Susan L. Smith

Location of death in Canada. A comparison of 20th-century hospital and nonhospital locations of death and corresponding population trends.

This report compares 20th-century Canadian hospital and nonhospital location-of-death trends and corresponding population mortality trends. One of the chief findings is a hospitalization-of-death trend, with deaths in hospital peaking in 1994 at 80.5% of all deaths. The rise in hospitalization was more pronounced in the years prior to the development of a national health care program (1966). Another key finding is a gradual reduction since 1994 in hospital deaths, with this reduction occurring across all sociodemographic variables. This suggests nonhospital care options are needed to support what may be an ongoing shift away from hospitalized death and dying.

Mustard gas and American race-based human experimentation in World War II.

This essay examines the risks of racialized science as revealed in the American mustard gas experiments of World War II. In a climate of contested beliefs over the existence and meanings of racial differences, medical researchers examined the bodies of Japanese American, African American, and Puerto Rican soldiers for evidence of how they differed from whites.

Toxic legacy: mustard gas in the sea around us.

This essay examines the toxic legacy of American and Canadian sea disposal of mustard gas after World War II. Military ocean dumping of mustard gas and other chemical warfare material has created an enduring and global environmental and public health problem.

Health legacies of war on and beyond the battlefield.

5 The health legacies of war are ubiquitous: everpresent and everywhere. Consider the ongoing wars in Afghanistan since October 2001 and in Iraq since March 2003, part of the so-called “War on Terror” launched by President George W. Bush after the attacks on the United States on September 11, 2001. These wars have produced casualties not only among troops in combat, but also among civilians in neighborhoods, detainees in prisons, and newborn babies. In March 2010, for example, physicians in the Iraqi city of Falluja reported high rates of birth defects in babies. They attributed infant heart defects and nervous system disorders to the use of sophisticated American weapons and exposure to hazardous military waste in the environment.1 In April 2010, two former American soldiers released an open letter of apology to the Iraqi people for the shooting of civilians, including children and journalists, in a Baghdad neighborhood.2 Such reproductive, environmental, and community harms are central components of the health consequences of war. Examination of the impact of war raises important questions about human rights and medical ethics. As George Annas and Jonathan Moreno warn, the military is too often overlooked in the study of bioethics, yet it has been integral to its history.3 International standards clearly state the parameters of ethical and legal behavior in wartime, yet violations are inevitable when national security and military necessity trump all else. Consider the evidence of the American torture of “detainees” in U.S. custody at military prisons in Abu Ghraib in Baghdad and Guantanamo Bay in Cuba.4 For example, Omar Khadr, a Canadian citizen and one of the youngest detainees in Guantanamo, was the victim of physical and mental abuse as he awaited trial for his role as a child soldier in the war in Afghanistan. Khadr was only fifteen years old in 2002 when he was captured in a shootout in which he allegedly killed an American army medic. In an effort to gain military intelligence, the Bush administration permitted torture by the Central Intelligence Agency (CIA) as part of the interrogation tactics used on suspected terrorists like Khadr.5 The techniques included such procedures as forced feeding, sleep deprivation, and water boarding. The U.S. government justified the physical and mental trauma faced by detainees on the grounds of national security. According to Dennis Edney, one of Khadr’s Canadian lawyers, justice demands transparency and the rule of law, yet the U.S. and Canadian governments abuse their power and cling to secrecy. Such actions, Edney points out, raise troubling questions about the future treatment of all soldiers captured in a war zone.6 Furthermore, in June 2010, Physicians for Human Rights released a report alleging that the CIA not only engaged in torture of detainees, but also human experimentation. The report suggests that physicians working for the CIA engaged in unlawful and unethical experimentation as they monitored the medical data on detainees during the brutal “enhanced” interrogations in order to provide future legal protections against accusations of torture and improve intelligence gathering techniques.7 The history of the health consequences of war was the subject of a two-day event at the University of Alberta in Canada in September 2009. Entitled introduction

