Alternative Approaches to Ethics

On the blog Somatosphere, there has been a recent series on anthropological approaches to ethics and morality. The key intervention of social science approaches to morality (which one also finds in areas such as feminist bioethics) is a focus on how contexts contour the many situations of ethics. From considering how contexts give rise to ethical meaning to questions of how relations and environments contour one’s moral options, a view of “the social provides” needed depth to how we analyze ethics and also the social situations that render a social issue into a necessarily “ethical” one.

I also wanted to point readers of Bill of Health to Somatosphere because it offers a real resource to readers interested in health policy, biotechnology, bioethics and social studies of health, medicine, and illness. Somatosphere is especially focused on topics that lay at the intersection of Science and Technology Studies (STS) and social studies of medicine.

Given the inherently interdisciplinary nature of bioethics and its wide expanse of interests across overlapping themes, it is important to also survey scholarship in other fields that are relevant.

The series I’ve highlighted below is part of a series on anthropological approaches to ethics and morality. In particular, the series offers a Reader’s Guide on the topic for those hoping to find out more about both anthropological and ethnographically-inflected approaches towards (and theorizations of) ethics and morality.

Part of a multi-series “Reader’s Guide,” readers can find a list of seminal texts here.

A doctor in Mtimbwani, Tanzania helps a woman and child.

Two Reasons Why Wealthy Nations Ought to Address Medical Brain Drain

African governments spend millions of dollars every year training physicians who will leave their home countries to live and work in wealthier nations. The result is that for countries like Ethiopia, Kenya, and Sierra Leone, more of their native physicians are now in the United States and Europe than at home. This massive movement of physician has likely contributed to health crises in many African nations, where citizens die of easily curable diseases each year.

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Literally Sick (and Tired) of Daylight Saving Time

Healthcare was at the top of many voters’ minds in last week’s election, with a range of health-related issues appearing on ballots across the country. Among other health-related measures, three states voted to expand Medicaid, Massachusetts rejected a ballot measure that would limit nurse-to-patient ratios, and Nevada exempted menstrual products from the state sales tax. But a California measure to end daylight saving—less clearly health-related on its face—could also have some important implications for health.

Proposition 7 asked California voters whether they supported allowing the State Legislature to establish permanent, year-round daylight saving time (DST). It received about 60 percent of the votes. Following the vote, in order for California to actually end the tradition of turning clocks back in the fall and forward in the spring, the State Legislature would first have to approve this decision by a two-thirds majority. It would then need to be approved by Congress.

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organ transplant

The NRA versus Medical Professionals: Only One is Interested in Saving Lives

Advocating for patients is in a physician’s job description. Sometimes we forget that, and need a reminder. The National Rifle Association, a little itchy with its Twitter finger, needed a reminder.

Gun-related injuries and death are a clear public health problem, inspiring a set of guidelines by the American College of Physicians published recently in Annals of Internal Medicine.

To which @NRA had this to say: “Someone should tell self-important anti-gun doctors to stay in their lane.” Read More

Out of Touch NRA tells Front-line Healthcare Providers to “Stay In Their Lane” on Gun Control

An unnamed columnist writing for the National Rifle Association Institute for Legislative Action blog advised physicians and other healthcare providers to “stay in their lane” when it comes to advocating for gun control.

This appears to have been sparked by the position paper published in the October, 2018 Annals of Internal Medicine authored by the Health and Public Policy Committee of the American College of Physicians. The author of the blog post argues that the paper and subsequent position statement is flawed, claiming that there is “not enough evidence” to suggest that stricter gun laws would have any effect of the rates of gun violence in the United States.

The conclusion is that medical providers should keep to doing what they do best (practicing medicine) and leave the discussion of gun control to the “experts”, by which the author apparently means gun owners and the NRA.

This article would have likely been just another throw-away piece had it not caught the attention of thousands of medical providers on Twitter. Retweets carrying the hashtag #ThisIsMyLane went viral, relaying stories of gun-shot victims that physicians, nurses, EMS providers and others have had to treat. Some were accompanied by pictures of blood-stained trauma bays or operating room suites.

It seems like an odd move to criticize the very people who have to deal with the carnage of gun violence, and given the response, the NRA picked the wrong people to bully. There were more than 16,000 comments within just a few hours, mostly from healthcare providers denouncing the article and the accompanying tweet.

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Anya Prince on Gene Therapy and Exacerbating Health Care Inequalities

Anya Prince, a legal scholar and thought leader in the field of genetic discrimination, will present a new paper at Monday’s Health Law Workshop that interrogates whether gene therapies will exacerbate inequalities in health care, as more treatments enter the market. “Gene Therapy’s Field of Dreams: If You Build It, Will We Pay?” focuses on some of the many issues raised by the prices of gene therapies.
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close up of the back of a baby's head while breastfeeding

Toxic Breastmilk: When Substance Abuse Relapse Means Death for Baby

Recently, a nursing mother in Pennsylvania made national headlines when her infant died from ingesting a combination of fatal drugs through breastmilk.  According to the coroner’s report, the infant died from a combination of methadone, methamphetamine, and amphetamine toxicity. The Bucks County District Attorney charged the mother, Samantha Jones, who also has a two-year old child, with criminal homicide. According to published reports, Jones was undergoing Medication Assisted Treatment (MAT) and receiving doses of methadone to treat her addiction to opioid painkillers.

Multiple commentators swiftly voiced opposition to the District Attorney, decrying the criminal charges against Jones, arguing it is “highly problematic” to levy criminal charges against a person undergoing treatment for Substance Use Disorder.

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digital health at harvard logo

Can Computer Simulations Enhance Vaccine Trials?

Infectious disease emergencies are opportunities to test the efficacy of newly developed interventions—for example, drugs, vaccines, and treatment regimens. Yet they raise many intertwined challenges around politics, logistics, ethics, and study design.

It is essential to advance the discussion of how such products can and should be tested while remaining consistent with the efforts of CEPI, WHO, and others who encourage development and testing of candidate vaccines in advance of emergencies. Read More