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"It has become appallingly obvious that our technology has exceeded our humanity." Albert Einstein. Birth and Death. The Enkin Lecture. January 24, 2007. THIS PRESENTATION WILL BE DOWNLOADABLE FROM OUR WEB SITE http://www.healthandeverything.org /. The Enkin Lecture.
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"It has become appallingly obvious that our technology has exceeded our humanity." Albert Einstein Birth and Death The Enkin Lecture January 24, 2007 THIS PRESENTATION WILL BE DOWNLOADABLE FROM OUR WEB SITE http://www.healthandeverything.org/
The Enkin Lecture Celebrating the essential role of science in the service of humanity and promoting a key role for humanitarian values in science
Three parts of this talk • Birth and death before science • Contributions of science to birth and death • The future of humanitarian values about birth and death
Birth and Death Before Science • Wide spread importance of birth and death • Most societies marked both • Wide variety of myths, rituals and processes • Associated with technology • The Adam and Eve story links birth & death • When they leave the Garden of Eden • They will age and die • Women will feel pain during childbirth
Ancient Births and Deaths • Mythological Births • Of the gods • Ancient Deaths • Of figures like Socrates
Pre-scientific Birth and Death • Inuit and Aboriginal Examples • Birth and death places
Lest we think there was no technology • Technology was associated with many of these rituals and processes • Markers, buildings, processes and so on
The Rise of Modern Science • Modern medicine has its roots in the early stages of modernity as far back as Galileo and Descartes
René Descartes’ Mechanical Man ...if the body of man be considered as a kind of machine, so made up and composed of bones, nerves, muscles, veins, blood, and skin, that although there were in it no mind, it would still exhibit the same motions which it at present manifests involuntarily, and therefore without the aid of the mind.... René Descartes Meditations, Book VI
A Geometry of Health • “Healthy” machine runs smoothly • Descartes said in the Discourse “The preservation of health has always been the principle end of my studies” he hoped to devise “a system of medicine which is founded on infallible demonstrations.”
Science and Return to Eden • Other early scientists, like Robert Boyle, had among their objectives the indeterminate prolongation of life and the elimination of illness and pain – including the pain of childbirth. • This Edenic vision has taken many forms through the years
Representations 1700-1900 • Representations of birth and death were not scientific • Most were not institutional • Many were figurative
Scientific Medicine • Originated with Cartesian and other modern Ideas • Began to come to fruition with Koch and Pasteur • Elimination of some diseases e.g. small pox • More complete understanding of others, e.g. polio and cholera
Promise for the Future • Clear and precise accounts of birth and death • Greater clarity about the limits surrounding birth and death Evidence based best practice around birth and death
Philosophical Reinforcement • The early Wittgenstein • Logical Positivism • Extreme view of knowledge and science • Only evidence is scientific evidence
Before Modern Medicine • Maternal mortality in 1880 was about 500 deaths per hundred thousand. • Infant mortality as recently as the 18th century was as high as 200 per 1000 births • Life expectancy was in the 40s until the late 19th century
England & Wales Scotland Typical Infant mortality trends 1848-1999 Source : Birth Counts, 2001
Science Supports Medical Birth and Death • From 1900 births and deaths began move to hospital • The promise was that Clear scientifically based protocols for both birthing and dying would emerge • The movement from midwives was also quick • USA 1915 - 40% 0f births attended by midwives. • USA 1935 - 10% (54% non-white) • USA 2006 - 5% • Canada midwifery eliminated as a profession • Reemerged as certified profession 1990 in Ontario.