Periodic Reporting for period 2 - LEVIATHAN (Taming the European Leviathan: The Legacy of Post-War Medicine and the Common Good)
Okres sprawozdawczy: 2022-04-01 do 2023-09-30
The goal of the Leviathan project is to develop a balanced and multidisciplinary historiography of post-war Europe through the lens of medicine by studying forms of interaction through a comprehensive European framework. We achieve this by focussing our research on the following areas: ‘Body’, ‘Reproduction,’ ‘Risk,’ and ‘Utopia’. Leviathan takes a multidisciplinary approach: neither economics nor politics nor ideology nor everyday life, but an integration of these perspectives makes it possible to understand the pursuit of the European common good. Our first work package, ‘Body’, addresses the politics of public health and medicine across post-war Europe. Our second area, ‘Reproduction’, explores the frontiers of life, encompassing beginnings, aging and end-of life decisions. Our third work package, ‘Risk’, explores the negotiations and management of risk in medical research and development. Our fourth area focusses on ‘Utopia’. We analyse the ‘making of Utopia’ via the development of behavioural sciences and the use of health communication and propaganda.
Body: By focusing on the development of high-tech medicine, we show that the trans-European network of transplantation was driven by scientific constraints and civil society. A study on balneosanatoria investigates the development of medical facilities, infrastructure and technology. In addition to studying the ‘Semashko’ medical model and medical migration, we explored key political figures and cooperation within international organizations and among experts to highlight cooperation across the systemic divide. We analysed normative aspects of biopolitics and studied transnational collaboration of population geneticists via organisations in Europe. Another example looks at the development of policies regarding homes for children with disabilities. We studied public debates on biosocial concepts in a transnational context and how these were implemented. We also explored health laws in different states - both socialist and capitalist - to uncover the connections between law and socio-economic realities.
Reproduction: We engage with R&D, marketing and distribution, and the (mis)use of drugs in the field, for example via a study of the clinical trials of the abortion pill Mifepristone and the debates on women’s reproductive rights. By analysing the R&D of (sex) hormones, we show how socialist states participated in and benefited from medical advances. These studies show the close connections of drug research and the use of new substances in both permissible (contraception) and non-permissible contexts (abortion, doping) across the systemic divide. We also address the normative perspective of social inequities, exclusion and discrimination by comparing abortion and reproductive rights across various states. Another aspect looks at research about the social inequalities via a study of the history of Bulgarian gerontology. A comparative case study on aging focusses on care homes and home care in Albania and Italy. Comparing discussions of end-of-life decisions across Europe, for example in the Dutch context, assists in outlining the key concepts and dimensions of the “autonomy” debate.
Risk: We demonstrate how the legacy of the Holocaust made the medical profession more reflective about issues related to medical ethics within European societies. We can also show the extent to which codified medical deontology — rather than the Nuremberg Code — served as a central reference point within different national and cultural contexts. A key area of analysis is shaped by the post-war legacy of eugenics. We trace debates about disability and definitions of work capacity in both Eastern and Western European countries. In doing so, we can better understand how post-war welfare and health policies were shaped by medically-based productivism. The example of the prevention and control of poliomyelitis shows the consequences of certain health policies. The politics of risk are also analysed via the development of European ethno-psychiatry in the context of global mental health policy. This case study examines cross-cultural projects focused on mental disorders undertaken by the World Health Organisation to analyse the dialogue between psychiatrists from different states across western, central and eastern Europe and beyond.
Utopia: The history of chemical enhancement explores the shared methodologies and beliefs among European psychopharmacists who aimed to enhance the behavioural choices, intelligence, physical performance, and moral character of trial participants. We examine the cooperation of national organizations, both at state level and within the public sphere, within the field of TB prevention. We also analyse the dissemination of healthcare propaganda to promote socialist and state-managed healthcare and a further study examines the “invisibility” of people with special needs via an exploration of visual archives in Bulgaria. This work package also considers the potential consequences of ‘utopian dreams’. Using the example of uranium mining on both sides of the Ore Mountains under Soviet occupation, we examine how such a project (more than 10,000 cancer deaths) could be carried out, and how civil society involvement was articulated in the GDR. The rise of suggestology and unorthodox research fields (e.g. psychotronics) opens another perspective on educational efforts and scientific visions in Europe and beyond.
