Tag: pastoral care

Bioethics Blogs

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.

Bioethics Blogs

“Humanists,” Academic Philosophers, Critical Distance, and Clinical Ethicists


The October 2016 Annual Meeting of the American
Society for Bioethics and Humanities (ASBH) announced its theme for the
Washington, D.C., convocation several months ago: “After over half a century of
work, and as ASBH celebrates its coming-of-age, we have chosen to focus on
‘critical distance’ and our ‘insider-outsider’ status at our 18th annual meeting.”
Some may be relatively unfamiliar with these notions of “critical distance” and
“insider-outsider” status.


            In
the early 1970s, when medical center and medical school thought leaders began
hiring “humanists” to teach, round with teams, and attend morning reports and
noon conferences, it was unclear what – if any – specific outcomes might
result. However, the center executives and deans wanted to try something to
help inject human values and humanistic thought into the educational process to
offset the very strong influences of advancing technologies, specialization,
and materialism, and to assure the outraged public in the face of recently
revealed research scandals.


            These pioneer
“humanists” were theologians, religious studies scholars, and philosophers. In
just a few years, the philosophers were predominating in this growing field of applied
ethics educators and scholars. In explaining this transition, Art Caplan wrote:
“It proved very difficult to do bioethics in public in anything approximating a
religious voice. … [I]t quickly became clear that to command the attention of
scientists and physicians, as well as policy-makers, a more secular voice was
required. Philosophy, emerging out of decades of mainly futile wrangling about
meta-ethical issues, was more than happy to oblige … .”
Caplan AL. The birth and
evolution of bioethics.

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 discernment of knowledge: sexualized violence in the Mennonite church by Stephanie Krehbiel

This case begins with an unsettling email. It came from a powerful man of the church, a Mennonite executive, and it was a response to an email from me, in which I told this leader that he was perpetuating violence against queer people.

I was an ethnographer writing about the Mennonite movement for queer justice, and I also was a Mennonite, at least by background. In the interviews I was doing with LGBTQ Mennonites around the country, I kept hearing the word violence: rhetorical violence, spiritual violence, institutional violence, systemic violence. The violence they spoke of was often quiet and subtle, invisible to many. It happened in the wording of denominational statements, in all the ways in which LGBTQ identities were cast as worldly distractions from more important church work; it happened in families, inherited patterns of sexual shame that thrived on the specter of a monstrous sexual outsider. It happened most particularly in the process of what Mennonites call “discernment.”

Mennonites have little in the way of doctrine. What they do have are committees, some of which are called “discernment groups.” Listening committees are a regular feature of Mennonite discernment, particularly in the realm of LGBTQ people, who in the course of the forty-year history of their organizing within Mennonite contexts have often been invited to “share their stories” in front of appointed listeners. I will return to discernment, but for the moment, I will say two things about it.

One, I don’t believe I know any LGBTQ Mennonites for whom the word “discernment” fails to produce groans, eyerolls, and other expressions of deep cynicism.

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

Dignity and Destiny, Part 2

The following is the second in a two-part review of John Kilner’s new book entitled Dignity and Destiny: Humanity in the Image of God (Eerdmans, 2015). This review was originally published in the Spring/Summer 2015 (Vol. 4.1) issue of the Journal of the Christian Institute on Disability (JCID), for which I serve as Book Review Editor. Information on the JCID, including subscriptions and downloadable articles, can be obtained at http://www.joniandfriends.org/jcid/

 

My last post (“Dignity and Destiny, Part 1,” January 14, 2015) traced John Kilner’s argument that creation in the image of God has to do more with God’s intentions for us—to be conformed to the image of Christ—than it does with our present capacities or functional abilities. For Kilner, the “image of God” is not a substantial (physical) object to which one can point, or a degreed property of which one can have more or less. Instead, it is a fixed and invariable standard—namely, (the person of) Christ himself—to which people made “in,” or “according to,” that image, and who have “embraced” their intended destiny through faith in Christ, are being conformed over time. At present, sin interferes with our ability to reflect godly attributes; it does not, however, affect either the “image of God” itself, or humanity’s status as created in (according to) that image. Consequently, a lack of present capacities or functions on the part of any individual human being cannot be taken as evidence that that individual somehow fails to be “in,” or to “bear,” the image of God.

In the book’s concluding chapter, Kilner lays out a few of the implications of the foregoing theological investigation.

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

A Role for Clinical Ethics Consultants in Stem Cell Tourism

Recently Dr. Christopher Thomas Scott of Stanford
University wrote a great paper titled “The Case of Stem Cell Counselors” in
Stem Cell Reports which draws parallels
from the field of genetic counseling arguing for the need for stem cell
counsellors (1). Scott outlines that due to increases in the number of stem
cell trials combined with fraudulent therapies being offered around the world,
the time is ripe for having counsellors help patients navigate the clinical
stem cell research/therapy landscape. These experts can help patients identify
and distinguish legitimate trials from unproven interventions, explain the
risks, benefits and therapeutic options, and serve as a resource to provide
them with educational information.

On a related topic, my colleagues and I at AMBI were
going to write a paper arguing that clinical ethics consultants should be
involved in countering the impact of stem cell tourism and serve as a resource
for patients who are contemplating undertaking an unproven stem cell based
intervention (SCBI). We thought that clinical ethics consultants are in a
unique position to offer advice and counselling to patients seeking unproven SCBIs
for a few reasons.

First, clinical ethics consultants are trusted by
patients. While holding institutional affiliation with a hospital or treatment
center, they function at arms distance length from the clinical team and so
patients may regard them as unbiased and trustworthy. Especially because
clinical ethics consultants may form a strong relationship with patients, ethics
consultants may be in a unique position to convey warnings about unproven
SCBIs. There is some empirical data suggesting that patients are distrustful of
the medical team and the research enterprise as being unresponsive to their
needs.

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.