"According to the U.S. Department of Health & Human Services, 119,849 people are currently waiting for an organ transplant, but for most it is only hoping."
"[...], Indonesia announced controversial legislation allowing for the chemical castration of convicted pedophiles."
Today I give myself up to Humanity.
I offer my life, my entire existence - for the purpose of aiding other lives.
So that the strong remain strong and the weak and small find shelter under my wings.
I resign myself to being a humble supporting character in a play,
an architect of a prestigious town, even the combat medic on the field of
War.
Quiet, silent, and unnoticed. Enabling others to achieve their dreams.
I give myself so that others can fight their battles
While I heal them. The war is long, injuries will accrue.
But I promise myself to live for them.
To provide my support: mental, physical, spiritual.
So long as I “first do no harm.”
Today I surrender my energy, life and soul
To the healthier future generation of tomorrow.
For when there exists peace and my role considered decrepit and useless
Only then is my mission accomplished
And I may rest at last.
"The merit in Michelle Obama exposing sexual violence and rape culture as forefront in this campaign speaks to the importance of participation by politicians as ethical agents."
"a team of Japanese scientists led by Katsuhiko Hayashi, revealed their success in making mouse egg cells in a dish, and using those eggs to successfully produce fertile mice pups."
Radiant mother, bespeckled with sweat
Will vaginally deliver, barring no threat
“Through my blood proudly come to your start
I’ll always love you, till death do us part”
One hour pushing, doctors mention
C section
Two hours of pushing, doctors threaten
C section
C section
Three hours. Mamma has strength. Baby is fine.
C section
C section
C section
Risk for infection demands dissection
“Time is what we need”, nurse disagrees
Mom cries, “my body is not my own”
Doctor’s decisions aren’t crafted to please
Of course.
She was trained to say no.
Avoid death and lawsuits; a quid pro quo.
Meds, curtain, disconnect mind from torso.
Surgeons stained satin, splatter bleached floor
Uterus outside chest, refugee in a war
of knives and sutures. Baby’s once home
bloody, battered, bandaged. Glory dethroned.
Same moment
Frozen in time, beautifully grotesque
Mother holds baby girl close to her chest
Tired baby sleeps on tired moms warm breast
Father, tear stained cheeks sing ineffable bliss
Heart full, gives his little angel a kiss
Radiant mother, bespeckled with sweat
Has delivered despite some grave threat
“Through my blood you’ve proudly come to your start
And I will love you, till death do us part
Cesarean sections in the United States have risen to 50 percent in the past two decades. We continue to have the highest risk of maternal and neonatal mortality in developed countries.
Osterman, Michelle, and Joyce Martin. "Trends in Low-risk Cesarean Delivery in the United States, 1990–2013." National Vital Statistics Reports 63, no. 6 (November 5, 2014): 1-16. Accessed October 23, 2016. http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_06.pdf.
"The benefit of drug-gene testing is a reduction of people becoming ill due to an adverse reaction to a prescription and dosage."
"Dutch government officials have proposed a new law that would allow elderly people who are considered physically and psychologically healthy to choose to end their lives via assisted suicide."
"Hopefully developments will likely provide important information about how the public deals with issues of reproductive ethics."
"Recently, paramedics and doctors alike have been encountering an uptick in the use of this little-known substance, and unlike opioids such as heroin, overdose reversal medication has proved ineffectual when needed the most."
"It is also, however, plagued by controversy."
"The direct physiological effects of obesity are well documented, but what often gets swept under the rug is the indirect sociological effects that obese patients face in a clinical setting."
"A five-month-old baby is living healthily after an incredibly unique birth."
I was created, framed and pristine.
A trophy of cells, of carbon and stardust of perfect geometry. The perfect shell and automaton.
Machinery, creaking aluminum cogs and wheels, gears that whirl
in unison – Man.
Sinew and elastic rubber bands, our extensions flushed.
A body of artifice, of false truths and illusory fog.
I learned to be made of actual steel,
for skin and muscles, even bone, decay. Cold to
touch, reflective, impenetrable.
But
You melted my soul, freed my newfound beating heart, the sacred flame
burned away the arm and leg He gave me, leaving my
Humanity to escape from its temporary prison.
Love and kindness, hatred and despair, creativity and inspiration. I felt it all – liberated.
The essence of human life beyond the steel.
I bared my ribs, titanium white and color burst forth from the prism.
Showering down in a pitter-patter of eternal rain drops that left
my body corroded in the scrap heap.
I was sculpted by Him in His image. I am free and omniscient.
Yet why am I broken?
"The significance of a revision of bioethical principles does not lie in its ability to entirely rectify practical issues; this conquest seeks to advance the current and continued relevance of the field."
"The Wall Street Journal reported that almost two-thirds of the world’s population lack access to safe, affordable surgical care."
"We must recognize and celebrate the efforts of humanitarians, public health workers, lawyers, doctors, teachers, janitors and the many others who work day-in and day-out to leave the world a little better than they found it."
