Showing 191 - 200 of 469 annotations tagged with the keyword "Medical Ethics"

Saying the World

Pereira, Peter

Last Updated: Dec-14-2006
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This three-part collection of poems offers powerful images and vignettes from the life of a family practitioner living and working among the urban poor. The first section is the most explicitly medical in theme, including poems that pay painful tribute to a mother after stillbirth, a hydrocephalic child, an addict covered with boils, a young man murdered at eighteen, an old man with a failing heart.

The second section weaves images from the writer's personal story together with those from his life as physician, and the third focuses primarily on life lived as a gay man among the sick and dying, patients to be treated and friends to be mourned while life remains to be claimed and savored.

Despite the pain and grief attested to in many of the poems, a lively voice of clarity, compassion, and consent to the goodness of life even on hard terms gives the collection a defining note of celebration. Pereira's lines about a bereaved Cambodian seamstress suggest something true about his own work: ". . . she joins the circle / of other Khmer women to sew. / Punctuating the fabric / with yellow thread, finding her remnants / into a piece that will hold." ("What is Lost")

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Love in the Driest Season

Tucker, Neely

Last Updated: Dec-14-2006
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Neely Tucker, a white journalist from Mississippi on assignment to Zimbabwe, and his wife, Vita, an African American from Detroit, volunteer to spend time with orphaned and abandoned children, many victims of the desperation caused by AIDS. In the orphanage, where a distressing number of children die due to lack of medicines or basic materials, or lack of adequate staff training, they come upon and find themselves deeply drawn to a particularly tiny, sick, vulnerable baby, abandoned in the desert. The director of the orphanage picks a name for her as she does for the other orphans: Chipo.

The Tuckers arrange to take her home, first for weekend care visits, hoping thereafter to do a more permanent foster care arrangement and then adopt her. A long story of struggle with Zimbabwean bureaucracy ensues, through which one learns much about suspicion of white Americans who want children, the ways in which child care becomes one more issue in partisan politics, and how abandoned children are caught in adults’ power struggles. Interspersed with this moving story are brief accounts of sometimes harrowing trips to other parts of Africa, including sites of major warfare in Rwanda and Uganda.

Tucker also intersperses memories of encounters with families in Bosnia during his work there. Ultimately, and only after much persistence, empathetic individuals in the system, and some newly learned under-the-table skills, the adoption papers come through and the family makes its way back to American where Tucker begins his ongoing assignment at the Washington Post.

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Lethal Dose

Snodgrass, Steven

Last Updated: Dec-12-2006
Annotated by:
Taylor, Nancy

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Jeff Taylor, a young surgeon whose career was cut short by a hand accident, decides, after finishing a residency in anesthesia, to enter the newest residency program offered by Northwest Regional Hospital: a program in euthanasia. The novel features three residents and their superior; a reporter for a tabloid who tapes hospital conversations; Pennington, a wealthy conservative who wants to increase pressure on those performing abortions; and Micah Chaine, an ex-priest hired by Pennington to work behind the scenes setting up demonstrations and setting off bombs.

Chaine, feeding on his own religious beliefs, decides those involved in the euthanasia program must die. When Pennington wants out of their deal, Chaine kidnaps Pennington's wife and one of the euthanasia residents and sets bombs for the others.

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Annotated by:
Stanford, Ann Folwell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

With some 70 characters and a wide array of events spanning 500 years and several continents, the plot of this novel is less a linear plot than an elaborate web of events. Peopled with addicts, alcoholics, corrupt judges and politicians, unscrupulous and greedy land speculators, and a host of other unsavory characters, the novel also tells the story of resistance to Euro-American oppression and a growing effort of indigenous people and their allies to retake the land and ultimately to become agents of its healing. Woven throughout the novel are folk stories of the past, pronouncements on the present and predictions of a dire future for the offspring of the European conquerors.

