Tag: narrative ethics

Bioethics Blogs

Refugees, Narratives, or How To Do Bad Things with Words

By Anna Gotlib

ABSTRACT. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine some of this election’s cruelest, most violent, and most racist rhetoric, reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future. To that end, I problematize the representations and treatment of refugees within the United States from three distinct groups: European Jewish refugees of the Second World War; the Eastern Bloc refugees of the mid- and late twentieth century; and the current Syrian, largely Muslim refugees. I begin by defining the concepts of homelessness and moral luck. Second, I examine the three varying histories of refugee policies in the context of these two notions. Finally, I conclude with a combination of despair and hope: First, I offer a few observations about the role of language in the recent presidential election; second, I propose alternatives to the resulting linguistic and political violence by extending Hilde Lindemann’s notion of “holding” into sociopolitical contexts.

“How odd I can have all this inside me and to you it’s just words.”
― David Foster Wallace, The Pale King

I.  Introduction

The American election of 2016 was, in its vitriol, polarization, and outcome, unlike any in recent memory. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine and confront the fact that some of this election cycle’s cruelest, most violent, and most racist rhetoric was reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future.

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

War Metaphors in Health Care: What Are They Good For?

by Kayhan Parsi, JD PhD

Protest singer Edwin Starr powerfully asked in the early 1970s: “War, what is it good for?” Apparently, it’s good enough to use in a variety of metaphorical turns of phrase. The war on poverty. The war on cancer. The war on Alzheimer’s. The war on drugs. The war metaphor seems irresistible. How else to elevate a social problem and make it the object of our intense focus and attention, not to mention financial support? These metaphors figure prominently in many areas of public life. Take policing. As scholars Peter Kraska and Victor Kappeler have stated about the use of military metaphors in policing: “The ideological filter encased within the war metaphor is ‘militarism,’ defined as a set of beliefs and values that stress the use of force and domination as appropriate means to solve problems and gain political power”. Similarly, health care is replete with militaristic metaphors. Cancer garners the most intensely militaristic metaphors. We often say that someone lost their battle with cancer. Yet cancer is not alone. As Nie and colleagues argue in this month’s target article, such militaristic metaphors are commonly found in the world of HIV cure and research. Why do we continue to use such militaristic metaphors in health care?

Thinking and speaking in metaphors is such a part of being human that it’s almost unremarkable to us. Philosopher Mark Johnson and linguist George Lakoff have made significant contributions in our understanding of how metaphorical thinking shapes our morality and our moral understanding has persuasively argued that we think imaginatively about our moral problems and that our thinking is inevitably metaphorical.

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

Is There A Happily Ever After For Medical Humanities & Bioethics?

by Craig Klugman, Ph.D.

I attended my very first academic conference in 1997, which happened to be the Combined Meeting of the Society for Health and Human Values, American Association of Bioethics, and Society of Bioethics Consultants. I was also in Houston the next year at the very first meeting of the American Society of Bioethics & Humanities. Bioethics and Medical Humanities had married and that was their reception.

This has not been an easy marriage. Some medical humanities scholars have expressed feelings of being slighted, minimized in programs, and not always having a seat at the table. A few in bioethics have expressed concerns that the humanities scholars do not want to play with others and have their own agenda. In this marriage, the couple sleeps in separate bedrooms.

As someone with a doctorate in medical humanities and who was trained in medical anthropology (narrative phenomenology) and bioethics, I never understood why the parents seemed to bicker. From my perspective both clearly had contributions to make to the other. I have published in both bioethics and medical humanities journals as well as have presented at meetings of both. I use films, stories, and writing in my bioethics courses; and discuss issues of ethics and professionalism in my medical humanities class.

In the last few years, some in medical humanities have been in an open marriage, having their own meetings (Health Humanities conference) and linking with other like-minded organizations (MLA). Still, I did not understand why our parents fought. Was it merely a question who got top billing?

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

Bioethics: The Revolution is Over

by Craig Klugman, Ph.D.

