Updated draft?

If you posted a revised update of a previous draft, please email me so I don't overlook it. jpo

Falter

From Bill McKibben's new book Falter: Has the Human Game Begun to Play Itself Out? (We'll have to forgive his omission of Franklin from the first line...):

Good News

Well everyone, it has been real this syemester, so I figured I would try to do something a smidge different than my usual work. One of my favorite comedians with a news comedy show, Russle Howard, goes out of his way to find good news to share at the end of the show.

So, here is some good news.

Baltimore, Climate Change, and Immigration

Welcoming people to our country, a country that values diversity, is ultimately a good thing. It is a better thing when these people are skilled in supporting green industry. Speaking of going green.

Biodegradable Mardi Gras Beads

As someone who was there, seeing the recycling bins full of the things, this is a great idea! The fact that it will also spread the use of algae in the public sector. Changing perspectives can really do wonders for a product.

LGBTQ+ and Surrogacy in New York

This is a morally grey area, but, by working with the law for regulation and support, we can work towards understanding and control of this new market. Healthy babies that are loved is hard to say no to.

Speech Assistance Technology

Helping a stroke victim recover is difficult. Giving them something to be understood and communicate relieves that frustration and grants advocacy.

A 12 Year Old and an App for Her Grandma

We all remember Elizabeth's presentation and the simulation of the 15 minutes of what it was like to be that kind of patient. Creating an app to assist with memory and independence is a selfless act for a family member.

And finally, a musical number(it's old but still good).

I think we forget during our busy lives and all this dark news that there is good in the world, I hope I have brightened your day.

STEM is Great, STEAM is Better(Make up Post)

The article is right, the moratorium, unofficial or otherwise, needs to be understood on a scientific level. All a moratorium is, is a scientific taboo in writing. Its rules so that people can learn about the tools before someone gets hurt. They are temporary and they allow science to catch up with our understanding of a topic before we do something that gets someone killed.

Its and opportunity to explain what science is doing so fear can be eliminated. There was one on the modification of food and now that is gone, we have new opportunities to expand our horizons on the use and improvement of fungal, insects, bacteria and drought resistant crops in the right environments.

No, its something else that makes me scratch my head.

Promoting STEM.

So, Science, Technology, Engineering and Math(AKA STEM) are not only the most forward moving jobs right now, they also are huge in schools. I went to a trade school for a portion of my high school career where they had nursing students, culinary students, HVAC students, car mechanic students, and even police students. I was in a biomedical science class. In it, of course we used science mainly, but we statistically analyzed our information(Math), we had laptops and used devices like EKG's and sensitive temperature changes(Technology), we drew up plans for an emergency room and built models of potential medical devices(Engineering).

But we did something else too.

We drew out and labeled the parts of the heart. We attached clay to a skeleton to show how the organs fit together. We made crafted proteins out of paper and pipe cleaners. 

We did Art. The extra letter added to create the acronym STEAM.

So, as much as we want the next generation to be informed, lets also remember that the world needs the creative ideas just as much as the ones that feed us.

What is the point of a moratorium if nobody thinks outside the box after it is done?

Study Guide

UPDATE, Apr. 22. "Solidity" having been partial, and the exam being long enough at 25 questions, I can assure you all that 1/3 of the questions will NOT come from your presentations. Thanks, Josiah, it was a reasonable request but evidently we're all pretty busy. At ease, everyone. jpo

****This isn't exact, but about 1/3 of questions come from our presentations. I think we could all do each other a solid by posting in the comments section the answers to our presentation questions so we can all do well and feel at ease! Just a suggestion ☺. I will be posting mine after my presentation today.****

-Class Quizzes-

Mar’12

2. What happened when Dennis Cotter submitted an editorial on the drug epoetin?

4. Give an example of how bad drugs can be made to look good.

6. How did the publisher Elsevier damage its own reputation?

8. What would likely happen if the baby trade moved to a donor model?

10. What's a "mundane" example of appropriate parental control over the fate of their offspring?

Mar’14

2. The U.S. is the only developed country in the world without what?

4. Henrietta's chart described her "household" as what?

6. Why wasn't carcinoma in situ treated by most doctors in 1951?

8. Why wasn't Gey's assistant excited about the new cell sample?

10. What were Henrietta's children's consuming questions?

Mar’19

2. Steve Jones says we know what of genetics?

4. What's the best way to engineer a tall person, and what does that tell us about the effects of "Many Assorted Genes..."?