Female Genital Mutilation (FGM), also known as Female Genital Circumcision (FGC) or “cutting” to those who practice it, is the intentional partial or total removal of a female’s genitalia. The World Health Organization (WHO) estimates that over 200 million women have undergone this practice in 30 countries, mostly in the Middle East, Asia, and Africa. In the past three weeks, two major world players made bold comments regarding FGM, attracting the attention of international media. On September 15th, a committee of British MPs in the House of Commons declared in their report Female Genital Mutilation: Abuse Unchecked, “it is beyond belief” that while about 137,000 girls were subjected to FGM in 2011 in just Wales, there has not been one successful prosecution. FGM was made illegal in the UK 30 years ago[1]. According to the scathing report, when this “horrific crime” and “violent child abuse” is inflicted, it causes “severe physical and psychological pain and leaves survivors with lifelong health consequences.”
On the opposite end of the spectrum, an Egyptian MP stated on September 7th that women must undergo female circumcision in order to limit their “sexual appetites” and help curb men’s “sexual weakness” due to the widespread impotence of Egyptian men[2]. Though the practice was made illegal in 2008, the MP’s remark is indicative of the widespread cultural imperative within Egyptian society that demands female circumcision in return for societal acceptance. According to a 2015 Egyptian’s Health survey, 87% of women reported being cut[3]. Though Egyptian FGC has existed since the Pharonic period, there has recently been a slight decline among younger women, possibly in response to the 2008 prohibition.
FGC is thousands of years old and is practiced across thousands of unique cultures and tribes. The techniques and symbolic meanings vary drastically, therefore the the physical and emotional implications on the lives of women do as well. According to some proponents, female circumcision is used to promote the health, beauty, and protect the virginity of a woman. As reported by Dr. Moges, many supporters claim medical benefits, such that FGC, “enhances fertility, controls and prevents waywardness of girls... the clitoris is dangerous and hinders intercourse, creates impotency, and kills baby at delivery”[4]. Those who oppose female genital mutilation cite that this practice is a massive violation of human rights, resulting only in lifelong harm. Western feminists critique that FGM is an extreme form of control over a woman’s sexuality. WHO (an organization that values Western medicine) recently released a report stating that FGM causes, “severe bleeding, pain with urination, later cysts, as well as complications in childbirth and associated with death of the newborn”[5].
Bettina Shell-Duncan is anthropology professor who specializes in FGC and speaks on the need to clarify cultural misconceptions. First and foremost, emphasizing that this practice is largely done by and for females. Unbeknownst to those unfamiliar with nuances of the practice, a great number of women feel pride partaking in this cultural tradition and in joining the ranks of their mothers, sisters, and ancestors. Even if a father does not wish to subject his daughter to “cutting”, his personal opinion is largely irrelevant as cutting is a collective decision made by a community, deeply embedded in societal function. Shell-Duncan believes that fostering a contextual understanding of motive is the first step the West should take to eradicate FGM. She claims it is imperative to realize that parents subject their daughters to the practice because they want the best possible future for their children – like most parents do – and they believe cutting will ensure this.
Shell-Duncan notes that when many refugees come to Europe they, “very quickly realize that … the future for their girls might not be best secured by being circumcised any longer”[6]. This is reflected in a recommendation from the MP’s House of Common’s report. The report calls for a commitment from those who come into contact with children- especially those trained in health, education, and social work – to identify and report FGM. They assert that, “prosecutions will not be possible if we wait for daughters to report their parents to the police, which is unlikely to happen”[7]. Studies have found that many community workers ignore FGM when they see it. It is vital that community workers are properly educated so that they will to foster a commitment to identification and reporting.
The report admits that new policies on education and even the practices of targeting girls and their parents through the legal system has proven to be ultimately unsuccessful. Shell-Duncan goes further in identifying that eradication programs need to reach out to extended families and authority figures in these communities who have influence over the acceptance of the practice within their cultural enclave. Female circumcision is a sacred cultural tradition that allows a girl to enter into the realm of womanhood. The Egyptian MP comments speak to how deeply embedded this tradition remains in the social order. If the West wants to eliminate the practice, it will require a massive shift in the way a culture understands women, physicality, and rites of passage.
___
In America there have been no prosecutions under the federal anti-FGM law since 2012, and only one criminal prosecution of FGM related activity[8]. According to the Center for Disease Control and Prevention, at least 150,000 to 200,000 girls have undergone FGM in the United States and these numbers remain in an upward trend. A recent report released by FBI estimated that at least 500,000 women in America are at risk of undergoing the procedure[9]. Both the UK and America publicly condemn FGM as a serious legal offense, whereas Egypt and other similar countries recognize FGM as a legal offense, but fail to publically condemn it. The UK is the primary Western country beginning to recognize the realistic challenges in actually prosecuting FGM. This may lead anti-FGM cultures to creatively implement more effective policies that mustbegin with the refusal to see FGM as reductively barbaric, rather as a diversely practiced and deeply embedded social act.
References:
[1] United Kingdom, Parliament, House of Commons. (2016). Female Genital Mutilation: Abuse Unchecked. London.
