Powerpoint 2 (Rec 6,7) (Case Study : Moral Labs (Chp 7 - Case 6 - Miracle…
Powerpoint 2 (Rec 6,7)
Culture in Medicine
Important part of our dataset
Bio medicine bracket off too much info that is relevant (p557)
how is a clinician set of belief impact how they perform care
how do we collect patient belief?
culture highly influential
complete inability to recognize the connection between the mind to the body and therefore we don't really deal well with the depression. inability to adjust one's life to required medical care.
De Vries an Rott
Role of Belief
positive effect of a healing encounter might have. including sugar tablet.
healing agent or encounter that does not have a biochemical effect. white coat effect.
Case Study : Moral Labs
Key Combat to Harris's universal rules
being a moral agent is so much more complicated
4 major lesson
straight anthropology - "thick description". collect all information. "thick description" of first person, phenomenology, - action, motive, - not just raw facts, but emotional debate
virtue ethics. goal is to create a good life / happy life. p9&10. cannot be reduced to a single life or rule. not about surviving but thriving. p11 -- not in evaluative claim but a descriptive that they are evaluative
that is the shift from institutionalize ethics to moral reasoning / virtue ethics / relational ethics.
Family is the primary moral site. it happens in the family over time. Time = past and the present are acting on each soccer game.
Laboratory - it is about experimentation. try on different persona. moral experimentation.
illness narrative vs clinical narratives
Case 1 : Andy soccer game
Andy doing moral work - i want to prove i can be normal kid / good kid. falling in a wheel chair proves it.
Case 2: Delores
addicted to cocaine, lost custody of children to grand mother
drill team -- reinhabit the streets in a different way, how do we define space? It is a courtroom or workshop?
4 different space
artisan workshop, moral imagination, requires human capacity that other animals lack.
relational ethics - apprentice. when you become a moral person, you find people you be an apprentice to.
p70 - where you prove your case
marcy is someone who has failed in the courtroom of life
culturally driven - you have to defend yourself
there is a judge, plaintiff and defendant.
** everytime you come across "judging" in your readings, use this metaphor
concept of suspended free space
virtues / ideals , to promote ethical engagement, need space for people to work to pursue the good (moral reasoning, trying ethical responses, solving different problems)
Case 3: Sasha
sasha not her son cannot deal with the disfigurement p90
Case 4: Dotty
Doctor gives up power for the sake of healing
Doctor gives up authority, gives up clinical narrative, show respect -- is the hero
Clinical narrative produce by physician. clinical narrative produce by patient mom. confessional / corrective clinical narrative.
2 conflicting ethical sources
The moral dilemma is...[the obligations in conflict]
Chp 5 -- Commensurability / Comparability - can they even relate. or are they completely unintelligible to each other. Why important? If you have a moral compass (you know you have ethics), you need to tell yourself to be commensurable.
all goods are commensurable (rejection of moral incommensurability).
drives the burden to each of us to resolve moral dilemma (cannot use universal morality). if we don't, we don't flourish.
Chp 7 - Case 6 - Miracle Baby.
Andrew, although agree with the clinician over the facts, doesn't agree with the conclusion. Is there moral incommensurability?
Their moral reasoning differ so radically because it is embeded in different / an incommensurable narrative. narrative = is a test / trial.
Doctor believes in the technology. if technology say it is a dead baby, it is a dead baby.
what is the problem about saying it is incommensurable? We (all humans) have faith that the future exist, so must be able to imagine that other moral worlds exist. Ethical relativism.
Parents = God as a moral source
Principles vs virtues
Institutionalized codes / laws vs moral reasoning
Collective process of ethics
collective narrative, how ethics is negotiated in social settings, how respond to each other,
public communal ethics / communal narrative (explicitly challenging clinical narrative - janelle taylor)
role of friends = mirror, to test
Morality of your friends, they are your friends because they share the same morality. sometimes confronted with conflicting moral framework.
narratives - is just a performance (not a fact) in a particular social context / audience, a test, it can be revised
context have a "past" and a "future"
needed for "enduring self"
confessions / ritualized speech - help people through major ethical hurdles, cathartic value, public nature of confession,
e.g. chp Dotty is not a clinician but she can put together clinical narratives. Doctor gives up power for the sake of healing.
concept of hope
virtue ethics - there is an "enduring self." we make different moral decisions but same self and need a way to "frame" / justify our changing/evolving moral self. Things like faith, hope, miracles, -- things that doesn't have a rationale cling very well to enduring self.
Quiz - know all case names, diagnosis, main problem in the story line, key terms on slides, relate key terms to cases, citing names, citing diagnois, - seargent, smith morris, janelle taylor.