Tag: social interaction

Bioethics Blogs

Stakes of Life: Science, states, policies, publics and ‘the first thousand days’ by Fiona C. Ross

Welcome back to the “First Thousand Days of LifeSomatosphere series. Here we continue to explore the ways that a global health initiative driven by new findings in epigenetics and neuroscience and by a reframing of theories about health and disease in terms of developmental origins shape ideas about (global) health and population futures, invigorate campaigns, and take form and settle in localized contexts. Understanding the links between science, biomedicine, policy, population, well-being and relationship as simultaneously both meshed and contingent, our series posits questions about what affordances and limitations lie in new modalities of understanding human illness and well-being. It examines how policy is made and with what effects for its recipients, how states are implicated in health and its others, what forms of the everyday materialize under the lens of new findings in epigenetics and epidemiology, what modalities of knowing emerge and how they settle with older forms, and how ethnography might contribute.

Describing the research programme driven by the Thousand Days research group at the University of Cape Town, I noted that,

The emergent field both synergises a range of disciplines in the bio- and social sciences and develops new sites of humanitarian intervention, reframing current debates about population, well-being and ‘the best interests of the child’ in newly biological ways. As these findings are taken up in policy and practice, we are witnessing the making of a social object with material effects’ (www.thousanddays.uct.ac.za).

Our project has explored that making, its prior conditions and its effects.  As Michelle Pentecost noted in her opening to the Somatosphere series, the framing ‘offers fertile ground for careful thought about contemporary concepts of life, life-giving and care, offering spaces for critically assessing not only how states and people understand and enable health and well-being but also how life is conceptualized by different disciplines.’ 

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

Meet Tomorrow’s World: A Meeting on the Ethics of Emerging Technologies

By Marcello Ienca
Marcello Ienca, M.Sc., M.A., is a PhD candidate and research assistant at the Institute for Biomedical Ethics, University of Basel, Switzerland. His current projects include the assessment of intelligent assistive technologies for people with dementia and other neurocognitive disabilities, the regulation of pervasive neurotechnology, and the neurosecurity of human-machine interfaces. He is the chair of the Student/Postdoc Committee of the International Neuroethics Society and the current coordinator of the Swiss Network for Neuroscience, Ethics and Law.

Technology is rapidly reshaping the world we live in. In the past few decades, mankind has not significantly changed biologically, but human societies have undergone continuous and unprecedented developments through technological innovation. Today, most human activities—from messaging to geolocation, from financial transactions to medical therapies— are computer-mediated. In the next decades, the quantity and variety of activities mediated by digital technology is bound to increase exponentially. In parallel, with advancements in artificial intelligence (AI), robotics and microcomputing, the friction between man and machine is set to vanish and the boundaries at the human-machine interface are bound to blur. In an attempt to anticipate our technological futures as well as their impact on our societies and our systems of values, the International Neuroethics Society (jointly with the Temporal Dynamics of Learning Center, the Science Collaboratory of the University of California, San Diego, and the National Science Foundation) sponsored a public event on the Ethics of Emerging Technologies as part of the 2016 annual INS meeting in San Diego, California. The event was organized by INS President Judy Illes, INS Executive Director Karen Graham, Dr.

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

Overcoming The Challenges In Advance Care Planning For Dementia Patients

Many newly diagnosed dementia patients
may have capacity and be fully able to state their preferences about future
medical care when they lose capacity. Their decisions about risks and benefits
of medical treatments while they have capacity flow from their critical interests which are the kinds of interests, which if not
satisfied, would make them think they were worse off in some way or that their
life had not be worthwhile. When a patient is capable of articulating his or
her critical interests we know what is most important about them in terms of
making their lives meaningful. So it would seem that preferences that stem from
critical interests about future medical care provides the most definitive
evidence possible, i.e. substituted judgment, for both medical and family caregivers to have as a basis on
which to be reasonably sure they are making decisions that the incapacitated
patient herself would make if she were in this same situation.

However, many incapacitated dementia
patients who by definition are no longer able to express their critical
interests are indeed still able to express preferences based in their experiential interestsExperiential interests are abiding
biologically based, immediate interests grounded in the quality of one’s life
from activities in which they are finding satisfaction, pleasure, and amusementThe
situation becomes particularly challenging when it appears that the
incapacitated dementia patient is expressing a preference based on experiential
interests that runs contrary to a prior expressed preference stemming from
critical interests.

