At the moment he’s prepared for his whole career, Biden faces the limits of his power

 

He has been on a first-name basis with European leaders for decades. He knows Vladimir Putin well, and says he’s read just about everything the Russian president ever wrote. He was President Barack Obama’s point man on Ukraine. He chaired the Senate Foreign Relations Committee.

This is the moment President Biden has always said he’d be ready to face.

But as he confronts what could become Europe’s biggest conflict since 1945, Biden is also staring at the limits of the American presidency, as all his diplomatic efforts and economic threats were unable to prevent a determined authoritarian from invading a weaker country.

“He’s got a lot of experience in the world. He has engaged on this specific issue diplomatically when he was vice president and knows a lot of the characters,” said Brian Katulis, the vice president for policy at the Middle East Institute. “But that knowledge and expertise I’m not certain helps him, in part because of how this has developed and how brutal Putin is prepared to be.” continues

Do you think Biden is doing the right thing by holding himself responsible for the gas prices?

Is Biden being truthful that the sanctions are "designed to punish and weaken Russia afterward"? 

(when asked why he did not impose more sanctions if they were to work as they should he said "the current measures are powerful and punitive". )

Do you think Biden's history with Ukraine has affected anything? (Biden held more than 80 phone calls with Ukrainian leaders since 2015. In 2014, Obama assigned Biden the task of coordinating U.S. policy toward Ukraine. His son Hunter joined the board of Burisma (where Hunter was paid 50,000 a month), a Ukrainian gas company owned by a former government minister later accused of corruption.)

Is Taiwan Next?

 Russia’s invasion of Ukraine makes the frightening possibility of China seizing control of the island more real. As Russian tanks roll over Ukraine, Vladimir Putin’s crisis will reverberate around the world, possibly most dangerously in the Taiwan Strait. An attempt by Beijing to claim Taiwan by force has just become more likely. That’s not necessarily because there is a direct link between Putin’s invasion of Ukraine and Beijing’s menacing of Taiwan, but because the war for Ukraine is the most unfortunate indication yet of the frightening direction of global geopolitics: Autocrats are striking back.

With the disintegration of the Soviet Union in 1991, the long American struggle against global authoritarian threats seemed to have been won. Just about everywhere, dictators were on the run—Indonesia, Myanmar, Brazil, South Korea, the Philippines, Chile, and even Russia itself. Globalization was working its supposed magic, spreading liberal political and economic ideals, prosperity, and, hopefully, an end to big-power confrontation. Sure, the Chinese Communist Party was entrenched in Beijing, but its cadres appeared to be partners in the global order, content to get gloriously rich and immerse themselves in the trading networks and international institutions created by the democratic powers. Continues 

Do you think Taiwan will be invaded if Russia is not met with reparations? 

The article describes China as " a power with increasing economic, diplomatic, and military might" would you say the same? The article describes Russia as declining in power. Do you think others view America as Declining in power? 

 The New Yorker magazine

Shouts & Murmurs

February 28, 2022 Issue

Dear Ethicist, I’ve Planted Two Bombs

By Dennard Dayle

https://www.newyorker.com/magazine/2022/02/28/dear-ethicist-ive-planted-bombs-on-two-buses

Dear Ethicist,

I’d like to play a game. For years, I considered myself above terrorizing public transportation. But I’ve wound up doing just that. At this moment, two high-yield explosives are hidden on rush-hour buses, and disarming one will trigger the other. Now someone needs to make a decision.

I’d love to leave it to law enforcement, but they’ll never find my work in time. And police violence is real. If something happened to me, the dead-man switch in both devices would go off. I’m not sure I could live with that.

Thankfully, there’s you. Arbiter of ethical and unethical. Right and wrong. Life and death. Can you decide which bus survives? You have thirty minutes, so I hope you check your in-box often.

Consider the riders. Among the passengers on Bus One is a retiree, uncertain about whether to confess a long-past affair. On Bus Two is a teacher who recently caught a destitute honor student cheating and is deciding whether to report it. Which of them should live to ponder their separate quandaries?

Ideally, we spare the innocent, right? Does that mean sparing Bus One, on which sits a lifelong activist for a race she’s come to fear? Or Bus Two, where the conflicted heir of a tobacco billionaire dozes? If you fail to choose, both will become ash.

Maybe our careers define our worth. Bus One carries the transmasculine aide to an Alabama legislator. Bus Two carries the designer of a sustainable fashion line that relies on Xinjiang cotton. In half an hour, neither will exist.

