Publishing and Paternalism in the Grenfell Mission: Wilfred Grenfell’s Accounts of a Boy Patient and Doctor-Patient Relations in Northern Newfoundland and Labrador, 1900–14

In 1906 Dr. Wilfred Grenfell, founder and head of the Grenfell medical mission of northern Newfoundland and southeastern Labrador, published a short article in Putnam’s Monthly about a nine-year-old boy named Clem Richards, who had shot himself in the knee while hunting seabirds. The boy’s identity was disclosed in full, with Grenfell including his name and image as well as a detailed description of his living conditions. The “story” of the boy’s injury and recovery became a favourite of Grenfell’s, and it was modified and republished in a number of magazines and books between 1906 and 1923. This article explores the appeal that Richards’ accident held for Grenfell and argues that his dramatic mid-winter rescue of the boy helped Grenfell promote his mission and construct a public image of himself that would appeal to American readers and donors. By comparing published accounts with Richards’ medical case record, however, we also see how much Grenfell distorted the incident to heighten its drama and reader appeal. The article also considers how the mission’s dominance over northern Newfoundland and southeastern Labrador enabled Grenfell to use Richards’ name and image for mission publicity with no consideration of patient consent.

Does radiology require informed consent for radiation risk?

Recent trends in medical decision-making have moved from paternalistic doctor-patient relations to shared decision-making. Informed consent is fundamental to this process and to ensuring patients’ ongoing trust in the health-care profession. It cannot be assumed that patients consent to the risk associated with medical exposures, unless they have been provided with the information to make that decision. This position is supported by both the legal and ethical framework around Radiation Protection detailed in this commentary.

Medical experts as health knowledge providers

The rise of wemedia in China has brought challenges to public health communication(PHC), such as the change in doctor-patient relations and the vulnerabilityof trust. As few researchers have touched upon the issue of identity constructionduring PHC in Weibo, this study aims to fill this gap and investigate one health informationprovider's discursive construction of multiple identities in Weibo and itspragmatic effect on trust building. Through this study the author attempts to contributeto the existing scholarship on the dynamics of identity-relation constructionin wemedia and the pragmatic construction of trustworthiness in a PHC context.

Following the algorithm: How epidemiological risk-scores do accountability

Epidemiological risk scores are calculative devices that mediate and enact versions of accountability in public health and preventive medicine. This article focuses on practices of accountability by following a cardiovascular risk score widely used in medical counselling in Germany. We follow the risk score in the making, in action, and in circulation to explore how the score performs in doctor-patient relations, how it recombines epidemiological results, and how it shapes knowledge production and healthcare provision. In this way, we follow the risk score’s various trajectories – from its development at the intersection of epidemiology, general medicine and software engineering, to its usage in general practitioners’ offices, and its validation infrastructures. Exploring the translations from population to individual and back that are at work in the risk score and in the primary prevention of cardiovascular disease, we examine how versions and distributions of accountability are invoked and practiced as the score is developed and put to use. The case of a simple risk score used in everyday counselling brings into relief some key shifts in configurations of accountability with emerging versions of ‘health by the algorithm’. While there is an increasing authority of algorithmic tools in the fabric of clinical encounters, risk scores are interwoven with local specificities of the healthcare system and continue to be in the making.

Miscellaneous Public Authority Functions

Doctors owe a duty of care to their patients, and this duty will be owed regardless of whether the doctor is a public sector employee operating within a statutory framework or is providing health care privately. Medical negligence claims in relation to the care which doctors provide to individual patients are outside the scope of this book. Cases arise, however, that do not involve individual doctor-patient relations and raise broader questions of medical policy. In such instances, the fact that the defendant is a public authority exercising public powers is likely to be material to a determination of whether a duty of care should be imposed, and it is such cases we consider in this section. It should be noted that the potential liabilities in negligence of the bodies that regulate the medical profession are not considered in this chapter, but are examined in Chapter 14, where we consider professional regulators.

Epilogue: HIV/AIDS

Unlike previous chapters, which are driven by the primary sources, this one relies on works by scholars and activists. From studies of the US, Australia, and Africa, this chapter finds a sharp break during the early 1990s in perceptions of HIV/AIDS’s social and political consequences. From emphasizing hate, violence, discrimination, and stigmatization, AIDS scholars and activists began focusing on the outpouring of volunteerism, charity, compassion, and successes from political activism: organizational developments (CBIs), volunteerism across communities—gay and straight, creativity in the arts, reshaping doctor–patient relations, the enhanced importance of nursing, achievements within the power structures of cities, and advances in gay and lesbian rights. This chapter brings together the book’s three principal categories for exploring the social side effects of epidemics in history—hate, compassion, and politics.