Tag: traditional medicine

Bioethics Blogs

The Impossibility of the Inert: Placebo and the Essence of Healing by Thomas J. Csordas

The concept of placebo is predicated on the opposition between active and inert, deploying this opposition to assert that an action or substance with no inherent active principle can have a paradoxical effect “as if” it were active.1 My thesis is that there is no such thing as the inert in human affairs, relationships, or experience. Think of the apparently simple retort of the bullied child that “sticks and stone may break my bones but names can never hurt me.” Contrary to this retort, names can indeed hurt. They are not inert, but carry an actual force identifiable as hate or disdain. And what of the retort itself? Is it a vain, desperate, and ultimately inert act of self-protection, effective only insofar as it taps into the “as if” logic of the placebo? I think not, though like any remedy it must be applied under the right conditions and with the understanding that it may not be uniformly effective in the degree to which it buffers the noxious influence of name-calling with an equivalent, self-confident force of self-esteem. There is also, however, an easily overlooked element of materiality in the retort. That is its rhythm: the fact that it is phrased in trochaic meter. It is not only that meter adds the force of incantation or song, but that it directly engages the embodied existential immediacy of the situation, contributing an element of jauntiness encompassing not only tone of voice but posture and gesture.

The notion of materiality as I have just used it is of value in reflecting on the impossibility of the inert.

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

End of Life Doulas

Birth doulas have been supporting women through childbirth since the 1980s. In 2003, Henry Fersko-Weiss, co-founder of the International End of Life Doula Association (INELDA), adapted the philosophy, tools, and approaches used by birth doulas to create a program with a new kind of doula, an end-of-life doula, to support and guide people through the dying process. This new approach brings deeper meaning and greater comfort to dying people and their loved ones.


That first program created was highly successful and became the model for two additional hospice programs Fersko-Weiss built in New Jersey. Through these programs, hundreds of people have had the benefit of end-of-life doula services in the final days of life. In addition, the INELDA end-of-life doula principles and techniques have been presented in public trainings at the Open Center in New York City and the Institute for Traditional Medicine in Toronto, Canada.


INELDA, an international nonprofit organization, is the next step in the evolution of the end-of-life care approach. INELDA is dedicated to helping hospices build end-of-life doula programs. It is committed to setting the standard for end-of-life doulas and supporting them in their professional life. INELDA will also continue to research and develop new tools and techniques to further advance best practices in end-of-life care.

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

Beyond Miracles: How Traditional Chinese Medicine Establishes Professional Legitimacy in Post-colonial Macau by Loretta I.T. Lou

[Editor’s Note: An earlier version of this article appeared in Imponderabilia: The International Student Anthropology Journal (2014). This piece is updated with new data and photos collected between 2015 and 2016.]

In Search of Reclusive Doctors (xunzhao yin shi yishu) was the first Chinese TV documentary about medical miracles “made” by doctors of traditional Chinese medicine (TCM). When it was first broadcasted in 2001, it evoked great public interest in the Pearl River Delta region. In exalting the Chinese doctors’ miraculous power to save people on their deathbeds, the documentary paradoxically placed great emphasis on the scientific validity of TCM and folk medicine. In line with this, Mei Zhan’s ethnographic study of TCM doctors in Shanghai and San Francisco also found that the legitimacy of traditional Chinese medicine is built upon its ability to treat difficult cases (Zhan 2001:454). She argues that TCM doctors have used “miracle-making” to “craft a niche for traditional Chinese medicine within a biomedicine-centered health care system. The everyday practice and discourse of traditional Chinese medicine has come to be a site for the ‘production of the extraordinary’” (Ibid).

In an environment where TCM is in fierce competition with biomedicine, it is understandable that some TCM practitioners feel they have to establish their legitimacy through miracle-making. However, my research in Macau suggests a different story. A former colony of Portugal (1557-1999), Macau was returned to the People’s Republic of China in 1999 and is now a Special Administrative Region (SAR) of the PRC. Although Macau had the first Western-style hospital in Asia, it was not until 1984 when the Macau-Portuguese government finally reformed its health care system and established a public health network composed of a government hospital and a dozens of community health centers.