Reproduction: We engage with R&D, marketing and distribution, and the (mis)use of drugs in the field, for example via a study of the clinical trials of the abortion pill Mifepristone and the debates on women’s reproductive rights. By analysing the R&D of (sex) hormones, we show how socialist states participated in and benefited from medical advances. These studies show the close connections of drug research and the use of new substances in both permissible (contraception) and non-permissible contexts (abortion, doping) across the systemic divide. We also address the normative perspective of social inequities, exclusion and discrimination by comparing abortion and reproductive rights across various states. Another aspect looks at research about the social inequalities via a study of the history of Bulgarian gerontology. A comparative case study on aging focusses on care homes and home care in Albania and Italy. Comparing discussions of end-of-life decisions across Europe, for example in the Dutch context, assists in outlining the key concepts and dimensions of the “autonomy” debate.
Risk: We demonstrate how the legacy of the Holocaust made the medical profession more reflective about issues related to medical ethics within European societies. We can also show the extent to which codified medical deontology — rather than the Nuremberg Code — served as a central reference point within different national and cultural contexts. A key area of analysis is shaped by the post-war legacy of eugenics. We trace debates about disability and definitions of work capacity in both Eastern and Western European countries. In doing so, we can better understand how post-war welfare and health policies were shaped by medically-based productivism. The example of the prevention and control of poliomyelitis shows the consequences of certain health policies. The politics of risk are also analysed via the development of European ethno-psychiatry in the context of global mental health policy. This case study examines cross-cultural projects focused on mental disorders undertaken by the World Health Organisation to analyse the dialogue between psychiatrists from different states across western, central and eastern Europe and beyond.
Utopia: The history of chemical enhancement explores the shared methodologies and beliefs among European psychopharmacists who aimed to enhance the behavioural choices, intelligence, physical performance, and moral character of trial participants. We examine the cooperation of national organizations, both at state level and within the public sphere, within the field of TB prevention. We also analyse the dissemination of healthcare propaganda to promote socialist and state-managed healthcare and a further study examines the “invisibility” of people with special needs via an exploration of visual archives in Bulgaria. This work package also considers the potential consequences of ‘utopian dreams’. Using the example of uranium mining on both sides of the Ore Mountains under Soviet occupation, we examine how such a project (more than 10,000 cancer deaths) could be carried out, and how civil society involvement was articulated in the GDR. The rise of suggestology and unorthodox research fields (e.g. psychotronics) opens another perspective on educational efforts and scientific visions in Europe and beyond.
The ethical, historical, and legal aspects of public health policy making have been analysed, for instance, in two jointly written papers which focus on the “Vaccination Cold War” and “Autonomy and Social Responsibility”. Public engagement and research dissemination has been achieved via a public symposium on Medicine and Politics, and multiple interdisciplinary seminar series including one on medical anthropology, in Bulgaria.
Research on health laws and the public health regulations of the period has proven to be novel, as has research on the post-war European development of medical deontology and ethical codes, developments in pharmaceutical trials across Europe, and different levels of collaboration regarding health communications across Europe.
Interdisciplinary collaboration is a key aspect of our synergy team. What we have found to be most beneficial and intellectually stimulating has been the effect of methodological pluralism on our research processes. Advances beyond the state of the art are expected as a result of the integration of previously unknown sources (such as the personal archives of important figures in the history of medicine), and new transnational approaches highlighting the intellectual alliances on both sides of the systemic divide.
Our collaboration with other stakeholders is also noteworthy. This concerns external scholars and other forms of knowledge transfer. In collaboration with artists and curators from the HFBK (University of Fine Arts, Hamburg), the Hamburg team developed a novel artistic exhibition including original works inspired by the themes of medicine and utopia entitled ‘Medical Utopias in Art: Imagining Health’ (https://www.ches.uni-hamburg.de/news/hfbk.html). This exhibition will be accompanied by a catalogue publication.
Research on health laws and the public health regulations of the period has proven to be novel, as has research on the post-war European development of medical deontology and ethical codes, developments in pharmaceutical trials across Europe, and different levels of collaboration regarding health communications across Europe.
Interdisciplinary collaboration is a key aspect of our synergy team. What we have found to be most beneficial and intellectually stimulating has been the effect of methodological pluralism on our research processes. Advances beyond the state of the art are expected as a result of the integration of previously unknown sources (such as the personal archives of important figures in the history of medicine), and new transnational approaches highlighting the intellectual alliances on both sides of the systemic divide.
Our collaboration with other stakeholders is also noteworthy. This concerns external scholars and other forms of knowledge transfer. In collaboration with artists and curators from the HFBK (University of Fine Arts, Hamburg), the Hamburg team developed a novel artistic exhibition including original works inspired by the themes of medicine and utopia entitled ‘Medical Utopias in Art: Imagining Health’ (https://www.ches.uni-hamburg.de/news/hfbk.html). This exhibition will be accompanied by a catalogue publication.