Forum Posts by
Nancy Berlinger

Posted on August 24, 2018

A long-anticipated policy change proposed by the Trump administration that would count the use of many federally-subsidized programs against immigrants currently eligible to use them threatens public health and would undermine ethical practice in health professions and systems. The policy would expand the definition of a public charge, someone likely to become dependent on government… Read more

Posted on July 5, 2018

Amid the volume of coverage and commentary on the politics of immigration and the consequences of crackdowns and criminalization, here is a selection of recent work – analysis, personal essay, fiction, mixed-media – that can spark the moral imagination.

Posted on June 20, 2018

The Russian poet Anna Akhmatova was a mother separated from her child by a state policy of terror. During the 1930s, she and other mothers would gather outside a Leningrad prison, desperate for information. One day, after 17 months of “waiting in prison queues,” another woman whispered to her, “‘Could one ever describe this?’ And… Read more

Posted on June 12, 2018

In April, the U.S. Justice Department announced that it would criminally prosecute migrants who had been apprehended after crossing the U.S.-Mexico. border. An immediate consequence of this announcement, explained in detail here, is the separation of children from their parents. Rather than being allowed to stay with their children in an immigrant detention center while… Read more

Posted on March 30, 2018

The language of shame has been prominent in the aftermath of the mass shooting at a high school in Parkland, Florida. In a March 23 essay in The New Yorker, filmmaker A.J. Schnack, who in 2015 began a video project, “Speaking Is Difficult,” to document initial reports of mass shootings, wrote about Americans’ habits of… Read more

Posted on February 27, 2017

On February 21, the Department of Homeland Security released new policies prioritizing deportation of undocumented immigrants. Will this policy shift affect health care access for this population of 11 million? Two public health studies from Arizona suggest that immigration crackdowns change health-seeking behavior. During and following the 2010 enactment of Arizona SB 1070, a highly controversial… Read more

Posted on December 19, 2016

Health care access is local; creating, financing, expanding, or restricting health care access for a low-income population involves local, state, and federal policies. During the Obama administration, health insurance for the estimated 11 million undocumented immigrants in the United States remained severely restricted by this population’s broad exclusion from federally financed public benefits such as Medicare,… Read more

Posted on March 22, 2016

For previous posts on the Singapore Casebook project, a collaboration among the Centre for Biomedical Ethics at the National University of Singapore, The Hastings Center, and the Ethox Centre at the University of Oxford, see here and here .The first edition of this public, web-based casebook, “Making Difficult Decisions with Patients and Families,” was published… Read more

Posted on February 17, 2016

The public health catastrophe known as the Flint water crisis is also a textbook case about the consequences of immigration policy, including the federal stalemate concerning reform and state-level policymaking, on the health of undocumented immigrants living in this low-income city. This population is vulnerable under normal circumstances, as well as during public emergencies. They… Read more

Posted on February 5, 2016

As the Washington Post reported, a recent CNN Democratic Town Hall in New Hampshire featured Hillary Clinton’s response to a question about physician-assisted dying from Jim Kinhan, an 81 year old man who described himself as a Clinton supporter and as a person who is “walking with colon cancer with the word terminal very much… Read more

Posted on January 19, 2016

The Supreme Court announced that it will hear a legal challenge to President Obama’s 2014 executive action to protect an estimated five million undocumented immigrants from deportation and permit them to work legally. The implementation of the Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) program and an expansion of the Deferred Action for… Read more

Posted on October 29, 2015

On October 28, North Carolina Governor Pat McCrory signed HB 318, the “Protect North Carolina Workers Act.” This new example of state-level anti-immigrant legislation, a trend that had been curtailed by the U.S. Supreme Court’s 2012 decision in Arizona v. United States, is aimed at restricting local efforts to protect undocumented and new immigrants and… Read more

Posted on October 23, 2015

A previous post described the Singapore Casebook project, a collaboration among the Centre for Biomedical Ethics at the National University of Singapore, The Hastings Center, and the Ethox Centre at the University of Oxford. The first edition of this online casebook, Making Difficult Decisions with Patients and Families, is widely used in undergraduate and professional health… Read more