Or perhaps love should decide. On Bus One is a neurologist with a longtime love of the N.F.L. Bus Two has a woman who keeps her aging mother from watching reactionary news networks. I doubt that either will find peace before the explosion.

Finally, remember the workers who make mass transit possible. The driver of Bus One knows that her mother hides money from the family. Bus Two’s driver just received a friend request from an old fling’s son. What’s best for them: silence, confrontation, or C-4?

Ah, the classic “two ships, two detonators” problem. I wish I could say that this is the first time I’ve been asked to choose between two buses, boats, or theme parks full of people. But challenges from high-concept domestic terrorists are a daily reality in my field. I endured three trolley problems before completing my dissertation.

Destroy both buses. I don’t care.

There’s no ethical way to engage in your game. You’re an unreliable source, so I cannot fairly evaluate the lives at stake. Even if you’re telling the truth, you’ve left out critical information about the passengers’ dependents, their health, and their willingness to explode. There’s more variance in the latter than you might assume.

Furthermore, my earnest engagement would encourage you to target other advice columnists. If you challenged Dan Savage with sexless couples suspended over a shark tank, I’d be blamed. And rightly so.

I advise you to take a closer look at your potential victims. As their captor, you have a relationship with them, and that gives you the responsibility of choice. What do you want your bombs to stand for? Destroy any bus that conflicts with your values, whether it’s one, both, or neither.

I suspect that it is neither. Your note implies that you’re not interested in mass transit at all. That you’ve compromised your values for attention. What, then, do you want to terrorize? A stock exchange? The U.N.? Your father’s condo? Whatever it is, seek it out and plant bombs you believe in. Even if it’s hard. Then, and only then, will you be ready to face the Batman. ♦

 

Potential Exam Question for Antibiotic Resistance Presentation

Hi everyone! 

Here's a potential exam question from my presentation on Antibiotic Resistance:

Q: What kills more Americans each year than HIV/AIDS, Parkinson's Disease, emphysema, and homicide combined?

A: MRSA (methicillin-resistant Staphylococcus aureus)

Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T : a peer-reviewed journal for formulary management, 40(4), 277–283.

 (Sub)urban Sprawl: American Dream, Ecological Nightmare

Good morning! Tomorrow I'll be giving a presentation discussing sprawl (urban and suburban sprawl are essentially synonyms) and its effects on the environment around us, our socioeconomic structure, and our personal health. What can we do about these horrors? Positive expansion can find footing through multiple methods, we'll be discussing high-density alternatives and steps taken towards eco-city living,. 

Why should we explore positive expansion? Sprawl has been shown to have much higher air pollution per capita, result from and promote classist and racial segregation, and decimate natural populations of organisms. We'll be discussing how each of these are affected by sprawl, though sprawl is by no means the sole cause of any.

Some discussion questions I'll put forward (though I welcome any others of course):
    Considering ecological, social, and health impacts of sprawl, should we place more value on            alternative     expansions?
        If so, which alternative should we be funneling money into? (Density = greater access to               amenities and less automobile reliance, Ecocity = much greater biodiversity and lower                   heating/cooling costs)​

    Does the burden of alternative expansion fall solely upon government legislature and funding?​
        Do you and I, as citizens, have any means or obligations to personally promote positive                    expansion?​

   If we pursue positive expansion, there are certainly sacrifices. Some of which would be: a loss       of a personal "yard"; lower control of organisms, including "pests"; living conditions are less       individualistic, more community-based; and potentially the loss of the convenient personal           automobile. Are these sacrifices justified, and are we comfortable compromising freedoms for       ecological, social, and health improvements?​

    Southern States are disproportionately guilty of "sprawling" despite being an ecological                hotspot. There are multiple reasons for this (historically agrarian, poorer regions, etc.) and            there is no easy answer, but how  could we promote positive expansion in southern states? ​

I look forward to discussing this topic with everyone!

Put Sunflowers in your pockets

Excuse the language, but this will be quoted in the history books. What did you guys think of this moment? 

Additionally, Americans are being encouraged to leave Russia by our government, U.K. is arming Ukraine. It's becoming scary. 

 When the Hippocratic Oath meets the hypocrisy of the unvaccinated

BY DR. CAROL HUTNER WINOGRAD AND PAUL RUPERT, OPINION CONTRIBUTORS — 02/23/22

THE VIEWS EXPRESSED BY CONTRIBUTORS ARE THEIR OWN AND NOT THE VIEW OF THE HILL

 https://thehill.com/opinion/healthcare/595521-when-the-hippocratic-oath-meets-the-hypocrisy-of-the-unvaccinated

The historic COVID-19 pandemic has brought us to a critical point. Pillars of our advanced society — hospitals, schools, businesses — have been severely stressed or on the cusp of failure. As both veterans of medical institutions and patients with serious chronic conditions, we are keenly aware of the fragility of our beleaguered emergency room, intensive care and other hospital staff. We fear for their future.

