Tag: case studies

Bioethics Blogs

Luhrmann and Marrow’s Our Most Troubling Madness by Murphy Halliburton

Our Most Troubling Madness: Case Studies in Schizophrenia Across Cultures

T.M. Luhrmann and Jocelyn Marrow, editors

University of California Press, 2016, 304 pages

 

A key premise of this volume of ethnographic case studies is that schizophrenia, or the various conditions we label as schizophrenia and related psychoses, varies in crucial ways in terms of experience, prognosis and outcome in different sociocultural contexts. Tanya Luhrmann’s introduction to the volume, which features twelve articles presenting twelve individuals diagnosed with schizophrenia (including three cases presented by Luhrmann), casts doubt on the biomedical model of schizophrenia, or at least the strong biomedical model where an individual’s biology is the determining factor in the pathogenesis of schizophrenia. Support for this critique comes from within the fields of psychiatry, psychology and related disciplines, and not just from anthropology, the disciplinary home base of many of the authors in this compilation. This supports the volume’s efforts to speak to an audience beyond the contributors’ own disciplines and “serve as a positive catalyst for change” in how we treat psychosis, especially in European and North American settings (5).

The introduction also briefly traces the history of theories of schizophrenia in psychiatry and anthropology, including moments when the two fields overlapped as with Gregory Bateson’s theory that schizophrenia results from a “double bind” that develops in a person’s psyche from conflicting social cues. This theory, put forth by an anthropologist, had a significant place in psychiatrists’ understanding of pathogenesis until the rise of the medical model deflected the blame from families toward “random bad genetic luck” (16).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals–March 2017, Part II by Julia Kowalski

This is Part II of March’s article round-up. You can find part I here.

In addition to the articles below, Theory, Culture and Society features an interview with Michel Foucault from 1983.

New Genetics and Society

Everything and nothing: regulating embryo research in Canada

Alana Cattapan & Dave Snow

This article examines how medical and scientific professionals experience and engage with the governance of embryo research in Canada. Drawing on the history of embryo regulation in Canada and the findings of a survey conducted with lab directors in Canadian fertility clinics, we identify a disjuncture between the rules established by legislation, regulations, and research ethics guidelines and the real-life experiences of professionals in the field. This disjuncture, we argue, is the result of both the absence of implementation mechanisms that would give substance to the governing framework, as well as an inability on the part of medical and scientific professionals to engage in robust self-regulation. Overall, we demonstrate that in an ethically charged and highly technical area of policy-making like embryonic research, clarity about the roles and responsibilities of government and professionals in policy-making and implementation is critical to effective governance.

Not just about “the science”: science education and attitudes to genetically modified foods among women in Australia

Heather J. Bray & Rachel A. Ankeny

Previous studies investigating attitudes to genetically modified (GM) foods suggest a correlation between negative attitudes and low levels of science education, both of which are associated with women. In a qualitative focus group study of Australian women with diverse levels of education, we found attitudes to GM foods were part of a complex process of making “good” food decisions, which included other factors such as locally produced, fresh/natural, healthy and nutritious, and convenient.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Lenore Manderson, Elizabeth Cartwright and Anita Hardon’s The Routledge Handbook of Medical Anthropology by Casey Golomski

The Routledge Handbook of Medical Anthropology

Edited by Lenore Manderson, Elizabeth Cartwright and Anita Hardon

Routledge, 2016, 393 pages.

 

This is not a run-of-the-mill medical anthropology reader. Thank Routledge, its editors, and contributors for it. As someone who regularly convenes intermediate-advanced courses in medical anthropology, I’m grateful for its readability, teachable qualities, and particular theoretical angles. I’m going to trace four areas where I think the new Routledge Handbook of Medical Anthropology is innovative among the current offerings of similar edited volumes on the market for our discipline.

 

Visual innovation :: contextualized photographic figures

Recently, there’s been hot and necessary discussion about the images used for anthropology book covers: Tunstall and Esperanza (2016) over at Savage Minds provide interesting practical guidelines for book cover image selection as a way to decolonize anthropology. Ethnographies of medicine, suffering, and war with nuanced photographic figures of belabored people arguably make these books more compelling and help them win awards (De Leòn with Wells 2015, Biehl with Eskerod 2007, 2013), and also raise ethical questions about the images we choose to give life to our writing. The Routledge Handbook contains 16 photographic figures, taken by both contributors and others selected from a global Internet-based call-for-submissions in 2015, each placed as a ‘prelude’ (xii) to its respective chapter. A thoughtful, roughly 150-175 word description by the photographer accompanies each figure, giving it fuller context beyond the usual one sentence caption.

