UIC CONFERENCE EXPLORES IMPACT OF ILLNESS AND MEDICATION ON IDENTITY
Would weight gain of 30 to 50 pounds affect how you feel about yourself? How about if you no longer could perform sexually or experience sexual pleasure? Would a persistent hand tremor make you feel self-conscious?
The UIC College of Pharmacy is bringing together experts from the United States and Canada to examine the intersection of chronic illness, medication and identity and raise awareness of this hidden issue at a groundbreaking symposium at the UIC Health Sciences Center, April 2.
Chronic illness, alone, can transform an individual. Medication can minimize the destructive biological impact of chronic illness. It also can affect the self-image of a chronically ill individual. The ability to manage a chronic illness through medication may empower a person or undermine an individual's sense of autonomy and control.
Additionally, medication is "imbued with potent cultural meanings," said Bruce Lambert, associate professor of pharmacy administration in the UIC College of Pharmacy and symposium organizer. "A Prozac prescription, for instance, may be a status symbol for some people in our culture. Conversely, there are some people who won't inject insulin because they associate needles with heroin use and addiction," he said.
Medications also may be imbued with personal meanings. Whether cultural or idiosyncratic, what medication means to an individual is likely to affect that individual's willingness to comply with a prescribed drug regimen. Medications are the most common treatment for chronic illness, Lambert said, yet at least half of the time, they are not taken "as directed."
Side-effects, too, can have a profound impact on an individual's daily life and identity and, hence, compliance. Medications for depression can cause sexual dysfunction, weight gain and chemical dependence. High blood pressure drugs can cause frequent urination, impotence and fatigue. Drugs for epilepsy and psychosis can cause mental clouding and movement disorders.
"These identity issues have clinical and practical relevance," Lambert said. "We want health professionals to consider the meaning of medication to patients, not just the impact of medication on kidney or liver function. Medical professionals are beginning to consider pain as the fifth vital sign. We want self and identity issues to be the sixth vital sign," Lambert said.
Lambert notes that though the impact of illness and medication on identity is an active area of research among social scientists, it has not penetrated the biomedical clinical specialties. "The sense of self is systematically ignored by most medical specialties," Lambert said. With the aging of the baby boom population, the number of chronically ill individuals is rapidly increasing, making it more important for health professionals to understand these issues, Lambert added.
Lambert organized the symposium in response to an initiative by university president James Stukel to encourage faculty to explore the relationship among science, technology and society.
The symposium, "Technologies of the Self: Examining the Intersection of Medication, Identity and Illness," takes place Monday, April 2 from 8:30 a.m. to 5:30 p.m. at the Chicago Illini Union, 828 S. Wolcott Ave., Room C. It is organized into three sections: Self and Chronic Illness, Meaning of Medication, and Integration into Practice. The schedule with background on the presenters is attached.
To report on this issue, interview presenters in advance of the conference or to cover the conference, please contact Jody Oesterreicher, (312) 996-8277.
For more information about UIC, visit www.uic.edu
TECHNOLOGIES OF THE SELF: EXAMING THE INTERSECTION OF MEDICATION, IDENTITY AND ILLNESS
Monday, April 2, 2001
Welcoming Remarks, by Rosalie Sagraves, dean, UIC College of Pharmacy Introduction, by Bruce Lambert, UIC associate professor of pharmacy administration
Self and Chronic Illness Panel Presentation
Body, Self and Biography in Chronic Illness, by Juliet Corbin, registered nurse, doctor of nursing science and well-known author of numerous books including "Unending Work and Care: Managing Chronic Illness at Home" and "Shaping a New Health Care System: The Explosion of Chronic Illness as a Catalyst for Change."
Illness Intrusiveness and Self-Concept in Chronic Disease, by Gerald Devins, professor, department of psychiatry, University of Toronto
Living Illness as a Story, by Arthur Frank, professor of sociology, University of Calgary
Respondent, Barbara O'Keefe, professor and dean of the School of Speech, Northwestern University
Meaning of Medication
An Unwelcome Career: Drugs and the Medicalization of Depression, by David Karp, professor of Sociology, Boston College
The Meaning of Medications and Medication Use, by Michael Montagne, Rombault Distinguished Professor of Pharmacy, Massachusetts College of Pharmacy, Boston
Anthropological Perspectives on Pharmaceutical Practice, by Nancy Vukovich, investigator, Kaiser Permanente Center for Health Research, Portland
Respondent, Gary Albrecht, professor of health policy and administration, UIC School of Public Health
of Medication, Identity and Illness Concerns into Practice
Medication and Mental Illness: Is There Room for Negotiation?, by Dr. Naomi A. Levy, department of psychiatry, MacNeal Hospital, Berwyn, Ill.
Swept Away: Indigent Patients' Agendas, Outcomes and Lives Drowning in a Sea of Drugs, by Dr. Gordon Schiff, director of the department of medicine, Clinical Quality Research Unit, Cook County Hospital, Chicago
Psychoanalytic Perspectives on Medication, Identity and Illness, by Dr. Jerry Winer, professor of psychiatry, UIC Medical Center and director, Chicago Institute for Psychoanalysis
Respondent, Dr. Joseph Flaherty, head of the department of psychiatry, UIC Medical Center
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