6. What is Jessica Cussins' practical objection to the results of DTC genetic tests?

8. There aren't enough what to support population-wide screening for the BRCA genes?

10. How should leading geneticists have responded to loose talk in the early '90s (and still) about "the gay gene," "the violence gene," etc.?

Mar’21

2. Why was BiDil removed from the market?

4. Funding in 2014 was 50% greater for research areas including the word gene (etc.) than for those including the word _____.

6. Creating ethical standards for medical research is the flip-side of what "coin"?

8. Apart from being extraordinarily lucrative for the local doctors who procure test subjects in developing countries, what's another important reason why so much human research is conducted in Africa and other poor regions outside the U.S.?

10. What two questions should be prerequisite to conducting research in the third world? What should precede human research anywhere in the world?

Mar’26

2. Why is speed critical in getting drugs approved and on the shelves as early as possible?

4. Guinea pigs rely mainly on what to insure their safety?

6. DARPA projects include research on drugsto keep soldiers awake and fed for how long?

8. Fear of chemical weapons during the Gulf War led to the administration of what vaccine prior to FDA approval?

10. What percentage of DARPA projects fail?

Mar’28

2. Women who experience failed fertility treatments often exhibit symptoms of what?

4. How much does surrogacy typically cost in the U.S.?

6. What has become a cultural expectation for many LGBT people?

8. Who fills the need of outsourced surrogacy?

10. New reproductive technologies provoke a rethinking of kinship markers while raising what questions?

Apr’2

2. What intentional act contributes to making surrogacy especially controversial?

4. What's problematic about the goal of racial family matching "in a commercial context"?

6. What was PlanetHospital's rationale for only accepting surrogates who already have children of their own?

8. Why does PH say all surrogate births must be by cesarean delivery?

10. Parents who disclosed their children's donor status regarded what as essential to the child-parent relationship?

Apr’4

2. What are the two new alternatives to the "medical model" of disability?

4. Brief acquaintance with disabled people should demonstrate what?

6. The ADA of 1990 has not markedly altered what?

8. What analogy does Asch see between flying the Confederate flag and enumerating testable genetic diseases?

Apr’9

2. Why does assisted reproduction in America get less oversight than many other areas?

4. Preselecting _____ traits is no longer the stuff of sci-fi.

6. What did Richard Lewontin say about race and genetics?

8. Racial narratives are always about what?

10. Docs who use race as a diagnostic "shortcut" are blind to what, and have their attention diverted from what?

Apr’11

2. What trendy unfounded argument may segregate medicine, fatten drugmakers' profits, and fail to address the underlying causes of premature African-American mortality?

4. Under what conditions should the FDA grant race-specific approvals?

6. What do many consumers not realize about DNA tests? Why?

8. What makes it difficult for two analysts to come to the same conclusion about fingerprints?

10. How did Lukis Anderson's DNA end up on Raveesh Kumra's body?

Apr’16

2. Critics of the standard Mendelian gene-centric view want to depose genes as what?

4. What's P.Z. Myers's apt analogy for epistasis?

6. What's the mainstream scientific perspective on race?

8. Why does Obasogie think government has a moral and ethical responsibility to support race impact assessments of new biotechnologies?

Apr’18

2. "Our universities need to devote more resources" to what?

4. Why did some progressives who support stem cell research oppose the 2004 California stem cell initiative?

6. What do "some feminists and social liberals and progressives... [and] free market liberals and economic conservatives" say about commercial reproductive surrogacy?

-From Prezi’s-

Chris Presentation 2:

2. What percentage of doctors believe an apology won’t affect a malpractice suit being filed

against them according to a Medscape survey?

