Tag: health services

Uncategorized

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.

Uncategorized

Why Addiction Narratives Matter

By Katie Givens Kime
Image courtesy of
Merrimack Repertory Theatre.

“My Higher Power is: Science!” proclaims Sean, a newly recovered alcoholic. “Sean” is the lead character in a comedic play, “The White Chip,” which premiered last year at Merrimac Repertory Theatre outside of Boston, Massachusetts. Written by Sean Daniels, the play dramatizes Daniels’ own near demise from alcoholism, and his experience of recovery. Neuroethics is writ large as the play tells the story of how critically important various addiction etiologies can be for those struggling with alcoholism, or addiction of any sort. In Sean’s case, the etiology is the brain disease model of addiction (BDMA) in a notable combination with the “Higher Power” understanding of 12-step programs, which he credits with saving his life. Behind the curious twists of the play, questions linger: which model of addiction should be presented to those in recovery, when so much conflict exists amongst addiction researchers, clinicians, and recovery care providers? At what point does an effective (potentially life-saving) narrative of addiction etiology supersede the obligation to provide all sides of the controversial matter of addiction modeling?

When Sean “hits bottom,” he has destroyed his career, his marriage, his health, and nearly lost his life while driving drunk. He enters a rehabilitation facility, but struggles with the suggestion that he find a “Higher Power.” Such a practice is reflective of the metaphysical claim central to Alcoholics Anonymous, and every other 12-step program: surrender to a Higher Power of the addict’s understanding, and is perhaps the most significant distinguishing feature separating 12-step methods from other recovery pathways.

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.

Uncategorized

What Does It Mean to Be a Just Institution?

[Cross-posted from the Public Health Post Blog, where it originally appeared on March 17, 2017.]  By Lauren Taylor   The Trump administration is prompting many of us in health services to ask new questions about if, and how, to draw lines … 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.

Uncategorized

Ethics & Society Newsfeed: March 10, 2017

Image via

Politics

White House Slammed by Federal Ethics Chief for Not Disciplining Kellyanne Conway
U.S. government’s official ethics watchdog blasted White House for not taking disciplinary action against senior counselor Kellyanne Conway for promoting Ivanka Trump’s products on TV

Trump’s Ethics Order Seen as Boost for Shadow Lobbying
President Trump’s speech to the joint session of Congress on Tuesday explains executive order to ban lobbying for five years for officials who leave office – addresses the ethics of “draining the swamp”

George W. Bush’s ethics lawyer says Jeff Sessions’ denial of Russia talks ‘a good way to go to jail’
Alleged ethics violations Jeff Sessions may have made when he claimed under oath that he “did not have communications with the Russians”

ACLU lawyer files ethics complaint against Sessions over Russia testimony: report
An American Civil Liberties Union (ACLU) lawyer, Christopher Anders, formally filed an ethics complaint against Attorney General Jeff Sessions over his testimony to the Senate Judiciary Committee denying any contact with Russian officials

Trump’s team nixed ethics course for White House staff
White House staff has received no ethics training under the Trump transition team and now presidency

Medical Ethics

House Republicans would let employers demand workers’ genetic test results
Bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars; employers see that genetic and other health information

Prisoners with serious mental health problems face urgent treatment delays
Prisoners in the UK are supposed to receive mental health services after being referred to such a unit within 14 days and new official numbers have indicated that regulations are not being followed

New pregnancy testing technique needs limits say ethics body
Press release from the Nuffield Council on Bioethics explores the ethics of Non-Invasive Prenatal Testing (NIPT) and explains why they are calling for a moratorium on the use of the new technology

Ethical Implications of User Perceptions of Wearable Devices
Wearable devices can save time at medical appointments and may even save lives – ethical implications of having large amounts of personal information stored in devices that are shared with third parties

When Evidence Says No, But Doctors Say Yes
Medical costs increasing and patient benefits are declining  – ethical conundrum of why medical professionals continue to prescribe unnecessary treatment, and calls for responsible regulation

States Wrestle With Legalizing Payments For Gestational Surrogates
Legislators proposed a bill that would regulate gestational surrogacy — potentially adding legal oversight to fertility clinics that facilitate these pregnancies

Environmental Ethics

EPA environmental justice leader resigns, amid White House plans to dismantle program
Key environmental justice leader at the Environmental Protection Agency has resigned, saying recent budget proposal to defund work would harm the people who most rely on the EPA

Why Won’t American Business Push for Action on Climate?

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.

