Rowman & Littlefield Publishing Group

Creating a Positive View

By Ellen D.B. Riggle, PhD

As an academic researcher, I have typically taught and written  about things that would depress and scare ordinary people (actually, these things depress and scare me too):  depression and anxiety, psychological abuse, drug and alcohol abuse, violent attacks, discrimination and everyday prejudice.  I discuss these topics in the context of the stresses that people who identify as lesbian, gay, bisexual or transgender (LGBT) face and have to cope with.  It seems that in my academic training, I was taught to focus on negative issues.  Implicitly I was taught that if nothing is “wrong” then everything must be okay, and we don’t need to talk about that.

Focusing on “what’s wrong” is important.  For example, the current focus on the violence and psychological abuse associated with bullying is essential to providing all children and adults with a safe environment for living their lives.  We are all responsible for solving this problem so we all need to be talking about it.  But in focusing on what’s wrong, sometimes we forget to also focus on “what’s right.” 

 “What’s right” are stories that often get ignored or that just aren’t seen as interesting enough to make the news.  A case in point:  my friends, two women who have been partners for decades and are devoted parents and now grandparents, spend their time and energy acting as mentors and positive role models for young LGBT people and their allies in the pursuit of social justice -- they don’t make the news.  The Rhode Island Catholic Bishop who opposes marriage equality by stating that “homosexual activity is immoral, an offense to God, a serious sin” – he makes the news.  This creates an imbalance in the messages that we are exposed to and impacts the stories that come to mind when we think about LGBT lives.

If we are to successfully address issues such as stigmatization, bullying and other public health risks for LGBT people, we must create a culture that, on a regular basis, celebrates instead of denigrates LGBT lives. How do we change this imbalance of messages and create a celebratory culture?  One way to address this challenge is to share the positive stories of LGBT lives.  In our research with over a thousand LGBT people, we have heard stories of personal growth and life lessons that can benefit us all.  We have heard stories about the benefits of living an authentic life and how that brings people closer to their family and friends.  We have heard stories from many people about the importance of being flexible and creative in relationships with their partners so that both partners flourish.  We have heard about how people develop compassion for others and engage in work or volunteer activities to support and benefit people in need.  All of these actions come from positive qualities that people associate with their LGBT identities. 

Our personal stories have power over how we define our own lives and they have power when we share them with others.  Talking with others about the positive aspects of LGBT identities, recognizing the benefits of these identities in individual lives and the life of our communities, is an important part of creating a celebratory culture.  Sharing stories of LGBT lives will help to re-balance and re-focus the conversations that people have. 

Ellen D.B. Riggle is Professor of Gender and Women’s Studies and Political Science at the University of Kentucky.  She is co-author of A Positive View of LGBTQ: Embracing Identity and Cultivating Well-Being.  For more information about her research, go to www.PrismResearch.org.

Addicted to Addictions

By David J. Ley

A few weeks ago, a woman came up to me after a presentation I had given, on why I believed sex addiction was a dangerous myth. She was in tears, as she told me about her son whom she had lost about a decade ago to the ravages of alcoholism. She told me that near the end of his life, her son was in a very expensive private-pay treatment facility, and called her up to ask if he had ever been sexually abused.

As this mother told me this story, and disclosed this part, a look of anguish creased her face. “I told him that I didn’t think he ever was, and he told me that at the facility, therapists had told him that not only was he an alcoholic, but that he was a sex addict as well. And that his sex addiction must have come from being sexually abused.”

The lady’s son sadly died a few weeks after that, from complications related to his severe substance abuse. For a decade, this poor woman has lived with tremendous fear and guilt, guilt that her son might have been sexually abused, something she didn’t prevent, or even know about. She was anguished that the unknown abuse, and her apparent unknowing neglect, might  have contributed to her son’s tragic life and loss.

I was the first person this woman ever heard, who said that sex addiction was a myth, a moralizing and unsubstantiated label that people throw around callously and casually. I gave her some peace, she told me, because for the first time in a decade, she could see that her son probably hadn’t been abused, and wasn’t addicted to sex. These therapists were merely riding the train of sex addiction, throwing that diagnosis at anything they could lasso with it, regardless of the consequences. If they could convince her son that he wasn’t just an alcoholic, but a sex addict too, what did they get out of it? Who knows? Maybe money. Or maybe they just saw every problem in the young man’s life as a form of addiction, and threw that label around to impress themselves.