4. How many brain surgeries were performed on the wrong side of the brain in one year at Rhode Island Hospital?

6. How did Carol Weihrer describe being conscious during the surgery?

8. Legally, as it was not deemed compensation, what was the official reason the Meija family was given the money?

Chris Presentation 1:

2: What are the three types of approaches doctors utilize according to Atul Gawande

4: By 2030, 1/2 or 2/3 of people worldwide will be essentially ______

Nathan Presentation 2:

2. What is a myocardial infarction?

4. What does START stand for?

6. When was the last time the DOT updated their ethical standards?

Nathan Presentation 1:

2.  What is a hemipelvectomy?

4. What is the suicide rate for physicians?

6. Name the one quality that separates good doctors from the very best.

Josiah Presentation 2:

2. What is the title of the essay I am discussing?

4. What is phenomenology?

Josiah Presentation 1:

2. Who is Rene Descartes?

4. What does scientific medicine eschew? Objectivity or subjectivity?

6. According to Cassell, what is the obligation of physicians?

Kevin Presentation 2:

2. Who does Dobbs blame for perpetuating all the exaggerated stories surrounding genetics?

4. What leukemia drug serves as an example of the progress of genetic research?

6. How much was spent on the research and development of the Human Genome Project?

8. What bit of misinformation is part of 23AndMe’s marketing?

10. What is the bottom line business plan of most genetic testing companies?

Kevin Presentation 1:

2. What do Athanasiou and Darnovsky say that the techno-eugenic vision urges us to forget about?

4. How much money was invested into biotechnology in 2015?

6. What are some things in the movie clip that the doctor mentioned being able to manipulate?

8. What does Silver describe as “the ultimate legacy of unfettered global capitalism?”

Sean Presentation 2:

2. What are the two principles that would morally require euthanasia under some circumstances?

4. Which did Dr. Cox employ with his patient, Lillian Boyes?

Sean Presentation 1:

2) Which president vetoed the bill for stem cell research that was voted for and approved by Congress?

4) Why is there no federal law prohibiting cloning of an embryo as of right now?

Elizabeth’s:

2. List a "Code Status" and explain what it means.

4. What is a living will?

6. In the stage model, how many stages are there in the progression of dementia?

Emma’s:

2. What kind of symptoms can look like a benefit in an Autistic person?

4. Why can the term spectrum confuse people trying to understand Autism?

6. What kind of exposures to a pregnant woman are thought to increase the likelihood of Autism?

8. Are all comorbid conditions equally expressed in Autistic individuals? Why might this be?

Lilly’s:

2. Who warned against the treatment of only one part of the body?

4. Who coined the term Holism?

Women at the Salk Institute say they faced a culture of marginalization and hostility

‘I Want What My Male Colleague Has, and That Will Cost a Few Million Dollars’

Women at the Salk Institute say they faced a culture of marginalization and hostility. The numbers from other elite scientific institutions suggest they’re not alone.

Northern San Diego County is a scientific mecca, home to some of the world’s leading biotech companies, renowned research institutions and a world-class university. But the Salk Institute for Biological Research, perched on a cliff above the Pacific Ocean in La Jolla, is distinguished even among its neighbors. Jonas Salk founded the institution in 1963 as a kind of second legacy, after the millions of lives saved with his polio vaccine. He envisioned it as a place where scientists would work in open, collaborative laboratories, free from university bureaucracies: They would be professors, supervising graduate students and postdocs, but with no teaching requirements. He recruited 10 of the top men in biology to join him, including Francis Crick, newly famous for discovering, with James Watson, DNA’s double helix. In a 1960 letter, Watson called the idea “Jonas’s utopia.”

By 2017, the biochemist Beverly Emerson had worked in this utopia for 31 years. She was, at the time, onto an exciting idea — a novel approach to understanding tumor growth — but her 66th birthday was coming up, and with it her contract with Salk would expire. To renew it, the Institute required that she have enough grant money to cover half her salary. She didn’t.

Emerson had pinned her hopes on a new funding initiative she was developing with the Salk’s president, Elizabeth Blackburn. So when she went to meet with Blackburn that fall, she thought it might be about their progress. Instead, she found Blackburn flanked by the Salk’s chief finance and science officers. “You and I have had long careers,” Emerson remembers Blackburn saying. She knew it was over.

Emerson broke the news to her lab employees and turned to the work of shutting down experiments. On her final day, she took one last look around; she had spent 40 years going to a lab almost every day, and couldn’t imagine a life without one. The Salk made no announcement of her departure. It was Kathy Jones, another professor, who sent around an email letting colleagues know Emerson was leaving, and thanking her for her years of service...

