Heiner Fangerau

The COVID-19 pandemic has exacerbated and magnified the vulnerability of convicts, psychiatric patients, elderly and disabled people in need of care, and children in institutional care or custody. Taking the move from the media coverage of “Total Institutions” during the pandemic, this paper explores the ways in which Goffman’s concept was mobilised in the public discourse to raise awareness of the extreme predicament of these vulnerable groups, as well as of the whole locked-down society. Whereas the metaphoric expansion of this terminus technicus to cover the whole community under lockdown threatens to dilute its specific meaning and overshadow the special vulnerability of inmates, we argue that the feeling of shared experience of “totalisation” bears a transformative potential. The possibility of taking stock of the multilayeredness (cognitive, rational, emotional) of the shared experience may enable collective cognizance of the structural roots of special vulnerability, thriving in the extant total institutions.

During the nineteenth century physiologists and clinicians developed several graphical recording systems for the mechanical registration of heart sounds. However, none of these replaced traditional methods of auscultation. The paper describes criticism of the aural sense as one of the driving forces behind the development of phonocardiography and analyses its variants from a technological and clinical perspective. Against the background of the physiological “method of curves,” the parameters that prevented the implementation of phonocardiography against overwhelming odds are highlighted. Contemporaries denied specific evidence beyond auscultation. Many clinicians also feared that the art of auscultation was being undermined by the new, reproducible mechanical methods. The paper argues that phonocardiography was on the one hand regarded as impractical in clinical settings; on the other hand—and even more important—implicit practices, tacit knowledge and cultural models fostered skepticism against the new method. The argument of “self-evidence”—often connected to medical images, curves, graphs or tables—was not valid for the visualization of cardiac sounds in the opinion of the promoters of acoustic heart sound registration and its individual interpretation. Rather, the acts of subjective hearing and objectively reporting what was heard seemed “self-evident” for pathophysiological characteristics and the development of a diagnosis. Therefore, auscultation and phonocardiography coexisted with different emphases. While auscultation remained the method of choice for a bedside diagnosis, phonocardiography played its role in differential diagnostics or research settings.

Kaum ein Thema scheint im privaten wie gesellschaftlichen Leben so umstritten zu sein wie die gesunde Lebensfuhrung - Pravention ist ein Kampfplatz von politischen Steuerungsinteressen, okonomischem Kalkul und weltanschaulichen Positionen. Durch die Aufarbeitung der soziohistorischen Entwicklung verschiedener Praventionsverstandnisse tragt dieser interdisziplinare Sammelband zu einem umfassenden Verstandnis von Gesundheitsfursorge und -vorsorge bei und lasst die politischen, soziologischen, rechtlichen und philosophischen Aspekte klar hervortreten.

Alter, Altern, Zeitlichkeit und Geschichte sind eng miteinander verwoben. Nur ein irgendwie geartetes Verständnis der Zeit und ihres Verstreichens erlaubt es überhaupt, Altern als einen Prozess zu beschreiben, der unaufhörlich mit dem Beginn der Existenz eines belebten oder unbelebten Objekts beginnt und chronologisch voranschreitet. Nicht notwendiger Weise ist dieser Prozess von einem Aufeinanderfolgen von Ereignissen begleitet, die positive oder negative Effekte auf das alternde Objekt ausüben, wie sie sich beispielsweise in Lernprozessen oder einer verminderten Resistenz gegen Schädigungen ausdrücken könnten.

Sowohl auf der Ebene der Konzepte von Gesundheit und Krankheit als auch auf der Ebene der Personen, die miteinander in medizinischem Kontext in Kontakt stehen, spielt Anerkennung eine Rolle in der Medizin. Im Beitrag werden drei wesentliche Ebenen der Anerkennung in der Medizin betrachtet: a) Die Anerkennung von Krankheits-/Gesundheits-/Diagnostik- und Therapiekonzepten, b) die Anerkennung des Anderen in der Arzt-Patient-Beziehung, c) die Anerkennung von Kolleginnen und Kollegen innerhalb der medizinischen Professionen.

By revisiting some of the main concepts surrounding the rationale of our work, this introduction further explores the topic implicit in our book’s title. In other words, this introduction develops the argument that, given its authoritative voice, biomedical knowledge not only has been influential with cultural producers but that it also plays a major role in creating expectation and meaning for the general public. Video games, TV series, novels and even art: all those products can, in a way, be affected by biomedical and scientific knowledge. As such, the consumption of those artefacts, coupled with the anticipation created by it, may serve as a proxy for how people comprehend and understand this particular area of scientific production. Here we also emphasise that the influence of biomedicine on culture is not a one-way process. Given that specialists and researchers are also consumers, the opposite is also true: cultural products, then, may also inform biomedical knowledge. Finally, at the end of this introduction, we discuss our chapter’s threefold division. Since this book intends to introduce our topic to a wider audience, we present it from a multidisciplinary point of view whilst providing our reader with particular examples in the form of focused case studies and larger historical and social perspectives.

