Tag: social class

Bioethics Blogs

In the Journals – August 2017 by Livia Garofalo

Here is the article round-up for August, put together in collaboration with Ann Marie Thornburg.  There is a special issue section of Social Science and Medicine out this month on Austerity, Health, and Wellbeing (abstracts below). Also of note is a recent ‘Takes a Stand’ statement on the End of AIDS published in Global Public Health by Nora Kenworthy, Richard Parker, and Matthew Thomann. You can take advantage of the article being temporarily free access and on early view here. Enjoy!

 

Cultural Anthropology (Open Access)

Tangles of Care: Killing Goats to Save Tortoises on the Galápagos Islands

Paolo Bocci

If calls to care for other species multiply in a time of global and local environmental crisis, this article demonstrates that caring practices are not always as benevolent or irenic as imagined. To save endemic tortoises from the menace of extinction, Proyecto Isabela killed more than two hundred thousand goats on the Galápagos Islands in the largest mammal eradication campaign in the world. While anthropologists have looked at human engagements with unwanted species as habitual and even pleasurable, I discuss an exceptional intervention that was ethically inflected toward saving an endemic species, yet also controversial and distressing. Exploring eradication’s biological, ecological, and political implications and discussing opposing practices of care for goats among residents, I move past the recognition that humans live in a multispecies world and point to the contentious nature of living with nonhuman others. I go on to argue that realizing competing forms of care may help conservation measures—and, indeed, life in the Anthropocene—to move beyond the logic of success and failure toward an open-ended commitment to the more-than-human.

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

Configurations of diagnostic processes, practices, and evidence: a conference report by Natassia Brenman

Every two years the Medical Anthropology at Home network organises a conference to present and discuss recent work. The ninth conference, held in June 2016 in Northern Norway, was organized by Mette Bech Risør from The Arctic University of Norway and Nina Nissen from the University of Southern Denmark. To address the theme of Configurations of diagnostic processes, practices and evidence, the conference placed diagnosis and diagnostic processes centre-stage — as classification and practices in-the-making, exploring a wide variety of actors, and organizational and discursive levels.

Thirty-two people presented papers in eight sessions broken up by two stirring keynote lectures, one delivered by Simon Cohn — from the London School of Hygiene and Tropical Medicine, UK — and the other by Annemarie Jutel — from the Victoria University of Wellington, NZ. The papers, grounded in rich ethnographic material, offered critical reflections on new developments and transformations of socio-medical realities in Europe, the United States, Canada and Brazil. As medical anthropologists critically engaging with diagnostic practices in our respective projects, we (Natassia Brenman and Anna Witeska-Młynarczyk) each presented papers and participated in the lively discussions that took place over the four days. In the following reflections, we seek to capture the key themes that emerged from the sessions, and to consider how the overarching aim of advancing anthropological debates on diagnosis was pursued throughout the conference.

Diagnosis as containment: an opening thought

Simon Cohn’s opening keynote reflected on how we, as medical anthropologists, might maintain a focus on local practices in a world where it is increasingly hard to represent single bounded locations.

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

Expanding The Moral Community: Why is it so hard?


Much of American history can be described as the struggle to
expand the moral community in which an increasing number of human beings are
seen as having basic rights under the constitution. We forget sometimes that
though the inclusion of all people was perhaps implied in our early documents,
as in “We hold these truths to be self-evident, that all men are created
equal…” from the Declaration of Independence, it has taken historical time and
struggle to come closer to realizing that ideal. This struggle has been the
quest for recognition of more and more individuals not assumed initially to have
the right to vote and exercise control over their lives, which included African
Americans, women, minorities, and more recently the LGBT community. The growing
recognition of more and more individuals as being full fledged citizens has
been a slow, often painful, birthing process of freedom, in the sense of
unleashing human potential and possibilities, within the democratic process.


 


The recent uproar over the
Anti-LGBT law
passed in North Carolina is a reminder of how difficult it is
for many states and communities to accept and accommodate historically
marginalized people into the mainstream of society. This law was a quick
reaction by the right wing North Carolina legislature and governor to an
ordinance passed in Charlotte, similar to what other cities around the country
are doing, allowing transgender people to use restrooms according to their
gender identity. Perhaps this law also should be seen as a reaction to the
Supreme Court ruling in 2015 legalizing same-sex marriage, which has been
propelling society toward greater openness and acceptance of LGBT life styles,
integrating them into the mainstream.

