Tag: fasting

Bioethics Blogs

Filling the Vacuum: Immigration, Health Policy and Latino Leadership in Medicine

By Jacob Begres and Orlando Sola

“When Mexico sends its people, they’re not sending their best. They’re not sending you. They’re not sending you. They’re sending people that have lots of problems and they’re bringing those problems with us. They’re bringing drugs, they’re bringing crime, they’re rapists, and some, I assume, are good people.”
-Donald Trump

The history of the United States is defined by waves of immigration, starting first with English religious migrants and moving through migration from Europe, Asia, Africa, and South America.  Though we have seen periods of migration from a variety of cultures and ethnicities, the Latino experience has been particularly entwined in our country’s history and reaches back to the very founding of the nation, when lands inhabited by Spanish-speaking communities were integrated into the new American social fabric.  Despite this long history of Latino migration, however, the history of discourse surrounding Latino economic and political migrants has been fraught with bigotry and historical myopia from its political leaders.  We need look no further than our own presidential election to find examples…

As such, the Latino community has been, and continues to be, the subject of countless debate questions, conferences, and political advertisements in the current media.  Yet few, if any, of the individuals involved in current political discourse have understand the Latino experience in America. Latino migrational trends continue to grow as Latinos are the fasting growing demographic in the United States – in fact, during the decade of 2000-2010, half of the nation’s population growth was due to Latino immigrants alone. 

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 — September 2016, part II by Aaron Seaman

And, now, part two of September’s journal posting! (Part one is here.)

Medical Anthropology Quarterly

“I Hope I Get Movie-star Teeth”: Doing the Exceptional Normal in Orthodontic Practice for Young People

Anette Wickström

Orthodontics offer young people the chance to improve their bite and adjust their appearances. The most common reasons for orthodontic treatment concern general dentists’, parents’ or children’s dissatisfaction with the esthetics of the bite. My aim is to analyze how esthetic norms are used during three activities preceding possible treatment with fixed appliances. The evaluation indexes signal definitiveness and are the essential grounds for decision-making. In parallel, practitioners and patients refer to self-perceived satisfaction with appearances. Visualizations of divergences and the improved future bite become part of an interactive process that upholds what I conceptualize as “the exceptional normal.” Insights into this process contribute to a better understanding of how medical practices intended to measure and safeguard children’s and young people’s health at the same time mobilize patients to look and feel better. The article is based on an ethnographic study at two orthodontic clinics.

Huichol Migrant Laborers and Pesticides: Structural Violence and Cultural Confounders (open access)

Jennie Gamlin

Every year, around two thousand Huichol families migrate from their homelands in the highlands of northwestern Mexico to the coastal region of Nayarit State, where they are employed on small plantations to pick and thread tobacco leaves. During their four-month stay, they live, work, eat, and sleep in the open air next to the tobacco fields, exposing themselves to an unknown cocktail of pesticides all day, every day.

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

Feed a Virus, Starve a Bacterium?

Thinkstock/Stockbyte

Yes, the season of colds and flu is coming. You’ve probably heard the old saying “feed a cold and starve a fever.” But is that sound advice? According to new evidence from mouse studies, there really may be a scientific basis for “feeding” diseases like colds and flu that are caused by viruses, as well as for “starving” certain fever-inducing conditions caused by bacteria.

In the latest work, an NIH-funded research team found that providing nutrition to mice infected with the influenza virus significantly improved their survival. In contrast, the exact opposite proved true in mice infected with Listeria, a fever-inducing bacterium. When researchers forced Listeria-infected mice to consume even a small amount of food, they all died.

Just like humans, when mice and other mammals come down with many infectious illnesses, they often lose their appetites and shun food. In the new study reported in the journal Cell, a team led by Ruslan Medzhitov, a Howard Hughes Medical Institute Investigator at Yale University School of Medicine, New Haven, CT, and former Lurie Prize winner from the Foundation for NIH, set out to explore how the presence or lack of nutrition might influence recovery from infections [1].

In one series of experiments, the researchers infected mice with the influenza virus, which caused potentially life-threatening bouts of the flu. As expected from past observations, the flu-sickened mice reduced their food intake. However, when the researchers pumped more nutrition into some of the sick mice via tube feeding, their odds of survival were significantly better than those who weren’t given the extra nutrition.

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

Blood During Ramadan

By Peter Young

 

The death toll in a series of three explosions at Ataturk International Airport in Istanbul has risen to 44, with 238 originally wounded and 94 currently hospitalized as of late last week. The airport reopened the morning after, cordoning off the sections where blasts had occurred, and the city of Istanbul is now in a state of mourning over innocent victims lost. These unfortunate events bring up an opportunity to discuss how differences in belief can influence medical ethics. Turkey, a predominantly Muslim nation, has culturally defined ethical considerations that translate to differences when providing healthcare.