At the recent 17th Annual Meeting of the American Society for Bioethics & Humanities, the association honored Baruch Brody with the Lifetime Achievement Award. During his address, Brody said that we are in the era of “normal” bioethics. The age of the revolutionary nature of this field is long over.

Brody talked about Thomas Kuhn’s, “The Structure of Scientific Revolution.” In this tome, Kuhn talks about two types of science—normal and revolutionary. Revolutionary science is what happens when an accumulation of data and observations shows that the world does not work as theory predicts. As an example, Kuhn talks about how when subatomic particles were discovered, the prevalent theory of physics—Newtonian physics—could not explain the behavior of these very small particles. This forced a creative revolution that led to the positing of quantum mechanics from which Einstein found the general theory of relativity and even today, physicists search for the grand unified theory.

But once a new theory is proposed and accepted, the work of science moves to normal science where the theory is further proven, refined and its implications and applications are explored. For example, in 2012 the predicted Higgs Boson was discovered at CERN. In 2011, the results of the Gravity Probe B project proved that Einstein’s predictions about the behavior of gravity around an object in space.

Brody described the founding of bioethics as a moment of revolution. Bioethics moved philosophy out of the ivory tower and into the clinic; it connected humanities scholars with government panels and the media; and it shifted the focus from doctors paternalistically making decisions to patient autonomy.

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 Scylla and Charybdis of Medical Ethics: Not Enough Medicine, Not Enough Ethics

I was at a conference last week in
medical ethics, and I was surprised by, or perhaps appalled at, the attitude
displayed by many of the philosophers regarding the importance of medical
knowledge in medical ethical decision making. Several of them proudly announced
a total ignorance of the medical issue they were speaking on, and also showed
no interest in what I would call “real world” implications of their
conclusions.
  Although I have a PhD in
philosophy, I am not a philosopher in the sense that I am capable of, or
interested in, spinning arguments from “thin air” with no grounding in medical
facts, and no implications for real medical practice.
  Medical ethics must begin in real life issues
and problems, and end with equally real and meaningful conclusions that can be
applied, and sometimes even empirically tested.
 

This
is not to say that philosophers cannot make good, or even great,
medical/clinical ethicists. But they need to begin with a healthy respect for
the way in which the “facts on the ground” inform the ethical
decision-making.  A brief example
illustrates my point.  In Hilde Lindemann
Nelson’s famous
article explaining narrative ethics, she discusses the case of
Carlos and Consuela. Carlos is an HIV positive gang member
wounded in gang violence, who is recovering from his injuries in a
hospital.  He is now ready for discharge,
but needs dressing changes at home.  He
wants his sister Consuela to do the dressing changes, but he insists that she
not be told about his HIV status. 

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

“Reasonable Accommodation” for Families of ‘Brain Dead’ Patients

The NIB Forum is pleased to post a contribution from a board member, who comments on a case study from volume 1, issue 1.

“Reasonable Accommodation” for Families of ‘Brain Dead’ Patients


By Jeffrey Spike, PhD

Martin L. Smith and Ann Lederman Flamm published a Case Study in Narrative Inquiry in Bioethics’ first issue (Vol 1, No 1, Spring 2011, pp. 55-64): “Accommodating Religious Beliefs in the ICU: A Narrative Account of a Disputed Death.” It was a careful and detailed description of a woman, Sarah, in her mid-to-late 20s who is left dead by neurological criteria after an apparent un-witnessed cardiac arrhythmia at home. There have been a number of discussions of cases like this, including one I wrote with a colleague over 15 years ago (Jeffrey Spike and Jane Greenlaw, Journal of Clinical Ethics, Vol. 23, No. 3, Fall 1995): “Persistent Brain Death and Religion: Must a Person Believe in Death in order to Die?” The title was deliberately provocative, both in inventing a new term for these corpses that exist in limbo, dead but pink and breathing thanks to a ventilator and drugs to maintain blood pressure, and also deliberate in raising the question of the intersection between personal beliefs (including religious beliefs) and medical realities.

The outcome of the case in Smith and Flamm was described as a deus ex machina: another hospital accepted the transfer of the patient. Thus their article leaves it an open question for others to consider: what should be done in such cases?

Here then are some suggestions.

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.