‘Beyond the Body’ & ‘Diagnosing Loss’: a conversation

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‘Beyond the Body’ artworks on display at University of Cape Town.

In Conversation: Dr Halina Suwalowska (University of Oxford) meets Dr Nina Liebenburg (University of Cape Town)

Beyond the Body: a portrait of autopsy’ is an art exhibition inspired by narratives of people involved in post-mortem procedures, depicting ethical dilemmas presented by the practice of examining the body across different cultures. Recognised as ‘learning from the dead’, autopsy has been of significant importance to medicine and science, but often a painful concern of the living.

The exhibition is a collaborative project between Dr Halina Suwalowska (Ethox Centre, Wellcome Centre for Ethics and Humanities, University of Oxford) and artist Anna Suwalowska (Royal College of Art).

The artwork inspired by Halina’s research, interprets the difficult questions posed and brings new perspectives on autopsy. Here art explores a range of viewpoints; A pathologist asking if the rights of the living to know the cause of death supersede the rights of the deceased to keep their secrets; A Buddhist priest discussing five elements determining stages of death, but also the universe; A scientist introducing less invasive autopsy in children to minimise body disfigurement, describing difficult conversations with grieving parents, amongst others.

In April 2022 ‘Beyond the Body’ was shown at the Michaelis School of Fine Art at the University of Cape Town as part of the ‘Diagnosing Loss’ exhibition, curated by Dr Nina Liebenberg (The Centre for Curating the Archive, University of Cape Town).

The following transcript is a conversation between Halina and Nina:

Halina Suwalowska (HS): What is the ‘Diagnosing Loss’ exhibition about? How did you come up with the concept and title of the exhibition?

Nina Liebenberg (NL): ‘Diagnosing Loss’ grappled with ideas of loss as it is understood and studied by a wide range of disciplines. It took inspiration from the artwork created for the exhibition ‘Beyond the Body: a portrait of autopsy’.

The exhibition also brought together several artworks from Michaelis School of Fine Art staff, students, and graduates, along with objects sourced from the university’s Physics, Pathology, Mathematics, Chemistry, Special Collections, Anatomy, and Biological Sciences Departments.

By combining disciplinary objects (used in the various science and medical curricula) with a selection of artworks that either spoke to the theme of loss or used scientific material as subject matter, the exhibition allowed certain previously obscured qualities to surface in the disciplinary materials (affective and poetic ones, for instance): a small non-descript anatomical model of the ‘empty’ space of the brain evoked the loss of memory and the devastation of Alzheimer’s; whilst a mathematical equation representing what one ‘loses’ by predictions not coinciding with targets (in the context of machine learning), paired with a
sculpture of an abdomen from which a shower of white handkerchiefs spilled to the ground, enabled a viewer to reflect on (and perhaps ridicule) the dated ‘body as machine’ mantra of science. The title was a play on the impossibility of understanding/navigating/measuring/traversing/estimating/figuring/calculating or
representing loss. (Try as we might…)

‘Diagnosing Loss’ also serendipitously coincided with another exhibition that opened a week later in the downstairs gallery on the Michaelis Fine Art Campus. ‘Of Smoke and Ash’, curated by Jade Nair and Duane Jethro, marked the anniversary of the devastating fire that destroyed UCT’s African Studies Library in April of 2020. Because of their close proximity, ideas of loss resonated between these two shows during the two weeks they ran concurrently.

(HS) How has the ‘Beyond the Body’ exhibition inspired the creation of the ‘Diagnosing Loss’ exhibition?

(NL) The ‘Beyond the Body’ exhibition focuses on the procedure of the autopsy, and it grapples with how scientific and ethical standards on this procedure have changed over time, and the dilemmas it poses to different cultures…For me, the paintings also spoke of the autopsy as a last act of trying to understand or grasp loss – an attempt at reasoning why a life has been lost, or a last fortress against the onslaught of grief and the absence of reason that accompanies death.

