Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the “television doctor” by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering (...) and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the “doctor-hero” as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House’s character as the central figure who is personally and interpersonally problematic but biomedically effective. (shrink)

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the “television doctor” by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering (...) and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the “doctor-hero” as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House’s character as the central figure who is personally and interpersonally problematic but biomedically effective. (shrink)

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

Volume 20, Issue 4, May 2020, Page 59-61.

This essay review of Margaret Atwood's Payback centers on the observation that the book does not dwell on the unnatural face of interest and finance. In this era of financialization, debt has been thoroughly uncoupled from the concept of payback. The least valuable debt is the one that is promptly repaid. It is this aspect of debt—the interest, not the principal—that has attracted the richest tradition of social condemnation. As stable forms of production and exchange were replaced by international arbitrage, (...) the link between debt and sorcery became evident to observers around the world. More profoundly, Atwood's widely shared commonsense impression that consumer debt is a measure of self-indulgence does not hold up empirically. It turns out that our unprecedented levels of household indebtedness were overwhelmingly a function of nondiscretionary spending. Even as Americans owed one hundred percent of GDP in individual debt in 2008, the real Faustian bargain was not a “enjoy now, pay later” scheme for “glitzy, short-term junk.” The truth is much scarier, and points toward a different set of cultural and theological references than the ones Atwood investigates. The dividing line between solvency and insolvency, it turns out, is not consumption but reproduction: the most certain route to financial disaster is having a child. (shrink)

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

Bethany Henning argues that within the naturalistic strains of American philosophy, there is an implicit theory of the unconscious that finds its fullest expression within the work of John Dewey. Although the unconscious contributes to all experience, it plays a principal role in experiences that are emphatically aesthetic.

We live in a time of erotic dysfunction: In 2020, and again in 2023, there was a brief media frenzy in the wake of studies published by UCLA that concluded that Gen Z is having statistically less sex than millennials did in their formative years. The generational angle made for good headlines, but the same surveys indicated that people of all ages are having less sex than they used to (Herbenick et al.; Wellingham). We needn't work hard to identify likely (...) factors that might have led us here. The pandemic undoubtedly shifted our tolerance for closeness and contact, which has only reinforced the proliferation of technological commodities (devices, apps, platforms) that have made isolation ever more convenient. These... Read More. (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

The dubious relation of “subjective” experience to “objective” reality finds its correlate in the opposition we often suppose between culture and nature. Twentieth century theorists, most notably Freud, have claimed various methods for interpreting the illusions of one realm that hide the truths of the other. Ricœur has famously called the psychoanalytic method of dream interpretation a “hermeneutics of suspicion,” which he sees as a threat to the “mytho-poetic core of imagination.” John Dewey regarded the binary opposition between culture/nature as (...) particularly dubious, preferring to see them as reciprocal phases of a continuous process; if cultural life is an interpretation of the biophysical environment, that environment surely has its say. However, in the century since Freud, the tactics of suspicion have proven themselves to be indispensable for developing of critiques that reveal the subtle operations of anti-democratic ideologies, perhaps at the expense of democratic faith. This paper considers if there are less suspicious, more Deweyan possibilities for the interpreting and sharing of dreams, not for the benefit of the psychic health of the individual dreamer, but for the sake of a recovery of democratic life. (shrink)

This paper explores the connection of offshoring and outsourcing to nonconsensual global pharmaceutical trials in low-income countries. After discussing reasons why the topic of nonconsensual offshored clinical trials may be overlooked in bioethics literature, I suggest that when pharmaceutical corporations offshore clinical trials today, nonconsensual experiments are often foreseeable and not simply the result of aberrant ethical conduct by a few individuals. Offshoring of clinical trials is structured so that experiments can be presented as health care in a unique form (...) of outsourcing from the host country to pharmaceutical corporations. Bioethicists’ assessments of the risks and potential benefits of offshore corporate pharmaceutical trials should therefore systematically include not only the hoped for benefits and the risks of the experimental drug but also the risk that subjects will not have consented, as well as the broader international consequences of nonconsensual experimentation. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

Anthropology of Consciousness, EarlyView.

