Preface

Bioethics and Medical Issues in Literature has multiple uses. First, it is part of the Exploring Social Issues through Literature series developed to meet the needs of secondary school students and their teachers who will delve into social issues identified in a range of accessible literature. When used in the language arts curriculum, the book intersects social studies issues and literature. Furthermore, educators in the arts and humanities and sciences can benefit from examining social issues in the intersection of literature and science. Along with the clear interdisciplinary benefit for students, the material fosters communication skills by building vocabulary because literary, scientific, and medical terms are clearly defined, giving easy access to the nonspecialist. The provocative topics also inspire writing while offering the opportunity to study both the technical and human side of medicine. Through investigating medical topics situated in literature, the book informs, develops thinking skills, and challenges students who may feel encouraged to pursue higher education in science, medicine, and the humanities. Second, high school librarians will find this book a valuable reference for units in English, language arts and literature, history, cultural studies, science, and social sciences.

Third, students from high school through pre-med and other college students will find that topics in this book engage them in ethical debate, informed decision making, and career exploration. In addition, the topics teach important interdisciplinary lessons such as respect for diversity and the art of medicine. In fact, the depth of material presented here makes this book ideally suited for any one in or entering a health care profession because the stories included serve as ethical guides. They also address the socio-cultural as well as the psychological and physical dimensions of medical practice, showing how humanistic attitudes combine with scientific facts to represent different aspects of healing. For these reasons, it is not surprising that literature and medicine courses are flourishing at all levels from high school and college to medical school and throughout post-graduate training, as educators see the need of enhancing a science or medical education with the humanities. Bioethics and Medical Issues in Literature develops the desired critical and empathic thinking skills with its references all the way back to ancient medicine and selections that span a two hundred year period since the birth of modern medicine in the early nineteenth century to the present. Therefore, and last, public and academic librarians can recommend this book to the general reader to be read alone or to serve as a companion to the referenced literature written by insightful authors who blend literary and medical ideals into interesting and lively reading. It offers an amazing journey.

Besides drawing facts from the major disciplines of science and medicine to develop medical issues, this book considers ethical and humanist issues by frequently citing two other significant bodies of knowledge, bioethics, a discipline founded in the late 1960s, and literature and medicine, an interdisciplinary field of study established in the mid-1970s. It develops topics such as the Human Genome Project, stem cell research, Frankenscience, cloning, gene therapy, eugenics, utopias, organ transplantation, contagious and chronic diseases, doctor-assisted suicide, and public health issues such as sexually transmitted diseases and bioterrorism. The obesity epidemic, mental illness (diagnosis and therapies), cultural rituals, clinical studies, longevity and aging, compassion in end-of-life care, dying, and death are also addressed. Our rapidly changing technology has introduced many ethical controversies, making the medical field—both its education and practice—increasingly complex. Therefore, this book spotlights concerns such as the importance of communication in the doctor-patient relationship and the pertinence of issues relating to how we should now define death. It identifies the resources we will need to draw on in our brave new world of stem cell research to solve problems. Contemporary bioethicists even ask, What does it mean to be human? What science cannot explain, literature explores.

Some of the works chosen, like Shelley's Frankenstein and Huxley's

Brave New World, are familiar, regularly assigned classics because their important themes relate to contemporary issues. Medical topics are situated in these stories with references to hard science texts, with the common thread being we have much to learn from the past. Most of the titles have been translated to the big screen, showing how they have captured our imagination. The ten classical and contemporary works of fiction—seven novels, two plays, and a short story—selected for their relevance to twenty-first-century medical news stories ripped right from the headlines are contained in chapters with these thematic titles: "Technology's Creature," "A Brave New World," "Contagions/ Isolations," "Illness and Culture," and "End of Life—Disease and Death." The "Historical Context" section for each work contains a short author biography and defines the medical issues and humanities topics, giving an overview of their development in time. An in-depth evaluation of the issues set within the literature follows in the "Literary Analysis" section.

Each of the two sections in five chapters can be read alone. In addition, their arrangement is chronological so that each successive work builds on concepts that precede it. For example, Shelley's Frankenstein, although written 200 years ago, sheds light on Cook's Coma and late-twentieth-century organ transplantation by emphasizing scientific hubris and the need to monitor research. Camus's The Plague reflects on Walker's Possessing the Secret of Joy by showing how the media can be both charlatan and savior when alerting the public to medical dangers. Updike's Rabbit at Rest and Edson's Wit look, respectively, at heart disease and cancer, diseases that continue to plague humankind. Hawthorne's "Rappaccini's Daughter" and Feldshuh's Miss Evers'Boys reveal the dire consequences of medical discoveries both unconscionably applied and withheld. Huxley's canonical work Brave New World and Kesey's popular Cuckoo's Nest demonstrate that many mysteries of the human psyche are still left to solve. These are just a few of the ways to compare and to contrast the various issues in each section, which also contains a plot synopsis. The book includes a helpful historical overview, "Chronology of Events in Literature, Medicine, and Science," and at the end quick-reference definitions appear in "Glossary of Terms: Literary, Medical, and Scientific." In addition, with the belief that every text should offer an opportunity to build vocabulary skills, whether it be for personal use or for academic testing, potentially unfamiliar words are glossed at the end as well. Four appendixes list additional resources and references, such as recommended movies, Internet sites, books and articles, and specific ideas for teaching.