Spatially, Tucson, Arizona functions as a focal point, with much of the action radiating away from, or towards, the city. Arizona is about to go belly-up from the effects of a declining economy and devastating drought and growing civil unrest in Mexico. As the prophecies have foretold, the narrator reminds readers, the inexorable movement of the people is North, and while it may take 500 or 5000 years, the indigenous and their allies will reclaim the diseased and corrupted land (and presumably become instruments of its healing).

Into this milieu Silko inserts a host of characters who work as part of the resistance. Among them are twin sisters Lecha (a demerol-addicted psychic who helps police locate the bodies of murder victims and has a lucrative profession as a talk show guest) and Zeta (who has made a fortune running drugs and guns across the North and South American borders with the help of Lecha’s son and his sometime lover Paulie); twin brothers, Tacho (a chauffeur for the wealthy Menardo who also functions as a spy for the indigenous resistance movement), and El Feo (who heads that movement in the far South of Mexico). Both brothers commune with spirit macaws for advice.

There is an "army of the Homeless" who plan to retake "stolen" goods and land from the wealthy. The Barefoot Hopi organizes incarcerated prisoners for an uprising against the U.S. Government. Many of these and other characters converge at novel’s end at the International Holistic Healer’s Convention where "German root doctors" and "Celtic leech handlers" join with "new-age spiritualists" and the Green Vengeance eco-warriors.

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Invisible Man

Ellison, Ralph

Last Updated: Dec-12-2006
Annotated by:
Stanford, Ann Folwell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ellison uses the trope of invisibility in this novel that traces the Invisible Man’s journey from idealism to a grim realism about the racism that confronts him every step of his way. Every episode ends with the Invisible Man’s escape from near disaster, brought about by his naiveté and the virulent racism in which he must function. By novel’s end, the hero is living clandestinely in the basement of a large building, burning hundreds of lights at the expense of the electric company, and planning for an eventual re-emergence.

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Summary:

Sympathy for Mr. Vengeance tells the story of Ryu (Ha-kyun Shin), a young Korean man who cannot hear or speak, whose sister Han Bo-bae is dangerously ill with kidney disease. Because Ryu and Bo-bae are poor and there is no social system of health coverage in Korea, Bo-bae is not able to receive the transplant she needs to survive. Ryu wants to give his sister one of his own kidneys but he has the wrong blood type. When Ryu is laid off and given a lump sum in severance pay, he seeks out black-market organ transplant. He agrees to give one of his kidneys and ten million won (roughly US $10,000) in exchange for a kidney for his sister. Ryu awakens from anesthesia to find that his kidney has been removed and his money stolen by the black marketeers.

When a kidney becomes available through the hospital, Ryu and his friend Cha-youngmi (Du-na Bae) kidnap the daughter of a wealthy factory owner (Kang-ho Song) in order to raise the money to pay for it. The child dies in an accident and two vengeance plots unfold, that of Ryu punishing the black marketeers and the vengeance that the factory owner wreaks on Ryu and Youngmi for the death of his daughter.

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A Gesture Life

Lee, Chang-rae

Last Updated: Dec-06-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Franklin Hata, comfortably retired from his medical supply business, reflects on his life--a life that spans several continents, three cultures (ethnic Korean brought up in Japan and emigrating in adulthood to the U.S.), service as a medic in World War II (in the Imperial Army of Japan), adoptive fatherhood, and a fizzled out romance with a well-to-do suburban Caucasian widow. At first out of place in the wealthy New York suburb where he settled, Hata has worked hard to achieve acceptance there, taking pains to fit in, creating no disturbances, never complaining, even when provoked by thoughtless schoolchildren or narrow minded adults.

The major disappointment of his adult life has been his tempestuous relationship with his adopted mixed-race daughter, Sunny, who left his home to live on her own when only a teenager. Even failed parenthood, however, has been absorbed by Hata. For although Hata claims that he had always wished to "pass through with something more than a life of gestures," (299) in fact he has labored to maintain equilibrium with a carefully designed "gesture life" of daily routine and superficial social niceties.

