Tag: ownership

Bioethics Blogs

Owning Medical Professionalism

by Jon C. Tilburt, MD & Richard R. Sharp, PhD

Discontinuity, handoffs, and shiftwork have infiltrated the fabric of healthcare. These changes, made in the name of patient safety, may have the unintended effect of reducing residency training to little more than a terrible shift job, disconnected from the professional ethos so critical to the practice of medicine.

In their piece in AJOB this month Dubov and colleagues highlight several problems with resident duty hour restrictions. They postulate that cultivating a vocabulary of personal and professional “ownership” could counteract the detrimental effects of those restrictions.…

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

The Looming Public Health Crisis Threatening to Take Down China’s Health Care System

August 15, 2016

(Quartz) – In the 1980s diabetes was a rarity affecting just one percent of China’s population. Now, due to rapid economic development, and the subsequent growth in availability of high-calorie diets, cars and sedentary lifestyles, China has the highest number of diabetics in the world, totaling 109 million people in 2015—roughly 11 percent of the population. That makes China home to a third of the world’s diabetic population. The scale of this public health problem is huge, particularly because it comes at a time when the country’s health system as a whole is under reform, moving from a rudimentary socialist system to one that is open to private investment and ownership.

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

“As Americans, We Grieve”: Mass Shootings & Collective Trauma by Elle Nurmi

“As Americans, we grieve…”[1]

Mass shootings in contemporary American society have emerged as events of profound political and cultural symbolism; indeed, the news media has often attributed to them the label of “crisis.”[2] They have a singular status in the modern American collective consciousness, one not occupied by other forms of violence. Mass shootings have attained this status, I argue, precisely because their violence transcends the immediate act itself; they are threefold acts of violence, enacted on the bodies of their victims, the minds of their witnesses (both first and secondhand), and society collectively. Through the elaborate national discourse that has been constructed around them, mass shootings have emerged as attacks on society as a whole – mass violence in the most literal of senses. Individuals become witnesses and are thus implicated in the trauma of the event; simultaneously, their personal grief is transformed into collective pain. There are four key drivers that enable this threefold victimization: first, the sense that mass shootings represent a narrative rupture; second, the personalization of a collective anxiety tracing back to 9/11; third, the modern idiom of trauma, which provides a new lens through which to understand and justify the grief reaction; and fourth, the development of new normative grief rituals, performed through social media, which serve to create a shared trauma narrative and to allow individuals to affirm their group membership and community identity in a time of flux and fragility.

Mass shootings are felt as powerfully disruptive of the everyday; they are an inappropriate disruption of not only the “contingent, unremarkable and ordinary” stream of everyday life, but also the normatively coherent, telic narrative of individual and collective life.

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

My Patient

By Suzanne Minor

The student used the phrase “my patient” six times during the brief patient interaction: “I don’t like my patients to not exercise.”  “I like it when my patients eat healthy.”  “I like it when my patients take their medications” and so on.  Many students use this phrase occasionally, but this was striking.  I wondered what his motivation was.  Was he nervous?  Or did he think the patients were his?  After the interaction, I debriefed with him, asking him what went well and what he could improve. He did not bring up his use of “my patient” so I did.  He was unaware of his saying “my patient” and could not reflect on why he was doing so.  I asked him what he thought this phrase might mean to the patient.

“The patient”, he queried, “what does that have to do with it?”  I was frustrated, somewhat aghast that this third-year student, steeped in patient-centered interviewing throughout his first two years of school, missed that the patient had something to do with their own care and that the phrase “my patient” might claim ownership of another person or their attributes, such as soul, physical being, or responsibilities…

I asked him, “Who is responsible for the patient’s care?”

“I am,” he responded quickly.  Specifically relating the discussion to patient autonomy from his clinical skills training, he voiced some understanding that the hypothetical patient shared some responsibility for her care, but could not imagine this actual patient playing a chief role in their well-being as he felt that was his role as the physician-in-training.

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 – July Pt. II by Christine Sargent

Hello everyone! Please check out our roundup for the second half of the month. Also, the current issue of Hau has a symposium on Webb Keane’s Ethical Life: Its Natural and Social Histories (2016) that may be of interest, with contributions by Cheryl Mattingly, Rita Astuti, James Laidlaw, Nicholas Harkness, C. Jason Throop, Richard Schweder, and Webb Keane himself.

