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Keeping Faith: Ethics and the Physician-Writer

2003· article· en· W2088666651 on OpenAlexaboutno aff
Jack Coulehan, Anne Hunsaker Hawkins

Bibliographic record

VenueAnnals of Internal Medicine · 2003
Typearticle
Languageen
FieldMedicine
TopicEthics in Clinical Research
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineFaithMedical ethicsFamily medicineMedical educationTheologyPsychiatry

Abstract

fetched live from OpenAlex

Medical Writings19 August 2003Keeping Faith: Ethics and the Physician-WriterJack Coulehan, MD, MPH and Anne Hunsaker Hawkins, PhDJack Coulehan, MD, MPHFrom State University of New York at Stony Brook, Stony Brook, NY 11794; and The Pennsylvania State University College of Medicine, Hershey, PA 17033.Search for more papers by this author and Anne Hunsaker Hawkins, PhDFrom State University of New York at Stony Brook, Stony Brook, NY 11794; and The Pennsylvania State University College of Medicine, Hershey, PA 17033.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-4-200308190-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Writing about patients is a growth industry. While doctors have always shared detailed case histories with their colleagues, many physicians now publish stories about patients designed for a broader professional and lay public. Stories and poems written by physicians appear in medical journals, commercial magazines, and books and anthologies intended for a general audience. These stories about medical care are usually presented, either implicitly or explicitly, as the writer's real experience (hence, nonfiction), although the writers sometimes indicate that they have altered or fictionalized the work. In other cases, physician-writers produce first-person fiction (so indicated) that reads like real-life professional ...References1. Charon R. Narrative medicine: form, function, and ethics. Ann Intern Med. 2001;134:83-7. [PMID: 11187429] LinkGoogle Scholar2. Huyler F. The Blood of Strangers: Stories from Emergency Medicine. New York: Henry Holt; 1999. Google Scholar3. Bonadio W. Julia's Mother: Life Lessons in the Pediatric ER. New York: Griffin; 2001. Google Scholar4. Grim P. Just Here Trying To Save a Few Lives: Tales of Life and Death from the ER. New York: Warner; 2000. Google Scholar5. Zuger A. Strong Shadows: Scenes from an Inner City AIDS Clinic. New York: Freeman; 1995. Google Scholar6. Martin L. Pickwickian and Other Stories of Intensive Care: Medical and Ethical Challenges in the ICU. Cleveland, OH: Lakeside; 1991. Google Scholar7. Sacks O. Awakenings. New York: HarperCollins; 1990. Google Scholar8. Sacks O. The Man Who Mistook His Wife for a Hat and Other Clinical Tales. New York: Summit; 1985. Google Scholar9. Sacks O. An Anthropologist on Mars: Seven Paradoxical Tales. New York: Knopf; 1995. Google Scholar10. Gonzalez-Crussi E. Notes of an Anatomist. San Diego, CA: Harcourt Brace Jovanovich; 1985. Google Scholar11. Kearney M. Mortally Wounded: Stories of Soul Pain, Death and Healing. Dublin, Ireland: Marino Books; 1996. Google Scholar12. Quill TE. Death and Dignity. Making Choices and Taking Charge. New York: WW Norton; 1993. Google Scholar13. Groopman J. The Measure of Our Days: New Beginnings at Life's End. New York: Viking Penguin; 1997. Google Scholar14. Gawande A. Complications: A Surgeon's Notes on an Imperfect Science. New York: Henry Holt; 2002. Google Scholar15. Byock I. Dying Well: The Prospect for Growth at the End of Life. New York: Riverhead; 1997. Google Scholar16. Keizer B. Dancing with Mister D: Notes on Life and Death. New York: Doubleday; 1996. Google Scholar17. Hilfiker D. Healing the