Yet, each day our health care system faces the relentless demands of a daily tide of the nearly dead — largely unvaccinated, but needing and demanding sophisticated care nonetheless. Exhausted doctors and nurses try heroically to treat all comers. A general, vague understanding of the Hippocratic Oath seems to demand that everyone requires care regardless of the why of their conditions. Although the so-called oath is neither a true oath nor a binding contract signed by doctors and hospital administrators, the very notion of denial of care seems to betray the essence of the caring profession.

Nonetheless, a growing number of people have begun to suggest that vaccination should be a condition of treatment, with the simple phrase, “No vaccination, no hospitalization.” This emerging sentiment was challenged in a recent Atlantic article, “It’s a Terrible Idea to Deny Medical Care to Unvaccinated People.”

A physician and ethicist at the University of Colorado, Matt Wynia, summarized this view, “It is completely contrary to the tenets of medical ethics, which have stood pretty firm since the Second World War.”

“We don’t use the medical-care system as a way of meting out justice. We don’t use it to punish people for their social choices,” he added.

This view seems to miss the essential point of our current quandary. In our uniquely and deeply individualistic society, discussions of social dilemmas are quickly reduced to questions of personal liberty, choice and compulsion. Threats to essential institutions take a back seat to the widely reported and always moving stories of individuals. 

Given the resultant deep cleavage in worldviews, two camps emerge. Those who value science, American medicine and our health care systems are those who get vaccinated, wear masks and try to follow the evolving rules. We make every effort to stay out of the hospital unless all else fails.

(Continues at link above)

 SCIENTISTS RECORDED THE BRAIN ACTIVITY OF A PERSON AS THEY DIED, AND THE RESULTS ARE ASTONISHING

HE DIED WHILE HE WAS HOOKED UP TO A BRAIN MONITOR — AND WHAT SCIENTISTS SAW IS A FASCINATING GLIMPSE OF THE END.

TUESDAY Feb. 22, 2022 / BY TONY TRAN

https://futurism.com/neoscope/brain-activity-dying-person

It turns out your life might actually flash before your eyes when you die — or at least that’s what some researchers are suggesting in a new first-of-a-kind paper that revealed the brain activity of a dying person. 

The scientists were initially studying the brain waves of an 87-year-old epilepsy patient for seizures using an electroencephalography (EEG) device, according to the team’s paper published in Frontiers in Aging Neuroscience. 

However, the patient had a heart attack and died during the study, while still hooked up to the EEG. This gave the researchers a unique opportunity to record 15 minutes of brain activity of a dying person. 

The researchers found that there was an increase in brain waves known as gamma oscillations, which typically occurs during dreaming and memory retrieval. So a person who is dying, they suggested, might experience glimpses of their life flashing before their eyes. 

 “Through generating oscillations involved in memory retrieval, the brain may be playing a last recall of important life events just before we die, similar to the ones reported in near-death experiences,” said the University of Louisville’s Dr. Ajmal Zemmar, the lead author of the study, in a press release. 

This not only gives insight into an enigmatic and frightening moment that all of us will experience eventually, but could even offer better understanding of the “timing of organ donation,” Zemmar added. 

“These findings challenge our understanding of when exactly life ends,” the doctor said. 

Of course, there are some big caveats. For one, the paper only looked at a single case. The patient also had a history of seizures and brain swelling, which could impact the findings. 

However, past research into the brain activity of dying rats also showed similar gamma activity. That could suggest that this is a natural occurrence across numerous species. 

Zemmar added that while more research is needed, the insights gathered from the patient can actually offer a bit of hope and closure to families who are dealing with the death of a loved one. 

“Something we may learn from this research is: although our loved ones have their eyes closed and are ready to leave us to rest, their brains may be replaying some of the nicest moments they experienced in their lives,” Zemmar said. 

 

HIV & related ethical dilemmas

 

Pierce Creighton has shared a OneDrive for Business file with you. To view it, click the link below. Presentation.pptx

I am unable to make a post even after your invitation. I am not technologically inclined. So here is what I would have posted and here is my PowerPoint presentation.

Today I will be discussing HIV and different implications of ethical dilemmas it presents.  