I appreciate projects that aim to decolonize higher education, the academy and our respective discipline, and find Tunstall and Esperanza’s approach insightful.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Zika Timeline of Events

Zika Timeline of Events

February 14, 2017

Even though the Zika virus did not make national headlines until November 2015 when Brazil declared a national emergency after reporting an abnormally high number of cases of babies born with microcephaly or Guillain-Barré syndrome, the virus was actually first identified in 1947 in a rhesus monkey in the Zika forest of Uganda. Zika is a mosquito-borne disease that shows mild-to-moderate symptoms in adult humans. Its symptoms are similar to dengue fever and chikungunya. The first human case of Zika was found in Uganda and The United Republic of Tanzania in 1952.

In the intervening sixty years, some cases of Zika were found throughout western Africa and Asia. However, these populations seemed to have a fairly good immunity to the disease. It was not until the virus hit the Pacific Islands in 2007 that it became an outbreak. In 2013, a Zika outbreak occurred in several more Pacific Island nations, and it was during this time that Zika was suspected of causing neurological and autoimmune problems.

By March 2015, Brazil reported an illness that expressed a skin rash, and by May, Brazil confirmed that Zika was in the country. In July, they found that certain neurological disorders correlated with Zika infection, but this was isolated to the state of Bahia. Then, in October, Brazil reported an inordinate number of cases of microcephaly among newborns, and declared a national emergency in November. Meanwhile, cases of Zika were increasingly reported throughout northern South America and Central America. By January 2016, researchers had drawn preliminary links to pregnant mothers infected by Zika and babies born with microcephaly.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Problematic Pharmaceutical Pricing as an Investor Collective Action Problem?

The U.S. Senate Special Committee on Aging recently released its report Sudden Price Spikes in Off-Patent Prescription Drugs: The Monopoly Business Model that Harms Patients, Taxpayers, and the U.S. Health Care System (hereinafter Report).  Using four companies as case studies—Turing Pharmaceuticals, Retrophin, Valeant Pharmaceuticals International, and Rodelis Therapeutics—this Report specifically investigates one corner of recent drug pricing controversies: dramatically increased prices on old off-patent pharmaceuticals.  Per the Report, these companies pursued a business model that sought to “identify and acquire off-patent sole-source drugs over which they could exercise de facto monopoly pricing power, and then impose and protect astronomical price increases.”[1]

For a variety of reasons, these particular price increases are morally troubling.  It’s not just that these increases may be exploitative.  The plain human consequences of these businesses’ brazen, yet seemingly legal, decisions are gravely concerning.  These corporate actions harm patients in need of the companies’ drugs, the families and physicians who care for those patients, and the healthcare system that helps pay the tab.

What’s driving this morally concerning behavior?  A common refrain points to weak government regulation.  No doubt improvements can be made, but a significant and seemingly oft overlooked part of the answer may point to investors.  What role have investors played in pricing controversies and what role ought they to play?

The Report suggests that prominent shareholders were often in contact with the senior management of the investigated pharmaceutical companies.  These investors, even if not outright encouraging price increases, at least appear complacent.  Examples include:

  • A partner from Broadfin Capital, a major investor in Retrophin Inc.,

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals – January 2017 by Anna Zogas

Welcome to a new year of Somatosphere’s In the Journals section! Here are some of the articles available in January 2017. Enjoy!

Medical Anthropology

Chronic Subjunctivity, or, How Physicians Use Diabetes and Insomnia to Manage Futures in the United States
Matthew Wolf-Meyer & Celina Callahan-Kapoor

Prognostication has become central to medical practice, offering clinicians and patients views of particular futures enabled by biomedical expertise and technologies. Drawing on research on diabetes care and sleep medicine in the United States, in this article we suggest that subjectivity is increasingly modeled on medical understandings of chronic illness. These chronic conceptions of the self and society instill in individuals an anxiety about future health outcomes that, in turn, motivate practices oriented at self-care to avoid negative health outcomes and particular medical futures. At its most extreme, these anxieties of self-care trouble conceptions of self and social belonging, particularly in the future tense, leading patients and clinicians to consider intergenerational and public health based on the threats that individual patients pose for others.

Decoding the Type 2 Diabetes Epidemic in Rural India (open access)
Matthew Little, Sally Humphries, Kirit Patel & Cate Dewey

Type 2 diabetes mellitus is an escalating public health problem in India, associated with genetic susceptibility, dietary shift, and rapid lifestyle changes. Historically a disease of the urban elite, quantitative studies have recently confirmed rising prevalence rates among marginalized populations in rural India. To analyze the role of cultural and sociopolitical factors in diabetes onset and management, we employed in-depth interviews and focus groups within a rural community of Tamil Nadu.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

JHU Projects Explore Ethical Challenges

Hub Staff Report/Crossposted from the HUB

 


 

“Why is it that most of the university’s focus on contemporary ethical issues is concentrated on health care, public health, and the biomedical sciences? Surely other professions and other disciplines also face important real world ethical issues—shouldn’t Hopkins faculty, staff, and students be addressing these issues as well?”

