Justice (Basics 6); Premonition 6
- We wrap up our reading and discussion of Bioethics: The Basics with ch.6 on justice. The vaccination/immunization issue is raised here. Also see Eula Biss's On Immunity, below.*
- But first, on "enhancement": awhile back I saw a chilling fictional representation of how future mental/cognitive enhancements might lead to dystopia. It was episode three of the British series "Black Mirror," in which everyone is equipped with an implant called a "grain" - it's kind of a subcutaneous Google Glass, with instant access to one's entire archival memory (and with f/forward and rewind). The late David Carr on Black Mirror, MicroSoft's HoloLens, and our dwindling experience of "actual unencumbered reality"...
- And if that's not chilling enough, check out "The World of Tomorrow"...
- 1. What are the two major spheres of justice discussed by Campbell?
- 2. (T/F) Vaccination/immunization and restricted mobility are two of the measures used by preventive medicine to counter the spread of disease.
- 3. Another name for the micro-allocation of health care, concerned with prioritizing access to given treatments, is what? (HINT: This was hotly debated and widely misrepresented ("death panels" etc.) in the early months of the Obama administration.)
- 4. What "perverse incentive" to health care practitioners and institutions do reimbursement systems foster, as illustrated by excessive use of MRIs?
- 5. What is the inverse care law?
- 6. What is meant by the term "heartsink patients"?
- 7. How are Quality Adjusted Life Years (QALYs) supposed to address and solve the problem of who should receive (for instance) a transplant?
- 8. Who propounded a theory of justice that invokes a "veil of ignorance," and what are its two fundamental principles?
- 9. Under what accounts of health might we describe a sick or dying person as healthy?
- 10. Name two of the "capabilities" Martha Nussbaum proposes as necessary to ensure respect for human dignity?
==
Premonition
1. What grant to Joe DeRisi led to his "Red Phone"?
2. The new coronavirus Joe's lab identified in 2003 caused what syndrome?
3. Joe went "down the rabbit hole" to talk to who?
4. Joe said analyzing genetic sequences with the Virochip was like trying to find what?
5. What is the dark matter of genomic sequencing?
6. How does Joe think science is misunderstood?
7. How was the DeRisi lab like Willy Wonka?
8. What's an example of "screwed up incentives" inside the medical-industrial complex?
9. What is the Chan Zuckerberg Biohub's "preposterous goal"?
1. Do you agree that health care providers are ethically obliged to promote a fair balance between the rights of the individual and the welfare of society as a whole, and a fair distribution of benefits and burdens in society? Would you say that ethos is widely shared among physicians?
2. Reflecting on the present measles outbreak and the ebola quarantines of last summer, how would you rate the current strength and effectiveness of vaccination and restricted mobility as tools of preventive medicine? How might they be improved? Do you agree that most anti-vaccers lack a degree of social conscience?
3. Are you aware of examples of unjust "queue jumping"? 150 (Does the name Mickey Mantle ring a bell?)
- 4. Are there better alternative payment systems than reimbursement? Is it possible to reign in excessive tests and costs while retaining a reimbursement system?
- 5. How would you resolve the Lifeboat Scenario? 153f.
6. Do you agree that justice requires us to remove the social disadvantages caused by ill health and disability, and support a universal right to those health care interventions that will allow everyone to pursue their "normal opportunity range"? Would you be more or less likely to agree, if you found yourself behind the "veil"? 159
7. Are there any "attainable human capabilities" on Martha Nussbaum's normative list you'd not include on yours? 163
8. Elaborate on how bioethics overlaps with environmental ethics. 165
==
Eula Biss, On Immunity: An Innoculation
==
Eula Biss, On Immunity: An Innoculation
==
Bioethics articles... transhumanism articles... Dying while black: Perpetual gaps exist in health care for African-Americans...
==
Dr. Victor Sidel, Public Health Champion, Is Dead at 86
Dr. Victor Sidel, a leading public health specialist whose concerns ranged from alleviating the effects of poverty in the Bronx, where he worked for many years, to raising alarms about the potential impact of nuclear war, died on Jan. 30 in Greenwood Village, Colo. He was 86.His son Mark confirmed the death.
As a founding member of Physicians for Social Responsibility and International Physicians for the Prevention of Nuclear War, which won the Nobel Peace Prize in 1985, Dr. Sidel voiced his apprehensions about nuclear proliferation as a public health issue for more than 50 years. He served as president of the former organization and co-president of the latter.