First, we will talk about the disease itself, what cells the virus attacks and how it spreads. There have been multiple treatments for the disease that slow the spread to other cells but so far HIV is not curable or fully preventable should exposure occur. However, there is new Stem Cell research that has recently come out that seems to be able to prevent the disease and will soon go into human trials. 

The virus attacks CD4 T cells and spreads throughout them. HIV is a latent virus, meaning it does not have to immediately take hold of the individual, but after 10-15 years in some cases it will become active again and start to kill the host due to the poor immune system. It also is a large killer of infants especially within Africa, in some areas 50% of the woman who are pregnant are found to have HIV. 

How should we prevent the spread of HIV, do we have the ethical and legal power to go into poorer countries and mandate certain things? Should we provide drug users with clean and safe needles?  

References 

• Moderna Launches Clinical Trials for HIV Vaccine, Ralph Ellis, https://www.webmd.com/hiv-aids/news/20220128/moderna-hiv-vaccine 
• HIV Transmission, CDC, https://www.cdc.gov/hiv/basics/transmission.html#:~:text=Most%20people%20who%20get%20HIV,can%20help%20prevent%20HIV%20transmission.  
• How to Treat HIV, NIH, https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-treatment-basics 
• Sexually Transmitted Diseases, Medicine Net, https://www.medicinenet.com/image-collection/hivaids_picture/picture.htm 0 

Ethical Care of Underserved Patients

A report by the National Association of Community Health Centers found that 56 million Americans have inadequate access to a primary care physician and could be considered "medically disenfranchised." 

My presentation defines what it means to be "underserved" in healthcare and walks through the many qualifications that would deem an individual this title. Did you know that nearly 17% Americans are underserved when it comes to healthcare? This percentage is not huge, but I believe there needs to be a separation of statistic and human being. These are not numbers we are talking about, these are people. 

The categories we will explore include the following: poverty, disability, limited literacy, geographic location, and long-term confinement. These six characteristics are the main reasons for hinderance of adequate healthcare. 

In my presentation, I will discuss the absence of equality amongst differing socioeconomic situations as well as patients with varying levels of education. How can we work to ensure that we are all being treated equally and efficiently in the doctor's office? 

Presentation:

https://www.canva.com/design/DAE3_zLieWc/NT8HpaquDPR9ZQxJprtSCA/view?utm_content=DAE3_zLieWc&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink

Sources:

https://www.kff.org/other/state-indicator/population-up-to-200-fpl/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html#:~:text=26%20percent%20(one%20in%204,is%20highest%20in%20the%20South.

https://www.census.gov/library/stories/2017/08/rural-america.html#:~:text=About%2060%20million%20people%2C%20or,different%20things%20to%20different%20people.

https://www.nationalgeographic.org/encyclopedia/rural-area/#:~:text=Encyclopedic%20Entry%20Vocabulary-,A%20rural%20area%20is%20an%20open%20swath%20of%20land%20that,a%20city%2C%20or%20urban%20area.&text=In%20a%20rural%20area%2C%20there,far%20away%20from%20one%20another.

https://www.commonwealthfund.org/publications/newsletter-article/state-and-federal-efforts-enhance-access-basic-health-care#:~:text=A%20report%20by%20the%20National,live%20in%20shortage%20areas%20or

 

This Presentation is scheduled for Tuesday March 1, 2022

On July 12, 2021 Tennessee state health officials, under extraordinary pressure from the state’s Republican lawmakers suddenly fired Dr. Michelle “Shelley” Fiscus after four years of service due to her efforts to reach teenagers with information about how to get vaccinated against Covid-19.  Dr. Fiscus said the agency presented her with a letter of resignation and a letter of termination, but no reason for why she was being let go. After choosing the termination letter, Fiscus penned a blistering 1,200-word response published in The Tennessean in which she said she is “ashamed of Tennessee's leaders, afraid for her state”, and "angry for the amazing people of the Tennessee Department of Health who have been mistreated by an uneducated public and leaders who have only their own interests in mind."  Fiscus told The Associated Press "I don't think they realized how much of an advocate I am for public health and how intolerant of injustice I am…" 

Fiscus said in an interview with MSNBC host Chris Hayes that her job was to roll out the Covid-19 vaccine “across the state and to make sure that that was done equitably and in a way that any Tennessean who wanted to access that vaccine would be able to get one.”  In a written statement to The Tennessean newspaper she said “I have now been terminated for doing exactly that…”  She further stated that “tension with GOP lawmakers escalated when she publicized a public document on Tennessee's "Mature Minor Doctrine," a state Supreme Court case ruling from 1987 that states that Tennesseans 14 to 18 years old may be treated "without parental consent unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions…According to Fiscus, the health department’s attorney provided her the letter she shared with medical providers about the mature minor doctrine. The attorney had said the letter had been “blessed by the governor’s office.”  At a June 2021 hearing, Health Commissioner Dr. Lisa Piercey said she knew of only eight times this year when the doctrine was invoked, and three of them were for her own children, who received vaccines while she was at work.

