Racial Justice is Good Medicine
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A tweet from @diaamondmade reads "the way police is killing black men is the way doctors are killing black women... but y'all NOT ready for that conversation tho." It is dated 5/31/2020.
“The way police is killing black men is the way doctors are killing black women… but y’all are NOT ready for that conversation tho.” –Dime, MPH

Like many medical professionals, when I read this Tweet (above), I was hurt and immediately defensive. We aren’t militarized. We aren’t trying to kill people. We’re here to help people, not hurt them. Sure, there are some bad people who are doctors. But I’m not a bad person, and the vast majority of the people I work with aren’t bad people. This is so unfair!

But is it? I suspect it’s true that most police officers pursued that line of work to help people. Most of them are probably not bad people in the traditional sense. Like most of my friends on social media – both conservative and liberal – they no doubt espouse the belief that everyone is equal and should be treated equally. But George Floyd was still murdered. And black people die disproportionately with COVID-19. And black mothers are over three times more likely to die due to pregnancy and childbirth than white women.

The title for this image is "Black women face significantly higher maternal mortality risk." A chart shows 44 black women die for every 100,000 live births, whereas only 13 white women do.
From the ProPublica investigation of black maternal mortality

The ”goodness” or “badness” of individuals is not the point.

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New scholarly journal, The Journal of Philosophy of Disability, taking submissions beginning June 1 2020

Starting June 1st, the Journal of Philosophy of Disability (JPD) will begin accepting submissions. The JPD is a new peer-reviewed journal dedicated to questions regarding disability, broadly construed, and it is the first of its kind. Edited by Joel Michael Reynolds (Georgetown University) and Teresa Blankmeyer Burke (Gallaudet University), the journal will publish peer-reviewed articles, review essays, critical responses, and commentaries, as well as occasional topical clusters and symposia.

On the left, a headshot of Teresa Blankmeyer Burke, in color. She is wearing a red shirt under a black suit jacket. She has pale skin and long brown hair. On the right is Joel Michael Reynolds, also in a headshot. His photo is in black and white. He is wearing a dark collared shirt with a lighter colored suit jacket. He has pale skin, short black hair, and glasses.
Left: Teresa Blankmeyer Burke. Right: Joel Michael Reynolds.

The editors welcome scholarship from all philosophical perspectives, including analytic, continental, and pragmatist traditions, the history of philosophy, empirically informed philosophy, non-Western philosophy, and other traditions and fields that substantively engage research in philosophy of disability. The JPD will be published fully open-access by the Philosophy Documentation Center with assistance from Georgetown University. The JPD supports and is also supported by the Society for Philosophy and Disability.

Please send your submissions to jphildisability@gmail.com. Authors will include Eva Feder Kittay, Jürgen Habermas, Havi Carel, Leslie Francis, Kim Q. Hall, Adam Cureton, Andrea Pitts, Desiree Valentine, Joseph Stramondo, Kevin Timpe, David Wasserman, Melinda Hall, Chris Kaposy, Licia Carlson, and Christine Wieseler.

The Editorial board of JPD is:

Havi Carel, University of Bristol
Licia Carlson, Providence College
Adam Cureton, University of Tennessee, Knoxville
Linda Fisher, Central European University
Leslie Francis, University of Utah
Kim Q. Hall, Appalachian State University
Melinda Hall, Stetson University
Devonya Havis, Canisius College
Stephanie Jenkins, Oregon State University
Eva Feder Kittay, Stony Brook University
Quill R. Kukla, Georgetown University
Kelly Oliver, Vanderbilt University
Andrea Pitts, University of North Carolina, Charlotte
Joshua St. Pierre, University of Alberta
Mohammed Abouelleil Rashed, University of London, Birkbeck
Joeseph Stramondo, San Diego State University
Lorella Terzi, University of Roehampton
Kevin Timpe, Calvin University
Desiree Valentine, Marquette University
Simo Vehmas, Stockholm University
David Wasserman, National Institutes of Health
Gail Weiss, George Washington University
Christine Wieseler, California State Polytechnic University, Pomona

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What counts as adequate access to abortion care in a pandemic? A perspective from Canada
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This guest post comes to us from Martha Paynter and Françoise Baylis. Martha Paynter, RN is a registered nurse practicing in abortion and perinatal care and a PhD Candidate at Dalhousie University. Françoise Baylis, PhD is University Research Professor at Dalhousie University. The authors can be reached on Twitter @FrancoiseBaylis and @MarthPaynter.