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 Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic

by Lisa H. Harris, Neil S. Silverman, and Mary Faith Marshall

The inequalities of outcome are, by and large, biological reflections of social fault lines (Paul Farmer)

Three paradoxes characterize the Zika virus pandemic and clinical and policy responses to it:

  1. Zika virus has been shown to cause severe developmental anomalies in the fetuses of infected women. As a result, both women and men in endemic areas are asked to avoid or delay pregnancy. However, access to effective contraception and safe pregnancy termination is either not available (especially for those living below the poverty line) or a crime for many women in Zika-endemic regions. The Brazilian government is confiscating international shipments of pills for medical abortion and is reportedly aiming to increase sentencing minimums for women who obtain abortions for fetal anomalies linked to Zika infection.
  2. Global approaches to pandemic planning and response, including those for the current Zika outbreak, are generally concerned with nominal fairness and the neutrality of procedural justice (i.e., response and allocation strategies equalize chances for those among the general population to receive benefits [or experience burdens]). Pandemic planners strive for systematic fairness by using (ostensibly) random processes (such as first-come, first-served or a lottery) to allocate resources for those who are similarly prioritized. However, pandemics disproportionately affect the disadvantaged, meaning that neutral approaches to global Zika virus pandemic planning and resource allocation will perpetuate and in fact increase existing gender, social, and health disparities.
  3. Historically, concerns for the “vulnerability” of pregnant women and fetuses have resulted in the systematic exclusion of pregnant women from research.

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 Panama Papers: How much financial privacy should the super rich be allowed to enjoy?

The Panama Papers comprise a leak of 11.5 million files from Mossack Fonseca, the world’s fourth biggest offshore law firm. The leak has tainted the reputations of many celebrities, and some public officials have been forced to resign, including Icelandic Prime Minister Sigmundur Davíð Gunnlaugsoon, and Spanish Industry Minister José Manuel Soria.

Ramón Fonseca, Director of Mossack Fonseca, complained that his firm was the victim of “an international campaign against privacy.” At a time where privacy does seem to be under attack on all fronts, it is relevant to ask whether the super rich ought to be able to enjoy financial privacy with respect to their offshore accounts.

Most people in Western societies value both privacy and transparency. Privacy allows us to guard what is none of other people’s business. By shielding us from other people’s gazes and judgments, it enables freedom of thought and action, creativity, relaxation, and intimacy, among other benefits. In turn, transparency is one of the marks of advanced democratic societies, as it fosters fairness and accountability.

Privacy and transparency, however, can conflict, as in this case, and there can be such a thing as too much of both. A world with too much privacy would be one where people would be isolated, not sharing any information about themselves with others, and where criminals would never be found out. A world with too much transparency would be a stressful, shallow, and conformist one—with every act being publicly scrutinized, people would be afraid to think or act in ways that are not mainstream, stigmas and past mistakes would stick to people for the rest of their lives, and being a political or social dissenter would be extremely costly or impossible.

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 — February 2016, Part II by Aaron Seaman

And now for a very belated February post (not even the extra day could help this year…). However, there is much to dig in to here, including two special issues, “The Sociology of Health Care Safety and Quality” in Sociology of Health & Illness and “Anthropology and Medical Photography: Ethnographic, Critical and Comparative Perspectives” in Visual Anthropology. Enjoy!

Social Science & Medicine

Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care

Elisa Giulia Liberati, Mara Gorli, Giuseppe Scaratti

Delivery of interdisciplinary integrated care is central to contemporary health policy. Hospitals worldwide are therefore attempting to move away from a functional organisation of care, built around discipline-based specialisation, towards an approach of delivering care through multidisciplinary teams. However, the mere existence of such teams may not guarantee integrated and collaborative work across medical disciplines, which can be hindered by boundaries between and within professions. This paper analyses the boundaries that affect collaboration and care integration in newly created multidisciplinary teams. Empirical data are drawn from an ethnographic research conducted in the sub-intensive stroke unit of an Italian public hospital. Data collection involved 180 h of observations and conversations with 42 healthcare providers. Findings show that disciplinary boundaries hinder both intra-professional and inter-professional collaboration. Doctors from different disciplines adopt different, and sometimes conflicting, clinical approaches, doctors and nurses construct discipline-specific professional identities, and conflicts emerge between doctors and nurses from different disciplines over the regulation of the medical–nursing boundary. Achieving collaboration and integration between professionals from different disciplines may be particularly challenging when the group with less institutional power (nurses, in this case) has developed a high level of expertise on the needs of the patients targeted by the team.

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

“Fetal assault” and later environment effects on child development: using neuroscience as a tool for political policy

By Carlie Hoffman

Premature infant, courtesy of Wikipedia
“Crack babies,” “crack kids,” and the “lost generation” were all terms used by the public and the press in the 1980s and 1990s to describe children born to mothers who used crack-cocaine during pregnancy. Supported and spurred on by the media’s interpretation of preliminary research performed by Dr. Ira Chasnoff, among others, these children were often born prematurely, had tremors and a small head circumference, and, based on their description in the press, were expected to have neurobehavioral deficits, reduced intelligence, and deficits in social skills. These children were also anticipated to cost educational and social systems thousands of dollars as they matured and entered into schools and eventually the workforce.
Yet, after additional studies have been conducted and as the “crack babies” have grown into adolescents and young adults, it has been found that the negative outcomes widely described by the media were overreaching and unsupported. “Crack babies” did not, in fact, present evidence of severe, broad problems with social development and cognitive functioning and did not prove to have the predicted detrimental social and financial effects on the school system. Instead, many of these children have grown into successful adults over the past two decades. Dr. Claire Coles, a researcher responsible for producing the first studies that challenged Chasnoff’s findings, thought the era of the “crack baby” had finally come to an end. However, as Coles discussed during the December Neuroethics and Neuroscience in the News journal club, “crack babies” and similar stories about children exposed to opiates, have resurged in recent media publications (seen here and here) and are rearing their heads once again.