(HS) How did you curate the exhibition? Please tell us more about some of the objects and artworks you selected.

(NL) The object collections from across the university have been an enduring source of inspiration for me over my many years at UCT. When planning ‘Diagnosing Loss’ I had an initial list of potential objects I thought would be relevant to the theme, and would resonate with the artworks I chose to include.

These included the neck support from the Pathology Learning Centre. Made from oak, it was used to support the neck during a post-mortem examination. It is literally invested with traces of hundreds of losses – its scarred and worn surface analogous to a wounded, ill and traumatised body.

In addition to the neck support, the letters written to Dr Chris Barnard by children, after he performed the first heart transplant in Grootte Schuur Hospital on 3 December 1967 also seemed relevant. In one, a little girl asks him how to perform a heart transplant on the dead dove she found in her garden, while in another a girl relates how she caught a fish she thought was dead, but whose heart started beating again a few hours later: ‘Can you explain that?’ she asks ‘If a doctor says you’re dead and they take out your heart but it is still beating, are you dead or alive?’.

I also found an array of new objects I didn’t know existed, including a demonstration model in the Physics department that weighs air, and I sourced a new mathematical equation on loss from the Head of Mathematics, Professor Daya Reddy.

The artworks on show were gathered from postgraduates, staff and previous students and they were works that I either knew from memory or new ones I commissioned from staff or colleagues that I knew worked with medical or scientific themes or subject matter.

(HS) The opening talk took place at the Anatomy Lecture Theatre. Please tell us a bit more about the history of that place.

(NL) The Anatomy Lecture Theatre was used to teach anatomy and physiology to those first medical undergraduates in 1912. The cadavers that were dissected in the theatre entered the building from the back, where a lift would take it to the uppermost floor. It would then be wheeled into the lecture hall through an entrance on the opposite end of the room from the student entrance.

Students did not sit during these classes, but stood on steep steps above their lecturer to get a good view of the dissection. In the many years since then, the layout of the theatre has remained very similar. The steep incline was however fitted with chairs, but the two entrances remain in use (albeit for very different purposes!). We tend to enjoy the look of horror on our students’ faces when we tell them about the history of the building and the lecture theatre they are sitting in, at the start of every year!

(HS) What role does art play in medical and scientific projects? What is the value of having projects intersecting art, medicine and science? How can art contribute to initiating difficult conversations about death or loss?

(NL) In most universities, research occurs within specialised departments and rarely leaves these spaces. The curatorial, because of its public-facing nature, offers a new kind of academic ecology, allowing for the output of these environments to be translated and disseminated into new spaces and to diverse audiences. As such, it provides academics with new opportunities to address their publics. The method also generates a potentially productive space in which to think about how different forms of knowledge are shaped. In my own experience, the value of extending frameworks of knowing to include the
unexpected and the novel, has proven to be of immense value to both the sciences and the humanities, and confirms my conviction that projects which foster these engagements, are imperative tools for facing an uncertain future.

‘Diagnosing Loss’ was shown at the University of Cape Town from 15th April to 29th April 2022 and curated by Dr Nina Liebenberg from The Centre for Curating the Archive, UCT. ‘Beyond the Body’ continues to tour medical institutions around the world.

Please get in touch if you’d like more information on either of these exhibitions: weh@bdi.ox.ac.uk
Instagram: @anna_suwalowska

‘Beyond the Body’ & ‘Diagnosing Loss’: a conversation

Oxford Winter School 2022

In January, the highlight of our master’s program Philosophy, Bioethics and Health (BPH) at the Vrije Universiteit Amsterdam finally took place: the annual Oxford Winter School. Since the establishment of BPH in 2013, the Oxford Winter School has been an integral part of its second year’s curriculum. The Winter School revolves around a ‘critic-meets-author’ structure in which students present their reflection on academic papers written by scholars affiliated to the Wellcome Centre for Ethics & Humanities, after which they have the unique possibility to engage in a stimulating discussion with the author(s) and other participants in the session.