Mistakes in the medical field, Malpractice and otherwise

              Wherever humans are involved, mistakes are inevitable. For many fields, this presents fairly minor problems and can be rectified without physical harm. For the field of medicine, however, the stakes are high and even the most routine surgeries can turn disastrous. For my final report, I explored mistakes in the medical field, malpractice and otherwise.

             Of course, all measures should be taken to ensure the safety of every patient. All surgical instruments should be properly sterilized, all patient samples should be labeled and handled with care, etc., but even the most careful person makes mistakes. How do these mistakes, and how physicians are held accountable, affect the doctor to patient relationship?

Physicians these days are heavily reluctant to directly admit fault. Why is this the case; when a mistake is made (especially those mistakes in high risk situations) an apology is standard fare, right? Apparently not. According to a recent physician survey by Medscape, 81% of physicians reported that they did not feel an apology would make a difference in whether or not a malpractice suit would be brought against them. This is an interesting observation, as it indicates many physicians don’t believe an apology would make them any less likely to be sued. Why is this? In many states, there are laws protecting physicians who express empathy and are apologetic, but because of some conflicting wording, an apology CAN be used against them in court and is a strong weapon for the prosecutor to wield. This fact sheds light on why doctors are so reluctant to apologize. Instead they use vague, impersonal language to alert the patient of the situation without implying direct physician involvement. Instead of saying “I misplaced your biopsy results, but we’re doing everything we can to locate it now”, they may alter the speech to something resembling: “The results of your test are being located now and will likely be located soon”. Language like this serves to diminish a relationship between doctor and patient that can be so positive and productive.

            This is not a case against accountability. Physicians should absolutely be held to a high standard of care for their patients, because the effects of malpractice can be devastating. Consider the case of Rhode Island Hospital, which conducted 3 brain surgeries on the wrong side of the brain, all in one year. In one of these instances, the doctor and nurse tried to explain that they were not “trained how to do the pre-surgery checklist”. This is a silly excuse, obviously shifting the blame to other personnel for their own mistake. The second brain surgery was performed by an experienced surgeon (over 20 years), who interrupted the nurse performing the verbal checklist, saying it was unnecessary because he obviously remembered which side of the brain required surgery. He went on to operate on the wrong side of the brain. The patient died a few weeks later. This surgeon’s arrogance cost a patient his life. In the case of the third brain surgery, both the chief resident and nurse confirmed which side of the brain needed treatment, yet still operated on the wrong side. These were all examples of malpractice, and each patient paid heavily for these mistakes.

            These cases and many more prove the necessity for accountability. However, I think it’s important to analyze the effects of this current system on doctor-patient interactions. Personally, I think that the system works fine for cut and dry cases, but as we will discuss during the presentation, not all cases are so cut-and-dry.

Articles consulted:

https://www.medpagetoday.com/blogs/kevinmd/60192

For this next article, I will ask that you do not open it before class. I want to maintain the element of surprise when we discuss these cases of malpractice. Pretty please?

https://listverse.com/2013/05/29/10-horrible-cases-of-medical-malpractice/

Quiz questions (to be answered during the presentation)

What risk does a physician face if he or she admits fault after a procedure?

What percentage of doctors believe an apology won’t affect a malpractice suit being filed against them according to a Medscape survey?

Instead of directly admitting fault, what might a physician do to explain the situation instead of apologizing?

How many brain surgeries were performed on the wrong side of the brain in one year at Rhode Island Hospital?

Instead of the pectoral enhancement surgery he expected, what was the result of the surgery performed on Alexander Baez?

How did Carol Weihrer describe being conscious during the surgery?

How much money were the parents of Bryan Mejia awarded as a decision of the court?

Legally, as it was not deemed compensation, what was the official reason the Meija family was given the money?

Doing It with the Lights On...Ethics, That Is

The field of bioethics does good work for medicine and physician practice, but nearly everything we’ve discussed in class is usually centered around clinical scenarios and events. So what happens to ethics when medicine isn’t practiced in such nice and controlled conditions?

I’m talking about street medicine, the kind that paramedics and EMTs practice on a daily basis.