Uncategorized

Ethics & Society Newsfeed: March 10, 2017

Image via

Politics

White House Slammed by Federal Ethics Chief for Not Disciplining Kellyanne Conway
U.S. government’s official ethics watchdog blasted White House for not taking disciplinary action against senior counselor Kellyanne Conway for promoting Ivanka Trump’s products on TV

Trump’s Ethics Order Seen as Boost for Shadow Lobbying
President Trump’s speech to the joint session of Congress on Tuesday explains executive order to ban lobbying for five years for officials who leave office – addresses the ethics of “draining the swamp”

George W. Bush’s ethics lawyer says Jeff Sessions’ denial of Russia talks ‘a good way to go to jail’
Alleged ethics violations Jeff Sessions may have made when he claimed under oath that he “did not have communications with the Russians”

ACLU lawyer files ethics complaint against Sessions over Russia testimony: report
An American Civil Liberties Union (ACLU) lawyer, Christopher Anders, formally filed an ethics complaint against Attorney General Jeff Sessions over his testimony to the Senate Judiciary Committee denying any contact with Russian officials

Trump’s team nixed ethics course for White House staff
White House staff has received no ethics training under the Trump transition team and now presidency

Medical Ethics

House Republicans would let employers demand workers’ genetic test results
Bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars; employers see that genetic and other health information

Prisoners with serious mental health problems face urgent treatment delays
Prisoners in the UK are supposed to receive mental health services after being referred to such a unit within 14 days and new official numbers have indicated that regulations are not being followed

New pregnancy testing technique needs limits say ethics body
Press release from the Nuffield Council on Bioethics explores the ethics of Non-Invasive Prenatal Testing (NIPT) and explains why they are calling for a moratorium on the use of the new technology

Ethical Implications of User Perceptions of Wearable Devices
Wearable devices can save time at medical appointments and may even save lives – ethical implications of having large amounts of personal information stored in devices that are shared with third parties

When Evidence Says No, But Doctors Say Yes
Medical costs increasing and patient benefits are declining  – ethical conundrum of why medical professionals continue to prescribe unnecessary treatment, and calls for responsible regulation

States Wrestle With Legalizing Payments For Gestational Surrogates
Legislators proposed a bill that would regulate gestational surrogacy — potentially adding legal oversight to fertility clinics that facilitate these pregnancies

Environmental Ethics

EPA environmental justice leader resigns, amid White House plans to dismantle program
Key environmental justice leader at the Environmental Protection Agency has resigned, saying recent budget proposal to defund work would harm the people who most rely on the EPA

Why Won’t American Business Push for Action on Climate?

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.

Uncategorized

In the Journals: February 2017 by Christine Sargent

American Ethnologist

Good ramps, bad ramps: Centralized design standards and disability access in urban Russian infrastructure

Cassandra Hartblay

Accessible design seeks to reconfigure the social by restructuring the material. As the idea moves globally, it becomes entwined in local logics of moral obligations between citizens and the state. Wheelchair users in the city of Petrozavodsk, in northwestern Russia, talk about inaccessible infrastructure as being embedded in moral relationships. In their stories, hierarchies of expertise diffuse responsibility for outcomes and devalue user knowledge. When accessible design elements are installed to meet minimum standards, they are “just for the check mark” and often do not “work.” Wheelchair ramps produce value for businesses or governments by representing an idea of access that circulates as a commodity. Failed accessible design draws attention to a moral field governing the responsibilities of actors to produce a “good” built environment, imbricated in teleologies of progress. [disability, design, infrastructure, access, ramps, postsocialism, Russia]

Self-governance, psychotherapy, and the subject of managed care: Internal Family Systems therapy and the multiple self in a US eating-disorders treatment center

Rebecca J. Lester

“The self” has seen a surprising resurgence in recent anthropological theorizing, revitalizing interest in whether and how it can be studied ethnographically. These issues are brought to the fore by a newly popular psychotherapy technique, Internal Family Systems therapy (IFS), as practiced in a US eating-disorders clinic. There, clinicians and clients negotiate tensions between this model’s understanding of a multiple, refracted self and managed-care companies’ insistence on personal responsibility. In considering the moral and pragmatic work of IFS in the clinic, a new critical anthropology of selfhood illuminates the vectors through which economic and political commitments become imbricated in the self.

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.