Wounds: A Physician Looks at His Work. New York: Pantheon Books; 1985. Google Scholar18. Klass P. A Not Entirely Benign Procedure. New York: Penguin Putnam; 1988. Google Scholar19. Verghese A. My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS. New York: Simon & Schuster; 1994. Google Scholar20. Selwyn PA. Surviving the Fall: The Personal Journey of an AIDS Doctor. New Haven, CT: Yale Univ Pr; 1998. Google Scholar21. Stone J. In The Country of Hearts: Journeys in the Art of Medicine. New York: Delacorte; 1990. Google Scholar22. Flitter M. Judith's Pavilion: The Haunting Memories of a Neurosurgeon. South Royalton, VT: Steerforth Pr; 1997. Google Scholar23. Abse D. White Coat, Purple Coat: Collected Poems 1948-1988. New York: Persea Books; 1991. Google Scholar24. Abse D. Remembrance of Crimes Past. New York: Persea Books; 1993. Google Scholar25. Campo R. The Other Man Was Me: A Voyage to the New World. Houston, TX: Arte Publico Pr; 1994. Google Scholar26. Campo R. What the Body Told. Durham, NC: Duke Univ Pr; 1996. Google Scholar27. Coulehan J. The Knitted Glove. Troy, ME: Nightshade Pr; 1991. Google Scholar28. Coulehan J. First Photographs of Heaven. Troy, ME: Nightshade Pr; 1994. Google Scholar29. Coulehan J. The Heavenly Ladder. Canberra, Australia: Ginninderra Pr; 2001. Google Scholar30. Coulehan J. Medicine Stone: Poems. Santa Barbara, CA: Fithian Pr; 2002. Google Scholar31. Schiedermayer DL. House Calls, Rounds, and Healing: A Poetry Casebook. Tucson, AZ: Galen Pr; 1996. Google Scholar32. Shafer A. Sleep Talker: Poems by a Doctor/Mother. Philadelphia: Xlibris; 2001. Google Scholar33. Stone J. In All This Rain. Baton Rouge, LA: Louisiana State Univ Pr; 1980. Google Scholar34. Stone J. Renaming the Streets. Baton Rouge, LA: Louisiana State Univ Pr; 1985. Google Scholar35. Stone J. Where Water Begins: New Poetry and Prose. Baton Rouge, LA: Louisiana State Univ Pr; 1998. Google Scholar36. Straus MJ. One Word. Evanston, IL: TriQuarterly Books; 1994. Google Scholar37. Straus MJ. Symmetry. Evanston, IL: TriQuarterly Books; 2000. Google Scholar38. White KJ. The Patient Presents. Baltimore: The People's Pr; 2000. Google Scholar39. Selzer R. Rituals of Surgery. New York: Harper & Row; 1974. Google Scholar40. Selzer R. Mortal Lessons: Notes on the Art of Surgery. New York: Simon & Schuster; 1976. Google Scholar41. Selzer R. Confessions of a Knife. New York: Simon & Schuster; 1979. Google Scholar42. Selzer R. Letters to a Young Doctor. New York: Simon & Schuster; 1982. Google Scholar43. Selzer R. The Doctor Stories. New York: Picador; 1998. Google Scholar44. Nuland SB. How We Die: Reflections on Life's Final Chapter. New York: Alfred A. Knopf; 1994. Google Scholar45. Mates SO. The Good Doctor. Iowa City, IA: Univ of Iowa Pr; 1994. Google Scholar46. Charach R, ed. The Naked Physician: Poems about the Lives of Patients and Doctors. Kingston, Ontario, Canada: Quarry Pr; 1990. Google Scholar47. Belli A, Coulehan J, eds. Blood & Bone: Poems by Physicians. Iowa City, IA: Univ of Iowa Pr; 1998. Google Scholar48. Breedlove C, ed. Uncharted Lines: Poems from the Journal of the American Medical Association. Albany, CA: Boaz; 1998. Google Scholar49. LaCombe MA, ed. On Being a Doctor. 2nd ed. Philadelphia: American Coll of Physicians; 2000. Google Scholar50. Reynolds R, Stone J. On Doctoring: Stories, Poems, Essays. 