Tag: epidemiology

Bioethics Blogs

A Feminist Neuroethics of Mental Health

By Ann E. Fink
Ann Fink is currently the Wittig Fellow in Feminist Biology at the University of Wisconsin–Madison, with an appointment in Gender and Women’s Studies and concurrent affiliations with Psychology and the Center for Healthy Minds. Her research in cellular and behavioral neuroscience has appeared in the Journal of Neuroscience, Journal of Neurophysiology, PNAS and other journals. Ann’s interdisciplinary work addresses the ethics of neuroscience in relation to gender, mental health and social justice. 

Emotionality and gender are tied together in the popular imagination in ways that permeate mental health research. At first glance, gender, emotion, and mental health seem like a simple equation: when populations are divided in two, women show roughly double the incidence of depression, anxiety, and stress-related disorders1-3. Innate biological explanations are easy to produce in the form of genes or hormones. It could be tempting to conclude that being born with XX chromosomes is simply the first step into a life of troubled mood. Yet, buried in the most simplistic formulations of mental illness as chemical imbalance or mis-wiring is the knowledge that human well-being is a shifting, psychosocial phenomenon. Learning and memory research offers a treasure trove of knowledge about how the physical and social environment changes the brain. Feminist scholarship adds to this understanding through critical inquiry into gender as a mode of interaction with the world. This essay explores how a feminist neuroethics framework enriches biological research into mental health. 
Problems with “Biology-from-birth” stories 
What if understanding gender and health isn’t a tale of two gonads (or genitalia, or chromosomes)?

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

Things Which Have Once Been Conjoined: Science Fiction, Contagion, and Magic in the Age of Social Media by Samuel Gerald Collins

There are many interesting formations that might be called networked phenomena. Homophily and the tendency towards triad closure. Scott Feld’s Rule (I’m more likely to make friends with someone who has more friends than me). Small world phenomena (those 6 degrees of separation). “The Strength of Weak Ties” (reportedly the most cited sociology paper in history). In all, a series of social forms that complicates typical binarisms like individual versus group.

All of these have their positive and negative sides, but few networked phenomena have been met with more ambivalence than that of contagion, the idea that things (memes, viral videos, fashion) spread from person to person in a way that is similar to an epidemic; that is, people believe certain things or participate in certain behaviors without necessarily having “decided” to do so. Instead, the chances of “contracting” an idea, a fashion, or a new technology come down to the structural position in a network—a question, for example, of k-threshold models, where the chance of contagion depends upon the topology of connections vis-à-vis other infected nodes.

Given its identification with epidemiological contagion, it is not surprising that social contagion brings with it a negative valence, conjuring up fears of loss of autonomy, of being reduced to “hosts” for the “viral” propagation of information in a network. Contagion is at the heart of the fear and fascination of the zombie. It is also part of the latest panic in politics, one that centers on a vision of an electorate easily manipulated through fake news propagated through social media.

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

Some Comments about Being a Philosopher of Color and the Reasons I Didn’t Write a (Real) Paper for this (Seemingly) Ideal Venue for my Work

by Sean A. Valles

ABSTRACT. This special issue conspicuously lacks work by Philosophers of Color (with the exception of this commentary). I have been given this opportunity to discuss the impediments that kept me from submitting my relevant work, offered as a small step toward recognizing the impediments faced by other Philosophers of Color. I highlight factors including direct and indirect consequences of a disproportionately White community of US philosophers, and some underrecognized risk-reward calculations that Philosophers of Color face when choosing an article project. I urge further discussion of the topic, starting with an exhortation to choose the right phenomenon and accordingly frame the right question: Why are White philosophers deliberating the “ethical and social issues arising out of the 2016 US presidential election” in a prestigious journal, while Philosophers of Color are deliberating the same issues in tense classrooms, closed offices, and on-/off-campus forums?

This is not a real article. But in this special issue on the 2016 US election and Trump it is, to my knowledge, the only contribution written by a Philosopher of Color. It is a commentary about the fact that it is the only contribution written by a Philosopher of Color.

After Editor-in-Chief Rebecca Kukla expressed consternation that the issue was full of excellent papers, but written by a roster of White philosophers, I offered to say something about why I didn’t submit any of my relevant philosophical work (on nativism, racism, health policy, Latinx health, etc.), and why it didn’t surprise me that almost none of the other well-qualified Philosophers of Color did either.

