Tag: managers

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 Blogs

Politicians, Delusional Managers and the Future of the NHS: Have NHS Leaders Failed to “Speak Truth unto Power”?

Guest Post by David Lock QC

[NB: This is a slightly longer version of a post that appeared on the BMJ blog earlier today.]

Politicians, delusional managers and the future of the NHS:  have NHS leaders failed to “speak truth unto power”?

This blog is not a rant – well not too much of a rant.  It is an expression of serious frustration about the way the NHS is run and about the willingness of senior NHS managers to become complicit in dishonesty.  It also needs to acknowledge the brave role of some in the NHS – particularly in NHS Providers – who keep telling it as it is and being decried for doing so.

Everyone at the frontline knows the NHS is running on empty.  The more perceptive know that more money for the NHS alone will not improve services for patients.  But – and this is perhaps the unpopular “but” – NHS senior managers ought to accept their share of the responsibility for the present crisis.  The problem is the failure of NHS managers to “speak truth unto power” to those above them and to our political masters for too many years.  Long before Sir Ivan Rogers used the phrase, a 2015 FCO blog explained the centrality of this concept as part of public service as follows:

The UK Civil Service doesn’t have an official motto – but if it did, it would almost certainly be: “speak truth unto power”. It’s a maxim that’s in the blood of good civil servants, even if they know that it won’t make their lives any easier.

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

Are We All Flint? by Catherine Fennell

[This article originally appeared in Limn, Issue No. 7, “Public Infrastructures / Infrastructural Publics”.]

For the past several decades, Flint, Michigan, has staggered under waves of deindustrialization, disinvestment, and abandonment that have left the city depopulated, its built environment in shambles, and its remaining residents reeling from high unemployment and crime rates, a decimated tax base, and dwindling municipal services. While grim, Flint’s decline is by no means unique in a region whose cities have become synonymous with the booms and busts of twentieth century American manufacturing. Nor is the degree of its decay unusual. Aficionados of ruin will find crumbling infrastructures arresting and aplenty in most any “Rust Belt” city. What is singular, however, is the attention that Flint’s contaminated water has received in recent months, an attention that is now amplifying ongoing debates concerning America’s ailing and aging infrastructures. That amplification is especially apparent in variations of a phrase that has recently echoed through local, regional, and national media and activist circles: “We are all Flint.”

flint-water-filters-rg-bw

With every disclosed email, alleged wrongdoing, and denial of responsibility, the course of Flint’s contamination grows as murky and foul as the water that began flowing from its taps in 2014. In April of that year, the city switched its water source from Lake Huron to the Flint River. The switch unfolded amid a climate of intense fiscal austerity in which state-appointed emergency managers pushed Michigan’s most financially beleaguered cities to cut costs. In Flint, part of this push included a proposal to bypass Detroit’s Water and Sewerage Department as the city’s water supplier, and to instead source cheaper water through a newly constructed pipeline into Lake Huron.

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 – November by Christine Sargent

Hello trusty readers. Check out November’s haul for “In The Journals,” and be sure to check out the special issue of Science, Technology, and Human Values: Feminist Postcolonial Technosciences.

 

American Ethnologist:

Memory, body, and the online researcher: Following Russian street demonstrations via social media (open access)

Patty A. Gray

The Moscow street demonstrations of 2011–12 were the largest public gatherings in Russia since the collapse of the Soviet Union. They were also the largest-ever gathering of Russians on social media. While using the Internet to follow such large-scale social movements remotely, researchers experience social media as a context in which anthropology happens. They may think about “being there” in new ways that shift their focus to their own processes of memory making and sense of bodily presence. Experiencing and remembering social media in the body challenges the distinctions we might otherwise make between virtual and physical encounters.

Royal pharmaceuticals: Bioprospecting, rights, and traditional authority in South Africa

Christopher Morris

The translation of international biogenetic resource rights to a former apartheid homeland is fostering business partnerships between South African traditional leaders and multinational pharmaceutical companies. In the case of one contentious resource, these partnerships are entrenching, and in some instances expanding, apartheid-associated boundaries and configurations of power. The state and corporate task of producing communities amenable to biodiversity commercialization and conservation is entangled with segregationist laws and spatial planning. Rather than exclusion and the closure of ethnic boundaries, resource rights in this context foreground forced enrollment and the expansion of indigenous group-membership as modes of capitalist accumulation in an extractive economy.

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

End-of-Life Care for Older People in Long-term Care Facilities – International Conference

This conference (March 31st-April 1, 2017 in Kraków, Poland) is focused on the issue of improving end-of-life quality of care in long-term care facilities (LTCFs) across Europe with a special focus on the Polish context. 

The conference is targeted at healthcare and social workers, nursing staff as well as managers of LTCFs. Through presentations and workshops the conference participants will be familiar with the latest guidelines of care principles and tools for implementation and execution of a high-quality end-of-life care. 