 

The attacks in Turkey, for example, came in the middle of Ramadan, a month-long Muslim holiday where many fast during daylight hours. The act of fasting, already tough on the body, is not recommended for the young or light-weight. For a variety of reasons, blood banks in countries neighboring Turkey have faced shortages of blood products during the month of Ramadan. One obvious reason is that the act of donating may make a fasting person feel weaker and may force them to break their fast, if they need to eat or drink to replenish themselves. Others have a belief that donating blood somehow invalidates their fast. Fortunately for Turkey, Turks seem to have positive attitudes towards donating blood, although some do not fully understand related issues. In addition to positive attitudes, the Red Crescent, equivalent of the Red Cross, is well organized and was able to coordinate the movement of blood products from regional centers to Istanbul to treat those injured from last Monday’s attacks.

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

Top of the Heap: Anna Waldstein by Hannah Gibson

[For this installment of the Top of the Heap series, I spoke with Anna Waldstein, who is an ecological anthropologist and lecturer in medical anthropology and ethnobotany at Kent University, UK.]  

In response to discussions with my colleagues about ways to encourage our students to read more ethnographies, I designed a new assignment for “Anthropology of Health, Illness and Medicine,” the last time I taught it. Students were asked to read an ethnographic study with a medical anthropology theme (i.e. a “medical ethnography”) and to present a synopsis to their seminar group. My ulterior motive was to encourage students to read some of the medical ethnographies at the top of my heap, so that I could at least learn more about them, if I could not get around to reading them myself. In this respect, the assignment was only partially successful. The books at the top of my list were either not selected by any of the students, or were read by students in the seminar groups led by my colleague. However, several books that were (originally) much closer to the bottom of the heap (and some not even on the list of recommended ethnographies) generated memorable class discussions and have piqued my interest.

As I am getting ready to send my publisher the final version of my own forthcoming book on the “Hispanic health paradox” and “health sovereignty” in the United States, Gálvez’s (2011) Patient Citizens, Immigrant Mothers: Mexican Women, Public Prenatal Care, and the Birth-weight Paradox is at the top of the heap of books that I need to finish 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

Precision Medicine: Using Genomic Data to Predict Drug Side Effects and Benefits

People with type 2 diabetes are at increased risk for heart attacks, stroke, and other forms of cardiovascular disease, and at an earlier age than other people. Several years ago, the Food and Drug Administration (FDA) recommended that drug developers take special care to show that potential drugs to treat diabetes don’t adversely affect the cardiovascular system [1]. The challenge in implementing that laudable exhortation is that a drug’s long-term health risks may not become clear until thousands or even tens of thousands of people have received it over the course of many years, sometimes even decades.

Now, a large international study, partly funded by NIH, offers some good news: proof-of-principle that “Big Data” tools can help to identify a drug’s potential side effects much earlier in the drug development process [2]. The study, which analyzed vast troves of genomic and clinical data collected over many years from more than 50,000 people with and without diabetes, indicates that anti-diabetes therapies that lower glucose by targeting the product of a specific gene, called GLP1R, are unlikely to boost the risk of cardiovascular disease. In fact, the evidence suggests that such drugs might even offer some protection against heart disease.

Genetic approaches have increasingly been used to identify potentially promising new drug targets. In the study reported in Science Translational Medicine, researchers led by Robert Scott and Nick Wareham from the University of Cambridge, England, and Dawn Waterworth from GlaxoSmithKline, King of Prussia, PA, also wanted to explore whether genomic data could yield important clues about the potential side effects of drugs targeting particular genes.

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

Quantified Minds in an Optimized World

Natalie Salmanowitz

The quantified-self movement is hardly a covert phenomenon. From the Garmin watches people flaunt on their wrists, to the dizzying array of smartphone apps for tracking eating habits, lifestyle data has garnered infectious appeal. But it isn’t just about gathering information—it’s about using the data to maximize your potential.

While Garmin watches and lifestyle apps are fairly ubiquitous, a separate sector of the market is taking optimization to new heights: neuromodulation. Within this field is a plethora of consumer products, ranging from neurostimulation devices, to EEG neurofeedback headsets, to cognitive enhancement pills. Although these products differ in structure and function, they are united by a common rhetoric of harnessing mental resources to become your optimal self. Take the FocusBand, one of the many EEG neurofeedback headsets on the market. By monitoring and regulating brainwaves, users can allegedly optimize everything from baseball pitching, to meditation practices, to engagement among coworkers. As the company puts it, “draw from the power inside of you” and “master your mind.”

With a 30 second scan of almost any product in the realm of “consumerized neuromodulation,” it is hard to not feel bombarded by this optimization language. But how much of that is purely a marketing tactic, as opposed to a genuine reflection of the quantified-self craze? While some companies are likely just capitalizing on general interest in this space, others are most definitely devout worshippers of the quantified-self doctrine. For perhaps the most quintessential example possible, let me introduce you to Nootrobox, an up-and-coming cognitive enhancement supplement.