In the often-chaotic world of pre-hospital medicine, admirable standards like informed consent, respect for individual beliefs, and HIPAA can be sidestepped, whether intentionally or accidentally, because of this lack of control. Consider the following scene, which was pulled from the website EMSWorld and tweaked slightly:

“An elderly man collapses in front of a local coffee house. While he is being assessed for a probable myocardial infarction (heart attack), a woman runs up and says she's the man's caregiver, though she's not a family member. She has no documentation proving her claim. She insists the patient is a Christian Scientist and does not want medical treatment.”

What would you do?

It’s pretty likely that the woman above is telling the truth. That’s an awfully specific lie otherwise, but the trouble is lack of documentation. Because you can’t prove that this woman is the man’s caregiver through proper forms, you, as the paramedic, have to operate under something called informed consent. If the patient can’t communicate or isn’t in his right mind, you can assume he would ask for help if he were able to. It’s now a legal requirement for you to give the man all the treatment possible.

How about this one?

“A 25-year-old male sustained several gunshots to the chest and is bleeding profusely. On the way to the hospital, his wife tells you that he is HIV positive. You, as a paramedic, have already taken standard precautions (gloves, safety glasses, and other such equipment), but you now have to radio the ER to let them know this, as well as tell EMS dispatch so that the other crews who responded can be notified in case of accidental contamination.”

That’s a lot people to share patient information with, which isn’t going to make HIPAA very happy. The larger problem, actually, is the radio. Everyday civilians often have radios tuned in to the first responder frequency, meaning confidential patient information is now broadcast freely over the airwaves for anyone to hear. In this situation, there’s no getting around it, but it’s still a confidentiality breach.

Let’s take another example:

“A 67-year-old male patient's home healthcare provider calls in alarm because her patient has fallen unconscious. He was just discharged from the hospital last week. The home provider has the patient's advance directive and a copy of a DNR order from his hospitalization. However, there is no prehospital advance directive (out-of-hospital DNR).”

Here, we’ve got a bit of a medical loophole. There are two different kinds of DNRs: in and out of hospital orders. If you just want to be allowed to pass away at your own home but you suspect that your family will call EMS to try and save you, an out-of-hospital DNR is needed. In the above situation, you’d be compelled to try and save the patient, but once you got to the hospital, all efforts would have to stop because the in-hospital DNR would take effect. Clearly, though, this isn’t what the patient wants, but you don’t have a choice in the matter. Implied consent enters here again.

What about triage? Common EMS standards for mass casualty incidents involve categorizing patients by the simple triage and rapid treatment (START) method of applying different colored tags. Black for deceased or expected to perish, red for life-threatening but treatable, yellow for serious but not life-threatening, and green for minor (walking wounded). Sometimes triage is easy, and obvious fatal wounds are clear-cut, but the end result is still a first responder essentially deciding who he thinks can live and who can’t. This certainly isn’t to put down any paramedics, firefighters, or police working these incidents. It’s an acknowledgement that the line between red tags and black tags can be extremely hazy sometimes.

Issues like the scenarios mentioned have prompted many in the EMS and medical communities to consider whether the pre-hospital setting needs its own standard of bioethics to operate under. Traditionally, EMS has functioned using the DOT guidelines which haven’t been updated since the mid-70’s and standard bioethics applied in the clinical setting. What would that look like, though?

It’s a hard question to answer. At a conference of paramedics and other first responders, this same question was posed to them, and the sponsors of the conference got almost as many answers as attendees. Regardless of opinions, the need for a different set of guidelines for EMS is clear. The clinical setting and the pre-hospital setting are very different, and paramedics and first responders aren’t simple extensions of physicians. They operate under medical direction by a physician, but they have autonomy to make judgment calls in the field and deserve their own set of ethics for the chaotic field of pre-hospital care.

Quiz Questions:

1. What religious sect is known for refusing most medical treatment?

2. What is a myocardial infarction?

3. What is implied consent?

4. What does START stand for?

5. Which colors were associated with triage and what do they mean?

6. When was the last time the DOT updated their ethical standards?

DQ: What would the ideal bioethics for the pre-hospital setting look like to you?

