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Meeting Minutes, May 5, 2012

March 9, 2013

The minutes from the previous meeting 1/21/12 were reviewed and accepted.

1/23-27/12 via e-mail exchanges, Meg and Matt conveyed to Sue and Jere that the terms Jere had culled from MeSH and Loc looked to him to be highly pertinent for the bibliographic record.

2/8/12 Jere announced he had received the notification letter awarding “Conscientious objection in the healing professions: a reader’s guide to the ethical and social issues” from the American Library Association’s Carnegie Whitney Grant. [Congratulations Jere!]

Pursuant to our conversation about Love’s Knowledge in our last meeting, Jere had sent Martha Nussbaum’s more recent essay: Nussbaum M (2004): DANGER TO HUMAN DIGNITY: THE REVIVAL OF DISGUST AND SHAME IN THE LAW in The Chronicle of Higher Education (as well as two critical responses) for interested parties; all three are relevant to shame, disgust, moral emotional responses in law and stigma.

In an e-mail 1/25/12, Jere had indicated that Professor Nussbaum keeps a pretty thorough list of her bibliography (with links) on her faculty page at Chicago: http://philosophy.uchicago.edu/faculty/nussbaum.html

Julia discussed her recent experiences at the Abbie Hunt Bryce (AHB) Home, which is located near 46th and Keystone and which is devoted to providing shelter and services to terminally ill homeless persons. Meg provided additional information about the origins of AHB, modeled after the Malachi House in Ohio and the role of the Visiting Nurse Association and Dr. Greg Grammelspacher in establishing AHB here in Indianapolis. Julia indicated that, while some staff were paid, volunteers were very important in the operation of AHB. There followed discussion about the prospects for conscience sensitive palliative care and how Julia, in particular, might find opportunities to adapt the skills she had acquired in years of working with conscience-in-adversity among residential youth to working with conscience at end-of- life among the terminally ill. Susan remarked on the prospect, wondering about conscience sensitive approaches to the triad of patient/client, family and palliative care staff.

As it happened, Meg had met the Tuesday preceding this meeting with members of the palliative care team, at their invitation, for an hour to discuss moral imagination. The discussion was organized around the task of conceptualizing and drawing conscience. There were two doctors, a nurse, a chaplain and the program director. Meg had wished for more time with them, especially in order to do moralized genograms.

On February 20, 2012, John joined Meg for the senior elective in ethics at the School of Medicine. John thought this year he would concentrate on the role of imagination combined with spiritual elements in human beings that allow grasps of ‘concepts beyond reason.’ John reported on the workshops conducted at Christian Theological Seminary (CTS) for pastoral counselors emphasizing spiritual and psychological wounding and their treatments. He recited a moving poem, about Post Traumatic Stress Disorder: PTSD—1ST PERSON.

freud

SIGMUND AND NEURON TÊTE-À-TÊTE. INDIANA UNIVERSITY CONSCIENCE PROJECT © 2012

Ahead of this meeting John had sent an article for distribution to Conscience Project participants: Bromberg, PM (2003): SOMETHING WICKED THIS WAY COMES: trauma, dissociation, and conflict: the space where psychoanalysis, cognitive science, and neuroscience overlap. Psychoanalytic Psychology 20 (3): 558–574. John highlighted the author’s discussion of a remarkable convergence of neuroscience, cognitive research and an interpersonal/relational psychoanalytic approach that works at the interface of dissociation and conflict. Related reading: Matt mentioned a seminal essay by Eric Kandel on the same subject that might also be of interest [Kandel E (1983): FROM METAPSYCHOLOGY TO MOLECULAR BIOLOGY: EXPLORATIONS INTO THE NATURE OF ANXIETY. American Journal of Psychiatry, 140: 1277-1293].

John returned to the subject of Deb’s painting, Polishing the Mirror and made an association to Ya Wahid, the uniqueness of God that is reflected in each and every aspect of manifestation. Everything’ s a mirror for God’s “face” meaning God’s Presence [Meyer W, Hyde B, Muqaddam, F and Kahn, S (2011): Physicians of the Heart A Sufi View of the 99 Names of Allah, Sufi Ruhaniat International, p. 63].

Susan professed to be more and more cynical about the elective process, and had been looking to history for corrective experiences. She said she favored historical accounts of revolutionary times. She had been reading Robert Graves [Graves R (1982): Count Belasarius, Farrar Straus Giroux]. Susan considered Belasarius (6th century Byzantium) who lived in the time of Emperor Justinian and Empress Theodora to be a moral historical personage. Also in that category she placed Simon de Montfort (13th century England).