 

That question, posed by Johns Hopkins University trustee Andreas Dracopoulos to the Berman Institute of Bioethics, helped inspire and drive the JHU Exploration of Practical Ethics program, a grant program to fund research into interdisciplinary fields of ethics.

 

“IT IS EASY FOR US TO STAY AWAY FROM ISSUES LIKE WHAT WE’RE TALKING ABOUT TODAY. BUT IT IS IMPORTANT FOR US TO GRAPPLE WITH THESE ISSUES IN A THOUGHTFUL WAY, AND TO HAVE OUR OWN THOUGHT LEADERS COME TOGETHER.”

Sunil Kumar, JHU provost

The program provided funds for nine projects—some of which are still under way—that examine issues relating to criminal justice, higher education, economics, and environmentalism. At a symposium Tuesday, those projects were presented to members of the university community.

 

“Andreas’ provocative question—and it was provocative—set in motion a process of exploration among university leadership initiated by [JHU] President [Ronald J.] Daniels,” said Ruth Faden, the former director of the Berman Institute, in her remarks opening the symposium. “The goal of this process is to assess whether the university should expand its footprint beyond the traditional territories of bioethics and take on the full range of ethical challenges facing society.”

 

     Jon Spaihts, screenwriter of Passengers, and Prometheus, hosts the symposium

 

Some of the projects centered on ethical dilemmas surrounding climate change and pollution.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals – December 2016, Part I by Livia Garofalo

Here is the first part of our December article roundup. Three journals have special issues this month (abstracts in the post below):

Enjoy reading (and what’s left of the holidays)!

American Anthropologist

The Contingency of Humanitarianism: Moral Authority in an African HIV Clinic

Betsey Behr Brada

One consequence of the recent expansion of anthropological interest in humanitarianism is the seeming obviousness and conceptual stability of “humanitarianism” itself. In this article, I argue that, rather than being a stable concept and easily recognizable phenomenon, humanitarianism only becomes apparent in relation to other categories. In short, humanitarianism is contingent: it depends on circumstance and varies from one context to another. Furthermore, its perceptibility rests on individuals’ capacity to mobilize categorical similarities and distinctions. One cannot call a thing or person “humanitarian” without denying the humanitarian character of someone or something else. Drawing on research conducted in clinical spaces where Botswana’s national HIV treatment program and private US institutions overlapped, I examine the processes by which individuals claimed people, spaces, and practices as humanitarian, the contrasts they drew to make these claims, and the moral positions they attempted to occupy in the process. More than questions of mere terminology, these processes of categorization and contradistinction serve as crucibles for the larger struggles over sovereignty, inequality, and the legacies of colonialism that haunt US-driven global health interventions.

Scripting Dissent: US Abortion Laws, State Power, and the Politics of Scripted Speech

Mara Buchbinder

Abortion laws offer a point of entry for “the state” to intervene in intimate clinical matters.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Xenobiology and environment

PDF-logoSynthetic biology and xenobiology could be great tools for improving the environment, but there must be a balance in which the pursuit of benefits for humans is combined with respect for nature and its laws.

On 15th May 2015, Pope Francis published his encyclical Laudato si, in which he gave his views on the problem of environmental pollution that is devastating our planet, and how it affects not only nature, but ourselves, especially the most disadvantaged.

The problem of pollution, over-exploitation of resources and the global warming caused by these is being studied from different perspectives. One of these is the drive for research into new methods that can help us to obtain clean energy that will allow us to continue our development, obtain more resources for food and industry without depleting the planet, and methods for decontamination and repair of damaged ecosystems. Xenobiology could have a huge impact on all these projects in the future.

Xenobiology is a young discipline within synthetic biology that is at the forefront of some of the proposed projects. Xenobiology aims to add letters to the natural genetic alphabet to be able to obtain new words, and to write a story different the one told to us by nature. In the words of Floyd E. Romesberg, one of the principal investigators in the expansion of the genetic alphabet: “If you’re given more letters, you can invent new words, you can find new ways to use those words and you can probably tell more interesting stories” (Callaway, 2014).

A transformation of biology such as that envisaged by xenobiology still presents risks and certain ethical questions, but at the same time, it represents a new way to overcome our environmental problems.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Zika Virus Can Keep Growing in Infant Brains Even After Birth: U.S. CDC

December 13, 2016

(Reuters) – U.S. researchers have found evidence of the Zika virus replicating in fetal brains for up to seven months after the mother became infected with the virus, and they showed the virus can persist even after birth, according to a study published on Tuesday. The findings confirm earlier observations from case studies suggesting that the mosquito-borne Zika virus can grow in fetal brains and women’s placentas.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.