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The Cervical Cancer Inquiry and its report (known as the Cartwright Report) were momentous events in the recent history of New Zealand. Critical issues were at stake: matters of life and death; the life's work of leaders within the medical profession; professional reputations; public trust in the profession, and its own sense of self-worth. After seven months of considering evidence, Judge Silvia Cartwright, assisted by expert medical and legal teams and drawing on specialist opinion from all over the world, concluded that Associate Professor Herbert Green had been conducting unethical research at National Women's Hospital, and that many women had been affected. This book of essays recounts some of this history. Several of the contributors were participants: Clare Matheson writes as one of the patients; Professor Charlotte Paul was a medical adviser to the Inquiry; Sandra Coney (with Phillida Bunkle) wrote the article leading to the Inquiry; Dr Ron Jones was one of the three authors of the 1984 article, using data from Green's own patients, that demonstrated that carcinoma of the cervix had a significant invasive potential. Other authors are specialists in other fields: Professor Alastair Campbell and Associate Professor Joanna Manning comment from the perspective of medical ethics and medical law respectively; Ron Paterson is the Health and Disability Commissioner; Jan Crosthwaite is a philosopher with expertise in medical ethics. These essays not only review the history but also document how the Cartwright Report changed the whole landscape of medical practice and biomedical research in this country, leading to far better protections for both patients and research participants. Yet despite all the regulatory changes, the most significant change to which the Cartwright Report contributed was attitudinal - a rejection of medical paternalism and a new expectation that patients would be treated as partners in their care. The findings of the Report remain controversial and continue to be debated to this day. This book provides a perspective on the current debates and helps place them in context. As Clare Matheson (one of Green's patients) said: 'We must never forget lest it happen again'. Contributors include: Alastair Campbell, Silvia Cartwright, Sandra Coney, Jan Crosthwaite, Ron Jones, Joanna Manning, Clare Matheson, Ron Paterson, Charlotte Paul.
In 1984 the medical journal Obstetrics and Gynecology published a paper that would initiate an investigation into one of the greatest medical scandals of the late twentieth century. Titled "The Invasive Potential of Carcinoma in Situ of the Cervix", it discussed the results of an experiment that had been run at the National Women’s Hospital in Auckland, New Zealand, since 1955. The experiment looked at the natural history of cervical carcinoma in situ (CIS) – in other words, what happens if no treatment is initiated in a condition suspected (when the experiment began) to lead to cervical cancer. The paper divided participants into two groups, one that had negative results after biopsy or treatment, and one smaller group that continued to test positive. This second group had a significant rate of cervical cancer; some of these women were followed for twenty-five years without treatment, and in only 5% did the disease spontaneously resolve. For the other 95%, outcomes ranged from positive but localised results to metastatic disease and death. The authors said these results were in contrast with other, earlier papers about the experiment. After much research, Sandra Coney, one-time editor of a NZ feminist magazine, and Phyllida Bunkle, a women’s studies lecturer, wrote an article about the experiment, exposing the unauthorised research performed by one prominent gynaecologist in support of his belief that CIS was not associated with cervical cancer. Professor Herbert Green, a physician of considerable influence and power throughout New Zealand, persisted in his belief despite increasingly convincing proof of a progressive connection between the two conditions, never sought permission from his patients, or even told them what he was doing.
A history of the study of the tides over two millennia, from Ancient Greeks to present sophisticated space-age techniques.
Captain George Cartwright (1739-1819), an English merchant who spent time in Labrador between 1770 and 1786, is best known for the fascinating account of his experiences provided in his Journal of Transactions and Events during a Residence of nearly Sixteen Years on the Coast of Labrador (1792). In recent years more of his papers have been discovered and stand alongside his journal as important source material for the early colonial period in the Atlantic region. Transcribed from original documents and extensively annotated by Marianne Stopp, the new papers deal with practical matters such as how to build a house in a sub-arctic climate, the best methods of sealing, trapping, and salmon fishing, as well as merchant rivalries and trade with Aboriginal groups. Cartwright's papers are of value for what they tell us about early methods and materials; Stopp's detailed introduction provides a history of Cartwright's Labrador and discusses these new papers with respect to early architecture, ethnohistory, material culture, and Inuit studies.
It is often supposed that the spectacular successes of our modern mathematical sciences support a lofty vision of a world completely ordered by one single elegant theory. In this book Nancy Cartwright argues to the contrary. When we draw our image of the world from the way modern science works - as empiricism teaches us we should - we end up with a world where some features are precisely ordered, others are given to rough regularity and still others behave in their own diverse ways. This patchwork makes sense when we realise that laws are very special productions of nature, requiring very special arrangements for their generation. Combining classic and newly written essays on physics and economics, The Dappled World carries important philosophical consequences and offers serious lessons for both the natural and the social sciences.