Various Links and References:

Why EMS Needs Its Own Ethics

Some Ethical Issues in Prehospital Settings

EMS Providers Face Ethical Dilemmas in the Field

Ethics in EMS: Who Cares?

Doin' It With The Lights On

Lights and Sirens: The Education of a Paramedic

S. Kay Toombs and The Lived Experience of Disability

            S. Kay Toombs was Associate Professor of Philosophy at Baylor University. In 1973, at thirty years old, she was diagnosed with multiple sclerosis. Multiple Sclerosis is a progressively disabling demyelinating disease which causes the neurons in one's brain to fire less effectively. Myelin is a fatty wrapping that helps electrical information travel from neuron to neuron quickly. One main source of M.S. is an attack on myelin by the immune system, which causes it to slough off the axon of the neuron. It is a horrible disease which affects visual, motor, sensory, and autonomic functions. Lesions in the brain are also experienced. Unfortunately, it is incurable.

            Toombs came late to philosophy, receiving her PhD from Rice University in 1990. Since then, she has been prolific, writing several books, publishing many articles, and giving numerous presentations. The bulk of her work falls within the realm of phenomenology, or the philosophical study of experience. She places her illness front and center. Her work is an analysis of living with illness and critique of healthcare.

            In 1995 she wrote an essay called The Lived Experience of Disability, and I believe it is an important look at how a philosophical study of subjective experience and healthcare can come together. In it she critiques the biomedical model of disease, which she believes does very little to describe the experience of disorder. She relies heavily on her lived experience with M.S. and her resultant loss of mobility. Toombs argues, phenomenology is key to illuminating how medical practice can devise ways to “address the personal, social, and emotional challenges posed by chronic disabling diseases” (Toombs 10).

            The phenomenological concept of lived body is central to understanding this work. Lived body is how we perceive the world, not as a separate collection of individual sensations, but as a synthesis of them.  The body is not experienced as an object amongst objects, but as a lens through which we perceive and experience the world. For instance, to say one has a body is not the same claim one makes when they say they have a car (Toombs, 10). The body is a locus which pegs our position in space and the point with which we relate objects in space to our self, or egocentric space.

            Disability, especially immobility, affects our sense of lived body. It requires a reorientation of physical space. We are no longer upright and this changes our relationship with objects and our environment. Whereas we may have once conceived of objects as being near, once immobile, they become far (Toombs, 11). Everyday objects become obstacles. Shelves once in reach, are now beyond our grasp. Familiar terrain becomes cumbersome. A simple walk from the office to the classroom appears impossible for Toombs. The world becomes one of “restrictive potentialities,” where one is required to constantly modify their actions to suit the environment (Toombs, 11). In effect, the world becomes a problem to be solved. Restriction to a wheelchair expands this sense of lived body, which includes the object within egocentric space. It becomes a part of the calculation made to determine spatial orientation.    

            Immobility not only affects our relation to physical space, but to our self-perception. The gestures and ways of movement which make us uniquely our self, change. Outsiders who view and those who experience this change in corporeal movement see it as strange and unfamiliar (Toombs, 16).  Toombs describes her sense of movement as “unrecognizable,” even after years of experiencing immobility. She explains when she views herself in the mirror there is a sense of “puzzlement,” “is this reflection of me,” she asks (Toombs, 16). These effects together create a sense of what Toombs calls, “existential fatigue” (16). There is a limit to existential possibilities and autonomy. Our view of our self changes further when we consider uprightness is not simply a locus, but is a value laden perception. To be upright is synonymous with honesty or integrity. We assign value to those who can “stand on their own two feet” (Toombs, 17). The antithesis Toombs posits is, “weak-kneed” or “unstable.” We congratulate ourselves and others for their sense of independence. Many of our rituals revolve around standing up from our seats. Examples are encores or standing for applause. Those being commended or who inspire respect are asked to stand. Many religious ceremonies call for standing and singing to display adoration. Having to constantly be seated gives one the feeling of being less than, not being commendable, of constantly being looked down upon, and of being child-like (Toombs, 17). People view Toombs as dependent, unintelligent, and speak to her in the third person when she is accompanied by an able bodied person (Toombs, 17). Social convention changes. People awkwardly do things such as pushing her wheelchair for her without out asking her permission. Things we would normally see as violations of personal space, people presume she would welcome (Toombs, 17). This culminates in an irrational sense of shame. The feeling one should be able to be independent, but is unable to be so.

