what was in the best interest of the patient. This best interest was hedged on the availability of information/knowledge, good science, physicians’ objectivity, and cost, yet participants turned to these tropes differentially. Their engagements in the DTCA debate revealed an enduring connection between public health, science, and regulation.

Abstract: The purpose of this study is to understand the views of scientists as they relate to the ethics of using animals in research. To gather the perspectives of scientists on this topic, interviews were conducted with sixteen Northwestern University scientists who have used animals in their research. After presenting various moral frameworks within which one can reason about animal ethics, comments from the interviews were then compared with philosophical arguments made by certain ethicists. This thesis shows that, not only do different scientists think about animal ethics within different moral frameworks, but scientists also have drastically different ideas pertaining to the nature of morality itself. In addition, scientists ascribe moral relevance to a vast range of characteristics, and they also self-report many different sources of beliefs when it comes to animal ethics. All in all, this thesis demonstrates the wide array of views held by scientists on the ethics of using animals in research.

Abstract: While a great deal of literature has examined the impact of electronic medical records (EMR) on patient-doctor communication, little has discussed the impact on doctor-doctor communication. However, doctors often consult one another on cases and those patients who are under the care of a team of doctors (either from the same or different fields) are typically those who are the most ill and would benefit from effective communication between their doctors. One of the most common collaborations between doctors is that of the surgeon and referring physician, who together must assess whether the patient requires surgery and if so what type he/she is best suited for. This paper explores how EMR shapes physician-surgeon communication about and collaboration on patient care. Seven surgeons and eleven physicians participated in 30-minute semi-structured interviews concerning if and how they use EMR to refer a patient for surgery and communicate patient information to other healthcare providers pre-operation and postoperation. This study is not intended to measure the qualitative outcomes of patients, but rather outline the communication of patient information inside and outside the EMR. Based on the interviews conducted, doctors were found to rely more heavily on communication of patient information outside the EMR due to the widespread perception that EMR is intended to streamline billing rather than document diagnostic impressions or coordinate care. In response to this, I propose the addition of an annotation mechanism in the EMR to encourage doctors to communicate their thought processes and recommendations for future steps.

SHC Senior Theses Completed in 2012:

Abstract:
Although Asian Americans are the fastest growing racial group in the United States, this population has been one of the most poorly understood minorities in terms of qualitative health research—this is in part due to the influence of the 'model minority myth,' which suggests that Asian Americans' health does not need additional attention (Kwan and Au, 2010). This article describes a research project that implemented the Photovoice method to examine the lives of four Asian American adults living with visually identifiable disabilities. Specifically, this project aimed to examine the influences on each individual's understanding of disability as well as how these understandings of disability shaped each individual's health perceptions.

The participants, all first generation immigrants from China or Taiwan, each expressed a hybrid model of understanding disability, building upon East Asian conceptions of disability with their cultural and social experiences in America. The results of this project illustrate the importance of personal understandings of disability—as shaped by cultural, religious, and social roots as well as immigration status—as a framework for personal health beliefs. For participants, the social consequence of functional conditions served to determine personal perceptions of health. Furthermore, the results emphasize the importance of engaging with the disability experiences of minorities with disabilities, especially within the context of the ongoing American Disability Rights Movement. This article will also comment on the strengths and limitations of Photovoice as an interview method among this research population of Asian American adults with disabilities.

Abstract:
This thesis examines the ways in which women use storytelling to shape their experiences with abortion and address the associated stigma. The Internet is rife with digital story banks containing user-submitted narratives of abortion. Though similar in format, these story banks vary widely in overall purpose, with those found on pro-choice activist sites serving largely as a vehicle for pro-choice movement rhetoric and those that are independent and ideologically unaffiliated acting as a space for individual sharing and reflection. To explore the ways in which narratives of each type address abortion stigma, this research focuses on a selection of stories from the activist NARAL story bank and the independent Project Voice.

In each group, this thesis tracks how authors handle the themes of 1) motherhood and family, 2) guilt and regret, 3) anti-abortion sentiment, 4) sexual responsibility, and 5) "hard" reasons for abortion, a term that includes those procedures undergone for rape or out of medical necessity. In the ways that women handle each of these key themes, they work to portray their procedures in terms of responsibility; however, NARAL authors assert responsibility to a cause and a generation of women, while Project Voice authors consider responsibility in terms of abortion's impact on their personal relationships. In this way, the outside party to whom each storyteller claims responsibility is determined by the degree of social value each storyteller stands to lose through stigma. Across these two models of responsibility, both groups of women work to combat the stigma linked to abortion by framing the procedure in terms of good done for others. More generally, the research demonstrates the power of publicly shared experiential narratives in deflecting stigma, asserting political claims and shaping identity.

Other Recent Senior Theses in SHC:

Questions and Further Information

If you have any questions about the program, or simply wish to discuss possible topics, feel free to contact the SHC director at shc-dir@northwestern.edu.