The historical development of so-called ‘biomedicine’ is closely linked to the rise and evolution of new ethical fields, such as bioethics and medical ethics. In this chapter, we explain what is understood by ‘biomedicine’ today, highlight the major steps in the development of biomedicine, and discuss its association with the evolution of basic ethical theories into applied ethical arguments. Both biomedicine and bioethics have left their traces and were transformed in popular cultural products, including games and film. We will show how bioethics and biomedicine can be used to analyse these products and reveal their potential contributions to actual debates about the problems, fears, and hopes associated with certain biomedical technologies — debates that are set within the triad of biomedicine, bioethical reasoning, and popular culture.

Representations of medicine in pop culture often have an iconographic character. Thereby, they set in a double sense of self-evidence. They represent on the one hand, self-evidently a medical context, and on the other hand, they act to transport or at least illustrate self-evident medical pieces of knowledge. In this contribution, we will give an overview of the current research about the visual self-evidence. Different strategies that serve the production of self-evident images in medicine are described and their representation in popular culture will be displayed on the basis of three case studies. The case studies include the use of curves to record and display physiological movements, radiology as a tool to produce images from the interior of the body and neuroimaging techniques that were designed to illustrate the working brain.

This handbook explores the ways biomedicine and pop culture interact while simultaneously introducing the reader with the tools and ideas behind this new field of enquiry. From comic books to health professionals, from the arts to genetics, from sci-fi to medical education, from TV series to ethics, it offers different entry points to an exciting and central aspect of contemporary culture: how and what we learn about scientific knowledge and its representation in pop culture. Divided into three sections the handbook surveys the basics, the micro-, and the macroaspects of this interaction between specialized knowledge and cultural production: After the introduction of basic concepts of and approaches to the topic from a variety of disciplines, the respective theories and methods are applied in specific case studies. The final section is concerned with larger social and historical trends of the use of biomedical knowledge in popular culture. Presenting over twenty-five original articles from international scholars with different disciplinary backgrounds, this handbook introduces the topic of pop culture and biomedicine to both new and mature researchers alike. The articles, all complete with a rich source of further references, are aimed at being a sincere entry point to researchers and academic educators interested in this somewhat unexplored field of culture and biomedicine.

In a critical review of late twentieth-century gene-culture co-evolutionary models labelled as ‘global phylogeny’, the authors present evidence for the long legacy of co-evolutionary theories in European-based thinking, highlighting that (1) ideas of social and cultural evolution preceded the idea of biological evolution, (2) linguistics played a dominant role in the formation of a unified theory of human co-evolution, and (3) that co-evolutionary thinking was only possible due to perpetuated and renewed transdisciplinary reticulations between scholars of different disciplines—especially within the integrative framework of the ‘humanid’ and the ‘hominid’ branches of anthropology.

The scope and mission of the history of science have been constant objects of reflection and debate within the profession. Recently, Lorraine Daston has called for a shift of focus: from the history of science to the history of knowledge. Such a move is an attempt at broadening the field and ridding it of the contradictions deriving from its modernist myth of origin and principle of demarcation. Taking the move from a pluralistic concept of medicine, the present paper explores the actual and possible contributions that a history of knowledge can offer to the history of medicine in particular. As we will argue, the history of medicine has always been a history of knowledge, but for good reasons has always stuck to the concept of medicine as its object and problem throughout the ages, including the modern, scientific one. We argue that, in the history of medicine, the demarcation between scientific and non‐scientific represents an accident, but is not foundational as in the case of natural science. Furthermore, the history of medicine programmatically played a role in at least two academic domains (history proper and medical education), adjusting historical narratives of medical knowledge to its audience. Accordingly, we underscore that the history of both science and medicine, as traditionally defined, already provides room for almost the whole spectrum of approaches to history. Moreover, their different myths of origin can, and indeed must, be included in the reflexivity of the historical gaze. We argue that the position towards a history of science, medicine, or knowledge is not a question of narrative or theory, rather, it is a question of relevance and awareness of extant contexts.

Die Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert

In modern discourse about the history of science, it seems to be widely accepted that at the end of the nineteenth century, Germany was one of the leading countries in the production of science. In the past, historians of science tried to trace back a specific ‘German style’ of science that—in combination with other factors—determined this German dominance around 1900, especially in the life sciences. Considering the theoretical concept of ‘national styles’, it has to be kept in mind that around 1900, contemporaries already proclaimed ‘national styles’ of science as representations of national identity. Thus, the question arises as to how far existing historiographical conceptions of national styles may include earlier claims and prejudices. Careful reconstructions of contemporary discourses on national styles and inquiries into the ‘stylisation’ of a dominant, successful ‘German style’ are necessary. One of the contemporary critics of a ‘German style’ of science was the physiologist Jacques Loeb (1859–1924), who emigrated to the USA in 1891. Loeb corresponded regularly with the physicist and philosopher Ernst Mach (1838–1916). Ernst Mach can be considered Loeb's intellectual father with whom he corresponded about strategic, philosophical, and epistemological questions. Using the Loeb–Mach correspondence, the aim of the paper is to reconstruct Loeb's conception of a ‘German style’ of science and its differences to an ‘American style’. Changes in his views are discussed as well as the roots of his views and some of their consequences. Finally, Loeb's ideas on national styles and his working profiles before and after his emigration are compared to historiographical analyses of ‘American’ or ‘German’ styles of science around 1900.

