Curious Bioethics: Sept 11-17, 2023
🫄🏻Safe Ob/Gyn visits; UK surgeons & sexual harassment; Ashton & Mila's predator support letters; Child Poverty, Preventing physician deaths
Note: This issue addresses suicide and sexual assault (SA). Taking care of yourself may mean skipping this week’s content, and that’s ok.
In today’s curated collection, you’ll find:
🗞️Bioethics News: Female Surgeons’ Sexual Harassment; Child Poverty; How Liability Laws Impact Healthcare Access; What to Expect in Ob/Gyn Visits
📚Recommended Reading: A Good Man Is Hard To Find (on Danny Masterson and Ashton Kutcher)
🦉Educational Opportunities: Preventing Physician Death
Happy Sunday, My Curious Readers!
Shana Tovah!
I didn’t know that much about Judaism or Jewish culture growing up, but when I transferred to the University of Judaism in 2001 to study bioethics, that changed.
On a Tuesday shortly after my first semester started, the dorm room landline room rang loudly just after 6 am. My roommate groggily picked up the landline to hear her mom’s pressured speech, telling us two airplanes had flown into the World Trade Towers.
As New Yorkers were still digging through the towers' wreckage, hoping to find survivors, I celebrated my very first Rosh Hashanah. I listened to the shofar horn’s call. I ate fresh challah off thin paper plates, dipped apples in honey, and stained my fingers with pomegranate seeds. My friends laughed as I mimicked them, stuttering out “Leshanah tovah tikatevee vetichatemee” (“May you be inscribed and sealed for a good year”).
I learned about the Jewish New Year in my new school, with my new friends, and a new America where airplanes flew into buildings and killed thousands of people. It felt like a beginning we desperately needed while the national trauma unfolded. So for me, 9/11 is always connected to Rosh Hashanah.
I hope folks celebrating this year can hear the shofar, enjoy challah, apples, honey, and pomegranates, and be inscribed and sealed for a good year.
While I thought I had recovered when I wrote to you last week, the newsletter had only been out for a few hours when I developed symptoms of rebound Covid. I had been warned of covid rebound as a risk of Paxlovid, but it turns out it’s far more common with untreated covid (26% of untreated patients in one study). So I had to call out of work for another week. More fevers, more coughing. I’m getting better, but slowly.
The advice I keep getting - urgently and loudly - from everyone who knows me is to rest and take it easy. These folks know me and know I’m conditioned to go, go, go. But I’ve been trying to rest and relax.
I’ve streamed, I’ve read, I’ve napped…. I’m trying to rest like it’s my job.
🗞️ Bioethics in the News
Female surgeons sexually assaulted while operating
Female surgeons say they are being sexually harassed, assaulted and in some cases raped by colleagues, a major analysis of NHS staff has found.
The Working Party on Sexual Misconduct in Surgery (WPSMS) survey of 1,400 surgeons shows how sexual harassment and assault occur in operating rooms in the UK.
Two-thirds of women surgeons in the UK have been sexually harassed, and one-third report sexual assault by “colleagues.” 90% of women, and 81% of men, had witnessed some form of sexual misconduct.
With colleagues like this, who needs enemies??
If this news wasn’t bad enough, a recently retired UK anesthesiologist blamed women. Dr. Peter Hilton’s assertion that bullying happens and women surgeons simply need to “toughen up.” But women surgeons are already tough. Their toughness is not the source of the problem.
So long as we blame victims for the behavior of perpetrators, we will never fix toxic cultures.
Missouri Trans Clinic Closure Is A Page Out Of The Anti-Abortion Playbook
Liability laws significantly impact how medical care is provided. Anti-abortion laws are being repurposed to make providing gender-affirming care cost-prohibitive.
“These liability provisions make providing care prohibitively difficult. Firstly, their duration is much longer the typical liability timeframe associated with other medications and procedures. To put it in perspective, Missouri's medical malpractice lawsuits for all other medical procedures have a window of just 2 years. What amplifies the predicament is that there's no need to prove neglect—diverging sharply from standard malpractice suits where establishing neglect is pivotal. These specific provisions targeting gender-affirming and abortion care essentially render the practice financially untenable. Yet, the most most damaging aspect of these provisions is in the difficulty in fighting them in court.”