In the idleness of retirement and the solitude of his large, empty Tudor home, disturbing memories impinge on these routines and force a re-evaluation of his life and his relationship with the estranged Sunny. As a young medic during World War II, Hata had undergone an emotional and moral crisis when he fell in love with one of the Korean "comfort women" brought into his care in the Japanese army camp (in Burma) to which he was assigned. In the midst of rape and murder, Hata had to make choices, and these choices he can no longer justify to himself.

Further, he comes to understand that his relationship with his daughter has been colored by those long ago events. "In a way, it was a kind of ignoring that I did, an avoidance of her as Sunny -- difficult, rash, angry Sunny -- which I masked with a typical performance of consensus building and subtle pressure, which always is the difficult work of attempting to harmonize one's life and the lives of those whom one cherishes." (284)

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Set in 19th-century Japan, the film’s action centers on the experience of the young doctor Yasumoto (Yuzo Kayama) in his work as an intern at a hospital-clinic for the poor run by the experienced and wise Dr. Kyojo Niide (Toshiro Mifune), nicknamed "Red Beard." Coming from a wealthy and influential family, and fresh from a Western-influenced medical education at Nagasaki, Yasumoto had believed he was on the path to become physician to the shogun (equivalent to a king).

He is initially insulted and deeply unhappy with conditions at the distinctly inglorious clinic. The poverty and suffering (and smell) of the clinic’s patients disgust him, and he tries his hardest to get fired. The mysterious Red Beard, however, is extremely patient, and simply waits. While he waits, we see Dr. Yasumoto slowly being converted as he is brought into close contact with the suffering in the lives of several patients.

Initially rebellious and emotionally unable to watch patients die or assist in surgery, Yasumoto gradually becomes a seasoned and enthusiastic member of the clinic’s medical team and announces that Red Beard is his idol. At the end, when Yasumoto is actually offered the position of physician to the shogun, he refuses, in order to continue his work at the clinic.

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The Drowned and the Saved

Levi, Primo

Last Updated: Dec-06-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Primo Levi was imprisoned at the Auschwitz concentration camp in 1944. He survived the experience, probably in part because he was a trained chemist and as such, useful to the Nazis. Soon after the war ended, he wrote several books about his experience. The Drowned and the Saved, however, was written 40 years later and is the work of memory and reflection not only on the original events, but also on how the world has dealt with the Holocaust in the intervening years. Fundamental to his purpose is the fear that what happened once can happen (and in some respects, has happened) again.

Chapter 1, "The Memory of the Offense," dissects out the vagaries of memory, rejection of responsibility, denial of unacceptable trauma and out and out lying among those who were held to account by tribunals as well as among the victimized. Levi does not spare himself: "This very book is drenched in memory . . . it draws from a suspect source and must be protected against itself" (34). Even so, he insists, memory and the historical record are crucial to combating Nazi assumptions that their deeds would go unnoticed (they were destroying the evidence), or disbelieved.

In "The Gray Zone" (2) Levi challenges the tendency to over-simplify and gloss over unpleasant truths of the inmate hierarchy that inevitably developed in the camps, and that was exacerbated by the Nazi methodology of singling some out for special privileges. He outlines the coercive conditions that cause people to become so demoralized that they will harm each other just to survive. (And when they refused to collaborate, they were killed and immediately replaced.)

Chapter 3, " Shame," is, in my opinion, the most profound and moving section of the book. Levi begins it by discussing a phenomenon that occurred following liberation from the camps: many who had been incarcerated committed suicide or were profoundly depressed. This Levi attributes to shame and feelings of guilt. "Coming out of the darkness, one suffered because of the reacquired consciousness of having been diminished . . . Our moral yardstick had changed [while in the camps]" (75). Beyond that, there is the sense that "each one of us (but this time I say 'us' in a . . . universal sense) has usurped his neighbor's place and lived in his stead" (81-82).