At the end of each section students respond to the topics posed for oral and written discussion, as further contemplation builds the all-important critical thinking skills. For instance, noting that we live in a global community, students might argue the different sides of the main issue in Walker's Possessing the Secret of Joy: Should a First World country interfere with the culturally entrenched morality of a Third World African female ritual? Or, as featured in Camus's The Plague, they can scrutinize the ongoing role the media play both to educate and to sensationalize contemporary medical issues such as HIV and the Ebola virus, creating both informed and fearful citizens. By exploring sensitive distinctions, students develop a national social and international cultural perspective. These provocative issues lead to animated class discussions that create camaraderie among students with diverse backgrounds, interests, and career goals. By responding in writing to the questions, students usually delve deeper into their emotions. There is broad student interest in this book's central interdisciplinary concept that as science forges ahead, we will need the humanities to put the human face on medicine. By actively encountering bioethics and medical issues situated in stories, students make the significant connection that literature reflects the social issues incumbent in our world culture. Then they can apply this knowledge, combined with their own meaningful experiences and a mindful life, to form values and to make reasoned deliberations on ethical issues in our increasingly complex and interesting world.

At last, the intent of this book is to add to the growing body of literature that identifies and addresses these mounting twenty-first-century concerns by grounding students in an interdisciplinary program. Literature reveals the human condition, which after all is the subject of scientific endeavors, and this book declaratively answers the question, What is the role of the humanities in bioethics? Besides, adding humanities and social studies to science makes for lively discussions. As I respond thusly to these issues, I note that from Harvard University on down education reform is embracing a "skills across the curriculum" approach, arguing that all students are as capable of learning science as they are of mastering subjects in the humanities and social sciences. Educating our citizenry to make informed decisions with a dual facility is imperative as we face ongoing bioethical and medical challenges in our brave new world. "The unexamined life is not worth living," said Socrates, and the contents of Bioethics and Medical Issues in Literature should spur teachers and students on to conduct further research, resulting in critical thinking about the many new issues presented in the twenty-first century. It will be my pleasure to guide you toward that goal.

There are many people to thank who helped me over the three-year researching and writing period to complete Bioethics andMedicalIssues in Literature. Although an author's life is necessarily one of aloneness, I have not been intellectually isolated. Besides keeping company with the great thinkers whose ideas have contributed to this book, I have relied on numerous people and resources to authenticate my views. I want to thank my editors, Claudia Durst Johnson and Lynn Malloy, for their knowledge and support in helping me conceptualize the book and bring it to fruition. I appreciate Harris Methodist Fort Worth Hospital Director of Ethics David Isch for giving me an overview of hospital procedures, policies, and ethics. In educating myselfabout the role of institutional review boards in overseeing clinical research, I have benefited from communicating with The University of Texas Southwestern Medical Center Institutional Review Board Administrator Pat Fisher. Also from Southwestern, medical student and Doris Duke Fellow Louise P. King, J.D., described her medical school routine and experiences. Neuroradiologist Dr. Michael O. Harding was helpful in general medical discussions. I am further indebted to The University of North Texas Health Science Center Medical Humanities Director Sue Lurie, Ph.D., for comments on specific text and for helpful insights on related curriculum issues. A special thanks goes to the unsung heroes of literary achievement, the Fort Worth Public Library interlibrary loan researchers who in a timely fashion got for me an eclectic assortment of scores of books and articles from all over the country. I appreciate Linda Lucas's diligence and keen eye while reading my manuscript and commenting on its ability to reveal important social issues in pertinent literature. I am grateful to Beverly Robertson, R.N., for her insights on the human condition—the wonderful bodies we possess—especially our hearts and minds. In addition, as I worked on Bioethics and Medical Issues in Literature I tapped into the vast knowledge accruing from 10 years of research and interviews with medical luminaries who contributed to my forthcoming biography on Yale surgeon-writer Richard Selzer. He bears the responsibility for inspiring my medical humanities pursuits. Finally, I owe a very special debt of gratitude to my husband, James L. Stripling, for his continuing support, love and encouragement, and meticulous editing. I could not have written this book without him.

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