The United Nations Populations Fund estimates a significant increase in the number of unintended pregnancies due to COVID-19 lockdowns. Some of these pregnancies will be the result of limited access to effective contraception and some will be the result of domestic violence, including sexual violence. 

In Canada there are no legal restrictions on access to abortion. Nonetheless, access varies widely across the country. Longstanding challenges include important differences in provincial regulations and lack of willing providers outside of major urban centres. These challenges have been exacerbated by COVID-19 stay-at-home directives and travel restrictions.

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Are Coronavirus Triage Protocols Sacrificing Fat People? Should They?
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The coronavirus pandemic has sparked new fears among fat activists that fat people will be sacrificed in virtue of medical triage protocols used to ration ventilators, ICU beds, and medicine, which are all in critical supply throughout America (hereafter I focus on mechanical ventilation and other methods of oxygenation including extracorporeal membrane oxygenation, or ECMO, although the conclusions broadly apply). An April article from Bitch Media reports that the Twitter hashtags #NoBodyIsDisposable and #NoICUgenics began trending after a Washington state neurologist posted a now-deleted tweet saying that “Seattle has 12 machines, which is less than what’s needed. So a central committee there is deciding: You can’t go on [ECMO machine] if you’re [over] 40 years old, if you have another organ system failing, or…incredibly…if your [body mass index] is [over] 25. Turns out these are all major poor prognostic signs.” People organizing around the Twitter hashtags eventually developed a media and letter-writing campaign urging care providers to “refuse discriminatory triage policies” that target marginalized groups, including the fat, elderly, disabled, and those with AIDS.

Image shows a screenshot of a tweet from @FatRoseAction that reads "Don’t let #COVID19 triage kill disabled, fat, old, HIV+ and sick people! FIGHT FOR OUR LIVES: http://tinyURL.com/NoBodyIsDisposable #noICUgenics #NoBodyIsDisposable #HighRiskCovid19 #CripTheVote." There are two images within this image. One is of a fat woman with pale skin holding a sign that reads "I am not ready to die" while the other shows a dark-skinned woman holding a sign that says #NobodyIsDisposabl."

But are hospitals and healthcare providers sacrificing fat people to save others via triage protocols? And regardless of whether they are, should they? (Spoiler: the answers are maybe, and no, respectively).

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Health Disparities Highlighted by COVID-19 Also Show Up In Other Conditions: America’s Amputation Crisis
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In the United States, a new and troubling health disparity has arisen: Black folks are a disproportionate share of COVID-19 mortality. This highlights existing, background disparities that make some folks more vulnerable than others to the ravages of illness.

This has long been apparent to anyone looking at disparities in the health outcome of medical amputation. This ProPublica article profiles Dr. Foluso Fakorede who, upon noticing that Black folks were losing limbs to complications of diabetes at three times the rate of other folks for preventable reasons, set up a clinic to try to prevent limb loss among at-risk populations.

An image from the ProPublica article shows Dr. Fakorede, a Black man in a casual shirt wearing glasses, speaking with a Black woman patient. He is gesturing with one hand while his other hand holds her hands. On the wall behind them is a screen showing in an anatomical image of a heart.

As author Lizzie Presser puts it:

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UPDATE for FAB Congress on Oral Presentation paper times: NOT just 10 minutes

FAB 2020 virtual conference presenters: Please note that the error regarding shortened presentation times has been corrected, and even though the online form might say that you have ten minutes for your presentation (for example), you actually have your original in-person allotted time. Please email Anna Gotlib, FAB Congress organizer, if you have any questions or concerns: agotlib@brooklyn.cuny.edu.

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And thanks to Anna and IAB, with whose World Congress of Bioethics there is always a joint meeting of FAB Congress, for their work in converting from in-person to virtual conference so that we can still share our work with each other despite the pandemic response.

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5 (Controversial?) Thoughts from a Bioethicist on the COVID-19 Pandemic
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1. Universal health care matters, but it is not the panacea for failures within public health policies, social practices, and pre-existing historical and socioeconomic injustices (note Italy, the UK, and some other countries with universal health care that are not doing as well as one might have hoped).