Science, Technology, and Human Values

Living with Spinal Cord Stimulation: Doing Embodiment and Incorporation

Lucie Dallbert

Seen as contributing to human enhancement, implanted technologies have recently been receiving a lot of attention. However, reflections on these technologies have taken the shape of rather speculative ethical judgments on “hyped” technological devices. On the other hand, while science and technology studies and philosophy of technology have a long tradition of analyzing how technological artifacts and tools transform and (re-)configure our lives, they tend to focus on use configurations rather than the intimate relations brought about by implanted technologies. Even the cyborg has lost some of its hermeneutic power as it has been detached from its material grounds, becoming a discursive entity. In this article, I reclaim the importance of materiality and explore how people live (and learn to live) with spinal cord stimulation (SCS), which is a type of neuromodulation technology. Implanted in bodies and seemingly out of sight, this technology does not cease to matter. Embodiment and incorporation are crucial for people to live well with SCS. Embodying the neuromodulation technology entails groping processes in which gestures are central and an increased intimacy with one’s bodily materiality. Incorporating it is highly relational and entangled with the bodies of loved and distant ones, humans and nonhumans.

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

Family life is what makes us happiest according to Harvard

Who is right about the benefits or harms of family life : Harvard University or the Catalan MP?

Recently, several media have reported statements made by the Catalonian member of parliament (MP) Anna Gabriel (CUP, a pro-Catalan independence party), who believes in having children in common “like in the tribes”, considering that this way there is no “sense of ownership” of a child but that they are “sons and daughters that you have had and given birth to with others”. She sees in the family a “perverse logic” and “unrewarding”.

It is curious that Anna Gabriel, however, was not brought up any other way than in a family, and she has always been a great defendant of it. Her own family at least. The MP has stated on numerous occasions that her family has been instrumental in her social and political development, and has even said that her greatest treasure is “the values inherited from my family”.

At the same time as the MP’s statements, and as if it were an ironic coincidence, the prestigious Harvard University has just revealed the conclusions of the Harvard Study of Adult Development , which began in 1938 and which has closely followed and examined the lives of more than 700 individuals, and in some cases their partners. The study aimed to investigate which factors will determine if a person will age well and live a happy, healthy life, or if in contrast, they will suffer a disease or mental illness, something that seems to have a lot to do with loneliness.

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

Global Health Collaborations: Justice, not Charity

Parisa Fallah and Mark Bernstein advocate for sustainable, educational, and collaborative approaches to global health work.

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People doing global health work are often regarded as altruistic, but perhaps we should pause and think about this. Is it possible that the way we view global health work is wrong? What if this mode of thinking is counterproductive to the very goal of addressing health inequities? Could an entirely different mindset allow our global health efforts to more effectively lead to positive change?

Global health work should not be viewed as a philanthropic, optional endeavor, but instead should be considered a necessary undertaking to combat systemic inequities and to restore justice. We must make healthcare equitable worldwide, and we must do so through sustainable, educational, and collaborative approaches.

Several centuries ago, colonialism ravaged the global south. Countries were robbed of their resources and were overtaken by the quickly-growing industrialized empires of the north. When these countries finally gained independence, they were impoverished. Their resources were gone, their economies ruined, and their healthcare systems destroyed. The consequences of colonialism were dire and still exist today. Fortunately, there are people ready to help tackle one of the world’s toughest issues – access to healthcare.

Health is a human right. It is not a luxury reserved for the few; rather, it is a necessity that should be available, accessible, and affordable to all at the best quality possible. We need to recognize that we are a global family – that we need to take care of one another simply because we are all fellow human beings.

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

Sunshine Act Didn’t Deter Industry Pay to Physicians in 2015

July 12, 2016

(Medscape) – When the Centers for Medicare & Medicaid Services (CMS) launched its Open Payments program to reveal online what drug and device makers gave physicians and hospitals, the agency thought transparency could “deter inappropriate financial relationships,” as it said in a regulatory document. Whether or not professional conflicts of interest have lessened since the program debuted in 2013, the volume of money flowing from industry to clinicians has not. CMS published Open Payments data yesterday for 2015, showing that drug and device makers gave $7.52 billion in cash, food, and ownership and investment interests to physicians and teaching hospitals. That figure represents a 0.4% increase over the $7.49 billion reported for 2014.

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

U.S. Doctors, Hospitals Paid Billions by Drug, Device Makers: Government

June 30, 2016

(Reuters) – Doctors and hospitals in the United States received $7.52 billion in payments and ownership and investment interests from the makers of drugs and medical devices in 2015, according to data released by a government health agency. The data includes payments for items and services such as food and beverage, travel, education, honoraria as well as research, and is based on information related to 618,000 doctors, more than 1,110 teaching hospitals and 1,456 companies.

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.