A Plea to US Citizens: Contact your Senators about the current attempt to Repeal the Affordable Care Act without an adequate replacement
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EDITOR’S NOTE: Earlier this afternoon, the U.S. House (one of the chambers of America’s bicameral legislature) voted 217-213 to approve a bill to repeal major parts of the Affordable Care Act, AKA Obamacare. The measure that cleared the House will then have to clear the Senate, which may have to make changes to the bill to get it to pass. If it passes, the altered bill will have to go back to the House for approval, a process known as ‘reconciliation’. The House voted on the measure–an adapted version of their March attempt–without the complete analysis of its impact from the Congressional Budget Office, an analysis they generally look for on this kind of bill. The White House defended voting without the CBO report, saying that the bill contains too many unknowns for the office to successfully predict its effects. Philosopher and medical ethicist Rory Kraft brings us this brief consideration of the measure that passed the House today. For his cautionary notes about prior attempts, see his March 31 blog, “The ABCs of the AHCA: A is for abortion, B is for backward, C is for costly.”

I do try to strike a certain balance on political posts. While I don’t try to “hide” my positions, I also generally do not find discussions of politics on social media to be time effective. Thus, I tend to share news stories with interesting angles more than stating my own position or calling for action.

Today I will make an exception and ask folks to take political action.

Please call your Senators and ask them to vote against the AHCA and in particular this alteration of the ACA.   You can contact your Senator by looking them up on this site.

If you fall on the liberal side of political issues, it probably doesn’t take a lot to convince you that bill will be detrimental to the nation’s health.

If you fall on the conservative side, you may be interested to know that under the Upton amendment $8 billion dollars will be funneled into trying to prop up the individual markets, while still causing a loss of coverage for some 24 million people. This is not fiscally conservative. This is not compassionate conservatism. AND, members of Congress and their staff will be exempt from the changes that AHCA would bring to both Medicaid coverage and to the nature of employer-based coverage, including pre-existing conditions.

There is no question that there are aspects of ACA (“Obamacare”) that should be revisited and fixed. The AHCA does nothing to fix those problems.

Call your Congressman/woman and urge them to vote against this bill and bring forward a real approach to repair ACA.

Appendix from the Editor: You can learn more about this through the following links, all dated May 4, 2017.

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Labor Without Respite: Tennis, pregnancy, and other ‘unexpected feats’

This image shows a woman with pale skin and long blonde hair. A bookshelf is behind her as though the picture is taken in a professional office. She stares seriously at the photographer.

Verina Wild

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Agomoni Ganguli-Mitra

GUEST CONTRIBUTORS

Agomoni Ganguli-Mitra (Dr. sc. med., Research Associate, Liminal Spaces Project; Teaching Fellow, School of Law; Executive committee member, Mason Institute; University of Edinburgh Law School, UK)

Verina Wild (Dr. med., Philosophy Department, Ludwig-Maximilians- University Munich, Germany) 

This image shows the head and upper torso of tennis star Serena Williams. She is wearing tennis clothes in black, a black head band, a delicate silver necklace and a white watch. She covers her mouth with her hand, as if in astonishment.

Social media feeds are currently lighting up with news from Serena Williams and her first pregnancy. Articles are also picking up on the detail that given that the world class athlete is 20 weeks pregnant, she must have won the Australian Open in her first trimester. If you accept the fact that bodies of super stars, especially in relation to pregnancy, are a matter of public debate – so far, so good, for some happy news amidst otherwise rather unbearable headlines.

A particular piece in The Guardian however, gave us pause. The Guardian asked its female readers what ‘unexpected feat’ they ‘pulled off’ while pregnant.

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The Handmaid’s Tale: a roundup of media sources and related prior IJFAB Blog entries
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Editor’s Note: See “Body Ecology and Commodification in The Handmaid’s Tale” by Rebecca Bratten Weiss, and more to come.

