Journal of the history of medicine and allied sciences
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) establishes new standards for the protection of private health information in the United States. The Privacy Rule, one of the specific regulatory provisions of the act, went into effect 14 April 2003 for covered health care providers, institutions, and businesses. The Privacy Rule directly affected medical archivists and their collections. ⋯ The Privacy Rule is the first major regulation that protects the privacy of the deceased in perpetuity. It establishes requirements that researchers must satisfy in order to gain access to "individually identifiable health information" held by HIPAA-protected institutions. While these requirements will burden historians in some cases, the Privacy Rule could open up opportunities for well-prepared historians to work with a more extensive range of twentieth-century documents.
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J Hist Med Allied Sci · Jul 2007
Biography Historical ArticleDid J. Marion Sims deliberately addict his first fistula patients to opium?
American surgeon J. Marion Sims (1813-83) is regarded by many modern authors as a controversial figure because he carried out a series of experimental surgeries on enslaved African American women between 1846 and 1849 in an attempt to cure them of vesicovaginal fistulas, which they had all developed as a result of prolonged obstructed labor. He operated on one woman, Anarcha Westcott, thirty times before he successfully closed her fistula. ⋯ This article examines the controversy surrounding Sims' use of postoperative opium in these enslaved surgical patients. The evidence suggests that although these women were probably tolerant to the doses of opium that he used, there is no evidence that he deliberately tried to addict them to this drug. Sims' use of postoperative opium appears to have been well supported by the therapeutic practices of his day, and the regimen that he used was enthusiastically supported by many contemporary surgeons.
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Although the American literature on "war neuroses" expanded during World War II, psychiatrists remained more interested in dramatic instances of "combat fatigue" than in the problems of soldiers who broke down far from the field of battle. This bias in the medical literature shaped both diagnosis and treatment. It had an especially powerful effect on African American soldiers who, in the "Jim Crow" army of World War II, were assigned in disproportionate numbers to service units. ⋯ Despite its many criticisms of military medicine, the NMA argued that African American soldiers and veterans needed more, not fewer, psychiatric services. NMA members also joined their white counterparts in the campaign to diminish the stigma of mental illness, especially among the families of soldiers returning home. We need more investigation of the subsequent history of race and psychiatry, especially within the Veterans Administration.
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J Hist Med Allied Sci · Oct 2004
Historical ArticleBeyond informed consent: did cancer patients challenge their physicians in the post-World War II era?
Historians have debated the degree to which past patients have provided meaningful consent prior to medical interventions. This article, a chart review of 170 patients treated for cancer between 1945 and 1970, adds to this literature by exploring the years when informed consent was being introduced in medical practice. As would be expected in a largely paternalistic era, physicians controlled most of the clinical encounters, even concealing cancer diagnoses. ⋯ But a small group of patients challenged their physicians, leading them to learn more about proposed treatment options and perhaps make more informed decisions. Although motivated in part by the increasing attention to better consent practices, these patients spoke up for other reasons as well, possibly including their basic personalities, prior negative experiences in hospitals, or apprehensiveness regarding specific types of interventions. Further research should explore the factors--beyond the introduction of informed consent--that have historically promoted better dialogue between physicians and patients.
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J Hist Med Allied Sci · Jul 2002
Biography Historical ArticleThe Association of Hygieia with Asklepios in Graeco-Roman Asklepieion medicine.