The queer recluse, the shambling farmer, the clannish hill folk—white rural populations have long disturbed the American imagination, alternately revered as moral, healthy, and hardworking, and feared as antisocial or socially uncouth. In Peculiar Places, Ryan Lee Cartwright examines the deep archive of these contrary formations, mapping racialized queer and disability histories of white social nonconformity across the rural twentieth-century United States. Sensationalized accounts of white rural communities’ aberrant sexualities, racial intermingling, gender transgressions, and anomalous bodies and minds, which proliferated from the turn of the century, created a national view of the perversity of white rural poverty for the American public. Cartwright contends that these accounts, extracted and estranged from their own ambivalent forum of community gossip, must be read in kind: through a racialized, materialist queercrip optic of the deeply familiar and mundane. Taking in popular science, documentary photography, news media, documentaries, and horror films, Peculiar Places orients itself at the intersections of disability studies, queer studies, and gender studies to illuminate a racialized landscape both profoundly ordinary and familiar.
In the late 1980s, a national outcry followed the publication of Sandra Coney and Phillida Bunkle's 'Unfortunate Experiment' article in Metro magazine about the treatment of carcinoma in situ at National Women's Hospital. The article prompted a commission of inquiry led by Judge Silvia Cartwright which indicted the practices of doctors at the hospital and led to lawsuits, censure, a national screening programme and a revolution in doctor-patient relations in New Zealand. In this carefully researched book, medical historian Dr Linda Bryder provides a detailed analysis of the treatment of carcinoma in situ at National Women's since the 1950s, an assessment of international medical practice and a history of the women's health movement. She tackles a number of key questions. Was treatment at National Women's an 'unfortunate experiment'? Was it out of line with international norms? Did Herb Green and his colleagues care more for science than for their patients? Did women die as a result? And what were the sources of the scandal that erupted?
How fixed are the happenings in Nature and how are they fixed? These lectures address what our scientific successes at predicting and manipulating the world around us suggest in answer. One—very orthodox—account teaches that the sciences offer general truths that we combine with local facts to derive our expectations about what will happen, either naturally or when we build a device to design, be it a laser, a washing machine, an anti-malarial bed net, or an auction for the airwaves. In these three 2017 Carus Lectures Nancy Cartwright offers a different picture, one in which neither we, nor Nature, have such nice rules to go by. Getting real predictions about real happenings is an engineering enterprise that makes clever use of a great variety of different kinds of knowledge, with few real derivations in sight anywhere. It takes artful modeling. Orthodoxy would have it that how we do it is not reflective of how Nature does it. It is, rather, a consequence of human epistemic limitations. That, Cartwright argues, is to put our reasoning just back to front. We should read our image of what Nature is like from the way our sciences work when they work best in getting us around in it, non plump for a pre-set image of how Nature must work to derive what an ideal science, freed of human failings, would be like. Putting the order of inference right way around implies that like us, Nature too is an artful modeler. Lecture 1 is an exercise in description. It is a study of the practices of science when the sciences intersect with the world and, then, of what that world is most likely like given the successes of these practices. Millikan's famous oil drop experiment, and the range of knowledge pieced together to make it work, are used to illustrate that events in the world do not occur in patterns that can be properly described in so-called "laws of nature." Nevertheless, they yield to artful modeling. Without a huge leap of faith, that, it seems, is the most we can assume about the happenings in Nature. Lecture 2 is an exercise in metaphysics. How could the arrangements of happenings come to be that way? In answer, Cartwright urges an ontology in which powers act together in different ways depending on the arrangements they find themselves in to produce what happens. It is a metaphysics in which possibilia are real because powers and arrangement are permissive—they constrain but often do not dictate outcomes (as we see in contemporary quantum theory). Lecture 3, based on Cartwright's work on evidence-based policy and randomized controlled trials, is an exercise in the philosophy of social technology: How we can put our knowledge of powers and our skills at artful modeling to work to build more decent societies and how we can use our knowledge and skills to evaluate when our attempts are working. The lectures are important because: They offer an original view on the age-old question of scientific realism in which our knowledge is genuine, yet our scientific principles are neither true nor false but are, rather, templates for building good models. Powers are center-stage in metaphysics right now. Back-reading them from the successes of scientific practice, as Lecture 2 does, provides a new perspective on what they are and how they function. There is a loud call nowadays to make philosophy relevant to "real life." That's just what happens in Lecture 3, where Cartwright applies the lesson of Lectures 1 and 2 to argue for a serious rethink of the way that we are urged—and in some places mandated—to use evidence to predict the outcomes of our social policies.
Over the last twenty or so years, it has become standard to require policy makers to base their recommendations on evidence. That is now uncontroversial to the point of triviality--of course, policy should be based on the facts. But are the methods that policy makers rely on to gather and analyze evidence the right ones? In Evidence-Based Policy, Nancy Cartwright, an eminent scholar, and Jeremy Hardie, who has had a long and successful career in both business and the economy, explain that the dominant methods which are in use now--broadly speaking, methods that imitate standard practices in medicine like randomized control trials--do not work. They fail, Cartwright and Hardie contend, because they do not enhance our ability to predict if policies will be effective. The prevailing methods fall short not just because social science, which operates within the domain of real-world politics and deals with people, differs so much from the natural science milieu of the lab. Rather, there are principled reasons why the advice for crafting and implementing policy now on offer will lead to bad results. Current guides in use tend to rank scientific methods according to the degree of trustworthiness of the evidence they produce. That is valuable in certain respects, but such approaches offer little advice about how to think about putting such evidence to use. Evidence-Based Policy focuses on showing policymakers how to effectively use evidence, explaining what types of information are most necessary for making reliable policy, and offers lessons on how to organize that information.