On deciding to have a lobotomy:either lobotomies were justified or decisions under risk should not always seek to maximise expected utility

In the 1940s and 1950s thousands of lobotomies were performed on people with mental disorders. These operations were known to be dangerous, but thought to offer great hope. Nowadays, the lobotomies of the 1940s and 1950s are widely condemned. The consensus is that the practitioners who employed them were, at best, misguided enthusiasts, or, at worst, evil. In this paper I employ standard decision theory to understand and assess shifts in the evaluation of lobotomy. Textbooks of medical decision making generally recommend that decisions under risk are made so as to maximise expected utility (MEU) I show that using this procedure suggests that the 1940s and 1950s practice of psychosurgery was justifiable. In making sense of this finding we have a choice: Either we can accept that psychosurgery was justified, in which case condemnation of the lobotomists is misplaced. Or, we can conclude that the use of formal decision procedures, such as MEU, is problematic

Giving voice: an oral history of speech and language therapy

© 2020 Royal College of Speech and Language Therapists Background: The Royal College of Speech and Language Therapists (RCSLT) celebrates its 75th anniversary in 2020. The historical study of speech and language therapy (SLT) has been very limited. A small number of publications have traced the changes in the profession over time, but to date there has been no comprehensive work undertaken to gain an insight into the experiences of UK speech therapists who entered the newly formed profession after 1945. Aims: To use an oral history methodology to explore the life stories of early members of the profession. Methods & Procedures: Participants were recruited through RCSLT networks. Interviews were held across England and Scotland. Conversations were audio recorded and analysed using thematic network analysis. Archive material was used to complement participants’ narratives. Outcomes & Results: Participants were 19 women who qualified between 1945 and 1968. Three global themes emerged: personal, professional and political stories. On a personal level, each reported steps towards autonomy and agency within the social constraints they experienced. Professionally, all commented on the vast expansion in the range of identifiable clinical fields between 1945, when the first participant qualified, and 2008, when the last participant retired. Politics and social policies impacted upon their lives and, sometimes to their surprise, the participants found themselves campaigning politically in pursuit of fairness for their profession. Conclusions & Implications: This paper offers a unique insight into the challenges and achievements participants experienced over their careers as early practitioners in the UK profession