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

Health Affairs Briefing: Advanced Illness And End-Of-Life Care

Few areas of health
care are as personal, or as fraught, as care for people with serious
illnesses who are approaching death. At a point in their lives when their
needs are often as much social and spiritual as they are medical, people
are confronted with a fragmented, rescue-driven health care

system that produces
miraculous results but also disastrous failures.


As the nation’s population of individuals over the age of 65 is expected to
reach 84 million by 2050, addressing these challenges becomes increasingly
important, requiring coordination across multiple sectors and levels of
government. Innovations are needed to produce improvements in care
delivery; better communication between clinicians, patients and families; greater
uptake of advance care planning tools; and payment systems and policies
that support patient needs and preferences. 


The July 2017 issue of Health Affairs, “Advanced Illness and End-of-Life Care”
includes a comprehensive look at these issue and others. In addition, HA
is hosting a forum at the National Press Club on
Tuesday, July 11.


Topics covered will include:

  • Care At The End Of Life
  • Financing & Spending
  • Quality Of Care &
    Patient Preferences
  • Hospice & Palliative
    Care

The program will
feature the following presenters:

  • Melissa Aldridge, Associate
    Professor, Department of Geriatrics and Palliative Medicine, IcahnSchool
    of Medicine at Mount Sinai, on Epidemiology And Patterns Of Care At The
    End Of Life:Rising Complexity, Shifts In Care Patterns And Sites of Death
  • Rachelle E. Bernacki,
    Director of Quality Initiatives, Psychosocial Oncology and PalliativeCare,
    Dana Farber Cancer Institute; Assistant Professor, Harvard Medical School;
    and Associate Director, Serious Illness Care Program, Ariadne Labs, on A
    Systematic Intervention To Improve Serious Illness Communication In
    Primary Care
  • Julie Bynum, Associate
    Professor Geisel School of Medicine, Dartmouth, on High-Cost Dual Eligible
    Service Use Demonstrates Need For Supportive And Palliative Models Of Care
  • Janet Corrigan, Chief
    Program Officer for Patient Care, Executive Vice President, Gordon and
    Betty Moore Foundation
  • Katherine Courtright,
    Instructor of Medicine, Division of Pulmonary, Allergy, and Critical Care
    Medicine University of Pennsylvania Health System on Approximately One In
    Three US Adults Completes Any Type Of Advance Directive For End-Of-Life
    Care
  • Robrecht De Schreye,
    Researcher, End of Life Care, University of Brussels, on Applying
  • Quality Indicators From
    Linked Databases To Evaluate End-Of-Life Care For Cancer Patients In
    Belgium
  • Rachel Dolin, Fellow, David
    A.

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

Stakes of Life: Science, states, policies, publics and ‘the first thousand days’ by Fiona C. Ross

Welcome back to the “First Thousand Days of LifeSomatosphere series. Here we continue to explore the ways that a global health initiative driven by new findings in epigenetics and neuroscience and by a reframing of theories about health and disease in terms of developmental origins shape ideas about (global) health and population futures, invigorate campaigns, and take form and settle in localized contexts. Understanding the links between science, biomedicine, policy, population, well-being and relationship as simultaneously both meshed and contingent, our series posits questions about what affordances and limitations lie in new modalities of understanding human illness and well-being. It examines how policy is made and with what effects for its recipients, how states are implicated in health and its others, what forms of the everyday materialize under the lens of new findings in epigenetics and epidemiology, what modalities of knowing emerge and how they settle with older forms, and how ethnography might contribute.

Describing the research programme driven by the Thousand Days research group at the University of Cape Town, I noted that,

The emergent field both synergises a range of disciplines in the bio- and social sciences and develops new sites of humanitarian intervention, reframing current debates about population, well-being and ‘the best interests of the child’ in newly biological ways. As these findings are taken up in policy and practice, we are witnessing the making of a social object with material effects’ (www.thousanddays.uct.ac.za).

Our project has explored that making, its prior conditions and its effects.  As Michelle Pentecost noted in her opening to the Somatosphere series, the framing ‘offers fertile ground for careful thought about contemporary concepts of life, life-giving and care, offering spaces for critically assessing not only how states and people understand and enable health and well-being but also how life is conceptualized by different disciplines.’ 

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

Hastings Center – “The Last Stage of Life”

The Hastings Center has started a new project – 
 “The Last Stage of Life.”