2. Other than health care policy, the notion of a shared public common good–as opposed to libertarian individualism–is one of the central elements that will determine how we navigate pandemics and other tragedies. The United States is in the unfortunate position of having its federal government (and its supporters) rejecting this notion outright, and pretending that bullshit, bluster, intimidation, and magical thinking are what will help us through this. They are tragically wrong.

3. The economy matters–and it matters the most to those who are not its top beneficiaries. However, civilization does not equal economy, and the loss of human life cannot be weighed against economic collapse. Both matter, but one is not like the other.

4. Medical schools must drop the we-are-an-elite-guild approach, and allow more students to enroll. The COVID-19 pandemic will not only result in fewer medical professionals for the worst of reasons, but we will also lose medical professionals who leave medical practice due to psychological trauma. We will, of course, need the wisdom and expertise of the veterans, but we will also need a wave of medical professionals who have not been (as greatly or as directly) traumatized by the pandemic. We will need all those students who do not see themselves as the image of the medical professional to change their perspectives. And those of us who teach philosophy, medical ethics, and other related disciplines better work our asses off to try to change their minds.

5. Finally, speaking of trauma….We all might be traumatized now*. Differently, of course–and definitely some more than others. Be kind. Be kinder. To quote one of my very favorite philosophers, Tove Jansson: “We take everything too much for granted, including each other.”

*it certainly doesn’t seem reasonable to presume none of the people we encounter are traumatized, and should perhaps be a default that any person we encounter could be.

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Disablism In a Time of Pandemic: Some Things Don’t Change
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The Covid-19 pandemic is currently accompanied by a parallel outbreak of bioethical and clinical ethical discussion offering guidance for the difficult decisions that healthcare professionals and others face as the pandemic develops. Right at the moment there is a strong focus on the ethics of triage. In countries affected by Covid-19, healthcare professionals are having or will have to decide which patients get access to life-saving critical care – in the case of Covid-19 that means ICU beds and ventilators — when there is not enough for everyone in need. They want guidance on how to make those decisions in the most morally justifiable way. Just as much, patients, families and the general public want to know the basis on which such decisions are being made.

In all the published guidance that has appeared over the past weeks, one thing is disturbingly clear: many of these resources have shown a worrying degree of prejudice against disabled people, or disablism. Protocols from Alabama and Tennessee have been namechecked here. While it is easy to see in these evidence of a straightforward disvaluing of the lives of people with disabilities – and at worst, the seizure of a golden opportunity to get rid of a tiresome burden — I want to suggest that something more complex (though equally unacceptable) is going on. In this blog entry, I analyze disabilist assumptions and discriminatory norms in play in these discussions, and close with a set of recommendations for constructing better clinical guidelines.

This image contains white letters on a blue background bearing, as a quote, what Jackie Leach Scully says elsewhere in this blog entry: "...bioethics has a dismaying track record of oversimplifying the diversity hidden in 'disability' to the point of uselessness."

Disablist Assumptions

Three overlapping but conceptually distinct disablist assumptions critically endanger people with disabilities in a situation of clinical care triage.

  • First, there are assumptions about the overall health status of disabled people
  • Second, assumptions about disabled people’s quality of life
  • Finally, assumptions about disabled people’s social utility, which only becomes relevant if there is confusion about the role it plays (or shouldn’t play) in critical care decision-making.
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World Congress of Bioethics/FAB 2020 Virtual Conference Update

The World Congress of Bioethics Planning Committee, along with the IAB Board of Directors and WCB Internation Advisory Committee, is working diligently to transition the conference to a 3-day virtual meeting. With this change, a new registration structure and timeline will be announced in the upcoming weeks. The March 31 early bird registration deadline is no longer in effect and a new date will be shared when registration relaunches. 

During this time, if you have questions about the Congress proceedings please visit the Frequently Asked Questions area of the World Congress websiteor email contact@iab2020.org.

We would also like to encourage you to participate in our brief survey to share your thoughts on features of the in-person WCB most important to maintain in a virtual format.

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As the meeting continues to evolve, we will share the plans with you.   The 2020 World Congress of Bioethics will take place in a new virtual format with an adjusted price structuring for all participants.  

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COVID-19 Childbirth Restrictions Could Disproportionately Harm Black and Native Women
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A recent article by Kimberly Seals Allers discusses how COVID-19 safety restrictions related to giving birth and breastfeeding could potentially disproportionately harm black and Native American women.