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

Introduction: “Translating Vitalities: Spacecraft(ing)” by Judith Farquhar

Medical practice treats the body as an active field. Growth, pathology, healing, immune response, digestion, atrophy, arousal, pain, panic – none of these organic processes is stable, fixed, or indeed ‘a thing’; yet, they are all objects of interest for medicine. Medical intervention, whether it takes the form of an antibiotic or an acupuncture treatment, interrupts a flow of causes at a strategic point deemed to be crucial. Note that this point is not the cause of disease but a decisive moment in its (patho)genesis. Bodies are lived processual assemblages, as comparative medical anthropology has shown; their (our) powers and experiences extend beyond the skin and involve more than mere physical presence. The somatosphere is a site of activity, its scale and scope always emergent, always being negotiated, the specific nature of its spatiality always in question.

A processual and dynamic notion of lived embodiment informs the series of Somatosphere posts that follows this Introduction. These posts, appearing over the next six days, arise from a collaborative writing and art-making project entitled Translating Vitalities. Helped by generous funding from the Wellcome Trust[1] and the University of Chicago,[2] Translating Vitalities brings together a group of anthropologists, China scholars, artists, physicians of bio- and Chinese medicines, historians, musicians, physical scientists, and clinical researchers with the shared goal of exploring ‘translation’ – specifically that which engages with and arises from the criss-crossing vitalisms of contemporary medicines, humanities, art and science – as both a problem and an enabling space for creative trans-disciplinary engagements.

The posts in this series are a first attempt to translate our collective work into productive forms that, we hope, will engage wider audiences sharing our goals and orientations.

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

Health Law Events at AALS 2016

Next week, the 110th AALS Annual Meeting starts in New York.  I have collected those events at the meeting that relate to health law.

Thursday (Jan. 7) – 1:30 to 3:15P
Hilton, Gramercy West, 2nd Floor
Aging and the Law
Challenging Assumptions About Caregiving
In this session, a diverse group of legal scholars will help reimagine how the law might support both older adults and care providers by challenging common assumptions about caregiving relationships. Specifically, participants will challenge assumptions about the identity of caregivers, the scope of caretaking responsibilities, compensation for care providers, and the impact of traditional approaches to caring for older adults. Topics of discussion will include: (1) the role and legal treatment of non-family care providers, especially in relation to care for LGBT elders, (2) the “taboo” needs of care recipients including needs related to sexual intimacy; (3) the “myth” that surrogate decision-making and guardianship protects older adults; and (4) the Medicaid program’s hidden penalties for those who employ family members as care providers.
Speaker: Alexander A Boni-Saenz, Chicago-Kent College of Law, Illinois Institute of Technology
Moderator: Roberta K. Flowers, Stetson University College of Law
Speaker: Kristin B. Glen, City University of New York School of Law
Speaker: Nancy J. Knauer, Temple University, James E. Beasley School of Law
Speaker: Nina A. Kohn, Syracuse University College of Law
Thursday (Jan. 7) – 3:30 to 4:45P
Hilton, Nassau West, 2nd Floor
Law, Medicine and Health Care
Works-In-Progress for New Law School Teachers
Contracting for Results in Health Care?
Wendy Netter Epstein
Tackling the Social Determinants of Health: A Central Role for Providers
Jessica Mantel
Elizabeth Y.

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

How Traditional Chinese Medicine Finally Won Its Nobel Prize

October 6, 2015

(Quartz) – The year’s most prestigious prize in medicine has been bestowed upon Youyou Tu, the lead discoverer of powerful malaria drug artemisinin. In giving her the prize, the Nobel Prize committee has recognized the role ancient knowledge can play in the modern world. But her extraordinary tale, which began during the Vietnam war, also shows traditional medicine’s limitations.

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

Honouring Makayla

Sarah Wiebe discusses the significance of culturally-sensitive care in matters of life and death

__________________________________________

In a video posted to YouTube, the late Makayla Sault read a letter explaining why she declined chemotherapy. In that video, she says that, “This chemo is killing my body and I cannot take it anymore.” Seeing Makayla so full of life in this video is shocking. In Regional Chief of Ontario Stan Beardy’s words, Makayla was “full of spirit and a young warrior who fought her disease on her own terms to the very end.”

My heart goes out to Makayla Sault and her family. I can only imagine how difficult this must be for all those she touched during her eleven years of life. Though I haven’t lost a child, I have held the hands of loved ones struggling to reconcile with cancer and directly witnessed the distress it poses to the mind, body, and soul. Although removed from this immediate situation, Makayla’s story compels me to reflect on and to write about the politics surrounding issues of health, life, and death in Canada.

Last year, Makayla began chemotheraphy to treat her acute lymphoblastic leukemia. After twelve weeks, her family chose to stop that treatment and pursue traditional alternatives. As the widespread media attention and public debate reveal, this action sparked much controversy about the meaning of rights: of the child, of Indigenous peoples and, to the right to choose between life and death.