Discussion Questions:

1.      Should public health officials, especially medical doctors, be able to speak frankly about their medical recommendations to the public they serve, even as a doctor might speak frankly about their recommendations to an individual patient, without having to fear losing their job?

2.      How much power to implement public health policies should public health officials have?

3.      How do your views line up with Dr. Charity Dean’s views about this issue?

4.      Do you feel comfortable with politicians, most of whom are without medical training or expertise, deciding how to deal with a world-wide pandemic in your community and in ways that effect you and your family?

5.      What role should the courts play in implementing public health policies?

Quotes from The Premonition: A Pandemic Story

…local U.S. public-health offices reminded him of public services in Poland, but before the collapse of communism…these are the symptoms of a failed state.” (p. 255)

Each health officer knowing or having reason to believe that any case of the diseases made reportable by regulation of the department, or any other contagious, infectious or communicable disease exists, or has recently existed, within the territory under his or her jurisdiction, shall take measures as may be necessary to prevent the spread of the disease or occurrence of additional cases. (pp. 14-15)

She soon realized how few people, in practice, knew the law…The public-health officer had somehow come to be a recessive character. (p. 15)

… “To do the job of local public-health officer, you basically always need to be willing willing to lose your job.” (p. 32)

 2. What does Catherine Myser mean by "whiteness"?

…by talking about whiteness I am talking about a marker of location or position within a social, and here racial, hierarchy— to which privilege and power attach and from which they are wielded—and how this is complicated by a forgetting of the history of whiteness in the United States and by its current invisibility. Furthermore, by focusing on the dominance of whiteness in the cultural construction of bioethics in the United States, I do not wish to imply that whiteness does not operate in bioethics in other countries. Clearly the issue of whiteness is not simply a problem in the United States. As such, the question of whiteness concerns not only those who are shaping bioethics theory and policy but also those who will be affected by this theory and policy in the United States and elsewhere.

It seems like there must be a great deal of shame and guilt driving the legislative attempts to eliminate any teaching or books pertaining to U.S. racial history.  If we can't learn from out past, we are doomed to repeat the worst parts of that history.

 2. Who makes the hard decisions in public health?

And the need to make hard decisions in public health didn’t just go away. It got pushed down in the system, onto local health officers. They had little social status and were thus highly vulnerable, but they also had little choice, if they hoped to save lives. Local health officers across the country paid with their jobs and more in their attempts to control a disease without the help of the Centers for Disease Control.

I will share a particular experience of one of the vulnerable local health officers from Tennessee who was fired for doing her job.

 

Medical Apartheid:  The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

Harriet A. Washington

NPR "Fresh Air" interviewee highly recommended this book as well researched and well written.

He Wanted to Make the Whole World His Patient

Dr. Paul Farmer was the kind of doctor we all would like to have.

More than two decades ago, I had the great good fortune to spend parts of several years traveling with Dr. Paul Farmer, to Haiti, Peru, Cuba, Russia and Mexico for my book about his life. He was a good companion, funny and talkative and when I got sick from a night of too much rum in Cuba, he took care of me.

In airports, he would buy presents for people he was visiting at his next stop. He'd buy present after present until he could barely manage to carry them all. His itineraries weren't on any of the usual sightseeing lists. In Russia, for instance, he didn't see the Bolshoi Ballet but rather went to advise beleaguered doctors at a prison where inmates were dying of multidrug-resistant tuberculosis.

Paul's basic belief was that all human beings deserve equal respect and care, especially when they are sick. His dream, he once told me, was to start a movement that would refuse to accept, and would strive to repair, the grotesque health inequities among and within the countries of the world. When I first met him — in Haiti, in 1994 — he had already created a growing health care system in a desperately impoverished area. I thought he'd done a lot already. Now, looking back, I realize that he was just getting started.

In 1987, he and several friends had founded the organization Partners in Health. Membership has come to include thousands of young people, many of whom Paul taught and mentored, and legions of friends and colleagues in the countries where Partners in Health works. Paul was the main inspiration for so many efforts: medical education and hospital-building in countries such as Haiti and Rwanda; campaigns against diseases such as multidrug-resistant tuberculosis, AIDS and Ebola; providing surgery and giving chemotherapy in places where all sorts of illnesses and injuries have typically gone untreated... (continues)

Are we seeing the beginning of World War III?