People are living longer, but with more years of chronic illness and frailty. Many lack the financial, community, or health care resources they need to secure their own well-being, and often die in isolation or with family caregivers who themselves have become ill from the stress of their caregiving burdens. 


With support from the Robert Wilson Charitable Trust and with additional funds from Hastings’s endowment, the Hastings Center has begun a two-year planning process to determine how best the field of bioethics can meet the new and complex needs of our aging society and of aging people and their caregivers.  


As a first step, the Center recently brought together a wide variety of experts from numerous disciplines and societal sectors – including health policy experts, demographers, architects, philosophers, gerontologists, physicians, nurses, urban planners, and grant makers concerned with aging and end-of-life care. The meeting focused on defining a social ethics approach to this challenge and began identifying the values that should guide structures and policies to promote good and prevent harms and injustices to aging people and their caregivers. Among the questions explored were:

  • What is the epidemiology of population aging in the United States?
  • How well do our current structures and policies respond to age-related illness and frailty?
  • What is human flourishing in the face of frailty?
  • How can we understand and articulate what makes for a good life for people living with age-related illness and frailty, especially those with limited resources?

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

Hastings Center – “The Last Stage of Life”

The Hastings Center has started a new project – 
 “The Last Stage of Life.”


People are living longer, but with more years of chronic illness and frailty. Many lack the financial, community, or health care resources they need to secure their own well-being, and often die in isolation or with family caregivers who themselves have become ill from the stress of their caregiving burdens. 


With support from the Robert Wilson Charitable Trust and with additional funds from Hastings’s endowment, the Hastings Center has begun a two-year planning process to determine how best the field of bioethics can meet the new and complex needs of our aging society and of aging people and their caregivers.  


As a first step, the Center recently brought together a wide variety of experts from numerous disciplines and societal sectors – including health policy experts, demographers, architects, philosophers, gerontologists, physicians, nurses, urban planners, and grant makers concerned with aging and end-of-life care. The meeting focused on defining a social ethics approach to this challenge and began identifying the values that should guide structures and policies to promote good and prevent harms and injustices to aging people and their caregivers. Among the questions explored were:

  • What is the epidemiology of population aging in the United States?
  • How well do our current structures and policies respond to age-related illness and frailty?
  • What is human flourishing in the face of frailty?
  • How can we understand and articulate what makes for a good life for people living with age-related illness and frailty, especially those with limited resources?

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

Sentinal Policy Surveillance: A New Front in Legal Epidemiology?

Paul Erwin, Associate Editor of the American Journal of Public Health, recently wrote about the esablishment of a  Sentinel Practitioner Surveillance System for Policy Change Impact,  or what might be called “sentinal policy surveillance.” The network of twelve diverse health officers will … Continue reading

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 – April 2017 by Danya Glabau

Critical Public Health

On difference and doubt as tools for critical engagement with public health

Catherine M. Will

This paper argues that critical public health should reengage with public health as practice by drawing on versions of Science and Technology Studies (STS) that ‘de-centre the human’ and by seeking alternative forms of critique to work inspired by Foucault. Based on close reading of work by Annemarie Mol, John Law, Vicky Singleton and others, I demonstrate that these authors pursue a conversation with Foucault but suggest new approaches to studying contemporary public health work in different settings. Proposing that we ‘doubt’ both the unity of public health and its effects, I argue that this version of STS opens up a space to recognise multiplicity; to avoid idealising what is being criticised; and to celebrate or care for public health practices as part of critique. Finally I oppose the view that considering technologies, materials and microbes leads to micro-level analysis or political neutrality, and suggest that it allows us to reframe studies of public health to account for inequalities and to draw attention to weak or retreating states, active markets and the entangled relations of humans and non-humans across the world.

 

Biopolitical precarity in the permeable body: the social lives of people, viruses and their medicines

Elizabeth Mills

This article is based on multi-sited ethnography that traced a dynamic network of actors (activists, policy-makers, health care systems, pharmaceutical companies) and actants (viruses and medicines) that shaped South African women’s access to, and embodiment of, antiretroviral therapies (ARVs).

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

New Research: Legal Epidemiology in the Literature

It’s a rainy day on the East Coast; what better way to get through the damp than four new legal epidemiology articles? Our colleagues have published papers examining vaccine policies, telehealth reimbursement policies, scope of practice laws for health care … Continue reading

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.