Tag: disease outbreaks

Bioethics Blogs

The Trials of Patient O

By: Jennifer Cohen

In 1987, Harry Reasoner of 60 Minutes questioned Dr. Selma Dritz about her search in the early 1980s for the origins of the deadly outbreak of AIDS in the United States. “It was the whodunit of the century, and I was born nosy,” she tells him. The title of the 60 Minutes piece was “Patient Zero” who Mr. Reasoner explains “was a man – a central victim and victimizer” in the spread of AIDS.  Dr. Dritz, who had been the head of infectious diseases in the San Francisco branch of the Centers for Disease Control and Prevention (CDC), recalled warning Patient Zero of the danger he posed to others. In her retelling, Mr. Dugas callously rebuffed her concerns, showed little remorse for infecting others, and concluded their interaction with “screw you.” Also interviewed was Randy Shilts whose book, And the Band Played On, identified Patient Zero as Gaëtan Dugas, a Canadian flight attendant. Mr. Shilts explained that Mr. Dugas constituted what epidemiologists today call a superspreader – someone with unlimited ability to infect others and “speed this disease into every corner of America.”  The narrative of a villainous foreigner maliciously spreading a deadly epidemic culminated in an infamous New York Post headline condemning Mr. Dugas as “THE MAN WHO GAVE US AIDS.”

The story unraveled upon closer inspection.  In 1984, the CDC had indeed identified a “Patient O” who had sexual connections with other AIDS patients, but the “O” stood for “Outside” California. Nowhere in the study is “Patient O” identified as “Patient Zero” — i.e.,

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

Outpacing Pandemics

Vaccines are an essential weapon in fighting disease outbreaks. But how does the time taken to develop vaccines compare to the speed and frequency of outbreaks? And how can we do it better? An engaging data visualization via Mosaic

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

World Health Organization Rethinks Its Response to Disease Outbreaks

December 20, 2016

(Nature) – Three years after the start of the world’s worst Ebola epidemic, the World Health Organization (WHO) has created a programme to improve its response to disease outbreaks and to prevent another such calamity. In June, WHO director-general Margaret Chan named medical epidemiologist Peter Salama to lead a new health-emergencies programme intended to streamline the agency’s response to crises. As part of that programme, the WHO has launched the Emerging Diseases Clinical Assessment and Response Network (EDCARN) to provide guidance on how to care for people during disease outbreaks.

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

Child Vaccination Across America

Routine childhood immunizations are vital to individual and society health. Across the United States, immunization rates vary, and as a result, some communities have experienced preventable disease outbreaks. Higher immunization rates protect vulnerable children who are too young to be vaccinated as well as those who cannot be vaccinated for medical reasons

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

Not Getting Closure: Reflecting on the Vindication of Gaetan Dugas by Greg Clinton

Now drowned in the torrent of post-election analysis, on October 26, 2016, the journal Nature published a study which traced genomic data in an effort to map the spread of HIV in North America. The newsworthy conclusion of the study was a full-throated scientific vindication of Gaetan Dugas, the man erroneously dubbed “Patient Zero” in Randy Shilts’ And the Band Played On, a popular depiction of the spread of HIV in the United States during the early 1980s. Dugas was a French-Canadian flight attendant who became a person of interest in the epidemiological detection of HIV in its early days, since he had had sexual contact with so many of the early cases on the West Coast. The original researchers dubbed him “patient ‘O’” (for “outside”); Shilts and others translated this as “patient ‘0’”, or the index case. Shilts also portrayed Dugas as willingly careless and negligent. The study published in Nature concluded that Dugas was not the index case in North America; his demonization by Shilts and other media has been corrected.

The fervor over this vindication — garnering editorials and spots in The New York Times (here and here), NPR, the Chicago Tribune, New York Magazine, and Science magazine, among others — led me to reflect on the spectacle of disease narratives, not only what they emphasize, but what they tend to obscure. Epidemics are both disease events and media events. The spectacle of disease — the “literary” construction of a disease event in media, especially visual media — constitutes the social and political force of epidemics.