 There is tension in the air we look towards the situation happening currently between the Ukraine and Russia.

https://www.cnn.com/europe/live-news/ukraine-russia-news-02-23-22/index.html 

Two days ago, Putin gave a press conference where he threatened continued bloodshed in the Ukraine if they don't surrender to the troops he is sending. With the Ukraine being backed by the United States, this could escalate very quickly, and the consequences could be deterimental.

The world is still recovering from medical supply chain issues that arose due to the pandemic. With this in mind, how do you think that market will be affected by a world war? Can we afford a war? Will it cause our worldwide progress past covid to regress? 

Let me know your thoughts.

Henrietta Lacks traveling museum at Arcus Center spotlights medical breakthroughs, bioethics

 

"Johns Hopkins Hospital was treating [Henrietta] Lacks for cervical cancer in 1951 when her cells were sent to a nearby tissue lab without her consent. At that lab, doctors found her cells to be unlike anyone’s they had ever seen. Instead of dying, her cells—later called HeLa cells—doubled every 20 to 24 hours. 
Although Lacks died of cancer on October 4, 1951, at age 31, her cells continue to benefit the world. HeLa cells are used to study the effects of toxins, drugs, hormones and viruses on the growth of cancer cells without experimenting on humans. They’ve also been used to test the effects of radiation and poisons, to study the human genome, and learn more about how viruses work, playing a crucial role in the development of the polio and COVID-19 vaccines. And they have resulted in changes in bioethical standards including including informed consent, medical records privacy, and communication with tissue donors and research participants." Article continues

I find the story of  Henrietta Lacks extremely interesting. It definitely has brought light to the importance of informed consent. Of course, these acts do not just stay with the past but have current consequences. The genome of HeLa cells was published publicly which most would consider to be a violation of privacy for Lacks' descendants. NIH only recently attempted to make amends. Billions of dollars have been generated off of HeLa cells, but this has not been seen by Lacks' descendants. The Lacks' family is currently in the process of suing a biotechnology company and more companies may follow. The question remains whether they should be compensated for what some would consider one of the greatest breakthroughs of recent medical history: a human immortal cell line. Would compensation be considered justice? Retribution? And is that different from ethics?

Questions FEB 24

Beyond 9-12; Premonition 11/epilogue. PRESENTATIONS: 1. Julianna, “Ethical Care of Underserved Patients"; 2. Pierce, HIV pandemic

Premonition
1. What was the CDC's greatest trick?

2. Who makes the hard decisions in public health?

3. What's so embarrassing to Carter about the US pandemic response?

4. From the point of view of American culture, what's the trouble with disease prevention?

DQs

• Why doesn't the US have the institutions it needs to save itself? 279
• What should be done about the CDC?
• If you were the chief public health officer for the US, what would be your top priorities?
• 
  

Beyond

1. Some researchers see sex selection leading to what?

2. What does Catherine Myser mean by "whiteness"?

3. Decentering whiteness would enable bioethics to do what?

4. What obvious bioethical significance in Freddie Gray's death was generally ignored by the bioethical community?

5. Who "invented" Bob Dole?

DQs

• Has disability rights become an effective movement? Will its stature rise in the future?
• What "animal farm bioethics" issues concern you?
• Who should decide the meaning of "cosmetic"?
• Is disease a social construct?
• What's your initial response to any of Myser's questions of origin & knowledge? 118
• What do you think of James Baldwin's statement about whiteness? 121
• Is "decentering whiteness" liable to make white people, especially politicians, uncomfortable?
• Did the Obama presidency do anything to dismantle the historical legacy of equating American-ness with whiteness? Will the Drumpf presidency unintentionally have that impact, eventually?
• Is there something inherently wrong, unseemly, or troubling about bioethicists who are also entrepreneurs? 
• Are bioethicists overly fixated on technology? 130
• Is there something inherently troubling about bioethicists like  Glenn McGee starting their own businesses? 132
• Did Arthur Caplan do the right thing with his Celera stock options? 133
• Should financial incentives for participation in clinical trials be regulated, reduced, or eliminated? 
• Do you think the Nashvillian who participated in Eli Lilly's drug tests was typical? 135
• Is it unwise to prognosticate, particularly with respect to future developments in biotechnology? Was Glenn McGee just a little ahead of the curve in his forecast? 140
• Are IRBs effective? How might they be improved? 143
• Is our culture's seeming obsession with ED symptomatic of more deeply rooted issues?
• 
  

Five Things I Wish I’d Known Before My Chronic IllnessBy Tessa Miller
Finding out you have a chronic illness — one that will, by definition, never go away — changes things, both for you and those you love.