Over the next few weeks, IJFAB Blog will have several original blog entries on The Handmaid’s Tale, both the book and the new Hulu series that just began releasing episodes online Wednesday April 26, 2017. Until those are in and posted, this Editor provides a list of thought-provoking reflections on the book and the series from the general media:

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IJFAB blog has also had previous blog entries that address the general issue of control over women’s reproduction and the social importance of reproduction:

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Sleep as a matter of justice
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Over at the LA Times, Benjamin Reiss has a fine consideration of the ethical importance of sleep differences in his article, “African Americans don’t sleep as well as whites, an inequality stretching back to slavery.”

Poor sleep has negative health effects, and is more likely to result from having to live in certain circumstances: during times of slavery there were tight and crowded sleeping quarters while sometimes chained and women were particularly prone to sexual assault, and now there are unpredictable What we need, to put that knowledge into practice, are useful tools that help us provide best care at the individual level, selecting from the broad types of order uk viagra interventions available and systematically and quantitatively monitoring their impact. Thus, the magic pill commonly known as levitra price found its way to our collective consciousness. If any from the recorded side effects manifest throughout the course of treatment, discontinue the use prescription free tadalafil djpaulkom.tv of drugs. Dark chocolate is great because it is the purchase generic levitra http://djpaulkom.tv/page/2/ only way to save money while buying medicines. work shifts for lower-income workers who must live in more crowded circumstances in order to live more cheaply.  Vulnerabilities of race and class are compounded. I won’t summarize large portions of the article here, but I strongly recommend that you follow the link above to this thoughtful, beautifully-written piece that examines many parts of American history with respect to sleep and slaver including the role of medicine and medicalization in reinforcing differences in treatment of blacks and whites that affect sleep.

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Like and unlike: Late abortion in the case of wanted pregnancies, and miscarriage
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A recent article by Natalia Megas in The Guardian profiles three women who chose late abortions and who had very much wanted to be pregnant.  It is a moving exploration of the seriousness of abortion as a moral issue, and an important set of premises in why late abortion must remain legal and available. It also raises questions for me about whether the experience of late abortions of Yellow square bearing the words "A wanted pregnancy as much as a dreaded pregnancy can play differently than all one's previous imaginings. --Susie Orbach"wanted pregnancies shares elements of experiences of miscarriage, not just termination of unwanted pregnancies. But let’s start with real narratives from Megas’s article.

Early in the article, Dr. Jennifer Conti explains why women often must make such a decision:

Abortions that occur at this stage in pregnancy are often the result of tragic diagnoses and are exactly the scenarios wherein patients need their doctors, and not obstructive politicians… Asking a woman to carry a fatally flawed pregnancy to term is, at the very least, heartbreaking. I’ve often heard women say that they chose to end such pregnancies because of unselfish reasons: they couldn’t bear the thought of putting their fetus through even more pain or suffering.

One pregnant woman’s* fetus** had multiple congenital deformities which might cause the fetus to die during labor, caused complete or partial absence of the connection between the brain’s Continue reading

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Climate Change is a Medical Ethics Issue, and this graph shows why it’s real
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Medical ethicists and public health specialists have argued for some time that climate change is  a health issue and a medical ethics issue. The four links in the previous sentences are a nice starting point if you want to bone up on some aspects of why this is the case.

This brings us to an April 19th, 2017, article from Climate Central that went viral on Twitter the past few days.  This article included a graph that shows, for each month since the year 1880, which months were hotter than usual, or colder than usual.  Since “than usual” is a shifting target as more and more data is recorded, continual trends of “warmer than usual” show increasing warming, not just steady temperatures.

And that is precisely what the graph shows: there hasn’t been a cooler-than-usual month in 628 months. Each row on the graph represents one year, divided into 12 horizontal blocks with one for each month.  If the month is warmer than usual, it is a shade of red: the darker, the warmer.  If the month is cooler than usual, it is a shade of blue: the darker, the cooler.