The events leading up to and following Makayla’s passing raise a fundamental political question: who determines the right to let live and let die?

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

Aboriginal rights and refusal of treatment in Canada

Consider:

An 11 year-old girl, J.J., is diagnosed with high-risk acute lymphoblastic leukemia, a type of cancer that arises in the bone marrow. She is put on a 32-day course of chemotherapy with an estimated success rate of over 90%. Her doctors don’t know of anyone who has survived this illness without such a course of treatment. However, after just 10 days, her mother withdraws her consent to J.J.’s chemotherapy in order to pursue alternative, non-western remedies. J.J. doesn’t object, but both of her doctors believe that J.J. doesn’t understand either her illness or the importance of the treatment she is on. In all matters, she defers to her mother who is also her surrogate decision maker. The hospital in which J.J. is a patient appeals to Child Services, stating that by ceasing treatment J.J.’s mother has put J.J. into the position of a child in need of protection. Such a status would permit the hospital to continue treatment despite disagreement from J.J’s mother (in her capacity as surrogate decision maker). The case goes to trial, and a ruling is made in favour of J.J.’s mother. J.J. is taken out of the hospital in order to pursue non-western treatment alternatives. It is very likely that J.J. will die.

These are the details of a case that was recently argued in the Ontario Court of Justice. There is precedent in the Canadian legal system for disregarding the express wishes of parents who are also a child’s surrogate decision maker. For example, children of Jehovah’s Witnesses will continue to receive blood transfusions despite the fact that the tenets of their parents’ faith prohibit such a procedure.

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

STATES OF GRACE: Disability and Chronic Pain as a Bioethical Issue

STATES OF GRACE is a “must watch” film for health care providers. It deals with the health of caregivers, professionals and families, as well as that of persons who have become disabled. In STATES OF GRACE, Dr. Grace Dammann, is a revered physician who signed more than one thousand death certificates during the height of the HIV/AIDS epidemic. In 2008, just before memorial day, while commuting from work, another driver crashed head-on into her car as she crossed the Golden Gate Bridge. 

After seven weeks in a coma and twelve surgeries, Grace regains consciousness, her cognitive abilities surprisingly intact though her body left shattered. That’s the easy part of the story. When Grace returns home, following a year in rehabilitation hospitals, consummate Filmmakers Helen S. Cohen and Marc Lippmann shadow her and her family. Four years later, Grace remarkably returns to work, in her wheelchair, to serve in an innovative pain clinic that cares for San Francisco’s most resource stressed communities. The film’s eloquence is underscored by the work of acclaimed editor Kenji Yamamoto. 

To be honest, as stated on this site in 2010, “Grace’s life and persona before the accident was remarkable.” His Holiness the Dalai Lama presented Grace the Unsung Heroes of Compassion Award for her care of thousands of AIDS patients, during the era when HIV/AIDS was always a death sentence. How Grace and her family became a part of Isabel Allende’s extended family is reflected in the author’s memoir sequel, The Sum of Our Days. A Buddhist, the extraordinary relative sparing of Grace’s cognitive function seems a gift of her mindfulness practice. 

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

Doctor bets against traditional Chinese medicine

Beijing

The Beijing University of Chinese Medicine is one institution where the government promotes the practice.

BUCM

A sceptic of traditional Chinese medicine is challenging practitioners of the age-old craft to prove themselves by putting his own money on the line. One has accepted the challenge. At stake is the claim that practitioners can discern whether a woman is pregnant by her pulse.

Traditional Chinese medicine (TCM) is a point of contention in China. While the government is keen to promote its use in the clinic and, in modernized form, as part of drug discovery, some feel that much of it is unproven and that the government is throwing its money away. There have also been high-profile cases of fraud linked to such research, and the practice is criticized for its dependence on endangered species such as the Saiga antelope (Saiga tatarica).

Ah Bao, the on-line nickname of a burn-care doctor at Beijing Jishuitan hospital, has been an adamant critic of TCM on Chinese social media, often referring to it as “fake”. He issued the challenge on 13 September, and Zhen Yang, a practitioner at the Beijing University of Traditional Medicine, took him up on it.

Ah Bao put up 50,000 yuan (more than US$8,000), and at his urging others have donated more than 50,000 yuan, making the prize worth more than 100,000 yuan total. Ah Bao turned down Nature‘s request to be interviewed, saying that he has been overwhelmed by media attention.

Yang will have to assess with 80% accuracy whether women are pregnant.

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.