Photo by Chris Montgomery on Unsplash

This exceptional opportunity all motivated us to start the new year by studying the selected articles extensively. Even though this edition was online because of Covid-19 restrictions, the paper topics and the prospect of conversing with the authors made us eager to dive into it from the start. Guidance was provided in several preparation tutorials, in which the content of the articles sparked lively conversations that contributed to both the process of shaping the presentations and our growing enthusiasm. At the end of the rehearsals, we were left feeling excited, well-prepared and to be completely honest, also a little nervous.

Continue reading “Oxford Winter School 2022”
Oxford Winter School 2022

GPDPR: What it is, and why it’s important to get it right

On September 1 2021, NHS Digital will implement a new system for extracting millions of patient medical histories and other data from GP practices across the UK, in line with the new General Practice Data for Planning and Research (GPDPR) data collection scheme.

The announcement has been met with criticism by privacy activists and other organizations, who are concerned that the new system is being implemented too quickly, without adequate safeguards for patient data, and without sufficient public consultation. (In response to pressure from privacy activists, the original July 1 deadline has been postponed to September 1, 2021).

Let’s unpack some of the issues about GPDPR that have been getting the most attention.

Face and binary code

What exactly is GPDPR?

GPDPR is the new method for collecting patient medical data from GP records, designed to replace the General Practice Extraction Service (GPES) with a more cohesive and efficient system. Most of the information in your medical record held by your GP is stored using different codes (e.g., codes for a specific diagnosis, or prescribed medication). Periodically, this coded information is collected by NHS Digital and used for healthcare planning (e.g., what health and care services are needed in a local area), and medical research.

Continue reading “GPDPR: What it is, and why it’s important to get it right”
GPDPR: What it is, and why it’s important to get it right

Oxford-Amsterdam Spring School in Bioethics 2021

As with every other class and conference this year, the Oxford-Amsterdam Spring School too was an online affair! Some of us logged (and relogged thanks to malfunctioning Wi-Fi) into Zoom from the UK, and others joined from the Netherlands, Kenya, and Spain, among other places.

The point of the Spring School was to bring us doctoral students who are part of the Oxford-Amsterdam bioethics network together, and to give us an opportunity to present our bioethics research projects to an audience that included a panel of researchers who were experts in our unique research areas. This meant that the organizers of this event — Suzanne Metselaar, Gerben Meynen, Michael Dunn, and Ruth Horn — spent the weeks leading up to the event collecting our research protocols and scouting out specialist researchers who could give us constructive feedback.

Continue reading “Oxford-Amsterdam Spring School in Bioethics 2021”
Oxford-Amsterdam Spring School in Bioethics 2021

Oxford-Amsterdam Winter School: 8th (online) edition

Since its foundation in 2013, the Oxford-Amsterdam Winter School has been a highlight of the MA-programme Philosophy, Bioethics, and Health (PBH), a two-year MA-programme of the Philosophy Department and Medical Humanities, VU University (Medical Center) in Amsterdam.  

This year’s Winter School was in many aspects unique and different from previous editions. Unfortunately, the ongoing Covid-19 pandemic made an actual visit to Oxford and the Wellcome Centre for Ethics and Humanities impossible. However, flexibility and enthusiasm on both sides of the North Sea resulted in the first online edition of the Winter School. Even though all participants were sitting at home behind their own desk or kitchen table, there was a great sense of togetherness.

Continue reading “Oxford-Amsterdam Winter School: 8th (online) edition”
Oxford-Amsterdam Winter School: 8th (online) edition

Ethical treatment of guest workers with non-work related catastrophic medical conditions

Dr Voo Teck Chuan is an assistant professor at the Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine.  He was a Caroline Miles Visiting Scholar at the Ethox Centre in March-April 2019.

