Tag: education

Bioethics Blogs

Scales and the Emotional Underside of Fatphobia

Michael Orsini explains the pervasiveness of discrimination, fear, and hatred related to ‘fatness.’

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It’s convenient to dismiss the recent flap over the removal of scales at the Carleton University gym as yet another case of political correctness run amok.

Did Carleton Athletics simply cave in to pressure from overly sensitive gym patrons who were ‘triggered’ by the sight of a scale? While tempting, that would be the wrong question to ask in the wake of this controversy. Rather, what is it about weight itself that would unleash such a torrent of emotion and name-calling?

Conservative media commentators mocked the University for its decision, revealing the extent to which the conservative battle against political correctness is fueled by ugly views about fatness.

That is not to say that all liberals are fat-loving citizens. Far from it. Fatness arouses a range of complex moral emotions in all of us, from feelings of pity and sympathy to fear and disgust, regardless of our ideological leanings.

In a world in which we come to rash conclusions about people based upon their appearance, being fat or ‘obese’ is shorthand for being slovenly, lazy, and ‘out of control.’ As Nobel Prize winner Daniel Kahneman argues in his best-selling book, Thinking, Fast and Slow, we often make decisions based on visceral feelings, strongly felt emotions that typically serve as poor guides. For example, in discussing the palpable fear of shark attacks, Freeman Dyson notes that we pay more attention to sharks because they frighten us, even though “riptides occur more frequently and may be equally lethal.”

How does this matter here?

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

The First Cut is the Deepest

March 23, 2017

by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai

The First Cut is the Deepest

Last week, President Trump publicly unveiled his 2018 budget proposal. If left unchanged, that financial blueprint would increase US federal defense spending by more than $50 billion, while also appropriating billions more to bolster immigration enforcement and build a 2,000 mile-long wall along the US border with Mexico. A self-proclaimed deficit hawk, the President would offset those increased expenditures will sharp cuts to the US Departments of State, Energy, Health and Human Services, and the US Environmental Protection Agency.

In sharp contrast to campaign trail promises to boost the economy, create jobs, and protect Americans at home and abroad, however, Trump’s 2018 budget is likely to do the exact opposite. Consider, for example, the proposal to cut nearly $6 billion from the US National Institutes of Health (NIH).

Made up of 27 different institutions and centers, the NIH is the largest supporter of biomedical research in the world. Through the NIH or other funding agencies, the federal government supports almost half of all the biomedical research in the US. Private businesses support another quarter, and the remainder of biomedical research support comes from state governments and nonprofit organizations.

With an annual operating budget of $30 billion, the NIH provides training and support to thousands of scientists at its main campus in Bethesda, Maryland. Moreover, through a system of extramural grants and cooperative agreements, the NIH provides financial support for research-related programs to over 2,600 institutions around the country, creating more than 300,000 full- and part-time jobs.

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

REGISTER NOW (4/5)! Crowdfunding Medical Care: Identifying Ethical Implications

Crowdfunding Medical Care: Identifying Ethical Implications April 5, 2017 12:30 PM  Tosteson Medical Education Center, Room 227 Harvard Medical School, 260 Longwood Ave., Boston, MA Register for this event This event is free and open to the public, but seating … Continue reading

Source: Bill of Health, examining the intersection of law and health care, biotech & bioethics.

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

Aid-in-Dying Laws and the Physician’s Duty to Inform

Guest Post: Mara Buchbinder

Paper: Aid-in-dying laws and the physician’s duty to inform

Why do so many people assume that any clinical communication about aid-in-dying (AID, also known as assisted suicide), where it is legal, ought to be patient-initiated? Physician participants in my ongoing study tend to assume that physicians should wait for patients to initiate discussions of AID. The clinical ethics literature on communication about AID has reinforced this expectation by focusing on how to respond to patient requests. Consequently, bioethics has largely remained silent on whether there is a professional duty to inform terminally ill patients about AID laws and their clinical and legal requirements.

As a medical anthropologist, I pay attention to such gaps in professional discourse, as they often indicate ideas that are so taken for granted that they escape formal expression. In this case, bioethics’ silence on professional obligations to inform patients about AID suggests to me that initiating such a discussion is widely viewed as dangerous. But why? My recent article in the Journal of Medical Ethics began with this puzzling question.