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

How New York Hunts For Early Signs Of Disease Outbreaks

“It is just not possible to effectively monitor every communicable disease in real time with human eyes alone,” Sharon Greene said. “To be able to quickly and effectively and precisely detect an outbreak, to kick off an outbreak investigation process — the earlier that you can begin this it helps to limit sickness, it helps to limit death, and it makes it more likely that you will successfully solve the outbreak

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

CDC Deploys New Rapid Response Teams To Fight Zika

For many years CDC has sent epidemiologists, or scientists who analyze disease outbreaks and study ways to prevent future ones, to major disease outbreaks. But building on its experiences with Ebola in 2014, the agency also has created new rapid response teams, called CDC Emergency Response Teams (CERT), that bring expanded expertise to contain an outbreak as quickly as possible

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

The Climate Crisis Call For Fewer Children

Bioethicist: The climate crisis calls for fewer children

 

Travis N. Rieder, Johns Hopkins Berman Institute of Bioethics

 

Earlier this summer, I found myself in the middle of a lively debate because of my work on climate change and the ethics of having children.

 

NPR correspondent Jennifer Ludden profiled some of my work in procreative ethics with an article entitled, “Should we be having kids in the age of climate change?,” which summarized my published views that we ought to consider adopting a “small family ethic” and even pursuing fertility reduction efforts in response to the threat from climate change. Although environmentalists for decades have worried about overpopulation for many good reasons, I suggest the fast-upcoming thresholds in climate change provide uniquely powerful reasons to consider taking real action to slow population growth.

 

Clearly, this idea struck a nerve: I was overwhelmed by the response in my personal email inbox as well as op-eds in other media outlets and over 70,000 shares on Facebook. I am gratified that so many people took the time to read and reflect on the piece.

 

Having read and digested that discussion, I want to continue it by responding to some of the most vocal criticisms of my own work, which includes research on “population engineering” – the intentional manipulation of human population size and structure – I’ve done with my colleagues, Jake Earl and Colin Hickey.

 

In short, the varied arguments against my views – that I’m overreacting, that the economy will tank and others – haven’t changed my conviction that we need to discuss the ethics of having children in this era of climate change.

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 – June 2016, Part I by Anna Zogas

Here are some articles published in June that may be of interest. Enjoy!

Medical Anthropology Quarterly

Cancer and the Comics: Graphic Narratives and Biolegitimate Lives
Juliet McMullin

Cancer graphic narratives, I argue, are part of a medical imaginary that includes representations of difference and biomedical technology that engage Fassin’s (2009) concept of biolegitimacy. Framed in three parts, the argument first draws on discourses about cancer graphic narratives from graphic medicine scholars and authors to demonstrate a construction of universal suffering. Second, I examine tropes of hope and difference as a biotechnical embrace. Finally, I consider biosociality within the context of this imaginary and the construction of a meaningful life. Autobiographical graphic narrative as a creative genre that seeks to give voice to individual illness experiences in the context of biomedicine raises anthropological questions about the interplay between the ordinary and biolegitmate. Cancer graphic narratives deconstruct the big events to demonstrate the ordinary ways that a life constructed as different becomes valued through access to medical technologies.

“Time with Babe”: Seeing Fetal Remains after Pregnancy Termination for Impairment
Lisa M. Mitchell

Some North American hospitals now offer parents the opportunity to see, hold, and photograph fetal remains after pregnancy loss. I explore the social, material, and interpretive strategies mobilized to create this fetal visibility after second trimester–induced abortion for fetal anomaly. My analysis examines both the discursive framing of fetal remains in practice guidelines on pregnancy loss and the responses of a group of Canadian women to being offered “time with babe.” I show that while guidelines tend to frame contact with fetal remains as a response to women’s desires to see their baby and to feel like mothers, women’s experiences of this contact were shaped by more diverse wishes and concerns as well as by specific abortion practices and practitioner comments and actions.

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.