From 1880, when the chart begins, through 1915 or so, we see a mix of warmer and cooler months. Between 1915 and 1940 or so, we see a definite visual trend toward warmer months with decreasing numbers of cooler months.  And from 1940 on, there are very few cooler months. As we move from 1940 toward the present, the graph grows decidedly darker read.

The world is warming.  We may not be able to prevent it from warming further. But we must be asking ourselves what we can do to mitigate this damage, and to help those made vulnerable by it.

Several IJFAB blogs and peer-reviewed scholarly journal articles have addressed this in the past, as have some works published elsewhere but authored by members of the FAB community. You may find them useful for digging into this issue:

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Our own post-Easter resurrection: this Blog is fully operational
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Many thanks to PJ Welsh and Ezgi Sertler for the technical work behind the scenes restoring IJFAB Blog to full functionality!

We are up and running.  Got a possible blog topic?  Contact the editor!
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Thank you for your patience

Hello, dear readers. As you may have noticed, IJFAB Blog has been down for a week and a half. While the blog is back up, we are working to fix access to our archive of blogs. You may notice that links to our excellent store of prior entries are currently non-functional.


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Thank you for your patience as we work through these technical problems.

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TENTH ANNIVERSARY ISSUE OF IJFAB is an embarassment of riches
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Our parent journal, International Journal of Feminist Approaches to Bioethics, is celebrating its 10th anniversary.  Lo those many years ago in Spring of 2008, our first issue, Doing Feminist Bioethics, was published. In the second issue, Lyerly, Little, and Faden’s article on including pregnant women in research hit the mass media with a bang and still keeps popping up in the news as a useful tool for the general public, health care providers, and researchers.

This Spring, we celebrate the 10th anniversary of IJFAB, vol 10 no 1with an issue that kicks off with an editorial from Mary Rawlinson, who helmed the ship for many years, on the very concept of feminist bioethics.

Check out this screenshot of the essays in this issue, and the breadth of topics.

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To access any of these just go directly to the Table of Contents for the issue.

Happy first decade, IJFAB. Thanks for the embarassment of riches. Here’s to many more.

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WAY BACK MACHINE Spring 2016 IJFAB vol 9 no 1: articles on queerness and reproductive ethics, “boutique” ultrasound, homebirth, GMOs, feminist practices of bioethical pedagogy, feminist palliation

If you missed last Spring’s issue of our parent journal, International Journal of Feminist Approaches to Bioethics, Spring of 2017 is a good time to jump in the Wayback Machine–before President Trump in the US and Brexit in the UK and the Colombian peace deal with FARC and any number of other global issues–and check out Spring of 2016. For ease of use, here’s the table of contents.  Continue reading

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The ABCs of the AHCA: A is for abortion, B is for backward, C is for costly
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EDITOR’S NOTE: This piece’s posting was delayed by technical errors. However, the analysis of the American Health Care Act (AHCA) is still pressing and relevant. While the bill was pulled from a planned House vote in the US Congress on Friday 3/24/17 because Republicans (the GOP) did not have enough votes to pass it, House Republican leader Paul Ryan has vowed to try again after revisions to the AHCA. We do not know what they will be. Insofar as the elements critiqued by Rory Kraft remain in future versions, we still very much need this analysis. Indeed, Kraft analyzes some aspects of the proposal that did not receive a close viewing in news media, including the impact on access to abortion. At the end of Rory Kraft’s analysis, you will find a helpful list of other IJFAB Blog articles on health care and benefits reform in the US and other nations.

AUTHOR’S PREFACE:

This argument was originally written for another venue, and thus is quirky in that it assumes a certain level of informality and is not written to be either persuasive or educational in the manners that op-eds often are.  It is also at the same time a bit defensive (“please don’t troll me!”) and expressive.  Quite simply, this is my attempt to capture for others my own reactions to the bills being called collectively the American Health Care Act.  I’ve cleaned it up a bit, but essentially here are my reactions as to how the relevant bills stood as of late Thursday 3/9/17.