War! What is it good for? Mustard gas medicine

Mustard gas, which was named for its yellow-brown colour and mustard smell, has been in the news lately because of its use in the Middle East, including against civilians in Syria and Iraq. Many North Americans would be shocked, however, to learn of the deep connection between mustard gas, a

Contraception Controversies: The Clinic, the Pill, and the Birth Control Movement

The history of birth control continues to capture the interest of American history scholars and students alike. Specialists in gender and women’s history, as well as the history of medicine, have produced important scholarship on the history of abortion, sterilization, and contraception. Cathy Moran Hajo, in Birth Control on Main Street: Organizing Clinics in the United States, 1916–1939, and Elaine Tyler May, in America and the Pill: A History of Promise, Peril, and Liberation, provide the latest additions to the history of reproduction. They illuminate some of the key contraception controversies of the past and among historians, reminding us of the significance of the fight for reproductive rights to the history of modern America. In Birth Control on Main Street, Cathy Moran Hajo explores the development of birth control clinics, arguing that they were the center of the birth control movement in the early twentieth century. Hajo is an adjunct assistant professor in the Archives and Public History Program at New York University and an associate editor of the Margaret Sanger Papers Project. In her book she draws on a rich set of primary sources to provide details about the birth control movement at the local level across the U.S., focusing on the 1920s and 1930s. Evidence from more than 600 clinics reveals what birth control activists did, not just what they said. It reveals the birth control movement from the perspective of clinic workers and local activists who served approximately 300,000 clients. Hajo suggests that, to date, historical studies have either painted merely the broad strokes of the national story or they have provided detailed case studies of a single location. In this work she reveals the nationwide story of how birth control activists put ideas into practice.

Caregiving on the Periphery: Historical Perspectives on Nursing and Midwifery in Canada (review)

plified by her use of modern analogies and literary/televisual allusions, some of which are better judged than others. Academic readers may also feel slightly uncomfortable with a level of speculation and narrativization more common in the popular than in the scholarly realm. More substantively perhaps, the contextual studies that compose the bulk of the middle chapters, though always expertly grafted onto the narrative, sometimes stray a little too far from the central thrust of the book, leaving the reader impatient to return to the story at hand. This is especially true for the academic reader as there is relatively little in these sections that is new. Alongside her own research on Edinburgh medical education, the work of Hamlin on William Pulteney Alison, Cooter and Shapin on Edinburgh phrenology, Rosen on medical police, or Burney on forensic medicine is clearly discernable. Indeed, it is sometimes rather frustrating that Rosner does not do more to link her story more specifically to cultural politics of anatomy. For this dimension students of the subject must continue to rely upon Ruth Richardson’s peerless Death Dissection and the Destitute. Having said this, The Anatomy Murders is a beautifully crafted book, popular history as it should be written: intelligent, informative, and, above all, a rip-roaring read.

Making Room in the Clinic: Nurse Practitioners and the Evolution of Modern Health Care (review)

effectively shows how nursing organizations and politically organized nurses adopted feminist standpoints on a number of issues, but the text could benefit from more description of average nurses’ opinions about feminism. As the profession became more racially and sexually diverse, a more detailed picture of nurses’ responses to feminism would help to underscore the book’s thesis. What did the men whom the feminist movement helped usher into nursing in greater numbers think of the increasing influence of feminism? Did black and white nurses hold similar opinions about feminism and its effects on nursing? As increasing numbers of women became physicians, did feminism unite these women, or did their professions and the gendered connotations of their work divide them? A more thorough treatment might have allowed for a deeper mining of the sources to answer these questions. Instead of simply presenting the findings of contemporary studies of nurses as conclusive evidence of particular behaviors or beliefs, for example, Malka’s thesis would be strengthened by a discussion of the gendered and racial assumptions of the studies themselves. Still, Malka convincingly demonstrates the overarching effects of feminism on the nursing profession, and the arguments presented here add to our understanding of nursing history, as well as the history of women, gender, and second-wave feminism.