The conference is organized as the part of the PACE project – Comparing the effectiveness of Palliative Care for Older People in long-term care facilities in Europe which overall aim is to develop tools to assist practitioners and policy- and decision-makers to make evidence-based decisions regarding best end-of-life care.  

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

Contraception: Past, Present and Future And Why It Matters

September 27, 2016

(World Health Organization) – Despite the positive global trends there are large differences among and within countries. Over 200 million women worldwide would like to avoid a pregnancy but are not using an effective method of contraception. Reasons for this vary from each country but are related to a lack of supplies, cultural and political barriers and poor quality of services. For policy-makers and programme managers it is critical that their decisions are informed by important lessons that we can learn from history and knowledge of what opportunities the future holds.

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 one by Aaron Seaman

Welcome to part one of September’s journal post. We start off with a few special issues, which have been highlighted earlier, followed by a great batch of interesting articles for fall reading. Enjoy!

Transcultural Psychiatry – “Practical Anthropology for a Global Public Psychiatry

Medical Anthropology – “Nonsecular Medical Anthropology

New Genetics & Society – “Private, the Public, and the Hybrid in Umbilical Cord Blood Banking

 

Appetite

The traditional food of migrants: Meat, water, and other challenges for dietary advice. An ethnography in Guanajuato, Mexico

Carolyn Smith-Morris

The term “traditional diet” is used variously in public health and nutrition literature to refer to a substantial variety of foodways. Yet it is difficult to draw generalities about dietary tradition for specific ethnic groups. Given the strong association between migration and dietary change, it is particularly important that dietary advice for migrants be both accurate and specific. In this article, I examine the cultural construct of “traditional foods” through mixed method research on diet and foodways among rural farmers in Guanajuato, MX and migrants from this community to other Mexican and U.S. destinations. Findings reveal first, that quantitatively salient terms may contain important variation, and second, that some “traditional” dietary items –like “refresco,” “carne,” and “agua” – may be used in nutritionally contradictory ways between clinicians and Mexican immigrant patients. Specifically, the term “traditional food” in nutritional advice for Mexican migrants may be intended to promote consumption of fresh produce or less meat; but it may also invoke other foods (e.g.,

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

Special Issue! Private, the Public, and the Hybrid in Umbilical Cord Blood Banking by Aaron Seaman

“First, it critically examines the dichotomy between public and private cord blood banks, and shows that the mechanism and network of cord blood banks is far more complex than indicated by the dichotomy of the public and the private. …

“Second, there is an increased interest in the social, ethical and political aspects of cord blood banking as a location where scientific, economic, governmental and personal expectations converge. Cord blood banking attracts various actors with common, and competing, interests, including regulators, scientists, business people, medical staff, donors, patients and customers. Although academic publications have appeared on some of the contested values and discourses around UCB banking, such as waste, gift, hope, insurance and venture…, there is still little we understand about the collaborations, alliances and competition among these actors and stakeholders, as the processes involved in cord blood banking remain opaque. This special issue brings together the perspectives of midwives, managers in cord blood banks, parents, scientists and policymakers in different countries. Their standpoints highlight various perspectives on cord blood banks, as well as how a panoply of opinions and actions come about in their specific socio-cultural, economic and political context.”

As such, the articles’ abstract are below. Enjoy!

Hybrid practices in cord blood banking. Rethinking the commodification of human tissues in the bioeconomy

Christine Hauskeller and Lorenzo Beltrame

The STS and bioethical literature on umbilical cord blood (UCB) banking nowadays discusses the field as divided into opposite institutional arrangements, public versus private banking.

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

Gouging

Jumping to the defence of pharmaceutical companies over their pricing policies isn’t fashionable – and a lot of the time, it’s not going to end prettily.  But it’s perfectly coherent to think that the profit motive is one of the motors of innovation, and that it’s part of the quid pro quo for spending money on drugs that may do nothing; in fine, that the profit motive may actually be a necessary part of getting the good stuff we want.  To an economist, the phrase “normal profit” means the minimum profit necessary to keep a firm going – where average revenue equals average total cost.  But if that was all that was on offer, there’d be no incentive to enter a market in the first place: if you’re (on average) in the same place as you were before entering the market, why bother?  So it’s reasonable to think that there ought to be some level of supernormal profits.  They help ensure we get a world that’s better tomorrow than it was yesterday.

On this account, the problem is not with making a supernormal profit – oh, all right then: what in everyday English we’d simply call a profit – but with gouging and/ or profiteering.  The question that needs to be addressed is one of what level of profit, and what kind of return on investment, is reasonable.  In some sectors of the economy, it may be quite high.  For example, if I can manufacture a luxury good for which people are willing to pay through the nose, and make a stonking great profit from it… well, all hail me.

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

A Healthcare Consumer Gender Gap

August 16, 2016

(Managed Care Magazine) – It’s long been recognized that women interact with the health care system more than men—as patients, as caregivers, as coordinators of care for their loved ones, as the managers of medical bills. Given their regular exposure to a dysfunctional, disjointed system that dumps much of the burden of its inefficiency on patients, women take on more of the burden. And they’re angry about it.

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.