Question: Did your understanding of kinship change when you read these articles? If so, how?
The meaning of cosmology sets the framework for the rest of this discussion: Merriam-Webster Dictionary defines it as “a branch of metaphysics” or a theory “describing the natural order of the universe.” Studies of various cultures aid in explaining medical ethics. Advances in medicine have changed the circumstances we consider normal and complicated the factors that motivate our perceptions. Hence, the study of cosmology generates discussion about the bioethical problems we create.
Cosmology also elucidates how deeply ingrained our notions of kinship terms have become. Kinship has been extended to cultural, religious, and political spheres. We have adapted our lexical use of kin terms to reflect novel social situations.
“Thick Description: Toward an Interpretive Theory of Culture”
Clifford Geertz explains that anthropology and ethnography are fields of study that use copious amounts of evidence to postulate about human behavior (9). His presentation alone comments on anthropology. He uses blinking as a representation for this type of evidence. After the example was sufficiently explained, only then did the author offer analysis and provide his assertions on the topic.
“Cultural analysis is (or should be) guessing at the meanings, assessing the guesses, and drawing explanatory conclusions from the better guesses, not discovering the Continent of Meaning and mapping out its bodiless landscape” (12).
Geertz acknowledges the limitations of observation as a method. Examples are, instead, valued because they uncover patterns in behavior. This allows us to talk about social constructs that humans have engineered in the first place (12). Experts simply observe and then attempt to make conjectures on the behavior’s significance. This analysis of anthropology helps explain the type of evidence that the authors of the following papers employ.
“Does Submission to God’s Will Preclude Biotechnological Intervention?”
Questions: Who should have the responsibility to choose risky but potentially life saving procedures? Various cultures present different reasons for their ethical considerations; What factors influence your morals on these issues?
Sherine Hamdy asserts the following: “ I argue against the dominant narrative: that religious fatalism obstructs people from pursuing biotechnological intervention” (144). Merely considering the science, without cultural implications, does not allow us to discuss the ethical problems that have arised. She chooses to show this phenomenon through debates about organ transplants in Egyptian Muslim communities (143).
Muhammad and Ali’s stories were told in order to question their behavioral motives. Through anecdotes, she implies that it is easy to lose sight of your “sense of self” through illness. Instead, we resort to moral and often religious beliefs to cope with disease (145, 149). They both acted not according to a “fatalistic” approach (144) but, rather aligned their actions with their strong sense of right and wrong.
Ali found it easier to accept an organ if the donor was anonymous. “His refusal, […] was in particular [due to the] social situations in which he had to overcome [like finding his own donor] in order to proceed with the transplant” (151). Once sure the technology would cause no harm against others, Ali agreed to getting the transplant. Patients weigh the medical benefits against “sociomedical calculations of risk, costs and benefits” (147).
Naturalizing Power: “Father State, Motherland and the birth of Modern Turkey”
Questions: Does the concept of “mother” restrict women’s independence? Have we ingrained typical gender stereotypes through the way we talk about kinship terms?
Carol Delaney asserts that through kinship language, we propagate basic notions of man as procreator and woman as nurturer. The terms “mother” and “father” were established through traditional gender stereotypes but now extend to many human ideologies.
The Turkish society exemplifies how “language, culture and ideas” transformed our speaking about our relationships (188). Citizens originally promoted a “fatherland” theory. A construct that explained the pride and the conquering nature of distinguishing themselves as a country (180). The roles switched when they were under attack. By resorting to calling their nation a “motherhood, ” the Turks were internalizing the value of protection and defense (184).
Hence, Delaney claims that humans constructed these kinship terms early on, but the meaning of kin has drastically changed. For instance, the Turks internalized “nationality” as a feeling, whereas, “citizenship is much more restrictive [and clear-cut] as a child with a Turkish father is a citizen” (188). Hence, the “blurred boundaries between the seemingly distinct social domains of family, nation and religious communities,” (178) shows how connected our ideas of family are in other aspects of life.
Muslim Medical Ethics: Decision-Making Processes among Contemporary ‘Ulama’
Questions: What is your interpretation of the following decisions on medical procedures? How do the regulations created define a larger sense of what is ethical?