In the United States, where my research is based, in addition to many other Western societies, there is a pervasive cultural stigma against talking about death, as described in the Institute of Medicine’s 2014 Report on Dying in America. Yet there is something bigger at stake here for physicians, who may be more accustomed than most people to talking about death and dying: the idea that mentioning the possibility of hastening one’s death can be deeply injurious to the patient and the patient-provider relationship.

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

From My Students Most of All

By Zev Leifer

The Talmud (Taanis 7a) quotes Rabbi Chanina who declared that, “I have learned much from my teachers, more from my colleagues and most from students.”  There is a tendency amongst educators, in general and more so, I suspect, amongst medical educators (given their many years of training and vast experience) to take a top-down approach.  This approach assumes that we have a contractual relationship wherein “I have the knowledge and we are here so that I can share it with you”.

In contrast, the digital age has humbled many of “our” generation since the best advice when faced with a new piece of digital equipment or software, is to “ask a ten-year old” (even an anonymous ten-year old).  But our students?!  I submit that example is a challenge – to ego and to the “Central Dogma of Education” that information flow is unidirectional.

I would like to share some of my experiences teaching digital pathology, to perhaps update that notion…

For the past 35 years I have been teaching Pathology Lab at the New York College of Podiatric Medicine.  For most of that time, the classical techniques of diagnostic pathology – analyzing a glass slide of a tissue slice to determine if normal or pathological, or pathological to what extent – has been by looking at the slide in a microscope.  Now the world has changed.  For the professional pathologist and, by extension, for the aspiring pathology student, it is all digital.  The slide is digitized and, with appropriate software, made available on the computer which acts as microscope.

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

Intersectionality and the Dangers of White Empathy when Treating Black Patients

by Keisha Ray, Ph.D.

(Originally presented at the 7th International Health Humanities Consortium meeting in Houston, Texas)

I’ve had many odd, seemingly racially motivated experiences with racially uneducated and racially insensitive doctors and nurses. From being told by one of my white physicians that I sound white when I speak, to another physician calling me “sista girl” for what seemed like 100 times during our brief 15-minute interaction, or another physician who in disbelief kept asking me “Are you sure you’ve never been pregnant? It’s very rare for a black woman your age to not have had any pregnancies. Maybe you think I mean births, when I mean pregnancies?” At the time, I was only 25 years old. Although these stories made for good laughs between my friends and I, there is one experience that I have had with the medical profession that was less comical because my doctor’s attitudes about race could have had serious effects on my health.

When I was a senior in college I discovered I had hypertension. I went to see a doctor at a family medicine facility and was prescribed a common hypertension drug. While meeting with the doctor in her office, she was very reassuring and told me not to worry that this drug has been known to work very well for black people.

But this drug did not work for me at all. Consistently my blood pressure readings were 140/120 (what is considered “normal” varies but typically 120/80 is the standard). So after taking the drug for a month as instructed, I went back to see my doctor.

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

Pornography as a Public Health Issue

Jacqueline Gahagan advocates for a national sexual health promotion strategy.

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Pornography is concerned with the development and the circulation of sexually explicit books, magazines, videos, art, and music aimed at creating sexual excitement. Public health is concerned with keeping people healthy and preventing illness, injury and premature death. With the growing use of internet-based pornography and the relative ease by which it can be accessed, the effects of “online violent and degrading sexually explicit material on children, women and men” have become an important public health issue. This issue is best addressed through the development and introduction of a national sexual health promotion strategy – a strategy that includes current and comprehensive sexual health education in our primary, secondary, and post-secondary schools.

Health promotion, in concert with public health, involves encouraging safe behaviours and improving health through healthy public policy, community-based interventions, active public participation, advocacy, and action on key determinants of health. I am confident that several of these strategies can be used to address concerns about the ready access to internet-based pornography. For example, health promotion initiatives that take a harm reduction approach to healthy sexuality include an emphasis on screening and testing for sexually transmitted infections, the use of condoms, a shared understanding of consensual sex, as well as the use of other safer sex interventions.

A review of existing sexual health education in Canadian schools, however, reveals that many Canadian youth do not receive the level of sexual health education they need to help them make informed decisions about sexual risk-taking.