Child Poverty is a Choice
The long-term consequences of child poverty are severe. Not only does this directly harm children’s access to nutrition and education, it also adds immense stress to their parents, which makes parenting so much harder.
In 2022, the child poverty rate spiked to 12.4%, a dramatic increase of 7.2 percentage points from the previous year, according to data released Tuesday by the U.S. Census Bureau. The increase in child poverty resulted in 5.28 million additional children living in poverty…
The massive increase in child poverty last year was a completely predictable and avoidable tragedy. Powerful people inside and outside the federal government chose to let this happen because they had other priorities.
Despite the incredible success of the expanded Child Tax Credit in reducing child poverty in 2021, the government couldn't seem to prioritize kids in 2023.
Read
’s analysis of where the government spent our money instead.Concerned About Your OB-GYN Visit? A Guide to What Should Happen — and What Shouldn’t.
Women reporting sexual assault by their gynecologists told ProPublica reporters they didn’t know what to a typical exam should be like. So the newspaper put together a great set of resources.
If you are uncomfortable, in pain or confused about what is happening, consider saying:
“Can you please stop?”
“Let’s talk about this.”
“Can you explain why we’re doing this?”
📚 Recommended Reading
A Good Man is Hard to Find
Last week, The 70’s Show actor Danny Masterson was sentenced to 30 years in prison for 2 counts of felony rape. Ahead of his sentencing, numerous people submitted character letters to the judge.
Glowing letters were submitted by Masterson’s ex-co-starts Ashton Kutcher and Mila Kunis. The swift public backlash led Kutcher and Kunis to release a low-insight, non-apology video on their socials. Kutcher quickly resigned from the anti-child sexual abuse organization, THORN.
The character letters from Masterson’s former co-stars immediately reminded me of how harmful it was when numerous Harvard faculty members wrote letters supporting notorious abuser John Comaroff:
at Men Yell at Me captured the damage caused by people like Kutcher - who are not good guys, but not necessarily monsters - perfectly in her essay “A Good Man is Hard to Find.”The swiftness with which Comaroff's colleagues initially banded together to defend him might also send a disturbing signal to other powerful people: that if they commit sexual abuse, they can expect their friends and colleagues to jump to their defense. The development is especially distressing because it seems to walk back some of the progress made in the #MeToo movement. That movement showed that even ultra-powerful men like Harvey Weinstein and Matt Lauer (who worked as an NBC News anchor from 1997 to 2017) could be held accountable for sexual misconduct. But it's a lot harder for that to happen when other influential people try to protect those who are accused of sexual abuse.
For Kutcher, who faces the bulk of the backlash for his support of Masterson, it’s not about what he’s done, exactly. It's about the type of guy he represents. He is not the toxic bro, but he’s friends with him. He supports him. He calls out the nameless, faceless bad guys, but not the ones he’s friends with. Phantoms are easier to fight than buddies, after all. He’s the type of guy who benefits from patriarchy while still being the good guy because he’s not as bad as the rest of them. It’s building a life to look good, without actually doing the radical work of being good. He’s #NotAllMen, the ones who don’t actively do harm, but maybe don’t actively do good, either.
🦉Educational Opportunities
Today is National Physician Suicide Awareness Day.
If you or a colleague are suicidal and need emergency help, call 911 immediately or the National Suicide Prevention Lifeline at 988, or contact the Crisis Text Line by texting HOME to 741741.
In residency, my program director would say, “If you don’t answer your pager, I immediately think you are dead in a call room.”
Physicians have one of the highest suicide rates of any profession.
Like half of all physicians, I’ve lost colleagues to suicide. We often assume our competent peers have it all together, but some of us are simply better at covering up our worries and needs. When anesthesiologists die from drug overdoses, it can be unclear whether their deaths were accidental or intentional.
NPSA offers guides for individuals and organizations to help prevent physician deaths.
The video below is very pre-pandemic, but it captures the profound mental health impacts of our work, and the barriers that keep physicians from seeking support.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa
“I’m trying to rest like it’s my job” - this must be hard for you knowing your personality. Sending strength and hugs🤗