[2] Egyptian MP: Women must undergo FGM to control men's desires. (2016, September 7). Middle Eastern Monitor. Retrieved September 20, 2016, from https://www.middleeastmonitor.com/20160907-egyptian-mp-women-must-undergo-fgm-to-control-mens-desires/
[3] Egypt, Ministry of Health and Population. (2015). 2015 Egypt Health Issues Survey. Cairo.
[4] Moges, A. (2003, September 15). FGM: Myths and Justifications. Lecture presented at Eighth International Meropolis Conference in Austria, Vienna.
[5] New WHO guidelines to improve care for millions living with female genital mutilation. (2016, May 16). World Health Orginazation. Retrieved September 20, 2016, from http://www.who.int/mediacentre/news/releases/2016/female-genital-mutilation-guidelines/en/
[6] Khazan, O. (2015, April 8). Why Some Women Choose to Get Circumcised. The Atlantic. Retrieved September 20, 2016, from http://www.theatlantic.com/international/archive/2015/04/female-genital-mutilation-cutting-anthropologist/389640/
[7] United Kingdom, Parliment, House of Commons. (2016). Female Genital Mutilation: Abuse Unchecked. London.
[8] Female Genital Mutilation in the United States: Protecting Girls and Women from FGM and Vacation Cutting [Scholarly project]. (2013). In Sanctuary for Families. Retrieved September 20, 2016, from http://www.sanctuaryforfamilies.org/wp-content/uploads/sites/18/2015/07/FGM-Report-March-2013.pdf
[9] FBI Reaching Out About Female Genital Mutilation (13 May 2016). In Federal Bureau of Investigation. Retrieved September 21, 2016, from https://www.fbi.gov/news/stories/fbi-reaching-out-about-female-genital-mutilation
In a meeting today I was reminded of how pragmatism and futility of care collide. A colleague pulled me aside and asked for my opinion on a case. I agreed to listen and as I listened I began to understand how experiences, the truth, and hope collide with the concept of futility of care.
The case, an older patient, diagnosed with an aggressive form of cancer, refuses to follow medical recommendations. The patient is at a point where radiation and chemotherapy will not help. There is no cure. After much discussion, the patient agreed to palliative care and receiving intravenous feeding. The patient, despite the prognosis, believes this treatment will help strengthen them so they may receive chemotherapy. The family and the medical team understand the intravenous feeding will not bring about a recovery. There is no reprieve, no beating this form of cancer but the patient believes otherwise. My colleague’s query was: Is there an ethical obligation to intervene and stop any care which is futile? My answer was: there is an ethical obligation to understand the patient’s truth and respect their decision for treatment. To do this, we must examine the concepts of pragmatism and futility of care.
What we perceive, form judgments on, and then mold into our belief system comes from external experiences. William James, a Pragmatist, describes how, in the normal case, we have an established body of views and opinions, and issues about what to believe arise when a new experience puts them under strain. We will accept a new opinion when “[I]t preserves the older stock of truths with a minimum of modification, stretching them just enough to make them admit the novelty, but conceiving that in ways as familiar as the case leaves possible.”1 It is the patient’s experience and therefore their truth that treatment of any kind will strengthen the body allowing for further treatments which address the cause of the patient illness. In this case, the patient believes intravenous feedings will help them in their goal to fight cancer. They don’t have any reason not to think this because previous experiences with medical care have made them better. For the patient, medical care represents hope, and this is a form of truth which makes the patient comfortable. While the family and the medical team understand intravenous feeding is futile because the cancer is aggressive and will not let the patient heal enough to fight, the patient, despite the prognosis, remains faithful to an older form of truth. Forming truth out of experience creates a problem because, while, the patient has experienced better health through medical intervention facts gathered by the family and medical team has shown all care is futile.
Richard Rorty, a philosopher, may have the answer to the dilemma the family, patient and medical team are facing. Rorty said: “What pragmatists teach us about the truth is that there is nothing very systematic or constructive to say about truth at all. In particular, this concept does not capture any systematic or metaphysical relation between our beliefs and utterances, on the one hand, and reality on the other….sometimes we might find it useful to express our fallibility by saying that some of our beliefs may not be true”1 We are fallible.
We want our beliefs to be true because the truth we believe in gives us hope. In this case, the patient’s belief in intravenous feeding gives hope despite the growing realization there is none. Is the care futile? No. The intravenous feedings provide comfort to the patient who is coming to terms with their prognosis of death. Futility of care exists if there is harm done to the patient. There is no harm, and one could argue there is a benefit to the intravenous feedings because they’re providing hope to the patient, however, false it may be in the family and medical team’s opinion. There are times when if there is no harm to the patient and care is benefitting the patient, in this case allowing the patient to hold onto hope, care must continue. To remove treatment is to remove hope, and once removed, care becomes futile.
References:
1. Pragmatism (Stanford Encyclopedia of Philosophy), http://plato.stanford.edu/entries/pragmatism/ (accessed October 03, 2016).
"However, a recent study suggests that drinking beer and exercising are positively correlated."