Eich explores the implications of in vitro fertilization (IVF) and the creation of unnatural embryos. He asserts that “terminological inconsistencies, legal developments […] and manipulation of discussion” have shaped the following three bioethical conversations about reproductive technology (62).
The 1987 meeting of the Islamic Org. of Medical Sciences brought together scholars, lawyers and doctors to discuss Sharia law. After debates about linguistic terminology and questions of morality, the conclusion was that the beginning of life was not so clear. Science was “Islamized” because it, often, was not the best explanation for these complex moral issues (66). Being “human,” meant the “being” looked like a human and began “ensoulment” (67).
The meeting of 1989 addressed the extra embryos created by reproductive technologies and concluded they could be used for research because the embryo is not yet “human.” They interpreted abortion in a similar way. The Organization of Islamic Conferences (OIC) in 1990 was much more restrictive (72). Only the exact number of embryos should be created and any extra should be let die “naturally” (70). The “manipulation of discussion” (72) at this meeting resulted in a less democratic process and stringent religious guidelines.
Questions About the Writing Styles of These Readings: Each author had slightly different ways to presented an argument and incorporate evidence. Which paper(s) presented evidence that you found most effective and why?
Unit 2:
Alex,
I think you did a really great job summarizing each article. One area in particular that I found especially insightful was where you connected Clifford Geertz’s work to the other two articles. While reading the material, I definitely missed a big part of that connection, and I think you really helped elucidate how these articles are related. I do think the blog post could benefit from just a little bit more detail about the ethical implications considered in Sherine Hamdy’s article.
Overall, I thought this blog post was very insightful.
Unit 2:
Alex, your descriptions were very well organized and seemed to be backed up by evidence from the texts. To answer your question regarding who should be responsible for having an patient undergo a risky, yet life-saving procedure, I feel the doctor is in charge. I take this stance for two reasons. One (from an experience standpoint), doctors have gone through numerous years of medical training and know which procedures need to be undergone. Second (moral reasons), I agree with Dr. Yusuf and other doctors who mention that God wants us to protect our bodies from deterioration, even if that means receiving a transplant. I think the following quote corroborates the preceding statement, “He encouraged Ali, telling him that God had given people their bodies as a trust (amana) and that he was therefore responsible to take care of it”. I feel that individuals in situations similar to Ali’s should do what he did and receive advice from other doctors regarding their religious views on medical procedures and see if any different interpretations exist; in the long-run, the advice received may prove life-saving.
So, do you think that your beliefs about Gods will to extend life should trump those of a patient who might not see it that way?
Alex,
I thought that your post brought out a lot of interesting points that were brought to my attention while reading the article. If I could offer a suggestion it would be to expand your interpretation of the Hamdy article and perhaps include a brief summary of the conclusion.
For your question about who should be able to choose risky but life threatening procedures, I think that the notion of free will is important. Of course in an emergency situation the patient will not be able to provide consent and the doctors will do all they can to help the patient, but I think that human decision making takes many factors into account, something that is really clearly seen in Ali in the Hamdy article.
Good ideas.
Alex,
I am wondering about your interpretation of the anecdotal evidence Hamdy provides in her article. You said that she uses Mohammed and Ali’s stories to question their motives in the handling of their kidney diseases. I disagree; I think the goal of providing these narratives is to show the complexity of making a decision regarding medical treatment when it is intertwined with social and religious influence. For example, she follows Ali’s story through waves of different decisions; from being steadfastly against transplants to deciding they are acceptable to again being resistant to it. I don’t think it is their motives that are being questioned. I think the motive–to remain in God’s good graces, to keep his loved ones out of harm, to maintain a certain quality of life–is likely the same across cases like these. What changes is circumstance; certain events allowing for a loosening of steadfast religious belief to accommodate a new medical or social situation.
As for your question about who should be responsible for choosing risky procedures, I think Hamdy is ultimately arguing that this is up to the patient. The goal of the article seems to be to demonstrate to an audience of physicians–particularly nonreligious ones–that a patients decision whether or not to undergo a certain treatment is chock-full of complexity. It’s not a question of a religious patient being less knowledgable or being “fatalistic,” which is a conclusion doctors (western Doctors in particular) tend to jump to when they encounter these cases. I think it is the responsibility of the physician to communicate all medical risks of a procedure, but a good physician should be understanding that religious and moral belief have a large influence on medically-related decisions. These should be considered by a doctor on a case by case basis.
