Instructor: Judy Segal
Meets: Thursdays 2:00-5:00pm
This course will consider how practical truth is negotiated when medical matters we may wish were just resolved, scientifically and for good, turn out to be not resolved at all. Central to the course are questions of medical doubt and uncertainty.
How is medical uncertainty handled in an age of consumer choice—an age with relatively untested, and unstable, economies of information, expertise, and trust? What sorts of arguments are made in debates about public and individual health? How do experts, and what kind of experts, decide who is eligible for what tests, what diagnoses, and what treatments?
Our readings will be on medical dissonance. We will read Annemarie Mol on the logic of care and the logic of choice, when a rhetoric of neoliberalism comes up against good reasons for preferring care to choice. We will read Catherine Belling on the arguments of physicians and the arguments of patients, Belling using hypochondria as a trope for all that is uncertain in a medical/medicalized world. We will read Eve Ensler on the logic of the personal and the logic of the global, as (unlike most cancer narrators) she views her own cancer as occurring “in the body of the world.”
Some medical debates gain particular traction in the public realm: commentators discuss the value of annual mammograms and the value of prophylactic mastectomies; we read about the autism/childhood vaccination “debate,” although there is no scientific evidence to support a causal link between vaccination and the onset of autism. Online disputes are underway on the rightness and wrongness of changes to psychiatric diagnostic categories with the publication of the DSM 5 in 2013, the fifth, and first publically controversial, edition of the Diagnostic and Statistical Manual of Mental Disorders.
More reading will inform our exploration. Jonathan Metzl and Anna Kirkland have collected essays on the disputable nature of “health” itself. Joseph Dumit writes about the mostly (so far) uncontested problem of pharmaceuticals taken “for life”; Alan Cassels unfolds disagreements about the usefulness of screening programs, and, in particular, queries the status of the claim that early diagnosis=cure. Colleen Derkatch explores the way conventional western medicine has embraced, but not embraced (has disputed), complementary and alternative medicine.
Leah Ceccarelli, Celeste Condit, Kimberly Emmons, Lisa Keränan, Amy Koerber, and Karen Kopelson and are among the scholars provide rhetorical-theoretical frameworks for understanding scientific controversy and its medical examples.
Medical disputes may be approached from various theories and methodologies suggested by the disciplines constituting Science and Technology Studies. This course will use rhetoric as one lens for viewing such disputes, acknowledging that they are discursive (though not only discursive) all the way down.
No prior work in rhetoric is expected from students who wish to register for this course.
Students will do seminar presentations (on the model of conference papers) and will write essays (on the model of journal articles). Seminar participation will include coming to class prepared with discussion questions on the readings.
Seminar presentation – 30%
Term paper – 50%
Seminar participation – 20%
Partial list of readings:
Catherine Belling, excerpts from A Condition of Doubt: The Meanings of Hypochondria (Oxford 2012)
Alan Cassels, excerpts from Seeking Sickness: Medical Screening and the Misguided Hunt for Disease (Greystone 2012)
Leah Ceccarelli, “Manufactured Controversy: Science, Rhetoric, and Public Debate.” Rhetoric and Public Affairs, 2011
Celeste Condit, “Two Sides to Every Question: The Impact of News Formulas on Abortion Policy Options.” Argumentation, 1994
Colleen Derkatch, “Demarcating Medicine’s Boundaries: Constituting and Categorizing in the Journals of the American Medical Association. Technical Communication Quarterly, 2012
Joseph Dumit, excerpts from Drugs for Life: How Pharmaceutical Companies Define Our Health (Duke 2012)
Kimberly Emmons, excerpts from Black Dogs and Blue Words: Depression and Gender in the Age of Self-Care (Rutgers 2010)
Eve Ensler, excerpts from In the Body of the World: A Memoir (Random House, 2013)
Lisa Keränen, excerpts from Scientific Characters: Rhetoric, Politics, and Trust in Breast Cancer Research (Alabama 2010)
Amy Koerber, excerpts from Breast or Bottle?: Contemporary Controversies in Infant- Feeding Policy and Practice (South Carolina 2013)
Karen Kopelson, “Risky Appeals: Recruiting to the Environmental Breast Cancer Movement in the Age of ‘Pink Fatigue’” Rhetoric Society Quarterly, 2013
Jonathan Metzl and Anna Kirkland, eds. Against Health: How Health Became the New Morality (NYU 2010)
Annemarie Mol, excerpts from The Logic of Care: Health and the Problem of Patient Choice (Routledge 2008)