SLU Doctoral Student Wins Fellowship to Study Intersection of Gender, Health Care Ethics
As she pursues a career in academic medicine, Saint Louis University graduate student Michelle Bach is uncovering the ways that gender and bias influence mental health diagnoses. Now, with support from a national fellowship, as part of her dissertation research, she is reimaging the ethics behind psychiatric care and mental health care settings to improve patient care.
Bach’s research recently received an American Fellowship from the American Association of University Women (AAUW), which will allow her to complete her dissertation, “Disorder and Beauty: Seeking New Ethical Resources in Psychiatry.” The fellowship honors scholarly excellence and aims to tackle barriers women face in education.
“It comes down to working towards an ever-improving model of psychiatry that reduces suffering while affirming the people who suffer,” Bach said.
The Orlando, Florida native was drawn to the prestige of the Albert Gnaegi Center for Health Care Ethics – the center’s program consistently rank among the best in the nation – and to the diversity of research topics and methods graduate students pursue in and out of the center’s classrooms.
“I chose to pursue a Ph.D. in bioethics out of a conviction that examining our moral and philosophical commitments is just as relevant as biochemistry or immunology to providing truly good medical care to patients,” Bach, who is pursuing a combined M.D./Ph.D. degree in health care ethics, said. “Time for reflection is sparse in medicine. The dual degree track has given me time to think deeply about what the practice of medicine can and should be.”
Learn About Bach’s Award-Winning Work
Have you ever heard someone described as “borderline?” Such comments get bandied about to describe celebrities and bothersome co-workers, to explain upsetting behavior or dismiss a person as “crazy.” Yet even among medical professionals, the term “borderline personality disorder” can be used as shorthand for “difficult to deal with.”
With three-quarters of borderline diagnoses going to women and girls, some scholars argue that the borderline label is used to imply “non-compliant female.” The imprecise use of “borderline” is an example of a larger problem of diagnosing personality disorders within psychiatry. Because personality disorder diagnoses pathologize people’s personalities, and perhaps a substantial portion of their very personhood, the issue of hidden value judgments arises.
In my dissertation and this research, I examine value judgments inherent in personality disorder diagnoses without recapitulating anti-psychiatry arguments. Instead, I use philosophical, feminist and bioethical approaches to examine the deep-seated values that allow psychiatrists to make reasonably coherent judgments of personhood. I mine those values for untapped ethical resources that will help psychiatrists improve opportunities for healing.
In particular, I argue that psychiatry is indebted to aesthetics; this does not render psychiatry unscientific but rather reveals new pathways for aiding patients in shaping a good and satisfying life. By recognizing the aesthetic commitments inherent to but hidden in psychiatric practice, we can reimagine tools for care that move beyond the mechanistic.
The importance of this project is that it proposes a unique way to circumscribe the province of psychiatry while simultaneously opening up new avenues for relieving suffering.
Our focus on the patient is re-attuned from labeling what’s wrong to envisioning possibilities for beauty and completeness.
A fellowship from the AAUW means a lot to me because I hope to work in academic medicine and, while the number of female physicians is increasing, academic medicine leadership is still heavily male dominated.
Studies show that women receive less institutional support and are much less likely to remain in academic medicine, achieve senior rank or be placed in senior leadership positions relative to male counterparts.I am really excited to have the support and camaraderie of the amazing female scholars and academic leaders in the AAUW. Not only have I gotten support for my project, but I feel like I've been introduced to a whole network of role models.
Founded in 1818, Saint Louis University is one of the nation’s oldest and most prestigious Catholic institutions. Rooted in Jesuit values and its pioneering history as the first university west of the Mississippi River, SLU offers nearly 13,000 students a rigorous, transformative education of the whole person. At the core of the University’s diverse community of scholars is SLU’s service-focused mission, which challenges and prepares students to make the world a better, more just place.