3rd ed. New York: Simon & Schuster; 2001. Google Scholar51. Noddings N. Caring: A Feminine Approach to Ethics and Moral Education. Berkeley, CA: Univ of California Pr; 1984. Google Scholar52. Mohrmann ME. Medicine as Ministry: Reflections on Suffering, Ethics, and Hope. Cleveland, OH: Pilgrim; 1995. Google Scholar53. Friedman SS. Mappings: Feminism and the Cultural Geographics of Encounter. Princeton, NJ: Princeton Univ Pr; 1998. Google Scholar54. Hippocrates. Hippocratic Oath. In: Edelstein L, trans. The Hippocratic Oath: Text, Translation, and Interpretation. Baltimore: Johns Hopkins Pr; 1943. Accessed at www.pbs.org/wgbh/nova/doctors/oath_classical.html on 8 July 2003. Google Scholar55. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 5th ed. New York: Oxford Univ Pr; 2001:303-12. Google Scholar56. Siegler M. Sounding Boards. Confidentiality in medicinea decrepit concept. N Engl J Med. 1982;307:1518-21. [PMID: 7144818] CrossrefMedlineGoogle Scholar57. Hawkins AH. A Small, Good Thing: Stories about Children with HIV and Those Who Care for Them. New York: WW Norton; 2000. Google Scholar58. Coulehan J. Max and the golden mean.. In: Donley C, Kohn M, eds. Recognitions: Doctors and Their Stories. Kent, OH: Kent State Univ Pr; 2002:109-15. Google Scholar59. Appendix: Information for authors. Ann Intern Med. 2003; 139:I-22. Accessed at www.annals.org/shared/manu_format.shtml on 22 January 2003. Google Scholar60. Booth W. The Rhetoric of Fiction. 2nd ed. Chicago: Univ of Chicago Pr; 1983. Google Scholar61. Williams WC. The use of force.. In: Coles R, eds. The Doctor Stories. New York: New Directions; 1962:56-60. Google Scholar Author, Article, and Disclosure InformationAuthors: Jack Coulehan, MD, MPH; Anne Hunsaker Hawkins, PhDAffiliations: From State University of New York at Stony Brook, Stony Brook, NY 11794; and The Pennsylvania State University College of Medicine, Hershey, PA 17033.This essay grew out of a panel presentation on The Ethics of Writing about Patients at the meeting of the American Society for Bioethics and Humanities, Baltimore, Maryland, 24 October 2002.Acknowledgments: The authors acknowledge the support and suggestions of Amy Haddad, RN, PhD, who participated in the panel.Disclosures: None disclosed.Corresponding Author: Jack Coulehan, MD, MPH, Department of Preventive Medicine, HSC L3-086, State University of New York at Stony Brook, Stony Brook, NY 11794-8036.Current Author Addresses: Dr. Coulehan: Department of Preventive Medicine, HSC L3-086, State University of New York at Stony Brook, Stony Brook, NY 11794-8036.Dr. Hunsaker Hawkins: Department of Humanities, H134, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAffect and its Circulation in and Beyond Richard Selzer's “Imelda”Patients as Teachers, Medical Students as Filmmakers: The Video Slam, A Pilot StudyEmergency Medicine Narratives: A Systematic Discussion of Definition and UtilityEmergency Medicine Narratives: A Systematic Discussion of Definition and Utility 19 August 2003Volume 139, Issue 4 Page: 307-311 Keywords Bioethics Children Disclosure Emergency department Euthanasia Forecasting Infectious diseases Information technology Patient advocacy Preventive medicine ePublished: 19 August 2003 Issue Published: 19 August 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.012
metaresearch head score (Gemma)0.081
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Research integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.674
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0120.081
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.002
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.003
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.597
GPT teacher head0.611
Teacher spread0.014 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designTheoretical or conceptual
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations15
Published2003
Admission routes1
Has abstractyes

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