Seven Thanksgivings ago, I got sick and I never got better.

What I thought was food poisoning turned out to be Crohn’s disease, a form of inflammatory bowel disease (IBD) that doesn’t have a cure. It fools my immune system into attacking my digestive system, resulting in what I can only describe as the attempted birth of my intestines through my butthole. It’s a cruel and often debilitating disease.

Since that first hospital stay, I’ve had colonoscopies, biopsies, CT scans, X-rays, blood and stool tests, enemas, suppositories, rectal foams, antiemetics, antidiarrheals, antivirals, antibiotics, anti-inflammatories, opiates, steroids, immunoglobulin, biologics and three fecal transplants (if you want to hear a story about my 9-year-old poop donor and a blender, find me on Twitter).

My disease is managed now thanks to an expensive drug called infliximab, but the future is unpredictable. IBD works in patterns of flares and remissions, and little is known about what causes either.

When I was diagnosed, I didn’t know how much my life would change. There’s no conversation about that foggy space between the common cold and terminal cancer, where illness won’t go away but won’t kill you, so none of us know what “chronic illness” means until we’re thrown into being sick forever...
==
A Better Path to Universal Health Care

By Jamie Daw
Dr. Daw teaches health policy and management at Columbia University.

The United States should look to Germany, not Canada, for the best model.
As a Canadian living and studying health policy in the United States, I’ve watched with interest as a growing list of Democratic presidential candidates — Senators Bernie Sanders, Kamala Harris, Elizabeth Warren, Kirsten Gillibrand and Cory Booker — have indicated support for a Canadian-style single-payer plan with little or no role for private insurance. Approval of such a system has become almost a litmus test for the party’s progressive base.

But rather than looking north for inspiration, American health care reformers would be better served looking east, across the Atlantic.

Germany offers a health insurance model that, like Canada’s, results in far less spending than in the United States, while achieving universal, comprehensive coverage. The difference is that Germany’s is a multipayer model, which builds more naturally on the American health insurance system.

Although it receives little attention in the United States, this model, pioneered by Chancellor Otto von Bismarck in 1883, was the first social health insurance system in the world. It has since been copied across Europe and Asia, becoming far more common than the Canadian single-payer model. This model ensures that all citizens have access to affordable health care, but it also incorporates age-old American values of choice and private competition in health insurance...

Balancing Efficiency & Quality in Healthcare

With the rise of health care costs continuing to cause issues for people and those in charge of the healthcare industry, we come to the question “How can we fix all of this?” The main source of this issue is a lack of quality and efficiency balance within the United States. We are in a society where profit is more important than people. While I do think the U.S. understands that all patients are to be provided with quality care, they also know that this treat is received with a cost. Those in charge of the health care budget need to recognize that there should be a balance and cost-efficiency. This issue with healthcare is that it has almost gotten too expensive to be acquired by those who need it the most. Currently the country is performing the lowest in regards to healthcare among other countries. Ideally the United States would explore more alternative ways to go about distributing efficient, quality, and affordable healthcare for everyone. There have been many healthcare options made for those with lower income households, an example would be Obamacare. This is an issue that may never get resolved because of how the United States budgeting system works. Unfortunately, if something as important as healthcare for all citizens is granted, it would cost many people (mostly those that work in healthcare) a lot of their earnings. You would think that since many countries such as the United Kingdom, France, Norway, Poland, Greece, Austra, and many others all have working systems that allow their citizens free healthcare, our nation would have that figured out by now. Sadly, that isn’t our country's focus. 

Hey guys! I was supposed to give my presentation on February 17th, but it was storming pretty badly where I was and I haven’t been feeling the best. I’m not sure when I'll be able to present my issue to you guys, but whenever that can happen I am really looking forward to it. This is a topic I love to bring awareness to within my friend group or with my family, so I can't wait to hear you guy’s opinions. See you all in class! 

Here’s the link to my presentation: https://mtmailmtsu-my.sharepoint.com/:p:/g/personal/mar9d_mtmail_mtsu_edu/EfmvUjQCSP5KjamcOn4gOg4BsfBkBeLVXzQDoGcv39TTWw?e=VQ9qfB

Eugenics and Technological Advancements

 

Many of us are aware of the atrocities of World War II and Nazi Germany. When the war ended, people assumed life would go back to how it was. Although not remotely as cruel, the concept of eugenics persists today.