Modern feminist movements run the risk of being appropriated by capitalist agenda and commodified for mass appeal, thus stripping them of their revolutionary potential. I would propose that in order for feminism to challenge this, movements may want to consider the subversion of subjectivity. Deleuze and Guattari's notions of becoming-animal and becoming-woman emphasise a subjectivity not confined by rigid identity, such as man/woman. However, feminists have challenged this theory, suggesting it is difficult to both fight for and dispel the very (...) same notion, that is, woman. I argue that in first considering the feminine subject via the Lacanian understanding of ‘Woman’, it can be argued that feminine subjects can engage with becoming-animal to destabilise the notion of ‘Woman’. Riot Grrls, FEMEN and Pussy Riot all demonstrate tactics which could be said to utilise becoming-animal and have had varying success in avoiding commodification. (shrink)

This paper examines the drive for consensus from the perspective of the good government framework for federal advisory commissions in the United States. Specifically, the paper examines the Federal Advisory Committee Act (FACA) – the statute, its regulations, and case law. It shows that the FACA was intended to be an antidote to abuses in consensus‐making processes, including the failure to fully include competing views on commissions. The index of suspicion in the FACA scheme rises when a group work product (...) – including a consensus report – is to be the basis of recommendations to federal officials. Once FACA's requirements regarding committee composition are satisfied, the index of suspicion drops and FACA is indifferent to consensus‐making; but the conditions for informed, meaningful participation apply to members who dissent from, as well as those who participate in, consensus. In negotiated rulemaking, the push for consensus and closure creates unacceptable tension with the good government goals of openness and accountability. Proponents of consensus‐only bioethics commissions can learn from FACA‐related legislative, agency, and judicial insights that consensus‐seeking is not always desired by government officials; is rarely cost free; and that diversity and dissent enhance openness, accountability, and fairness. The burden of proof is therefore on proponents of a consensus‐only standard for bioethics commissions to demonstrate that a drive for consensus furthers sound decision‐making by government officials more than it sets back openness and accountability to a diverse public. (shrink)

(2010). The Pitfalls of Misreading: What Does “Industry Funding of Medical Education” Actually Say? The American Journal of Bioethics: Vol. 10, No. 1, pp. 24-25.

In Forsaking the Fall, Daniel Spencer argues that a Christianity which takes the Bible as authoritative for faith and which holds continuity with the deep tradition of the Church can still dispense with Original Sin and the lapsarian reading of Genesis and Romans 5. While not explicit in the introduction, the motivation for this move to reject the Fall and Original Sin seems to be a desire to account for humanity’s evolutionary origin. Without a historical Garden of Eden or Adam (...) and Eve, can a fully satisfying account of soteriology, Christology, and faithfulness to the biblical text still be held? (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

What I propose in this article is application of existing dispute resolution practices that take place outside the courtroom to the negotiating that takes place between health providers and families when they try to reach agreement about the limits of medical care that arguably is futile. Specifically, I focus on a bargaining paradigm that is associated with divorce proceedings, and suggest how this paradigm is at work in the conflict about futile treatment. At issue are not the well-publicized aspects of (...) high profile cases, but the rather unpublicized bargaining that goes no further than the clinical setting.Physicians and families who disagree about the futility of medical treatments frequently engage in give-and-take exchanges about whether to start disputed treatments, about what period of time might comprise a reasonable trial period if a treatment is to be administered, and about when and how to transfer a patient to another facility if the dispute cannot be resolved. (shrink)

Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)

In The Abuse of Casuistry Jonsen and Toulmin describe one view of moral reasoning as follows:Those who take a rhetorical view of moral reasoning… do not assume that moral reasoning relies for its force on single chains of unbreakable deductions which link present cases back to some common starting point. Rather, this strength comes from accumulating many parallel, complementary considerations, which have to do with the current circumstances of the human individuals and communities involved and lend strength to our conclusions, (...) not like links to a chain but like strands to a rope or roots to a tree.Whether or not all moral reasoning resembles “strands to a rope,” bioethics testimony certainly does. Bioethics testimony is eclectic, a composite of many loosely woven strands. Rarely, if ever, is bioethics testimony “a chain of unbreakable deductions.” Rarely is it “pure” ethics, much less pure normative ethics. (shrink)