In the concentration camp, says Levi, it was usually "the selfish, the violent, the insensitive, the collaborators of the 'gray zone,' the spies" who survived ["the saved"] while the others did not ["the drowned"] (82). Only the drowned could know the totality of the concentration camp experience, but they cannot testify; hence, the saved must do their best to render it. Since Levi was one of those saved, he is "in permanent search of a justification . . . " and although he feels compelled to bear witness, he does not consider doing so sufficient justification for having survived. In this chapter Levi also discusses why inmates did not commit suicide during their incarceration:" . . . suicide is an act of man and not of the animal . . . because of the constant imminence of death there was no time to concentrate on the idea of death" (76).

"Communicating" (4) deals with the emotional and practical consequences of not being able to understand the German commands of the captors, or the conversation of the mostly German speaking prisoners (Levi was Italian but spoke some German). Levi also describes the additional suffering of those who were cut off from all communication with friends and family. "Useless Violence" (5) gives examples of how the Nazis tormented their prisoners with "stupid and symbolic violence."

In "The Intellectual in Auschwitz" (6) Levi speculates about how and in what circumstances being educated or cultured was a help or hindrance to coping with the situation. In this chapter he considers also whether religious belief was useful or comforting, concluding that believers "better resisted the seduction of power [resisted collaborating]" (145) and were less prone to despair. Levi, however, was never a believer, although he admits to having almost prayed for help once, but caught himself because "one does not change the rules of the game at the end of the match, not when you were losing" (146).

Chapter 7, "Stereotypes," addresses those who question why many concentration camp inmates or ghetto inhabitants did not attempt to escape or rebel, and why many German Jews remained in Germany during Hitler's ascendance. As in all the other chapters of his book, Levi discusses the complexity of these situations. "Letters from Germans" summarizes his correspondence with Germans who read his earlier books. The book ends ("Conclusion") with the exhortation that "It happened, therefore it can happen again . . . " (199).

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Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

In this rich opening chapter of his work on the Nazi doctors, Lifton lays out the groundwork for answering the question of how German doctors became the agents of Hitler’s vision of the purified Aryan race, sterilizing involuntarily several hundred thousand citizens with a variety of mental and physical deficiencies. His answer, in brief: a romanticized genetics coupled with total political control.

Amazingly, the Nazi medical atrocities were carried out not against the opposition of Germany’s medical establishment, but with its approval. (Of course, there were individual dissenters, the more vocal of whom were removed from positions of authority or put to death). Nazi leaders worked hard to convert medical people to the official position. This was accomplished partly by force, but also partly by metaphor, as the normal language of medicine was used to hide the unethical nature of what doctors were being asked to do.

Individual patients were replaced by the racial term "Volk," meaning the (Aryan) people, and their rights were superceded by their doctors’ new duty to assure the health of this collective political idea. According to Nazi publicity, the Aryan race was in grave danger of "Volkstod," of dying out, because its genetic pool had been contaminated both by the transmission of inherited genetic defects and by the "foreign invasion" of Jews and their intermingling with members of the "superior" Aryan race.

To save their new patient, German doctors were expected to carry out the sterilizations, medical experiments, and, later, the euthanasia required by Nazi doctrine, which, in the words of one Nazi writer, declared that "misery can only be removed from the world by painless extermination of the miserable." Doctors were urged not to worry about ethical issues, because Nazi medicine was "nothing but applied biology."

In these ways, says Lifton, Hitler’s racial policies were ’medicalized’ and their evil made less obvious. Those who went along were billed as the "saviors of mankind," the "alert biological soldiers" whose actions would restore the purity of the Aryan race. Jewish doctors were not invited, of course, their research having been officially discredited in the mid-1930s, Lifton tells us, and their medical licenses revoked in 1939--in spite of the fact that they made up half the doctors in some large cities.

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