Transcript What the eye doesn`t see: ultrasound, monitoring, and the `unborn`

What the eye doesn’t see:
ultrasound, monitoring, and
the ‘unborn’
HI 269
Week 18
Seeing is believing:
A quick history of medical imaging
1895 Prof Wilhelm Roentgen discovers ‘X-rays’; they quickly become a popular
phenomenon and fad; only later are they adopted for medical purposes (eg only
In 1920 are 100% of fracture cases examined by x-ray in large US hospitals).
Seeing is believing:
A quick history of medical imaging
“It is worse than useless to suppose that any new method of forming mental
pictures, no matter how startling or radical, can equal the accuracy or
approach in value those which the science of medical diagnosis has taught
us to form with well-nigh infallible precision. It would be supererogation on
the part of anyone to think that the mental pictures which he might form by
use of the Roentgen rays could replace or even add much to the pictures
which modern physical diagnosis is capable of presenting. The property
which gives this new method of diagnosis its greatest value ... is its power to
form real images, to make tangible shadows where before only mental
pictures were possible. These tangible shadows eliminate the personal
equation of the observer from the resulting diagnosis, and thus remove
a source of error common to all methods that depend on the senses of the
individual for the accuracy of their results.”
CC Leonard, 1897
Seeing is believing?
Interpreting the x-ray
“The fondest swain would scarcely prize
a picture of his lady’s framework;
to gaze on this with yearning eyes
would probably be voted tame work!”
“Whether stout or thin, the x-ray makes the whole world kin.” 1897
“Sight is a much more satisfactory agent of information than hearing or
touch.” Philip Mills Jones, 1897
"I will admit that I can see broken bones; that I can see metallic foreign
bodies in the extremities, but when it comes to X- rays of the chest and to
some extent of the abdomen, I am much less clear. Frank Williams has just
shown you some plates and tells you that the heart is here and the lung is
here. Now I can't see a thing in these plates, and to be truthful, I don't think
he can." Dr. F.C. Shattuck, after a presentation by Francis Williams, 1899
Seeing the foetus before ultrasound
Leonardo da
Vinci, SketchBooks, c. 1510
Hunter, Anatomy of the gravid uterus, 1764
The Foetus
in Pop
Culture:
Giving the
Foetus a
‘Public
Presence’
‘The astonishing medical machine resting on this
pregnant woman's abdomen in a Philadelphia
hospital is “looking” at her unborn child in precisely
the same way a Navy surface ship homes in on
enemy submarines. Using the sonar principle, it is
bombarding her with a beam of ultra-high-frequency
sound waves that are inaudible to the human ear.
Back come the echoes, bouncing off the baby's
head, to show up as a visual image on a viewing
screen.’ (p. 45)
Text from Life’s ‘A Sonar “Look” at an Unborn Baby’, 1965
[quoted in Rosalind Pollack Pechesky, "Foetal Images: the Power of Visual
Culture in the Politics of Reproduction,", Feminist Studies, Vol. 13, No. 2
(Summer, 1987), pp. 263-292 at p.276.]
Foetus in Pop Culture
Art for Arthur C.
Clarke,
2010 Space
Odyssey,
novel (1982) and
film (1984)
Technologies and ideologies:
‘The Silent Scream’
Role of Cinematic technology
• Allows widespread electronic
distribution via TV, web..
• Edits image to increase drama (eg.
speeding up images to create sense
of fetal movement)
• Allows simultaneous ‘interpretation’
of images (which are not immediately
transparent without medical
expertise)
"Now let's turn to the actual film itself. We are now looking
at a sector scan of a real time ultrasound imaging of a 12
week, unborn child. The child is oriented in this direction.
You are looking now at the head of the child... here... the
body of the child... here.. and this image is the child's
hand approaching its mouth. Looking a little more closely
at the child, we can discern, the eye or the orbit of the eye,
here, the nose of the child, here... and the mouth of the
child... here.. and we can even look at the ventricle of the
brain, here… Now, we see the heart beating, here in the
child's chest …And we can see the child moving rather
serenely, in the uterus. One can see it shifting position
from time to time. It is still orientated in this manner and
the mouth is receiving the thumb of the child. The child
again is moving quietly in its sanctuary.“
Narrative of ‘Silent Scream’ 1985
1984 report by joint National Institutes of
Health/ Food and Drug Administration panel on
the use of ultrasound in pregnancy:
•
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Results of study:
“no clear benefit from routine use”
“no improvement in pregnancy outcome”
no conclusive evidence either of its safety or harm.
Recommendation:
not for “routine use” or “to view ... or obtain a
picture of the fetus” or “for educational or
commercial demonstrations without medical benefit
to the patient”
Approved for use to “estimate gestational age”
Images and the right to choose?
• This is the ONLY image
of a foetus I have been
able to find used in a
pro-choice political
context (and it is hardly
intended as a tool of
persuasion) Why?
• Could pro-choice
activists use medical
imagery to advance their
message?
Do technologies (necessarily)
create a tension between
maternal and foetal interests?
• Womb as ‘hostile environment’ or womb as
foetal ‘sanctuary’: do either of these images
benefit women?
• Can we envision a way of imaging the foetus
that would not exclude the woman carrying it?
• What do women gain from ultrasonography?
• Do men gain more (and if so, do their gains
come at cost to women?)
Reading Self-Assessment:
Did you notice these key terms and concepts?
• From Pollack Petchesky
• From Taylor
autonomous fetus/fetal autonomy
adversarial pregnancy
visual ‘bonding’
‘Silent Scream’/Dr.Nathanson
homunculous
fetus fetish
fetus as ‘patient’
‘prevalence of the gaze’
‘panoptics of the womb’
‘unskilled reproductive workers’
reproduction/pregnancy as consumption
fetus as commodity/person (‘commoditized’
vs ‘singularized’)
‘doctors as managers’/’mothers as
consumers’
pathological vs normal pregnant subjects
ethnography
• From Sandelowski
‘two-patient model’ of obstetrics
‘family-centred maternity care’
‘vicarious knower’/’parental
knower’/’professional knower’
Epistemology
Women as gatekeepers (and
spectacles)/men as spectators
‘democratization of fetal experience’
•
From Oaks
‘public fetus’/’fragile fetus’/fetus-as-subject’
fetal protection messages
‘pregnancy policing’
‘fetal abuse’
maternal/fetal conflict (but not paternal/fetal
conflict)
‘Smokey Sue/ Itty Bitty Smoker
Seminar Topics
• When does a woman become a mother,
responsible socially and legally for the
wellbeing of her child?
• Do men become fathers at the same time
and in the same way?
• Who qualifies as a ‘person’ in our culture,
and what effect have technologies of
visualization had on our perceptions of
‘personhood’?