 

Eugenics involves the idea of “racial improvement” and “selective breeding,” which is very common in today’s society, whether it be dog breeding or the GMO vegetation we eat. Due to recent advancements in society, new technology allow us to genetically engineer not only vegetables, but human embryos.  

 

Many people have different views on what can and cannot be changed. The science is extremely interesting and has the potential to not only change specific traits, but also cure many diseases. I believe there to be many pros and cons; this is what we’ll be focusing our discussion on!

 

  

Changes to CDC Guidelines leading to Changes in Federal Policy? Hmm.

 

The CDC suggests that we have progressed far enough to begin new regulations regarding COVID-19 prevention, even suggesting that we have begun the transition from pandemic to epidemic. This could lead to a drastic change on a federal level regarding mask mandates. I must forego my saltiness towards Tennessee's governor regarding our lack of mask mandates. Luckily, his jurisdiction ends at the airport, where federal regulations take over and masks are required. For now. 

I read the article below, and it led me to this topic. Are we safe enough to remove the federal mask mandate for travelers? Honestly, my answer is no, and I think that spawns from a shift in mindset since the pandemic. Keep in mind, many other countries, most notably those in Asia, already encouraged the use of masks for those who were sickly well before the current pandemic. I do not believe myself to be alone in finding comfort in wearing masks in crowded areas surrounded by strangers. If we were to remove our Federal mask mandate on travel, it would be all too easy for Americans to take off their masks and proceed to cough, sneeze, and breathe the same air as the hundred other strangers they are traveling with. Does this thought make you as uncomfortable as it does me? Cause yuck.  Think about it, we still have an....uncomfy amount of unvaccinated people and the largest amount of transfer is within that group. 

Perhaps I'm on my soapbox for no reason, but I think I'll continue to wear my mask in condensed spaces and definitely if I have the sniffles. The pandemic has made an antisocial out of me and I have no regrets. 

What are your thoughts? Has the pandemic changed how you view social interactions? Have you traveled during the pandemic? Are you pro-mask? 

https://www.wkrn.com/community/health/coronavirus/cdc-expected-to-issue-new-guidance-on-masks/ 

 

The Supreme Court is not being honest with you

Justice Amy Coney Barrett appears to be quite unfamiliar with her own judicial record, and that of her colleagues.

https://www.vox.com/2022/2/19/22934915/supreme-court-justices-not-honest-amy-coney-barrett-notre-dame-abortion-voting-rights

By Ian Millhiser  Feb 19, 2022, 8:00am EST

Justice Amy Coney Barrett delivered a speech this week that echoed decades of conservative talking points about the proper, limited role of judges in a democracy. But that restrained vision is completely divorced from Barrett’s own conduct as a conservative justice — not to mention that of the Republican majority she consistently votes with.

Her remarks, which were offered at an academic symposium hosted by Notre Dame Law School, were grounded in the rhetoric of judicial restraint that Republican politicians have used to talk about the proper role of the courts at least as far back as Richard Nixon.

The Court’s youngest justice drew a distinction between “pragmatists,” judges who “tend to favor broader judicial discretion,” and “formalists,” who “tend to seek constraints on judicial discretion” and “favor methods of constitutional interpretation that demand close adherence to the constitutional text, and to history and tradition.” She placed herself in the latter camp.

As a justice, however, Barrett has behaved as an unapologetic pragmatist. Along with the Court’s other Republican appointees, Barrett supports flexible legal doctrines that give her Court maximal discretion to veto federal regulations that a majority of the justices disagree with — especially regulations promoting public health or protecting the environment. And she’s joined her fellow Republican justices in imposing novel limits on the Voting Rights Act that appear nowhere in the law’s text.

The rhetoric of judicial restraint is potent, so it is understandable why Barrett wants to tap into that potency. Formalist rhetoric enables the justices to claim that they didn’t roll back voting rights or strike down a key prong of President Joe Biden’s efforts to promote vaccination because they prefer weaker voting laws and a flaccid public health system — they simply did what the law requires.

And Barrett is hardly the only justice to engage in such rhetoric. Justice Neil Gorsuch recently published an entire book claiming that judges should rely almost exclusively on the text of a statute or constitutional provision while interpreting it. Justice Clarence Thomas frequently calls for radical shifts in the law, claiming they are necessary to restore the “original understanding” of the Constitution. Even Justice Samuel Alito, the Court’s most partisan justice, recently attributed his new, entirely atextual limits on the Voting Rights Act to having taken “a fresh look at the statutory text.”

The problem with this rhetoric, in short, is that it bears no resemblance whatsoever to the current Supreme Court’s actual behavior.

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