Recently, the treatment of a guest worker with a life-threatening disease was highlighted in international news. Baby Jane Allas, a foreign domestic worker based in Hong Kong was fired by her employer after she was diagnosed with aggressive stage 3 cervical cancer, with her illness cited as the reason. In losing her employment visa, she lost her right to stay in Hong Kong and her right to access its heavily subsidized public healthcare. Her work termination was, in her words, akin to a death sentence because she would not be able to pay for her treatment if she were to return to her country. Even if she could pay, the urgent treatment that she needed would, according to her, be delayed as she would be placed on a wait-list.  Going for treatment would also not be easy as the hospital is far from her home. Continue reading “Ethical treatment of guest workers with non-work related catastrophic medical conditions”

Ethical treatment of guest workers with non-work related catastrophic medical conditions

First Edition of the Oxford-Amsterdam Spring School!

How often do we, as starting doctoral students, get the chance to practice defending our proposed research projects in front of a panel of scholars, each a respective expert in their field? Well, that’s exactly what happened in Amsterdam on April 11 and 12, 2019. Continue reading “First Edition of the Oxford-Amsterdam Spring School!”

First Edition of the Oxford-Amsterdam Spring School!

The Art of Being Directive without Being Directive? Roles of Ethical Experts in Psychiatry

Dr. phil. Joschka Haltaufderheide, M.A., is a researcher at the Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum. His fields of interest include concepts of ethical expertise and ethics consultation in healthcare. He was a Caroline Miles Visiting Scholar at the Ethox Centre in July/August 2018.

Ethical expertise, which mostly comes as part of clinical ethics support services (CESS) in mental healthcare, is a valuable tool in psychiatric practice. In Germany, since the mid-nineties, it has often been advocated as being useful for professionals in this field to analyze, clarify or resolve ethical issues in everyday practice. In a recently published study, two of my colleagues conducted the first psychiatry-specific survey to shed some light on the recent situation of CESS in psychiatry. In their survey, Gather et al. asked for 32 items regarding already established or planned structures of ethics consultation in psychiatric hospitals in Germany.[i] To our surprise, more than 90% of German psychiatric hospitals have already implemented ethical support structures of different types. However, despite this very high implementation rate, the number of actual cases dealt with in these services is low. Continue reading “The Art of Being Directive without Being Directive? Roles of Ethical Experts in Psychiatry”

The Art of Being Directive without Being Directive? Roles of Ethical Experts in Psychiatry

Time to Bury Concerns about Monetary Undue Inducements in Research

Ethan Cowan, MD, MS, is an Associate Professor of Clinical Emergency Medicine and the Director of Research and Community Engagement in the Department of Emergency Medicine at Mount Sinai Beth Israel Hospital, Icahn Mount Sinai School of Medicine, New York, NY and our 2018 Andrew Markus visiting scholar.

Recently, I was a co-investigator on a National Institutes of Health (NIH) funded project studying the initiation of buprenorphine/naloxone in the Emergency Department for patients with moderate to severe opioid use disorder. This medication assisted treatment is instrumental in the fight against the raging opioid epidemic in the United States. To help encourage patients to participate in the study we provided them with a monetary incentive for enrollment and follow-up.  This incentive was not particularly large but for the Institutional Review Board (IRB) it raised concerns about undue inducement. In this study, and others like it, the concern of IRBs seems to hinge on the belief that money somehow impairs the ability of a potential research subject to provide valid informed consent for study participation. But, is this problem real or imagined? Continue reading “Time to Bury Concerns about Monetary Undue Inducements in Research”

Time to Bury Concerns about Monetary Undue Inducements in Research

Vulnerability and Health Research: The REACH Project

Ariella Binik, Ethox Centre, University of Oxford

Vulnerability has long been recognized as a central concept in research ethics. It aims to identify populations in need of special protections and to clarify the protections that should be provided. Despite a long history in research ethics guidelines and considerable attention in bioethics scholarship, offering a clear and persuasive account of what it means to be vulnerable, who is vulnerable, and why they are vulnerable remains controversial. Continue reading “Vulnerability and Health Research: The REACH Project”

Vulnerability and Health Research: The REACH Project