Because patients with severe dementia
experience their lives in discrete moments, each expressing its own set of
experiential interests, there is also a concern about how to understand the
changing self of the patient and interpret her wishes and preferences
throughout the transitions, particularly at the end of 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

Offering Condolence in the Modern Era

As social media has surged
in our society, how we interact with people has shifted.  Some of us spend
more time texting and emailing than talking to a human face.  This may be
especially true for those who have an office job.  We as a society have
expressed concern about the possible health effects from increased screen
exposure, such as the impact computer screens have on vision and memory.  We also have expressed concern
about how screen exposure will affect childhood development, particularly
social interactions. So what affect has this increased screen exposure caused
on how we console another for the loss of a loved one?

Consoling is a skill that
clinical ethicists learn quickly as many consults is related to end-of-life
issues. It is as simple as offering a tissue for a grieving family member but
more than simply saying “I am sorry for your loss.”  It is an ability to
read another human’s grief.  Consoling is arguably a fundamental component
to our society as loss is a natural part of the human process.  Consoling
is a way of experiencing the grieving process and accepting loss.

A recent New York Times article gave us some
advice on how to console those who have experienced death.  The article
gave seven points of advice, one of which was “Facebook is not enough.” 
It made the point that a message or post via Facebook is a great first gesture
but that one should follow up with something more such as a condolence card or
attending the funeral.

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 – October 2016 by Livia Garofalo

Here is our “In the Journals” roundup for October. In addition to a rich selection of abstracts, also of interest this month are a Special Issue of Osiris on the “History of Science and Emotions” and two recent articles by Fernando Vidal on brains in literature and cinema (linked below). Enjoy!

 

Theory & Psychology 

Desire, indefinite lifespan, and transgenerational brains in literature and film

Fernando Vidal 

Even before the brain’s deterioration became a health problem of pandemic proportions, literature and film rehearsed the fiction of brain transplantations that would allow an aging person to inhabit a younger body, so that successive surgeries may result in that person’s immortality. Such fiction makes the brain operate like an immaterial soul that does not undergo physical decline. This article examines that fiction as elaborated in Hanif Kureishi’s The Body and several films in connection with older fantasies that articulate desire, eternal youth, and personal immortality, with philosophical discussions about brain and personhood, and with people’s assimilation of neuroscientific idioms into their views and practices of personal identity. In conclusion it discusses how, in contrast to philosophical approaches that tend to focus on self-consciousness, first-person perspectives, and individual autonomy, fiction may contribute to direct attention to relationality as constitutive of personhood.

SubStance 

Frankenstein’s Brain: “The Final Touch”

Fernando Vidal 

 

Critical Public Health

A critical examination of representations of context within research on population health interventions

Jean Shoveller, Sarah Viehbeck, Erica Di Ruggiero, Devon Greyson, Kim Thomson and Rodney Knight

Research that fulsomely characterizes context improves our understanding of the processes of implementation and the effectiveness of interventions to improve the health of populations and reduce health inequalities.

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 reader’s guide to the anthropology of ethics and morality – Part II by Webb Keane

Editor’s note: We asked several scholars which readings they would recommend to students or colleagues interested in familiarizing themselves with the anthropology of ethics and morality. This is response we received from Webb KeaneGeorge Herbert Mead Collegiate Professor of Anthropology at the University of Michigan. Reading lists from other scholars will be forthcoming in this series.

 

The anthropology of ethics and morality is as old or as new as you’d like to make it. After all, ethics and morality were motivating questions from the very start of the discipline, evident for instance in Tylor’s call for a reformer’s science, Durkheim’s worries about anomie, Weber’s account of the Protestant ethic, Benedict’s patterns of culture, and Mauss’s total social fact. Looking at the field from this angle, one might be tempted to echo the dry remark with which one of my teachers used to greet any new and exciting idea: “But that has been known since Aristotle.” To overemphasize continuity, however, can blind us to emergent possibilities; we shouldn’t let genealogy blind us to the freshness and specificity of what we can call “the ethical turn.” So why an ethical turn now? Here are two factors, among others. First, after a generation, the turn to power critique in anthropology, important though it has been, seems to have reached a certain limit. Once “power” (or, say, “neo-liberalism”) became the answer to all questions, it started to lose both its explanatory and critical force. The turn to ethics opens up new ways of looking at political commitment.

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

Graphic Anthropology Field School by Kim Tondeur

The Graphic Anthropology Field School (GrAFs) is a project launched by Expeditions, an independent network of scholars in the human sciences. For 11 years, we have been holding in Gozo (Malta) a summer school for anthropologists and social scientists, focused on the practice of fieldwork. Far away from sleepy lectures in gloomy classrooms, our aim has always been to keep our feet on the ground and experiment with tools and tricks for fieldwork practice.