This is a model of a carefully crafted and well written response.
Unit 2:
Alex,
I really enjoyed reading your perspective on these issues, and thought you did a nice job connecting the themes we have discussed thus far in class on kinship. To elaborate on your question, “who should have the responsibility to choose risky but potentially life saving procedures?”–I recently read one of Atul Gawande’s books called “Being Mortal: Medicine and What Matters In the End.” He cites several situations in which he saw the most important question doctors need to ask their patients before a risky procedure is: “What is your view of ‘the good life?” An inherently religious question that most patients are startlingly unprepared to answer. A recurring problem with modern medicine is doctors immediately presume patients want the “best medical treatment and the preservation of…creation,” as Hamdy explains (147); however, Gawande goes a bit deeper in his explanation of the decision making process in the patient:
“At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality–the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage–the courage to act on the truth we find. The problem is that the wise course is so frequently unclear. For a long while, I thought this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.”
Here we see that morality is not simply a question of right or wrong, but as Geertz quotes Goodenough: “culture is located in the minds and hearts of man,” (11) which is why in comparing ethical decisions cross-culturally, religious views of the patient and the context of their hopes and fears at a particular moment in time will ultimately determine how they interpret the truth they find.
Excellent
I really liked how you organized this blog post by posing questions and brief comments on each of the readings! Your question on the Hamdy ‘s article about who should have the responsibility intrigued me the most. I agree with your statement that Muhammad and Ali’s stories were told to question their behavioral motives, but I think it goes deeper than losing sight of your “sense of self.” I actually interpreted the ethnography to mean that the two patients found a greater sense of self in the end due to the illness.
Since they were such complex decisions, I thought Muhammad and Ali’s illnesses made them realize much more about their beliefs, morals, and what their life is worth living for. I think this was especially exemplified tnrough Madam Sabah’s words toward Ali. Though she claimed that they are both doing it for their families, Ali admitted, “Madame Sabah was just saying those things to make us both feel better.” Thus, the question of responsibility will forever continue to be a complex answer between patient, physician, and close family relations. Physicians use the term fatalism for patients as a blanket statement to explain the complexities of the situation at hand and patients eternally struggle with what is the best thing to do for themselves in the realm of Egyptian society. Furthermore, I think the question of who should be considered living (i.e. when brain-dead) is an extremely interesting question raised in this reading.
Hey Alex and Giang, I enjoyed reading your blog posts. In response to your question about who should make the life or death medical decision, I believe that you can only go as high as you training. Being first aid certified, I am able to decide if someone needs potentially life saving aid such as CPR or defibrillation, but that does not mean that I can get a scalpel and cut someone’s chest open. The decision of who decides if a lifesaving procedure is worth it should go to someone that has sufficient training in that field. I would have to say that the biggest moral factor in medicine, for me, is the respect for life. I think any and all medical advancements should be used to prevent death as long as no other lives are harmed. I also see where Delaney comes from with regards to the term “mother” restricting independence, but then again being a mother is said to be one of the best things someone can be. Generally, mother is used as an endearing term. We even call the world, from which all resources come from, Mother Earth.
Here are also some of my thoughts that crossed my mind while reading:
I thought that the subtle connections between Geertz and Hamdy’s essays were very interesting. Geertz mentions that new things initially are seen as amazing, but as time goes on, that feeling dies down, and she also mentioned with her winking example, how all things are circumstantial. Hamdy makes these same observations as initially dialysis is fairly frightening and seen as risky, but going three times per week quickly dulls that feeling, compared to an organ transplant which is more new and less common, and is still viewed as frightening. Just as our view of the wink changes based on information provided, so did Ali’s attitude towards organ transplant change based on the availability of an organ.
Interesting that you think experts should make the life and death decisions. Does this extend only to medical experts or to religious or philosophical experts as well? And what about the individuals whose lives are on the line? Demarcating the proper role for expert decision making is an important theme in this course.
Thanks for this thoughtful blog. You may want torelate the readings to one another more next time rather than treat them one at a time.