            Toombs proposes for effective treatment of degenerative diseases such as hers, practitioners and therapists must address the global sense and lived experience of the disorder.  They must help the patients not only deal with the objective symptoms of the disorder, but also the patients affective responses. Toombs gives the example of practical things like advising patients who have a loss of mobility to acquire a lightweight wheelchair. This helps patients retain a sense of independence. If they are unable to push the wheelchair themselves, this obviously adds to the sense of shame or embarrassment they may feel because of their dependence on others. Differences such as “using” and “being in” a wheelchair is not simply a matter of semantics for Toombs (21). They must also advise patients to see objects such as wheelchairs or walkers as extensions of bodily space rather than symbols of disability. Practitioners and therapists must also address the long-term concerns of patients and develop plans for how they may deal with them in the present. This endows patients with a sense of control over their future (Toombs, 21). Finally, at an even larger scale, allowing for better accessibility (even post-Americans with Disabilities Act) is necessary for elevating the quality of life for those with disabilities.

Toombs work can be found by searching the MTSU library or JSTOR.
Toombs CV.


DQ’s:

1.      How cognizant are we of our reactions and treatment around people with disabilities? Could we mistake helpfulness for condescension?

2.      Are we, as abled bodied people, cognizant of accessibility?  

3.      My research has found Neurologists and therapists have become better at addressing the progressive degeneration inherent in M.S. during treatment. What are some skills we can utilize when answering tough questions like, “will I lose my ability to walk?”

4.      Is an analysis of a patient’s subjective (affective) experience of a disease useful in treatment? Should we just treat the symptoms?

Quiz Q’s:

1.      Who wrote the essay I am discussing?

2.      What is the title of the essay I am discussing?

3.      Describe the concept of lived body?

4.      What is phenomenology?

5.   Is there a difference between “using” and “being in” a wheelchair? Is it just a matter of semantics?

Ugly Citation:
Toombs, S. Kay. “The Lived Experience of Disability.” Human Studies, vol. 18, no. 1, 1995, pp. 9–23. JSTOR, www.jstor.org/stable/20011069.

Philosophy of biology

	DailySEP (@dailySEP)
4/16/19, 6:25 PM The growth of philosophical interest in biology over the past thirty years reflects the increasing prominence of the biological sciences in the same period. Learn more about Philosophy of Biology here: plato.stanford.edu/entries/biolog…

Ethical Dilemmas in Advanced Technology

     I found this video extremely interesting even thought it is somewhat off-topic.

 

DQs:

1. Who is responsible for a death caused by technology? Is it pre-meditated murder because of a pre-set algorithm? If so, who is at fault?
2. Does a human's spontaneous reaction in this given scenario absolve them in whatever consequence?

The Products of Paperwork

     Physician and healthcare worker burnout have been common topics in our class this semester. However, the author of the linked article seems to think that things might be slowly improving as far as physician workload and experienced burnout. One thing that Mr. Heller mentions in his article is that most doctor’s spend a large amount of their time doing documentation and ultimately, they would rather be spending their time with patients.

     In my experience, documentation in healthcare is all that anyone seems to care about. It is time consuming and tedious. I can only imagine how much more documentation physicians must have to complete and maybe this focus on paperwork is what leads some patients to feel their doctor doesn’t care of doesn’t spend enough time with them. Maybe, we could find an efficient way to consolidate documentation so that physicians can spend the time doing what they want to do, which is, according to the article, spending more time with their patients. It reminds me of academic testing… the higher-ups are so concerned with testing that often times teachers lose the ability and freedom to be innovative in their instruction, rather they must check off the boxes that the test makers dictate. The same could be said with the concept of the IQ test as presented by Lilly in her midterm report. We are so focused on the numbers, the testing or the documentation that we are truly missing what is needed.

DQs:

1.     What drives society to focus on test results, IQ scores and documentation?

2.     What is being lost as a result of this focus?

3.     What improvements can be made to save time and improve the experience of physicians?

4.   What other issues do physician's face that may lead to patients feeling like they don't care?

https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/79257