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The Ethics of Environmentally Responsible Health Care.
A Conversation with Jessica Pierce, PhD (text and audio)
Dan Bednarz, Health After Oil
The first sentence of The Ethics of Environmentally Responsible Health Care reads, “The foundation of human health rests on healthy, stable ecosystems.” One rarely encounters this view expressed in medical literature, yet it lies at the heart of creating a sustainable modern healthcare system.
By far the majority of analyses of the American healthcare focus narrowly on reform –slight to dramatic- through rebalancing the (allegedly) three core issues of the 1) cost, 2) coverage and 3) quality of care. Pierce and Jameton locate medicine in the context of ecological sustainability, which correctly subsumes –not negates- these three issues.
As is often the case when great social change is occurring, few scholars see it coming and also offer a cogent outline of the ethical challenges posed by such momentous upheavals. Pierce and Jameton’s is one of those books.
For example, typically “medical ethics” is devoted to issues stemming from the (allegedly) sacrosanct value of what’s best for the patient. Questions about humanity’s organic connection to and responsibility to the natural environment are not asked or are given short shrift. These authors show how the earth is not a passive, inert and inexhaustible repository of goodies for medicine to dip into at will at no cost or consequence.
This book articulates an alternative discourse integral to the viability of healthcare in the 21st century, as its chapter titles evidence:
1) The Challenge of Environmental Responsibility; 2) Linking Health and Environmental Change; 3) Population and Consumption; 4) Environmental Aspects of Healthcare; 5) The Green Health Center; 6) At the Bedside; 7) Global Bioethics and Justice; and 
New Ways of Thinking About Bioethics.
Click here to listen to Jessica’s discussion with Dan Bednarz
(1 May 2009)
EB contributor Dan Bednarz is a specialist on the effects of energy decline on public health on medicine. His website is Health After Oil. -BA
The Oil Drum ponders H1N1 CLZ5 NGZ2
Nate Hagens, The Oil Drum
This post is an open thread to discuss the implications of H1N1 (or future variants) on energy. Who knows how serious this flu strain will be, or the next one? What we do know is that 1) our current long run energy decisions are largely being based on the erroneous but comforting assumption that price is a valid signal of future scarcity, 2) we have 6.77 billion humans, about 50% which are connected daily through a complex just-in-time delivery system of basic needs and information, and 3) we have an economic marker system that has way overshot what it was attempting to mark. What then might happen to future energy supplies if either the perception, or the reality of a flu or other pandemic in the next few years sweeps the globe?
(2 May 2009)
Global health expert discusses swine flu
Kerry O’Brien, ABC (Australia)
Highly decorated science journalist Laurie Garrett joins the 7.30 Report from New York to discuss the emergence of swine flu and its potential repercussions.
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… KERRY O’BRIEN: To what extent are authorities still in the dark about this virus – for instance, how much is still unknown about what’s happened in Mexico, particularly on what you call the denominator, the ration of deaths to incidents of the disease?
LAURIE GARRETT: It’s absolutely essential that we get a better idea of how many people in Mexico are actually infected or were infected at some time since mid-March and here in the beginning of May.
We don’t know whether we’re looking at something in the neighbourhood of 150 to 200 deaths in Mexico that are a result of 1,000, 2,000, 2 million, 20 million infections. It makes a huge difference. I’m sure that anyone in Australia would say, well, if I told you the odds are one in 20 million that you might die, you’re going to have a different reaction than if I told you the odds were one in 20,000.
… KERRY O’BRIEN: So what is now known about this virus?
LAURIE GARRETT: Well, we know that it is a triple reassortment virus, which is fancy way of saying this is a virus that was at sometime in humans, it’s sometime in birds and it’s sometime in pigs, and picked up bits of genetic material from all three.
So it’s a triple whammy, if you will. It’s capable of getting into cells of all three types or categories of animals, so, in fact, humans can give it to pigs, not just pigs to humans. And it seems to, at this time, fortunately, be vulnerable to treatment with Tamiflu, one of the three key drugs used to treat flu, but it is resistant to the other two.
And unfortunately here in North America we have another strain of a very, very similar virus, also of what’s called H1N1 type A influenza that is completely resistant to Tamiflu. So the real fearsome event would be if the two recombined and shared that genetic capacity, so then we would have a pandemic strain with capacity to infect three different species categories, with resistance to treatment, and with some virulence. We’re just not sure how virulent, because as we’ve said before, we don’t really know the denominator in Mexico.
… KERRY O’BRIEN: On the balance of probabilities, what are your biggest fears right now?
LAURIE GARRETT: What happens in the next few days will tell us whether what we’re dealing with here is a garden variety flu that just happened to have gone through pigs, but is no more likely to produce death and devastation than a normal flu; or whether we’re dealing with something that, indeed, is a significant killer flu.
(30 April 2009)
Why can’t we concentrate?
Laura Miller, Salon
Twitter and e-mail aren’t making us stupider, but they are making us more distracted. A new book explains why learning to focus is the key to living better.
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… You don’t have to agree that “we” are getting stupider, or that today’s youth are going to hell in a handbasket (by gum!) to mourn the withering away of the ability to think about one thing for a prolonged period of time. Carr (whose argument was grievously mislabeled by the Atlantic’s headline writers as a salvo against the ubiquitous search engine) reported feeling the change “most strongly” while he was reading. “Immersing myself in a book or a lengthy article used to be easy,” he wrote. “Now my concentration often starts to drift after two or three pages. I get fidgety, lose the thread, begin looking for something else to do. I feel as if I’m always dragging my wayward brain back to the text.”
… What to do? For most people, bailing on the Web or e-mail or cellphones isn’t even feasible, let alone practical or ultimately desirable. (I shudder at the thought of living without my beloved Tivo.) Besides, modern life really isn’t making us stupider: IQ tests have to be regularly updated to make them harder; otherwise the average score would have climbed 3 percent per decade since the early 1930s.
… Winifred Gallagher’s new book, “Rapt: Attention and the Focused Life” argues that it’s high time we take more deliberate control of this stuff. “The skillful management of attention,” she writes, “is the sine qua non of the good life and the key to improving virtually every aspect of your experience, from mood to productivity to relationships.” Because we can only attend to a tiny portion of the sensory cacophony around us, the elements we choose to focus on — the very stuff of our reality — is a creation, adeptly edited, providing us with a workable but highly selective version of the world and our own existence. Your very self, “stored in your memory,” is the product of what you pay attention to, since you can’t remember what you never noticed to begin with.
… the brain is not a unified whole, but a collection of “systems” that often come into conflict with each other. When that happens, the more primitive, stimulus-driven, unconscious systems (the “reactive” and “behavioral” components of our brains) will usually override the consciously controlled “reflective” mind.
There are excellent reasons for this. In the conditions under which humanity evolved, threats had the greatest salience; individuals who spotted and eluded dangers before they went chasing after rewards tended to live long enough to pass on their traits to future generations. As a result, we inherited from our distant ancestors the tendency to pay greater attention to the unpleasant and troublesome elements of our surroundings, even when those elements have evolved from real menaces, like a crocodile in the reeds, to largely insignificant ones like nasty anonymous postings in a Web discussion.
(29 April 2009)