Photo courtesy of Women’s E-News


Some hospitals are now classifying not only family members of laboring women but also doulas as “visitors,” banning them from entering hospitals or assisting with births.

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FAB 2020

Dear FAB members and FAB 2020 delegates,

We are still trying to work with IAB to find a workable solution for moving the conference to a virtual format.  For all those wondering what will happen with registration dates and fees, this is the only information we have right now:. https://iab2020.org/about/#FAQ
Once we know anything more with any specificity, we will let you know. 

We apologize for this ongoing lack of clarity.

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Best regards,

Anna Gotlib

FAB 2020 Organizing Committee

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Invisible Vulnerables
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Being a parent of someone in an especially vulnerable group makes one feel like you are sitting on a ticking bomb–in addition to the anxiety we all feel during this time of pandemic.

I am hiding out in our lovely spacious house in the woods with my husband, hoping that COVID19 will not find us. Both of us are in the “at-risk” category as we are both in our 70’s. We are both New Yorkers, but we are upstate because our 50-year-old daughter lives in a community here. Our daughter has a rare (and recently diagnosed) genetic condition which has severely limited her cognitive and motor abilities. She lives in a house with six other people all of whom are medically fragile. An amazing and dedicated staff care for them. For the last 18 years, we have brought her to our house on weekends where we play music, listen to symphonies, watch movies, do some physical therapy exercises, take long walks, and enjoy the wonderful meals my husband loves to regale us with. Our son and his family sometimes join us, and our grandchildren have developed a beautiful relationship with their atypical, but sweet and very loving aunt.

Next weekend will be the third in a row when we have not visited her and she has not come home with us.

As the novel coronavirus creeps its way from country to country, continent to continent, reminding us that as humans we share vulnerabilities and interconnections, we understand in a way we never have before that a harm to one can be a harm to all. The reminder is stark and painful and is turning our world topsy-turvy, giving us a surreal sense that we are living in a movie, in a virtual space, in anything but the world we know. The uncertainty, the timeline, the possible havoc it can wreak makes me think of the tsunami that washed away bartender, waitress, cleaning staff and happy tourists who were enjoying a day at a spectacular beach resort in Bali. I recall the picture of scores of vacationers and residents who stood at the edge of a beach watching in amazement as the water rushed back into the ocean before it returned with a force that swept them and thousands upon thousands away with its stunning force. Today, I feel as if we are sitting on that sand beach watching and waiting for tsunami.

We hear a lot about the vulnerable elderly, people in nursing facilities, in prisons, those who are fighting cancer or heart disease—conditions that weaken the body’s ability to fight the invading virus. For, in truth, that is all we have—our immune systems as we await a cure and vaccine. But one group of vulnerable people are rarely mentioned: people with disabilities and people whose disabilities ordinarily require a very high level of care, people like my beautiful daughter.

For these folks, there is no possibility of social distancing. Most would perish in a matter of days if left alone. For many, touch is the most. powerful form of communication. They remind us daily of our dependence and interdependence, of human frailty and precariousness. I might be able to explain to her why we cannot visit—why we can send only virtual kisses, not the close mushy ones she loves best. But I would not know if she understood. In likelihood, she would understand bits of it, but it would give her no coherent sense of what is happening in the world, and why suddenly what is occurring globally means she cannot come back to mom and dad on weekends, and why we are prevented from even visiting her in her house.

I feel enormous sadness for the millions and millions who will have their lives tragically disrupted by death, illness, loss of income and loss of dreams. I cannot comprehend how this could happen, much less happen in the United States.

Most of all I cannot help but fear for my daughter, for the people who live with her, and those who are similarly situated. Not only must they meet the tsunami with frail bodies, but they face an additional foe: the failure to recognize and value their lives.

The failure to speak of this vulnerable group is already an indication of how little they seem to matter to people.

Those who know people like my daughter have to make their people’s faces, their smiles, their beauty and love known to others. For those of us fortunate enough to have such a person in our lives, we know the treasure we have been granted. When you speak of the vulnerable, those most likely to suffer worst from this virus, think of grandma and grandpa, of uncle with the weak heart, the migrant in a crowded detention centers, the prisoner, but think also of those who live graceful lives of love—people like my daughter.

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