Using sleek and simple packaging, Nootrobox cherry-picks ingredients from the FDA’s list of “generally regarded as safe” substances to provide precisely measured pills and gummies that promise to energize your mind or ease you to sleep.

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

Emptiness and the Medical Encounter: The interior spatial requirements of encountering by Suzanne Cochrane

Thirty spokes converge in a hub
There where there is nothing,
That is the chariot’s usefulness.
Fashion earth to make a vase from it,
There where there is nothing,
That is the vessel’s usefulness

– Lao Zi

Emptiness…makes it possible to move about freely and succeeds in ‘letting pass’. The important thing is not to determine ‘what’ passes – assuming one even could – but to conserve its energy, as physics says, that is, preserve its activity.

– François Jullien

If your body [xing 形] is not correct,
The inner power will not come.
If at the centre you are not tranquil,
Your mind will not be ordered.
Correct [zheng正] your body and gather in the power,
Then it will pour in of its own accord.

– Guanzi jiao zheng, Ch.6

The medical encounter, and perhaps particularly the Chinese medical encounter, requires practitioners to place themselves in relation to the person with whom they are working, to achieve an intra-active entangled relation to the other. And we need to do so in a way that can enfold [4] knowledge of the patient-other into our frames of meaning, those diagnostic resources we hold for just this purpose to facilitate therapeutic intervention(s) and guide us through the conundrum of dis-ease, navigating the perturbations that afflict the patient-other. The messy, sticky, distracted business of encountering disorder can engender a multiplicity of resistances and vulnerabilities, which can both allow and impede the clear sight of what ‘really’ is ‘wrong’ and what might be fixed/transformed by the tools available.

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

Eating Disorders and Ramadan

One of those things that’d simply never occurred to me before was highlighted a few days ago in a story on Buzzfeed: how do you reconcile Ramadan fasting with recovery from an eating disorder?  Indeed: can you reconcile them at all?

“Food is obviously a big part of the holy month,” Sofia says. “Usually after breaking fasts, my family have bigger meals than usual, my mum cooks a lot of extravagant Pakistani dishes for iftar. It’s also a time when my extended family tend to visit more, or we go to the mosque and eat there.

“It’s really difficult to eat in public, especially because I’m still uncomfortable around a lot of foods. And what people usually don’t understand is how seeing all that food can make you feel so pressured. Last Ramadan I remember having to force myself to eat because everyone kept telling me to – and I couldn’t say no to them. When we came back from the mosque, I spent most of the night crying, because I felt I had no control.”

[…]

She adds: “I know in my head that I need to stick to the diet and do what my doctor says. But it’s still uncomfortable preparing food while my family aren’t allowed to eat or drink.” At times she “feels guilty while she’s eating”, she says, and there are moments when she’s tempted to go back to fasting again.

 

How central is the not-eating to Ramadan?  I mean: I know that there’re exemptions for things like medical conditions; but is there a mechanism for people not so much to be exempted, but to make an equivalent sacrifice?

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

Catholic Identity and Strong Dissent—How Compatible?

Written by Professor Tony Coady

University of Melbourne

In a previous Uehiro blog[1] I offered a number of fairly radical criticisms of church disciplinary practices, and of several prevailing “official” teachings of the Church, such as on artificial contraception, abortion and much else in the area of sexual and reproductive ethics. Subsequently, several people put the question to me: “Given your critical views of so much official church teaching, how can you still call yourself a Catholic?”  

Those who raise this sort of question for “liberal Catholics” seem to me captive to a certain view of adherence to the Catholic Church that I will call The Picture.  Their capture is understandable because The Picture had been assiduously cultivated by the church’s leadership for generations upon generations, so it is not surprising that outsiders and many insiders and ex-insiders take for granted its accuracy as a measure of Catholic identity. But recent turmoil in the Catholic Church has damaged The Picture severely as definitive of Catholic identity.

The Picture portrayed a proud monolith, firmly grounded in an array of crucial doctrines, disciplines and ageless, immutable moral teachings that united all Catholics in a posture of certainty against heresy and the numerous errors of any given age. It not only served to fortify adherents, but it attracted outsiders seeking certainty amidst what they saw as the gloom and confusion of modernity and its often strident, anti-religious outlook.

The first serious disfiguring of The Picture was made at Vatican Council II which overturned in its wake such proud pillars as the Latin Mass, the Index of Prohibited Books, most mandated abstinence and fasting routines, such as no meat on Fridays, the almost total subservience of the laity to clerical authority in matters religious and sometimes secular, disdain for the non-Catholic world, denial of freedom of conscience, as well as much else previously bound up with Catholic identification.

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.