In a paper in The New England Journal of Medicine in 1962, Dr. Sidel, Dr. H. Jack Geiger and Dr. Bernard Lown painted a grim picture of fatalities and injuries in the Boston area from a nuclear attack and posed ethical questions for surviving doctors.
“Does the physician seek shelter?” they asked, adding, “If the physician finds himself in an area high in radiation, does he leave the injured to secure his own safety?”
And in speeches beginning in the mid-1980s, Dr. Sidel (pronounced sy-DELL) used a metronome to stress what he described as the imbalance between worldwide spending on arms and health care. With the metronome set at one beat a second, Dr. Sidel explained that with every beat, a child died or was permanently disabled by a preventable illness, while $25,000 was spent on weaponry... (continues)
==
==
Dr. Victor Sidel, Public Health Champion, Is Dead at 86
Dr. Victor Sidel, a leading public health specialist whose concerns ranged from alleviating the effects of poverty in the Bronx, where he worked for many years, to raising alarms about the potential impact of nuclear war, died on Jan. 30 in Greenwood Village, Colo. He was 86.His son Mark confirmed the death.
As a founding member of Physicians for Social Responsibility and International Physicians for the Prevention of Nuclear War, which won the Nobel Peace Prize in 1985, Dr. Sidel voiced his apprehensions about nuclear proliferation as a public health issue for more than 50 years. He served as president of the former organization and co-president of the latter.
In a paper in The New England Journal of Medicine in 1962, Dr. Sidel, Dr. H. Jack Geiger and Dr. Bernard Lown painted a grim picture of fatalities and injuries in the Boston area from a nuclear attack and posed ethical questions for surviving doctors.
“Does the physician seek shelter?” they asked, adding, “If the physician finds himself in an area high in radiation, does he leave the injured to secure his own safety?”
And in speeches beginning in the mid-1980s, Dr. Sidel (pronounced sy-DELL) used a metronome to stress what he described as the imbalance between worldwide spending on arms and health care. With the metronome set at one beat a second, Dr. Sidel explained that with every beat, a child died or was permanently disabled by a preventable illness, while $25,000 was spent on weaponry... (continues)
==
==
 | Mother Jones (@MotherJones) |
We are this close to "designer babies" mojo.ly/1W5QtTe pic.twitter.com/KTO0VDpNHl | |
 | New Republic (@NewRepublic) |
What’s wrong with Craig Venter? bit.ly/1UWRU65 pic.twitter.com/F3b8scr06N | |
The USDA abruptly removes animal welfare information from its website
http://wapo.st/2kBZkTy
Measuring the wonders of an empathetic ear in the doctor’s office
http://wapo.st/2k4JHTO
1. What are the two major spheres of justice discussed by Campbell?
ReplyDeleteSocial justice and distributive justice
4. What "perverse incentive" to health care practitioners and institutions do reimbursement systems foster, as illustrated by excessive use of MRIs?
ReplyDeleteSystems can provide reimbursements to health care practitioners to do unnecessary tests and to over treat with expensive drugs/procedures
5. What is the inverse care law?
ReplyDeleteAvailability of good medical care tends to relate inversely with the needs of the population served.
Discussion Question 1: I think it is a very hard subject to talk about. Although I think each individual does have responsibilities to the society, I think the physicians first and foremost responsibility is to the patient. Everything else is second from that. An individual who comes to see a physician should be the only priority of the doctor. Other health care professionals like social workers defintiely have that responsibility, and so do other workers within the community, think specialties.
ReplyDelete6. Heartsink patients is a term used to describe patients who have a complex set of problems, not just medical but also social causes, and those who seek frequent medical attention, even though this is unlikely to be effective in helping them.
ReplyDeleteMore Premonition questions:
ReplyDeleteWhat is the Virochip?
2. (T/F) Vaccination/immunization and restricted mobility are two of the measures used by preventive medicine to counter the spread of disease.
ReplyDeleteTrue. The author points out examples when people's mobility can be restricted when they are infectious, stating that this illustrates the limitations of making individual autonomy the only norm in bioethics.
6. What is meant by the term "heartsink patients"?
ReplyDeletePeople in deprived areas with multiple problems are unkindly described as "heartsink patients."
7. How are Quality Adjusted Life Years (QALYs) supposed to address and solve the problem of who should receive (for instance) a transplant?
ReplyDeleteQALYs are calculations of the number of years of life to be gained by medical intervention multiplied the fraction of quality of those years. The person with the highest QALY score should receive the transplant.