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

The Problem with Binary

by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai

The Problem with Binary 

Throughout his raucous 2016 campaign, President Trump repeatedly claimed that he would be an ardent defender of the lesbian, gay, bisexual and transgender (LGBT) community. During the Republican National Convention, for instance, he proclaimed that, “As your president I will do everything in my power to protect LGBTQ citizens.” Despite this statement (which stood in stark contrast to the Republican Party’s virulently anti-LGBT political platform), and diverging from the public comments and actions when he was still a private citizen, since gaining the nomination and later the presidency, Donald Trump has largely kowtowed to the more homophobic wings of his party.

Although he has yet to repeal an Obama-era order protecting LGBT federal employees from workplace discrimination, for example, he has repeatedly expressed support for the First Amendment Defense Act. Modeled on the anti-LGBT legislation passed in Indiana when Vice-President Pence was governor of the Hoosier State, that Act would allow individuals, businesses, and healthcare providers to deny services to LGBT individuals based on their religious beliefs.

More recently, in spite of prior comments that “people should use the bathroom that they feel is appropriate,” Trump rescinded existing protections for transgender students. Previously, the federal government had issued guidelines that, while not legally binding, required public schools to allow transgender students to use bathrooms that corresponded with their gender identity rather than biological sex. Under the Obama administration, the Departments of Justice and Education had taken the position that existing regulations like Title IX, the federal law that prohibits sex discrimination in schools, also applied to discrimination based on gender identity.

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

Ethics of the Trump Budget: The Social Contract is Dead

by Craig Klugman, Ph.D.

President Trump released his blueprint for a 2018 federal budget. From an ethical standpoint, the President seems to operates from a Hobbesian standpoint—life is nasty, brutish and short. However, unlike Hobbes who believed that we came together to protect ourselves from this reality, the new budget seems to encourage this idea. The new budget makes deep cuts to all social and scientific programs while boosting the military. In Hobbesian terms, Trumps’ social contract is all about bullying outsiders while leaving insiders in a state of hopeless diffidence.

Since World War II, the United States has invested heavily in science and technology, developing transportation, and building a better world (and winning wars). Since the 1960s, the US has provided a safety net for the poor, support for the arts, and public broadcasting. Since 1970, the U.S. has worked to ensure that people have the opportunity for flourishing by protecting the environment, providing financial aid for college, and strengthening our relationships with international partners—peace through diplomacy.

The 2018 budget undoes 80 years of social progress and support. The new budget defunds the Corporation for Public Broadcasting, National Endowment for the Humanities, National Endowment for the Arts, and most development agencies. Also eliminated are environmental management, research and education; after school programs, clean energy, chemical safety, community services and development, national service programs, clean air, home investment programs, energy assistance programs for low income adults, minority business development, science education, support for the homeless, and peace.

In addition, the budget significantly reduces funding for science (medicine, basic research, NASA, climate science), health care, the Environmental Protection Agency, the State Department, Departments of Labor, Agriculture, Commerce, Education, Housing & Urban Development, Transportation and Interior.

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

Would You “Donate” Your Kidney for $1,000?

Crossposted from Rising to the Challenge, The Campaign for Johns Hopkins

 

Nearly 100,000 Americans sit on the waiting list for kidney donations, but only about 17,000 of the organs are transplanted each year — despite the fact that living donors can provide kidneys. What could help close the gap between the need and the supply? Might providing some kind of altruistic incentives or financial compensation for donors be a step toward saving thousands of lives, and with what ethical implications?

 

That thorny question is one of nine that Hopkins faculty are examining with Exploration of Practical Ethics grants administered by the Berman Institute of Bioethics. Established in part by a generous gift from university trustee Andreas Dracopoulos, the program funds one-year pilot studies that address key questions in professions and scholarly disciplines, within institutions, and throughout society.

 

“Research institutions like Hopkins are perfect for this kind of inquiry, because we don’t just produce graduates who can go out into the world and solve these problems. We produce the thought processes that inform the way future leaders will make decisions,” says Maria Merritt, an associate professor in the Berman Institute and Bloomberg School of Public Health. Merritt is overseeing the portfolio of funded awards in her role as program officer for the Exploration of Practical Ethics effort.

 

Vikram Chib and Mario Macis

 

Informing the debate over the ethics of payments for organ donation is the goal of a project proposed by Mario Macis, an associate professor in the Carey Business School, Vikram Chib, an associate professor in the Whiting School of Engineering, and Nicola Lacetera, an associate professor at the University of Toronto.

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.