Uncategorized

Biofinance: Speculation, Risk, Debt, and Value from Bios: A conference report by Danya Glabau

How does the financialization of life itself figure as a new means of producing value in modern technoscience? That is the question that motivated Kirk Fiereck to convene the panel “Biofinance: Speculation, Risk, Debt, and Value from Bios” at the 2016 American Anthropological Association meeting in Minneapolis, Minnesota this November. Fiereck, panelists Melina Sherman, Danya Glabau, and Emily Xi Lin, discussant Kristin Peterson, and chair David Pederson, offered new ways to think about how financialized life is a source of value, and what this means for the ethics and practice of biomedicine in sites throughout the globe.

In writing this conference report, Fiereck, Sherman, and Glabau each contributed short comments about their talks, which were edited together in the unified first half of this report. The second half includes further reflections that we have attributed to each scholar individually as a way to illustrate the diverse, possibly divergent, uses of “biofinance” as a concept.

 

The Papers

Melina Sherman opened the panel with, “Biofinancial Investments and Disinvestments: Examining the U.S. Opioid Epidemic,” which focused on the cultural and institutional construction of pharmaceutical markets – in particular, the market for prescription painkillers. Markets, especially those situated within the bioeconomy – an economic space in which capital is organized through life (bios) in its various forms – constitute the broader context in which biofinancial practices are situated. Her paper explored the ways in which the selective investments and divestments of federal regulators and opioid consumers condition the growth of this market. The market for prescription opioids is a good example of what Sherman calls an “addiction market” (see also Lovell, 2006), where addiction (understood as a destructive attachment – in this case, of a person to a prescription drug) is built-in to the cultural and economic processes that drive market formation and growth.

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.

Uncategorized

Extreme and Outrageous End-of-Life Communication – Beyond the Bounds of Common Decency

I have read hundreds of complaints in end-of-life medical treatment conflicts.  But I have never seen allegations like those in Wilson v. University of Alabama Health Services Foundation.  


I teach the tort of intentional infliction of emotional distress in my Torts class.  This is a textbook example.  The family is seeking $10 million in punitive damages.


90-year-old Elizabeth Monk Wilson was taken to UAB Hospital with a “full measures” advance directive.  The clinicians there disagreed with that plan and thought that only comfort measures were appropriate.  But the way in which they conveyed that to the patient is simply beyond belief.  Here are just a few examples from the complaint.


“You’re eaten up with colon cancer which is spreading and partially blocked your colon. You are going to die soon. You have lived your life. Accept your death.”


“Don’t you understand what I just said? Your mother is dying and we need to send her home. She is 89—let her die. She has lived her life and needs to let go and die. Our time and treatments will be wasted on her. She simply needs to die. She needs to accept it.  You need to accept it. We need to get her out of here and quit wasting everybody’s time.”


“I know what is best for you. When you code, the resuscitation attempt will break your ribs violently and cause you great pain and suffering. Why do you want to go through a violent procedure instead of dying? What is wrong with you? Your life is over.

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.

Uncategorized

A Dangerous Wait

Colleges can’t meet soaring student needs for mental health care. STAT surveyed dozens of universities about their mental health services. From major public institutions to small elite colleges, a striking pattern emerged: Students often have to wait weeks just for an initial intake exam to review their symptoms. The wait to see a psychiatrist who can prescribe or adjust medication — often a part-time employee — may be longer still

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.

Uncategorized

Special Issues! The Publics of Public Health in Africa | Anthropological Interrogations of Evidence-Based Global Health by Anna Zogas

I’d like to highlight a pair of Special Sections in the early 2017 issues of Critical Public Health. The first is “The Publics of Public Health in Africa,” guest edited by Ann H. Kelly, Hayley MacGregor, and Catherine M. Montgomery. The second is “Anthropological Interrogations of Evidence-Based Global Health,” guest edited by Elsa L. Fan and Elanah Uretsky. Here are the abstracts for the articles in both sections!

 

The Publics of Public Health in Africa 

The publics of public health in Africa (open access)
Ann H. Kelly, Hayley MacGregor & Catherine M. Montgomery

Excerpt: How do we understand the public character of public health in contemporary Africa? What are the parameters of community engagement in health care delivery, medical research and disease control programmes? To what extent is public health in Africa a project led by African Governments? Through what political processes and deliberative practices can African publics influence the priorities of research in health sciences and interventions which aim in broad terms to improve the health of such publics? Drawing insight from empirical research conducted with African scientists, nurses, community members, clinical trialists and policy-makers, this special section examines the multiple ways in which the publiccomes into being around public health provisioning and investigation in sub-Saharan Africa, its role and political reach. Collectively, these papers show how contestation and negotiation around different ideas about who the public is and what being public means can lead to the emergence of conflicting understandings, with implications for who and what is seen to represent the public interest, and for the acceptance of research and other interventions.

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.