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Insert Comma • A Portfolio of Leigh E. Rich
Categories: Ethics, Law, Philosophy, Utrinque Paratus | Comments Off on Undermining Communicative Action in the Medical Encounter

Informed Consent, Compelled Speech, and Promises to Pay Leigh E. Rich Abstract Book chapter for the edited volume The Twenty-First Century and Its Discontents examining legal and bioethical issues of informed consent, using examples from medical television dramas, philosopher Jürgen Habermas’ work on communicative action, and physician compelled speech laws. Ideally, informed consent is achieved […]

Categories: Books, Ethics, Health, Politics, Utrinque Paratus | Comments Off on Lessons From the Death Zone

What Jon Krakauer’s “Into Thin Air” Can Teach Us About the COVID-19 Pandemic and Why We May Be Doomed to Repeat It Leigh E. Rich Abstract Book chapter for the edited volume The Twenty-First Century and Its Discontents examining the novel coronavirus pandemic and the U.S. response through the lens of Jon Krakauer’s 1996 book, […]

Categories: Ethics, Feminism, Health, History, Law, Media, Philosophy, Politics, Television, Utrinque Paratus | Comments Off on “Men Against Fire”

The bureaucratization of dehumanization is nothing new. Examples can be found in many eras and places and during both wartime and peace. Modern warfare, however, has meant innovations in the techniques of killing as well as the “framing” of those being killed, whether accomplished by separating the act through distance or technology or training soldiers (and the public) to “see” the enemy differently. The U.K. anthology series Black Mirror revisits this question in an episode titled “Men Against Fire,” a direct reference to S.L.A. Marshall’s controversial 1947 book of the same name, Men Against Fire: The Problem of Battle Command. Marshall observed the battlefield as a lonely and traumatic place and portrayed this isolation—and an individual’s moral upbringing—for soldiers’ hesitancy to fire on an enemy, even when ordered or in danger of losing their own lives. What was needed, according to Marshall, were “well-trained foot soldiers” freed from such burdens. While bureaucratic techniques that dehumanize or obscure the Other can be particularly “useful” in war, they are perhaps more insidious beyond the bounds of war. Primary examples include Jim Crow and eugenics, with reverberations of both still felt today. Examining the Black Mirror episode, not in relation to war or Marshall but when men are not “against fire,” sheds light on why health disparities and other inequities persist and the need for movements like Black Lives Matter or new waves of feminism. In civil society, the “problem of battle command” has been understood by certain policymakers and powerbrokers as a hesitancy to limit safety nets (“entitlements”) or reproductive and civil freedoms of the “undeserving” in the name of protecting the financial and corporeal health of the social body. Viewing “Men Against Fire” through examples such as eugenic thinking reveals how discriminatory rhetoric against poor, minority, and other stigmatized populations has lingered during peacetime through the twentieth and into the twenty-first century. Unlike Marshall’s conclusion, the answer to ending such policies and practices is rooted not in overcoming a sense of morality but engaging in it.

Categories: Education, Social Science, Utrinque Paratus | Comments Off on Supporting learning engagement with online students

University students are increasingly demanding that traditionally taught courses are converted to an online platform. While quality standards are in place for the format and organization of online courses, professors often are left wondering what activities contribute to learning engagement for their online students. The research question driving this study was, what activities contribute to learning engagement for online students? To investigate this question, an online survey was conducted in one state university of all students taking an online course during the spring semester. With responses from 417 students and using three standardized scale variables for learning engagement, as well as two open-ended questions, course components related to strong learning engagement were identified and examined. Initial findings indicated a statistically significant moderate correlation of learning engagement with the use of higher-order learning and reflective and integrative learning techniques. Specifically, students who reported being highly engaged connected ideas from other courses, changed their understanding of a topic or concept, found connections between their learning and societal problems, and had fun. A regression model using these variables, along with control variables of student age, gender, and out-of-school work, resulted in an R2 of 0.484, suggesting that almost half of the variance in learning engagement can be explained via this model. Further analysis of the qualitative data identified certain aspects of online discussions and assignments as engaging, such as discussions and interactive assignments that are not merely “fun” from a student perspective but also integrate previous learning and connect to current social issues. This includes prompting students with thought-provoking questions that relate to “real-world” situations and inviting students to share diverse opinions as well as develop personal perspectives.

Categories: Books, Editorials, Ethics, Health, Media, Politics, Science, Social Science, Utrinque Paratus | Comments Off on Prestidigitation vs. public trust

Or how we can learn to change the conversation and prevent powers from “organizing the discontent” By Leigh E. Rich When Drs. Silvia Camporesi, Mark Davis, and Maria Vaccarella (2017) approached the Journal of Bioethical Inquiry about a symposium on “Public Trust in Expert Knowledge” as well as a panel session at the October 2016 […]

Categories: Editorials, Ethics, Media, Utrinque Paratus | Comments Off on Which lane should we be in?