The idea of offering a separated program entirely dedicated to graphic anthropology grew during the past two years. The project started quite randomly as a colleague saw me sketching a scenery. His interest was piqued and he suggested that we take some students to grab a coffee and sketch at a terrace as a group. Of course, the ulterior motive was to figure out if drawing could serve as observation and analysis in the field. But we quickly acknowledged it was more than that: drawings present numerous advantages at different stages of the research process. More importantly, sketching appeared as a handy activity for young and sometimes inexperienced researchers to access the field more easily. Also, it did not require any expensive gear nor specific skill: everyone can trace lines on paper.

GrAFs views drawing as a practice of “making” more than “taking” (Taussig 2011). Drawings are far less intrusive than photography, and encourage the necessity to take time, observe, wait, and get lost with fieldwork. In the field, the utility of sketches appears from a low-brow but most useful kind: sketching a scene gives one “a reason to be there” in situations where even senior researchers might struggle with a feeling of being “out of place.”

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 May 2016 Part II by Melanie Boeckmann

Part I can be found here. 

Social Science & Medicine 

Where the lay and the technical meet: Using an anthropology of interfaces to explain persistent reproductive health disparities in West Africa

Yannick Jaffré, Siri Suh

Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs’ goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health.

 Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes

Annegret F. Hannawa, Yuki Shigemoto, Todd D. Little

Rationale

This study investigates the intrapersonal and interpersonal factors and processes that are associated with patient forgiveness of a provider in the aftermath of a harmful medical error.

Objective

This study aims to examine what antecedents are most predictive of patient forgiveness and non-forgiveness, and the extent to which social-cognitive factors (i.e., fault attributions, empathy, rumination) influence the forgiveness process.

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

After the End of Disease: Rethinking the Epidemic Narrative by Dora Vargha

In conversations with people living with polio in Hungary, I often encountered members of the tight-knit community referring to themselves as “dinosaurs”. We are a breed that is about to die out, they said. Nobody gets polio anymore, some added, and they were right – epidemics, even sporadic wild polio cases disappeared from the country in the 1960s. Their words stood in stark contrast with celebrities like Jackie Chan, Desmond Tutu and Bill Gates showing on billboards all over the world that with the Global Polio Eradication Initiative we are ‘this close to ending polio’. Yet the urgency of the eradication campaign and the gradual disappearance of a polio generation over a lifetime both signified the same thing: the end of a disease. But what, exactly, is this end and what comes after?

In the following weeks, a series of posts by historians, anthropologists and sociologists will grapple with these questions as they consider epidemic narratives and the ways in which endings bear on global health issues. This series accompanies the interdisciplinary conference After the End of Disease, held on May 25-27 2016 in London. Bringing together practitioners and academics from various disciplines and fields, this event aims to initiate conversations on when and for whom diseases end, what happens when the end fails to come, who gets to determine the end and who gets left behind, how a focus on endings shape health policies and how we can critically rethink the temporalities of epidemics.

Public and academic discussions on the end of diseases have been abundant in the midst of recent epidemic crises.

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

Magic Words: A Numbered List by Vincent Duclos

  1. Boundary
  2. Biǎo 表
  3. Interiorization (Inclusion)
  4. The Fold
  5. Emptiness
  6. Pathway
  7. Tōng 通
  8. Media/Medium
  9. Resonance
  10. Excess
  11. Immunity/Community


1. Boundary

Boundary is such a common-sense concept that it hardly needs to be glossed. Indeed, the definition of the word in the Oxford English Dictionary flirts with tautology in its obviousness: “that which serves to indicate the bounds or limits of anything….” Interestingly, however, “boundary” in this definition takes an active verb, it “serves” to do something social, conceptual, and even political. In recent scholarship boundaries between knowledge domains are seen as disputed, just as the political boundaries between nation-states often are. It has become common in science studies to examine the very practice of “serving to indicate the bounds or limits of anything.” Historians and sociologists of science have analyzed border wars or boundary disputes in which scientists and commentators ask, about fields like psychology or cold fusion: is it really science, or is it superstition, error, ideology? Some observers of biomedicine have asked whether this field is, properly speaking, a science or, like “non-Western” healing modalities, a skilled art, thus challenging the distinctness of the two worlds of science and art.

Susan Leigh Star and James Griesemer have given us the useful notion of a boundary object, “which both inhabit[s] several intersecting social worlds and [satisfies] the informational requirements of each of them.” Boundary objects “have different meanings in different social worlds but their structure is common enough … to make them recognizable, a means of translation.” These uses of the concept of boundary do not presume that boundaries (“whether material or immaterial,” the OED says) exist in the world undisputed. 

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.