From Goya to Afghanistan. An essay on the ratio and ethics of medical war pictures

For centuries pictures of the dead and wounded have been part and parcel of war communications. Often the intentions were clear, ranging from medical instructions to anti-war protests. The public's response could coincide with or diverge from the publisher's intention. Following the invention of photography in the nineteenth century, and the subsequent claim of realism, the veracity of medical war images became more complex. Analysing and understanding such photographs have become an ethical obligation with democratic implications. We performed a multidisciplinary analysis of War Surgery (2008), a book containing harsh, full-colour photographs of mutilated soldiers from the Iraq and Afghanistan wars. Our analysis shows that, within the medical context, this book is a major step forward in medical war communication and documentation. In the military context the book can be conceived as an attempt to put matters right given the enormous sacrifice some individuals have suffered. For the public, the relationship between the 'reality' and 'truth' of such photographs is ambiguous, because only looking at the photographs without reading the medical context is limiting. If the observer is not familiar with medical practice, it is difficult for him to fully assess, signify and acknowledge the value and relevance of this book. We therefore assert the importance of the role of professionals and those in the humanities in particular in educating the public and initiating debate. © 2010 Taylor & Francis

Inleiding: Het medische verhaal en plein public. Geschiedenis van de medische publiekscommunicatie

Wantin

‘Margriet weet raad op nervositeit’. Medische betekenistoekenning aan ‘levensmoeilijkheden’ in het vrouwenblad Margriet 1950-1960

Medical communication about the management of depression, anxiety and sleeplessness in the Dutch women's magazine 'Margriet' between 1930 and 1960 The reporting of health and medicine in the media played an important role in the way people perceived, defined and coped with everyday health problems in the second half of the twentieth century. It was and still is predominantly a supply-market which is dominated by the medical approach; creating a medical aura of progress and the self-evidence of a cure. Although the medical approach figured also prominently in women's magazines, the reporting of illness and health is far more a product of supply and demand with a lively interaction between readers and the editorial office by the means of topic-related letter columns. As such women's magazines not only offer a gender-specific but also a more balanced source for acquiring a better understanding of how public definitions and perceptions of illness and health changed over time. In this article we will focus on the communication about the management of health problems related to depression, anxiety and sleeplessness in the prototypical Dutch women's magazine 'Margriet' between 1950 and i960. Our guiding research question has been: How do notions about depression, anxiety and sleeplessness and about responsive health behaviour, of which psychotropic drug use is a part, change over time in the reporting of health problems in Margriet? This question is of particular interest to learn more about the historical dynamics of the culture- and gender-specific public interplay between patients and doctors in terms of conceptualising the aforementioned health problems and defining medical coping strategies. Among other things we show that although there was hardly any mention of any 'functional division of labour' between mind and body in 1950, the mind-body dichotomy started to play an important role in the way health problems were perceived in i960

End-user involvement in developing and field testing an online contraceptive decision aid

Objectives: Decision aids in the field of healthcare contribute to informed decision making. To increase the usefulness and effectiveness of decision aids, it is important to involve end-users in the development of these tools. This article reports on the development of an online contraceptive decision aid. Methods: An exploratory, qualitative study was conducted in the Netherlands between 2014 and 2016. The development process of the decision aid consisted of six steps and included a needs assessment and field test. Interviews were conducted with 17 female students. Results: The needs assessment provided information on the preferred content and structure of a contraceptive decision aid and guided the development of the online contraceptive decision aid prototype. Participants had an overall positive impression of the decision aid prototype during the field test. Minor revisions were made based on participants’ feedback. Participants expected that the decision aid would positively contribute to decision making by increasing knowledge and awareness regarding the available contraceptive methods and their features and attributes, and by opening up to other options than the known methods. Conclusion: The developed contraceptive decision aid can contribute to better informed decision making and consultation preparation. Involving end-users in development seems valuable to adapt decision aids to specific needs and to identify in what way a decision aid influences decision making

Heredity and predictive testing of alcoholism: An exploratory study of the views of Dutch alcoholics, at-risk drinkers, and health care providers

Genetic knowledge and technologies are rapidly advancing. In order to translate this knowledge into public health interventions, it is essential to assess stakeholders' understanding, attitudes, and views. In this study we explored the views of 26 Dutch (former) alcoholics, at-risk drinkers, and substance abuse disorder service providers on the heredity of alcoholism and on predictive testing. Participants, recruited in two Dutch cities, were administered semi-structured interviews, which were analyzed using Interpretative Phenomenological Analysis. Our findings show a heterogeneous understanding of "alcoholism," risk prediction and interventions. Whereas service providers are skeptical towards predictive testing for alcoholism, self-identified alcoholics appear to be more positive. Alcoholics and risk drinkers categorize themselves into two distinct groups according to their perception of the role of heredity in the etiology of their alcohol abuse. Having a family history of substance abuse increased interest in having a genetic test. Our findings also indicate that knowledge of risk status does not automatically lead to an intention to change behavior. Health education and communication regarding the genetics of alcoholism should be targeted and tailored to the backgrounds and views of target groups

Dialogue guides awareness and understanding of science: an essay on different goals of dialogue leading to different science communication approaches

Dialogue has become a buzzword in science communication. Many governmental initiatives involving information transfer use dialogue as a selling point. We have, for example, a dialogue on genetic manipulation, a dialogue on the scientific future of Europe, a dialogue on food safety. Dialogue has almost become a communication target on its own, beside such things as public understanding or awareness of science. Dialogue is, however, just a technique, a method that can be used in any modality of science communication to serve any of its goals. New developments in the growing use of dialogue should therefore be considered as part of science communication as a whole. In this essay we discuss the various operationalizations of dialogue for different science communication modalities and goals, based on different notions of science. Dialogue offers various possibilities for science communication. There is an important difference between dialogue with a functional goal and dialogue with a conceptual goal. This distinction and its implications are based on our recent study on effective biomedical science communication on predictive DNA diagnostics