In counterpoint to the notion the course of history might be essentially shaped by extraordinary individuals, moral exemplars or otherwise, Meg was put in mind of Erin Greer’s discussion of Tolstoy’s idea set forth in War and Peace that historical movements could not be accounted for by appeal to great personages Greer E (2012): Tolstoy and Tahrir, The Normal School, a literary magazine, 5(1): 22-28.

Ethna and Susan continued the conversation about how much can be changed by persons in history. Susan remarked about technology forcing certain changes (she returned to this subject later). John was put in mind of the recently deceased Algerian President Ahmed Ben Bella whom John had once met and who John remembered had spoken of “my wobble in the world.” Ben Bella had fought in WWII on the side of the French, then against the French for Algerian independence. For background see: http://www.nytimes.com/2012/04/12/world/africa/ahmed-ben-bella-algerias-first-president-dies-at-93.html?pagewanted=all

There followed discussion of the expropriation of Christianity for political purposes. Susan elaborated on distorted perspectives in our times, referring specifically to the Texan influence upon inclusion of the creationist viewpoint in textbooks on science likely to become more widely spread. John was put in mind of the Scopes Monkey trail as depicted in Inherit the Wind. Meg mentioned Rabbi Sandy Sasso’s letter to the editor on fundamentalism and interfaith panels.

On the subject of interfaith Matt mentioned he’d completed an invited book review: Nurturing Child and Adolescent Spirituality: Perspectives from the World’s Religious Traditions. Karen Marie Yust, Aostre N. Johnson, Sandy Eisenberg Sasso and Eugene C. Roehlkepartain, editors. Lanham, MD: Rowan and Littlefield Publishers, Inc., 2006, 503 pp. (hardcover). The review was expected to appear in the August issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

There followed conversation about the ‘wobble in the world’ created by the ordination of women according to the Roman Rite of the Catholic Church, albeit without the blessing of Rome.

Returning to the subject of technology, Susan commented on the ready juxtaposition in media of what had previously been stated or professed by someone versus what someone professed most recently.

Meg further highlighted some of the contributions to the Symposium on Empathy in Bloomington, In. on 11/11/11. Meg also discussed this year’s Senior Elective experience. While all the learners engaged in the conscience sensitive tasks, three of ten also submitted projects directly related to conscience. Projects included paintings, poetry, letters, essays and a power point.

consciencedrawing

Moral decision making, medicine, and conscience at work.

The picture (above) was submitted by Ian H, MS4 (reproduced with permission, minor editorial changes in brackets):

For my final project I chose to do a representation of the differences in moral values people have when approaching a difficult medical situation like a comatose loved one. My picture portrays a physician sitting and discussing one such situation with a woman. The colored tendrils coming out of each person’s head represents their hopes, goals, thoughts, and ethics. The physician is driven by his Hippocratic oath and his love of his patient/concern for their health. The wife is driven by her religious views, financial concerns, family, the commitment of marriage, and hope (designated by the chalice which is actually a Unitarian Universalist symbol, but used differently here). While the tendrils are differently colored (signifying that perhaps one draws on a utilitarian argument and another is more [principlist]) both are centered around the patient. They also get very close to each other but never touch. The patient himself is surrounded on one half by my attempt at recreating a CT or MRI machine which represents purely the medicine being used in his diagnosis, treatment, and life sustainment. On the other side this machine morphs into a spiky, red and black half circle showing how these helpful machines may be seen as fearsome and alien to our patients’ loved ones who may not always understand them. Originally I just made up this red and black image, but in a later pathology lecture I learned that it looks uncannily close to a Laurell Rocket electroimmunodiffusion. In any case – that electroimmunodiffusion was something wholly unknown to me, so perhaps it works just as well. Ultimately there are multiple approaches to any ethical dilemma and even though they may be rooted in different ideals and have no obvious intersections, it is the work of the physician (and truly everyone) to try and reconcile them.

Meg recommended reading a book by William May [May W: (2011): Testing the National Covenant, Georgetown University Press]. She liked the concepts of covenant and commonwealth put forth and the concern for undocumented immigrants. A long time admirer of May, Meg had coincidentally encountered William May’s daughter in Batesville, Indiana where Meg was giving an invited talk.

Respectfully submitted,
7-02-12
Edited for Conscience Chronicles, 8-13-12
Matthew R. Galvin

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