Sunday, February 23, 2020

Who should survive?

I just discovered this influential 10-minute film online, and I'm a little amazed that it took me this long. I'll let it speak for itself. Here is how David Rothman describes the case that inspired it in Strangers at the Bedside:

Although there is something artificial about selecting a single starting point for this analysis, the case of the Johns Hopkins baby stands out. In 1967 a baby suffering from a digestive abnormality was born in a community hospital at Virginia's Eastern Shore. The infant was transferred immediately to the Johns Hopkins University Hospital, and his doctors discovered an intestinal blockage, a problem readily correctable through surgery. But the baby was also mentally retarded because of Down's syndrome. Upon being told of the situation, the parents refused to give permission for the surgery, and the hospital complied with their wishes. The infant was moved to a corner of the nursery, and over a period of fifteen days, starved to death.' 

In the opinion of several physicians at Johns Hopkins, the case was not all that unusual. It was common knowledge, at least within the profession, that many infants born with spina bifida -- a condition in which the spinal column is exposed and underdeveloped, causing paralysis, incontinence, and, frequently, mental retardation -- never left the delivery room; the chart entry read "stillbirth." (When it later became the practice to intervene aggressively with spina bifida infants, the number of "stillbirths" went down almost to zero.) The Hopkins staff also believed that recourse to the courts was a waste of time because judges would always uphold the parents' desires.

Nevertheless, the baby's death deeply affected the resident who had pulled the feeding lines (William Bartholome), the chief resident (Norman Fost), and the chief of service (Robert Cooke, himself the father of two handicapped children). Indeed, they were so disturbed by the course of events that they took the issue outside the hospital. With assistance from members of the Kennedy family, whose concern for the treatment of the mentally retarded was exemplified in the work of the Joseph P. Kennedy Foundation, they oversaw the making of a short film about the incident, with a ten-minute segment devoted to the case and then a fifteen-minute panel discussion on the ethical principles involved.

Saturday, February 22, 2020

"Do CEOs act like jerks because they are jerks, or because the language of management will create a jerk of anyone eventually?"

Molly Young ponders the meaning of corporate jargon, or "garbage language," whose purpose is to conceal our hidden anxieties about the value of what we are doing. "Computer metaphors appeal to us because they imply futurism and hyperefficiency, while the language of self-empowerment hides a deeper anxiety about our relationship to work — a sense that what we’re doing may actually be trivial, that the reward of “free” snacks for cultural fealty is not an exchange that benefits us, that none of this was worth going into student debt for, and that we could be fired instantly for complaining on Slack about it."

Friday, February 14, 2020

Joseph Shabalala has died at age 78


The first time I ever saw Ladysmith Black Mambazo perform was in 1992 at the University of Natal, where Joseph Shabalala was a member of the music faculty (and I was a post-doctoral fellow in the medical school.)  I've been a fan ever since. In fact, just before I heard the news that Joseph Shabalala had died, my daughter and I were listening to this collaboration between Ladysmith Black Mambazo and Dolly Parton.

Thursday, February 13, 2020

"I was surprised by the effect it had on me. I’d assumed that my skepticism and media literacy would inoculate me against such distortions. But I soon found myself reflexively questioning every headline."

McKay Coppins of The Atlantic has written the most demoralizing account of the coming election (and of future elections far beyond 2020) that I have read yet. He started by setting up a Facebook page and "liking" Donald Trump. This led him into a parallel universe of social media disinformation: Here's a teaser:

After the 2016 election, much was made of the threats posed to American democracy by foreign disinformation. Stories of Russian troll farms and Macedonian fake-news mills loomed in the national imagination. But while these shadowy outside forces preoccupied politicians and journalists, Trump and his domestic allies were beginning to adopt the same tactics of information warfare that have kept the world’s demagogues and strongmen in power.

Every presidential campaign sees its share of spin and misdirection, but this year’s contest promises to be different. In conversations with political strategists and other experts, a dystopian picture of the general election comes into view—one shaped by coordinated bot attacks, Potemkin local-news sites, micro-targeted fearmongering, and anonymous mass texting. Both parties will have these tools at their disposal. But in the hands of a president who lies constantly, who traffics in conspiracy theories, and who readily manipulates the levers of government for his own gain, their potential to wreak havoc is enormous.

If you'd rather listen to Coppins than read him, check out this episode of Fresh Air.