Future for the History of Science? An Interjection Oriented towards Science Policies Inspired by the History of Medicine. The author argues that diversity is the great strength of the history of science. It allows for flexible reactions to intellectual challenges posed by its various reference disciplines. This strength, however, might turn into a weakness, if diversity results in arbitrariness. These claims are illustrated by the example of the history of medicine as a sub‐discipline of the history of science: The history of medicine is currently able to acquire project funding because it is diverse and flexible. Simultaneously, it experiences the risks of flexibility and third‐party funding. Basic funding, scholarly interaction, and organized exchange seem necessary to ensure professional standards. It is concluded that the future for the history of science is bright, if it is able to preserve both its diverse creativity and a disciplinary sense for academic standards.

Shortly after bacteriologist Paul de Kruif had been dismissed from a research position at the Rockefeller Institute for Medical Research, he started contributing to a novel in collaboration with the future Nobel laureate Sinclair Lewis. The novel, Arrowsmith, would become one of the most famous satires on medicine and science. Using de Kruif’s correspondence with his idol Jacques Loeb, this paper describes the many ways in which medical science is depicted in Arrowsmith. This article compares the novel with de Kruif’s and Loeb’s biographies, and focuses on the struggles of the main character, Martin Arrowsmith, as an allegory of the institutionalisation of medical research in the US, shows that Sinclair’s purpose is to caricaturise scientific work in modern medical research institutions anywhere and shows that the novel depicts a reductionist philosophy of research that seems to contradict the “messiness” of medical practice

“Prizeworthy Research?” Wilhelm Roux and His Program of Developmental Mechanics. The Nobel Prize in physiology or medicine is awarded annually to a maximum of three laureates. Not surprisingly, the number of nominees is much larger. Drawing on Nobel Prize nominations in the Nobel archives in Sweden, the core of this paper deals with the nomination letters for the physiologist Wilhelm Roux to discuss competition and some controversies among German physiologists around 1900 in this particular context. The paper elucidates the arguments brought forward to portray Roux as a scientist who had conferred “the greatest benefit to mankind” in the field of physiology or medicine ; examines some other runners-up, and reconstructs why Roux as well as some of his peers were not awarded the Nobel Prize. On a more general level, we argue that an analysis of Nobel Prize nominations contributes to a broader history of excellence in science and medicine in the twentieth century.

The efforts of the European Commission to create a European Research Area in the field of biotechnology are accompanied by a growing demand for an ethical discourse. Cultural differences between the European Union's member states create a vital need to improve bioethical information structures in Europe so as to foster European bioethics discourses and to cope with ethical pluralism. Responding to the need for an increased European contribution to the international discussion on ethics in medicine and biotechnology, some of Europe's leading bioethics institutions have joined forces to establish the international network EURETHNET . 18 partners from nine European countries agreed to develop an information network and knowledge base in the field of ethics in medicine and biotechnology. This short communication displays the aims, scope and realisation of the network

ZusammenfassungDie Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert.

The German-born American scientist Jacques Loeb (1859–1924) was one of the most important promoters of experimental biology around 1900. He was best known for his physico-chemical explanations of psychological processes and his biotechnological approach to artificial parthenogenesis. At the start of the First World War, Loeb was deeply troubled by the deterioration of the international scientific community and the growing alienation of his German and American colleagues. The aim of this paper is to examine Jacques Loeb's activities aimed at advancing scientific internationalism before, during, and after the war. Loeb, for example, tried to negotiate the publication of German authors in American journals during the war, at a time when this was categorically rejected by publishers. Immediately after the war, he tried to create a specific system aimed at disseminating scientific literature and funding selected European colleagues, in order to overcome what he considered reactionary and hegemonic forces within German scientific institutions. His correspondence with eminent scientists from all over the world (amongst them Albert Einstein, Richard Goldschmidt, Otto Meyerhof, Otto Warburg, Paul Ehrlich, Wolfgang Ostwald, Wilhelm Roux, and Ross Harrison) will serve as a source for the analysis. Special emphasis will be placed on the question how Jacques Loeb integrated epistemology, his particular world view, and his social commitment into the workings of his own life and how he tried to extend his scientific goal of controlling biological systems to the sphere of international science