Some thoughts on print versus online, open access, and web presence: Future directions for the JBI and growing its global community By Michael A. Ashby and Leigh E. Rich For some time now, the editorial board (and various subcommittees) of the Journal of Bioethical Inquiry (JBI) has been giving a good deal of thought to […]

Categories: Books, Editorials, Education, Ethics, Social Science, Utrinque Paratus | Comments Off on Afterthoughts and foresight

Digging through boxes of bygone beliefs and brooding about the burgeoning of bioethics By Leigh E. Rich I recently unearthed a box long lost in the back of my closet, a box that has travelled with me across several states and too many years. I don’t think of myself as a pack rat by any […]

Categories: Editorials, Ethics, Health, People, Social Science, Utrinque Paratus | Comments Off on “Born like this / Into this”

Tuberculosis, justice, and futuristic dinosaurs By Leigh E. Rich I was born of disease. Not in the same circumstances as too many still today and so many others in the past, but my existence—or at least key narratives from life courses entwined with my existence—are rooted in disease. Had it not been for the “Spanish […]

Categories: Ethics, Health, Social Science, Utrinque Paratus | Comments Off on Nurses’ perspectives and medical errors

There is often a mismatch between patients’ desire to be informed about errors and clinical reality. In closing the “disclosure gap” an understanding of the views of all members of the healthcare team regarding errors and their disclosure to patients is needed. However, international research on nurses’ views regarding this issue is currently limited. The objectives of this study involved exploring nurses’ attitudes and experiences in hospitals in two German-speaking cantons in Switzerland concerning disclosing errors to patients and perceived barriers to disclosure. Nurses generally thought that patients should be informed about every error, but only a very few nurses actually reported disclosing errors in practice. Indeed, many nurses reported that most errors are not disclosed to the patient. Nurses identified a number of barriers to error disclosure that have already been reported in the literature among all clinicians, such as legal consequences and the fear of losing patients’ trust. However, nurses in this study more frequently reported personal characteristics and a lack of guidance from the organisation as barriers to disclosure. Both issues suggest the need for a systematic institutional approach to error disclosure in which the decision to inform the patient stems from within the organisation and is not shouldered by individual nurses alone. Our study suggests that hospitals need to do more to support and train nurses in relation to error disclosure. Such measures as hospitals establishing a disclosure support system, providing background disclosure education, ensuring that disclosure coaching is available at all times, and providing emotional support for all parties involved, would likely go a long way to address the barriers identified by nurses.

Categories: Books, Ethics, Media, Philosophy, Science, Television, Utrinque Paratus | Comments Off on “Hannibal” and the horrors of hyper-rationality

A common theme in detective stories is the introduction of an archenemy—often a serial killer who rivals the protagonist in intelligence and cunning but clearly lacks a moral center. This “two sides of the same coin” trope heightens the suspense in the storyline not only because the hero and the villain stand toe-to-toe (or brain-to-brain), especially in the final face-off, but also because the constructed symmetry suggests that there is but a fragile line between “genius” and “evil genius.” In the television series Hannibal, FBI consultant Will Graham and the cannibalistic psychiatrist Hannibal Lecter seem on the surface to fit these roles. Upon closer inspection, however, the two characters share little in common: While the latter is a medically-trained psychopath, impeccably poised but devoid of compassion, the former’s talent for catching killers stems from his “remarkably vivid imagination” and rare capacity for “[p]ure empathy.” This empathetic understanding, a combination of rational and emotive deduction, enables Graham to “see” what the FBI’s behavioral and forensic scientists cannot: a contextualized and embodied view of another’s actions rather than a reconstructed and technologized myopia of the “evidence that counts.” Interestingly, it also allows him to recognize each killer as human, not as some wholly distinct and monstrous “other.” In this way, it is instead the members of the FBI’s Behavioral Science Unit—inculcated with a “professional distance” that tends to transform all subjects into objects—that are “just like” Lecter. Thus, rather than merely another round of rivalry between hero and antihero, Hannibal calls into question the “objective distance” of professionalism and emphasizes that “genius” (revelation) is rooted not just in reason but also in emotional and subjective experience, exploring cultural fears of the fuzzy postmodern constructions of science and the self. While empathy poses certain real risks (from which Will Graham and the rest of us are not immune), Graham’s character and the Hannibal television program suggest that, rather than undermining understandings of the world or ourselves, an empathetic approach to discovery is more authentic and ethical because it leads to greater recognition of oneself and others—and who we are in relation with others (identity as co-constructed)—as well as greater capacity to take responsibility for our actions.

Categories: Editorials, Education, Ethics, Health, Social Science, Utrinque Paratus | Comments Off on “Leapin’ lizards, Mr. Science”

Old reflections on the New Archaeology (and musings on anthropology, art, bioethics, and medicine) By Leigh E. Rich Perhaps my favourite class as a graduate student in anthropology was an elective taught by the chair of our department, an immensely affable man who, despite his stature in the discipline and successes as a scholar, was […]

Categories: Editorials, Ethics, Media, Politics, Social Science, Television, Utrinque Paratus | Comments Off on Thirty years yet miles of the medium-metaphor to go

Jon Stewart, Neil Postman, and “understanding the politics and epistemology of media” By Leigh E. Rich Right after completing my doctorate, I took a job as a political reporter. The pay was lousy, the position had little to do with the health sciences, and the newspaper, though respected, wasn’t big enough to compete with the […]