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

R-E-S-P-E-C-T

Here’s an intriguing letter from one John Doherty, published in the BMJ yesterday:

Medical titles may well reinforce a clinical hierarchy and inculcate deference in Florida, as Kennedy writes, but such constructs are culture bound.

When I worked in outback Australia the patients called me “Mate,” which is what I called them.

They still wanted me to be in charge.

Intriguing enough for me to go and have a look at what this Kennedy person had written.  It’s available here, and the headline goes like this:

The Title “Doctor” in an Anachronism that Disrespects Patients

Oooooo-kay.  A strong claim, and my hackles are immediately raised by the use of “disrespect” as a verb – or as a word at all.  (Don’t ask me why I detest that so; I don’t know.  It’s just one of those things that I will never be able to tolerate, a bit like quiche.)  But let’s see…  It’s not a long piece, but even so, I’ll settle for the edited highlights:

Medical titles reinforce a clinical hierarchy and frame the physician-patient relationship as a deferential one, which is hardly appropriate in person centered care.

A while ago I spent some time shadowing hospital doctors. On one of my shifts, a woman was brought to the emergency department.  A physician entered the patient’s room and introduced himself in the usual way.

“Hello, Ms Smith,” he said, “I’m Dr Jones. I will be taking care of you.”  The woman visibly stiffened after hearing this introduction.  This seemed odd, until I heard her reply: “Well, isn’t that nice?

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 Oct 2015 – Part 1 by Francis Mckay

Hi all. Here’s the first part of this month’s roundup.

 

Configurations

Nano Dreams and Nanoworlds: Fantastic Voyage as a Fantastic Origin Story
Emily York

Fantastic Voyage, a 1966 Hollywood science fiction film based on a screenplay written by Harry Kleiner, is often associated with contemporary nanotechnology imaginings. In this article, I draw on ethnographic research conducted within a new nanoengineering department and undergraduate major to show how this film is deployed to produce a particular disciplinary and professional identity for nanoengineering. By juxtaposing my analysis of how the film is framed in the department with a close reading of the film itself, I show how both inclusions and exclusions constitute the “nano dream,” a boundary-drawing practice that constructs the nanoengineer as an intrinsically ethical identity. I further assess how the constitutive exclusions of a cultural object taken up within an epistemic community can potentially serve as the starting points for intervention—in this case, a critical pedagogy that posits a “critical nanoengineering” practice.

Number-Lines: Diagramming Irrationality in “The Phoenix and Turtle”
Adhaar Noor Desai

This article considers how changes in the concept of number allow both poets and mathematicians in the early modern period to imagine and articulate concepts that resist referential signification. Specifically, it examines how both Shakespeare’s “The Phoenix and Turtle” and Robert Recorde’s The Whetstone of Witte employ hybridized lines possessing characteristics of both discrete and continuous types of quantity in order to render irrationality. Tracing the development of a formalized poetic “number line,” which understands verses as negotiating between aural, accentual-syllabic numbers and visual inscriptions, this article claims that “The Phoenix and Turtle” functions diagrammatically.

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

Theorising Health Inequalities — A special issue of Social Theory & Health by Aaron Seaman

The current issue of Social Theory & Health is a special double issue on theorizing health inequalities. Comprising eleven articles, the issue developed out developed out of a 2012 symposium held at the University of Edinburgh, entitled “Where Next for Health Inequalities?” As guest editors Katherine E. Smith and Ted Schrecker write in their introduction (the full text of which is freely available):

Lewin (1951, p. 169) famously reflected that there is ‘nothing more practical than a good theory’. Yet in health inequalities research, and public health more broadly, the number of theoretical contributions pales in comparison to the ever-growing number of empirical studies. It is certainly true that most of these empirical studies are informed by social theory in that many employ indicators of social categories that reflect theoretical ideas sketched out by Marx, Engels and Weber (see Kapilashrami et al and Scambler and Scambler, this issue) but these theoretical underpinnings are rarely acknowledged, interrogated or considered in any detail. Where theoretical frameworks have been applied to the study of health inequalities, this has often been with the purpose of trying to understand, or help analyse, pre-existing data sets or findings, rather than to inform decisions about how we study, and try to tackle, such inequalities or to develop theoretical approaches that are specifically intended to help us better understand health inequalities as a phenomenon. The collection of articles in this special issue is an attempt to begin redressing the empirical bias described here; to demonstrate some of the practical implications that social theories have to offer those seeking to better understand, and tackle, a social problem as complex and persistent as health inequalities; and to illustrate the indispensability of theory in generating new hypotheses for empirical research, both qualitative and quantitative.

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.