Since the House leadership plan to repeal and replace the Affordable Care Act (ACA) was released late Monday March 6, I’ve had several people ask me what I think of the new plan.  This is my attempt to provide some insights.

First, like almost anyone who has looked at the ACA I have some problems with it.  The ACA is gargantuan in scope and has many side provisions which impact the functionality of it.  I can only assume that many of these were attempts to placate particular senators and/or congressmen who were wavering in their support of the bill.  The specifics of the bill are a mess while at the same time leaving big swaths to administrative regulatory language.   I say all this because I am concerned that some will take the following criticisms of the Budget Reconciliation act as a total endorsement of the ACA.

What do I think of these bills (the reconciliation language is split into two bills, perhaps in part to speed it through committees)?   Quite simply: they are horrible.

A is for Abortion, so I start with issues tied to that:

Continue reading

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Each English language user is about to meet their language’s new gender neutral singular pronoun, with the release of the new Associated Press Stylebook
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For some time now, there has been a movement to address the English language’s need for a gender neutral singular pronoun. This need originates in the growing realization that using “he” to refer to a person whose gender you do not know is exceedingly troubling: in case studies and examples, then, all professionals become presumptively men.

In addition, people who do not fit into classic gender norms may not want to be shoved into them by “he” and “she” as English’s only singular pronouns.  And as Marilyn Frye noted in The Politics of Reality, English’s use of only gendered singular pronouns requires use to constantly engage in “sex-marking” (the determination of others’ sex before we can know how to refer to them, relate to them, shake hands, touch them, interpret body language, deploy body language, etc.). It also requires each of us to constantly announce our sex by using the techniques that fit into established gender norms.

This reinforces rigid gender norms for dress and comportment and the maintenance of our bodies (hairy, or hairless? makeup, or not? heels, or tennis shoes?) in order to clearly signal and clearly determine each person’s gender and sex. Thus, many feminists have proposed, the absence of a gender neutral pronoun is one of many social and linguistic features that shore up traditional rigid gender norms and their content.   Feminist science fiction has postulated a range of possibilities including some which have come into occasional usage, including “ze” for the pronoun and “zir” or “hir” for the possessive.  The recent scifi novel Ancillary Justice features a main character who simply cannot sex mark people accurately, and so uses “she” to refer to all other characters in the book.

Increasingly, though, it seems we no longer need novel pronouns.  Language users have naturally begun to adapt a word already in use.  Consider the claim “Someone left their phone in the bathroom. I hope they come back for it.” We already use “they” in casual usage to refer to someone whose gender is unknown   And  for some time now, the use of “they” as gender neutral singular pronoun has been gaining formal endorsements.  In January of 2016, the American Dialect Society adopted it as officially correct English, and the Washington Post had already integrated it into its style guide.  The next big leap occurred when the Associated Press Stylebook, which is widely used by many news organizations and blogs as a guide to language usage, embraced “they” for this purpose.  On Friday, March 24, 2017, the AP’s lead editor for the Stylebook, Paula Froke, had this to say:
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We offer new advice for two reasons: recognition that spoken language uses they as singular, and we also recognize the need for a pronoun for people who don’t identify as a he or a she.

We also can use this wherever we need a gender neutral singular pronoun. Perhaps knowing that it is available will also lighten the burden of constant announcing and marking of sex and gender.

As  a side note, other revisions to the AP Stylebook that may be of interest to this blog’s readers include an explicit distinction between gender and sex. The entry on this reads “Gender refers to a person’s social identity while sex refers to biological characteristics… Not all people fall under one of two categories for sex or gender, according to leading medical organizations, so avoid references to both, either, or opposite sexes or genders as a way to encompass all people.”

With the imprimatur of a more universal style guide like the AP Stylebook, teachers and authors who had not yet adopted these usages in grading and writing may need to do so.

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