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In the years following FDA approval of direct-to-consumer, genetic-health-risk/DTCGHR testing, millions of people in the US have sent their DNA to companies to receive personal genome health risk information without physician or other learned medical professional involvement. In Personal Genome Medicine, Michael J. Malinowski examines the ethical, legal, and social implications of this development. Drawing from the past and present of medicine in the US, Malinowski applies law, policy, public and private sector practices, and governing norms to analyze the commercial personal genome sequencing and testing sectors and to assess their impact on the future of US medicine. Written in relatable and accessible language, the book also proposes regulatory reforms for government and medical professionals that will enable technological advancements while maintaining personal and public health standards.
The medical case report (CR) is a vital and viable medical genre with a history of more than 3000 years. With a few exceptions, the CR has had a typical format that has been consistent with the ideals of brevity, conciseness, and a matter-of-fact approach. CR in general and psychiatric CR especially, may benefit from more systematically emphasising and integrating relevant biopsychosocial (BPS) aspects.
Objectives
To discuss how to emphasise and integrate the BPS perspective in the CR.
Methods
Drawing on CR literature and our own experience as CR authors, we discuss how a broader BPS approach successfully can be included in the CR format.
Results
Some central factors that could be considered when including a BPS perspective in the CR are: 1) Actively eliciting the patient’s perspective and including this in the final report. 2) Including relevant information about the life and circumstances of the patient beyond the basic demographic information. 3) Making an effort to preserve the patient’s privacy also when more BPS information is included. The psychological and social constituents of the patient’s life should be central in the BPS-inspired psychiatric CR.
Conclusions
The traditional CR has a long-standing history in medicine and follows a typial conscise and brief format. ‘Hard facts’ and biological information have typically filled most of the text. We argue that giving psychological and social information more attention would improve the quality of many CR, and that this is especially relevant for psychiatric CR.
This introduction begins with a reading of Middleton’s The Revenger’s Tragedy, and with its evocation of Opportunity as a sexual temptress, which brings temporal concepts and gendered identities into conversation with each other in complex and revealing ways. The introduction goes on to set out the critical and conceptual foundations of the book as a whole, explaining how scholarly work which has focused on time, gender and performance has helped me to develop an understanding of the opposition of action and inaction, which I argue is central to the early modern temporal consciousness, to theatrical experience and to the early modern construction of gendered identity. In the second part of the introduction, I examine some of the ways in which early modern thinking about time and about gender developed in relation to classical ideas, religious and medical discourse and conduct literature, which workedboth to define and destabilise a conflicted binary opposition between waiting and not waiting. I then return to The Revenger’s Tragedy to illustrate how the play engaged with this supposed binary opposition, suggesting that its negotiation and complication were central to early modern performances of both gender and time on the early modern stage.
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