My research is necessarily interdisciplinary — part history of science, technology, and medicine; part legal studies; part professional studies; and part intellectual history.
By weaving together disparate strands of history, I work to show the historical origins of contemporary issues and policies and to demonstrate that ideas we often take for granted — for instance, privacy and confidentiality — are the product of myriad historical contingencies.
My dissertation, Creating Confidentiality: Physician‑Patient Privilege and Medical Confidentiality in the United States, 1776‑1975, is a case in point. It traces the long and complicated history of medical confidentiality and physician-patient privilege in the United States and is the first study of privilege to incorporate all of these disparate elements into one narrative.
In my dissertation, I emphasize the role that nineteenth‑century developments played in the evolution of medical privilege. I show that the first privilege statutes emerged at the state level as part of larger efforts to codify and streamline American legal codes. I demonstrate that the medical profession was at first ambivalent toward the rise of these early laws, but later came to embrace privilege as a powerful indicator of its own professional status. I argue that the rise of American capitalism in general, and the accompanying rise of the insurance industry in particular, transformed privilege from a minor and seemingly insignificant rule of courtroom evidence into a high-stakes issue, which then spurred efforts to curtail the scope of privilege in the twentieth century. In tracing this history, my dissertation examines the intersections between two of America’s most powerful professions — medicine and law — and carries implications to the broader history of professionalization. In my analysis of medical confidentiality, I show how professional ethics functioned as a means of legitimizing the medical profession in the nineteenth century.
Prior to developments in bacteriology and scientific medicine that occurred in the last decades of the nineteenth century, regular physicians (those educated in mainstream, orthodox medical schools) could not convincingly argue that their therapeutics were any more effective than the therapeutics of other non-traditional practitioners like botanists or homeopaths. This meant that medical ethics — especially when sanctioned by the state, as in the case of physician‑patient privilege — proved to be one of the only legitimate claims regular physicians could make to justify their claims to a monopoly over the profession. As regular physicians found new arguments to support their control over the medical profession, however, some began to see medical ethics as a restriction on the freedoms of physicians rather than as a protection. This transformation within the medical profession enabled the gradual erosion of physician‑patient privilege in the twentieth century.
This history is essential in order to understand medical privilege as policy in the twenty-first century, especially since the privilege continues to be a contested and unevenly applied rule in American courts. Most state courts, for example, recognize various degrees of privilege, while federal courts do not. Throughout my dissertation, I show that the current mosaic of laws governing medical testimony in the courtroom were cobbled together in response to numerous contradictory impulses — mostly in response to nineteenth century developments — and never intended as ironclad protections of patients’ right to privacy. Therefore, if privilege is to be a valuable safeguard of patients’ privacy in the twenty‑first century, the nation would need new statutes that reflect this priority.
I am currently revising my dissertation into a book manuscript. In doing so, I am working to reframe my dissertation from a study of physician‑patient privilege into a larger narrative that examines the history of medical confidentiality in the United States. Much of this work involves carrying my research further into the twentieth century, where I explore the distinctions and intersections between privilege, confidentiality and privacy. At the same time, this also requires me to address growing concerns about digital information and data privacy. I envision the final project as an interdisciplinary study that carries important implications for broader discussions of privacy, confidentiality, and healthcare policy in the twenty-first century. I expect to finish this project in 2020.
PROFESSIONAL EXPERIENCE
As a freelance historian, I have performed historical research and writing to assist in the development of new educational software.
I have provided research support for a variety of different projects. As a research assistant, I have:
- catalogued court cases as a means to trace the history of immigration detention in the United States
- combed through newspaper archives for any mention of Haiti in order to demonstrate the importance of Haitian independence to African Americans in the nineteenth century
- examined the letters and diaries of American executives abroad in an effort to trace the evolution of environmental policy
Selected Grants & Fellowships
- John L. and Naomi Luvaas Graduate Fellowship, University of Oregon, College of Arts and Sciences, 2018‑2019
- Dissertation Fellowship, Oregon Humanities Center, 2018‑2019
- Research Fellowship, University of Oregon, 2017‑2019
- Graduate Research Support Fellowship, Oregon Humanities Center, 2017‑2018
- Summer Research Award, University of Oregon Department of History, 2017
- Graduate Teaching Fellowship, University of Oregon, 2013‑2017