Focusing on the foetus: medicine, technology and professional identity

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Focusing on the foetus medicine, technology and
professional identity

• HI296
• Week 8

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Structures of surveillance the panopticon
Jeremy Bentham (1748-1832), Panopticon (1791)
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Discipline in the Panopticon

• Penitentiary why were panoptic prisons given
  this name?
• Benefit of panoptic surveillance you never knew
  when you were being watched, so you had to behave
  all the time
• Which was intended to instil self-discipline, and
  internalization of societys rules and codes of
  behaviour.

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Stateville Penitentiary Centre, IL. In use 1925
to present
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Presidio Modelo Prison, Cuba. In use 1926-1959
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Building the medical panopticon therapeutic
surveillance

• Concepts
• Moral Management
• Instilling self-discipline
• Therapeutic optimism
• Middlesex County Lunatic Asylum c. 1850
  (originally built 1829) ?

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Building the medical panopticon therapeutic
surveillance
Octagon Ward Johns Hopkins University Hospital,
1890
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Building the medical panopticon therapeutic
surveillance

• Rochester Methodist Hospital Radial Nursing Unit
  1957 (Built in collaboration with Mayo Clinic)
• Special Observation Unit, know as the silo

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Text from consumer ad http//www.allheart.com/om1
3fetal.html (accessed 18/11/08)
Fetal Stethoscope (Fetoscope) Designed for
superior auscultation of the fetal heart.
Stethoscope is equipped with chrome-plated brass
binaural and stem. The 22 inch black tubing can
be easily shortened to facilitate use of the
headrest. Listening to the Fetal Heart
Starting at around 20 weeks, the fetal heartbeat
can usually be heard without Doppler
amplification (ultrasound). At this point a
special stethoscope called a fetoscope can be
used. The heartbeat is best heard over the baby's
back, which often seems firm when you feel around
the uterus. It may be difficult to hear the fetal
heart by stethoscope if the mother is overweight
or if the placenta is on the front wall of the
uterus. PLEASE NOTE It gets easier to hear
later on in the pregnancy, so don't get
discouraged! Always remember that every pregnancy
is unique, and mothers should always consult
their obstetrician with any questions. These
fetal stethoscopes are intended for use by
professionals. Our Everyday Low Price 19.98, 2
for 38.98
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So who wins in the medical panopticon?
I am very unhappy now. The trial of my womanhood
which to me is so very bitter has come upon me
again. When my little Ellie is 2 years old, she
will have a little sister or brother. And this is
the end of all my hopes, my returning joyful
youthfulness Hannah Whitall Smith, 1852 Has
the unborn infant no rights? Is it a matter of no
importance whether we destroy that life locked up
in its mothers womb? Is there any moral
difference in murder within the womb from that
without? Dr. T Ridgeway Barker, 1892 The
obstetrician alone must be the judge of what is
to be done Dr. George McKelway, 1892
To my mind, the answer about whether to perform
a craniotomy or a cesarean section depends on
the social status of the woman, her desire for a
living child, and particularly upon whether she
is the mother of several children or is pregnant
for the first time. In the former event the
patient has already done her duty to the State
In the latter event such interference is highly
reprehensible decapitation is preferable to
forever abolishing the reproductive function of a
young woman. Dr. JW Williams, 1917 So long as
the child is within the womb or indeed within the
maternal passages, it is regarded by the law as
part of the womans body. Dr. Draper, 1890
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Reading Self-AssessmentCrucial terms and
concepts

• Panopticon
• Instrumental reality/clinical reality
• Technological imperative
• Tacit knowledge
• authoritative knowledge
• nursing gaze/medical gaze
• doctors time

• Fetocentrism
• Electronic Age of medicine
• Machine-body tending
• pre-conditioning/prepared birth
• Surveillance medicine
• epidemic of risk
• Cephalopelvic disproportion
• Symphisiotomy
• Pubiotomy

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Seminar topic Authority, images and infants

• To what extent does the power of medical imaging
  from x-rays to ultrasound -- emerge from their
  self-evidence, and to what extent does come from
  from the authority granted to them by medical
  professionals?
• Who does, and who should control the images
  created by these medical technologies?