Hastings Center Report最新文献

Tod Chambers's Redescribing Bioethics: How the Field Constructs Its Arguments reveals the rhetorical techniques that bioethicists, especially those from philosophy and religious studies, use in proving that their theory is the best solution to ethical issues in health and medicine. Like magicians, bioethicists have a pledge, turn, and prestige in presenting their work: they show an audience the case problem, hold that the extraordinary is actually ordinary, and then say that their approach is the only way through the moral morass. Rather than being original, Chambers argues, bioethicists compete on who is the better poet. This book review essay asks whether bioethicists are aware of their tools of persuasion or whether their techniques are simply part of the hidden practices of the field. By exposing the rhetoric of bioethics, Chambers's work makes clear why bioethics has become boring and is in need of some new tricks.

Xenotransplantation is increasingly touted as the solution to the organ crisis. Some bioethicists, however, have raised concerns about xenotransplantation's implications for health justice and animal welfare. We develop and sharpen these worries, and we explore how they might be mitigated. We compare xenotransplantation with several alternatives for addressing the organ crisis, including directing more money toward public health interventions, and argue that these alternatives are ethically preferable. In light of this, we argue that xenotransplantation is not a justifiable method of addressing the organ crisis. Societal funds and attention ought instead be directed toward more efficient and ethically superior solutions.

Aging societies frequently fail to imagine their own collective needs, including the care needs of people with dementia and who will be expected to meet these needs. This essay considers how to build a practice of moral imagination—a capacity to think about current and future challenges in ways that aim at better lives and greater justice—into rethinking familiar cultural narratives about dementia that fail to improve the lives of people with dementia or of dementia caregivers, who are usually family members. Focusing on real-world conditions in the United States and Canada, the essay outlines a public humanities project to improve public understanding and public deliberation about dementia care, through careful reflection on the stories that members of aging societies tell, share, and embed in civic dialogue.

Over the past decade, participatory arts programs for people with lived experience of dementia have expanded in scale, number, and approach, both in North America and the United Kingdom. This narrative analysis considers how participatory arts programs and practices generate implicit narratives about what it means to live with dementia and about the value and meaning of arts and creativity to human experience. Using as examples several large-scale, multiyear, community-engaged, co-creative projects, I argue that these projects and others like them (a) shift cultural imaginaries of dementia through implicit narratives that construct lived experience as a legitimate form of knowledge, (b) uphold creativity as a universal quality, and (c) reimagine health and well-being discourses to include understandings of well-being that include ill-being. The projects construct implicit narratives about what living with dementia means—shifting away from notions of dementia as pathology and loss toward understandings of dementia that include creative potential, citizenship, and new conceptualizations of well-being.

Much has been written about the biological, clinical, and epidemiological aspects of dementia. Dire, sometimes apocalyptic social and policy issues have been identified and discussed, and scores of books have been published explaining all of this to a popular audience and providing practical advice for patients and their families. But the vast professional and popular discourse on dementia has largely been ahistorical and uncritical. This essay argues that history can be the basis of a more critically informed discussion of dementia by showing that attitudes and ideas often taken to be natural and inevitable are, in fact, historically contingent, shaped by specific social and cultural circumstances. History can renew a sense of possibility by pointing out that things were not always as they are now, and that they might well be different in the future.

This essay considers policy narratives of aging and dementia, what they do, and where they lead. It is argued that a renewed policy narrative of dementia is long overdue, and the authors reflect upon the value of drawing on the established age-friendly cities and communities movement to help guide the crafting of this new narrative. The essay develops three points: first, that efforts to promote an age- and latterly dementia-friendly agenda have elided a series of tensions within each program; second, that these tensions often materialize and are perhaps best understood at the point where policy is implemented and “lived out”; and third, that such points of friction provide a useful focus for future dialogue between the hitherto largely parallel and disconnected trajectories of age- and dementia-friendly agendas. Fostering such a dialogue can strengthen an evolving policy critique and ultimately help refine policy-making.

This essay critically explores the intersection of brain health and dementia research within the context of Black men's lived experiences. It interrogates dominant narratives of brain health that prioritize individual responsibility while neglecting systemic and structural determinants of health. Drawing on a life-course perspective, the essay advocates for inclusive research practices that center Black men's voices, challenge deficit-based assumptions, and address systemic barriers to brain health. Finally, it outlines a roadmap for transformative research, advocacy, and care that advances brain health equity.

Within the dominant U.S. cultural imagination, dementia care is often constructed as a significant physical, mental, emotional, and financial burden, with a huge cost to individuals, families, and society. This cultural anxiety positions dementia as a signifier of dependence, helplessness, frailty, and loss. However, feminist disability studies offers a way to approach dementia and care as relational, collective, and political. Drawing on nine months of ethnographic research in the dementia unit of a nursing home, I illustrate how dementia care is a site of collectivity, resistance, and activism in a context of exploitation, control, and oppression. I uncover how institutionalized old women with dementia and immigrant and nonimmigrant women of color care workers navigate strict institutional routines, pressures of time management, and tightly controlled, predetermined care tasks and how they withstand these forces by making time for and giving time to one another, continuously (re)building relationships and investing in collective care that emphasizes interdependence.