Posted on June 24, 2013

AIDS in New York: The First Five Years is an exhibit running this summer at The New-York Historical Society, an organization so venerable that its name reflects how the city’s name was originally spelled.  The exhibit works on several levels: historically, as a story about how one city and region awoke to the emerging epidemic; politically,… Read more

Posted on July 28, 2011

On the first day of seventh grade, my math teacher, Mr. McDermott, proposed a wager to my class. We could read a novel called Flatland and write a book report. If we did so before the end of the year, we would get an A, no matter how well or poorly we did on homework… Read more

Posted on March 17, 2011

Runners visiting Tokyo know that the place to go is the Imperial Palace. The sidewalk loop around the palace grounds, in the heart of the city, gets you a 5K without any cross streets, and with the green rise of the grounds on one side balancing the traffic on the other side. I assumed my… Read more

Posted on February 7, 2011

To get an idea of just how challenging physician-patient communications can be in practice, read Amy Berman’s remarkable blog posting about her recent diagnosis with Stage IV inflammatory breast cancer, a rare and aggressive form of cancer that involves the skin and lymphatic system of the breast. Berman, whom I know through our mutual work… Read more

Posted on June 10, 2010

Here are some of the things we know, and keep forgetting, about complex systems: Complex systems are continuously changing. The individuals who are part of these systems are continuously adapting to changing conditions. Their adaptations further change but do not “fix” the system. Complex systems are not intrinsically safe or unsafe. Studies of workers in… Read more

Posted on December 21, 2009

The quality of Mercy Hospital is not strained, say hospital trustees. According to a recent survey published online in Health Affairs only 44 percent of hospital board chairs “chose clinical quality as one of the top two priorities” for assessing how well their CEO was doing, and trustees at low-performing hospitals were far less likely… Read more

Posted on November 17, 2009

“Turfing” is a practice that passes for problem solving.  To turf your problem is to reclassify it as someone else’s problem, and then to get it off your turf and onto their turf. As an organizational practice, turfing is a cousin of the workaround, in which workers encountering a system bottleneck or flaw – a… Read more

Posted on September 2, 2009

Denise Mina is ABD – all but the dissertation. Her acclaimed psychological thrillers grew out of her sidelined dissertation on the ascription of mental illness to women in the criminal justice system: according to her Web site, she misspent her grant money and wrote a novel instead. This novel, Garnethill (1998), grew into a trilogy… Read more

Posted on June 8, 2009

I recently spent several invigorating days at Lund University in Sweden as a guest lecturer at a “learning laboratory” for professionals who share an interest in the role of human factors in how complex systems make and respond to errors. When I give talks, the audience usually includes physicians, nurses, and other clinicians – but… Read more

Posted on May 7, 2009

In my senior year of college, I took a course on seventeenth century poetry. The professor had a thing about Stanley Fish. As in, we weren’t supposed to read Stanley Fish, or mention Stanley Fish. This is challenging when the subject is seventeenth century poetry, as Stanley Fish literally wrote the book on John Milton.… Read more

Posted on January 9, 2009

Pediatric palliative care is a tough subject. We like the idea of making sure that someone is paying attention to the suffering of very sick kids. We hate the idea that anyone has to do this, that any child would endure life-threatening disease or chronic, progressive conditions so early in life. While such illnesses are… Read more

Posted on October 21, 2008

I spent Election Day in South Texas, where the lively local campaign headquarters proclaimed itself “AlamObama.”  I had some time that afternoon to walk around downtown San Antonio. This was the end of El Dia de los Muertos, the Day of the Dead festival, and houses and shops were still decorated with colorful papel pecado,… Read more

Posted on August 29, 2008

Just in time for the last weekend of summer, Lori Andrews has reaffirmed her status as the nation’s foremost bioethicist/crime novelist. Immunity, Andrews’s third bioethics-themed thriller in three years, is her best yet. This time, geneticist-physician Alex Blake – civilian scientist at the Armed Forces Institute of Pathology, member of a top-secret Homeland Security commission… Read more

Posted on August 26, 2008

August is supposed to be the silly season in Washington, but on August 21 things got very serious for providers of reproductive health care services, when the Bush Administration announced that it was going ahead with a controversial “Provider Conscience Regulation” proposed, then rescinded, then revised, by the Department of Health and Human Services. The… Read more

Posted on August 12, 2008

American physicians’ growing alarm over parents who opt out of childhood vaccinations mirrors concerns in the UK. In a roundup of news from London, New York Times correspondent Henry Norman notes that a best-selling English novelist has a new title coming out based on the roiling debate there over the safety of vaccines. According to… Read more

Posted on March 19, 2008

I know what it means to miss New Orleans. I recently visited this utterly fascinating place for the first time when I gave a talk at a symposium on access and equity in health care organized by Louisiana State University. For two days, I got to eavesdrop on and participate in the local conversation on… Read more

Posted on January 25, 2008

The television writers’ strike threatens to interrupt the introduction of an intriguing new character on the long-running television drama ER: a chaplain. So far, Julie Dupree – young, attractive, tattooed, casually chic amid the ubiquitous scrubs, “pretty hot for a chaplain,” according to one doc – has been seen praying with a young pregnant woman… Read more

Posted on December 21, 2007

How much do American medical students know about military medical ethics? Not much, according to a survey conducted by a Harvard research team and published this fall in theInternational Journal of Health Services. More than one-third of students did not know that the Geneva Conventions required military health care providers to treat the sickest patients… Read more

Posted on August 31, 2007

A front-page story in The New York Times on August 31, on the American Cancer Society’s decision to dedicate its $15 million annual advertising budget to “the consequences of inadequate health coverage” for the fight against cancer, sent me straight to my in-box. On August 30, The Commonwealth Fund released a summary of a grant-funded… Read more

Posted on August 14, 2007

Lori Andrews, the hardest working scholar in bioethics, has, for the second year in a row, published a bioethics-themed thriller. Which means it’s time for “Beach Blanket Bioethics,”Bioethics Forum’s annual summer round-up of vacation reading that counts as work. In The Silent Assassin (St. Martin’s/Minotaur, 2007), Andrews’s sleuth, geneticist Alexandra (Alex) Blake, a civilian employee… Read more

Posted on March 29, 2007

From the March-April issue of the Hastings Center Report. The New England Journal of Medicine recently published a study that included data on physicians’ personal beliefs about three controversial medical practices: “terminal sedation” (palliative sedation of a dying patient), abortion after failed contraception, and prescribing birth control to an adolescent without parental permission. Of the… Read more

Posted on December 18, 2006

If you follow breast cancer as a nonclinician, you quickly learn that the San Antonio Breast Cancer Symposium is the meeting to watch: advocacy groups send correspondents, file reports, and hold post-meeting web conferences to discuss the latest research findings and clinical advances. But the big news out of this year’s meeting, which opened December… Read more

Posted on December 8, 2006

I gave a talk at a hospital in New Hampshire in mid-November. Residents of The Granite State are aware that getting in and out of northern New England can be a challenge, at the very least, especially when the weather turns cold. And so they graciously volunteer to drop off visitors at the airport, which turns out to be 75 miles… Read more

Posted on October 27, 2006

My husband is from St. Louis, where baseball is the local religion. During the World Series this week, he has been fulfilling the tenets of his faith: meticulously keeping score, muttering about “double-switches” and other National League mysteries, lamenting the sad decline in erudition and manners among baseball fans who did not have the great… Read more

Posted on May 19, 2006

Now that an FDA advisory committee has unanimously endorsed Merck’s Gardasil vaccine, which protects against four sexually transmitted viruses, including the type of HPV believed to cause 70 percent of cervical cancers: 1) If the Advisory Committee on Immunization Practices recommends next month that Gardasil be considered a “routine” vaccine for girls and young women… Read more

Posted on April 10, 2006

The first sentence of Albert Camus’s The Plague reads: “The unusual events described in this chronicle occurred in 194- at Oran.” The first sentence of Vincent McHugh’s I Am Thinking of My Darling (1943) could be identical, except for the location. McHugh’s novel is set in New York City, during the week after a virus,… Read more