A few decades or so ago, therapists believed they could recover memories of abuse, uncover buried memories of sexual, physical and even satanic abuse, in their patients. Because they saw symptoms they thought were related to a history of abuse, it didn’t matter that the patient said “Hey, I wasn’t ever abused.” But it turned out the patients were right and the therapists wrong. Lives were ruined, people went to jail and families were devastated because of the therapist’s well-intended arrogance.

They thought they were helping. But hundreds of lawsuits and settlements have now shown that those therapists hurt people. The myth of sex addiction hurts people too. This is why I’m challenging it every chance I can get. To demand that these therapists be responsible with the power they wield over people’s lives and fears.

David J. Ley is a clinical psychologist in practice in Albuquerque, New Mexico. He provides clinical and consultative services in numerous other states. Dr. Ley currently serves as Executive Director of a large outpatient behavioral health agency in Albuquerque and maintains a current caseload of clients. He is the author of The Myth of Sex Addiction and   Insatiable Wives: Women Who Stray and the Men Who Love Them.

Happy Birthday Dr. Seuss!

Oh, the Thinks You Can Think!

Today we celebrate the life of Dr. Seuss by sharing a great book which explores the philosophical and moral dilemmas often found in his stories. 

Since Theodore Geisel published his first children's book in 1937 under the pseudonym Dr. Seuss, children and adults alike have been captivated by the charming and laconic tales of whimsical characters and imaginative worlds. But Dr. Seuss' stories are more than just catchy poems; they often wrestle with serious philosophical and moral dilemmas, whether it is Horton discovering the very essence of life or the Lorax teaching us about morality. Dr. Seuss and Philosophy Oh the Thinks You Can Think! explores philosophical concepts such as the nature of the good life in Oh the Places You'll Go, the nature of knowledge in McElligot's Pool, Postmodernity in On Beyond Zebra, business and the environment in The Lorax, and moral character in How the Grinch Stole Christmas, among many others. Anyone who loves Dr. Seuss or is interested in philosophy will find this book to be intriguing and enlightening.

Learn more about the book, here.

The Messages in President Obama’s Spotify Playlist

By Benjamin S. Schoening and Eric T. Kasper 

Now that 2012 is upon us, so is another presidential election. Barack Obama is seeking a second term as the presumptive Democratic Party nominee for president, and four candidates are currently vying for the Republican Party nomination. There are many strategic decisions which these politicians make to promote their candidacies, including crafting inspiring speeches, offering eloquent answers to interview questions, and creating patriotic backdrops at campaign events. For as long as there have been American presidential elections, one of the candidates’ quadrennial considerations has also been selection of the right music.

President Obama made news on February 9th when he announced his campaign’s Spotify playlist. For those not familiar with Spotify, it is an online music service that streams songs to members of the website. President Obama released his playlist in 2012 in much the same way that he announced his iPod playlist during his 2008 candidacy. Playlists such as this can send powerful messages to the electorate, as they can transmit political ideas or associate a candidate with a notable musical celebrity. With this in mind, let’s have a look at a few of the 28 songs on President Obama’s Spotify playlist.

One of the more notable selections is Al Green’s “Let’s Stay Together.” President Obama previously sang the first few bars of this song at an appearance in the Apollo Theater in New York City on January 19th. Although originally written as a romantic song when first released by Green in the early 1970s, the song’s title and hook offer a powerful message from an incumbent president to the voters: vote for me, so that we can mutually continue along the path we are on now.

A second song choice by President Obama that musically asks for another opportunity to serve the country is U2’s “Even Better than the Real Thing.” In multiple places the overarching message is that the listener will be satisfied by giving the singer one more chance. The song goes on to refer to its audience as the real thing and even better than that. This can be interpreted as a way to “pump up” supporters of the President. Again, like “Let’s Stay Together,” the lyrics of “Even Better than the Real Thing” were clearly originally written with romantic intent, but the key catchy parts of the song can be co-opted to express relevant political messages.

REO Speedwagon’s “Roll with the Changes” exemplifies another important political theme for President Obama. The title of this tune harkens back to one of the President’s major campaign slogans from 2008: Change we can believe in. The lyrics go on to tell the listener that the singer is available when the listener is ready to move along with the changes that lay ahead. The lyrics also tell the listener that the tables have turned, and they imply that the darkest hour has passed. Certainly, one could see this as a message from President Obama that the economy is on the mend and things are getting better because of the changes he has implemented.

The songs a campaign chooses can also be used to thwart the message of the political opposition. One song on President Obama’s playlist that does this is “No Nostalgia” by Ages and Ages. Recently, Republican candidates have expressed a message that the country is on the wrong path, and only they can restore America to its past greatness. The hook of “No Nostalgia” takes aim at this notion, claiming that instead of looking to the past we should concentrate on the promise of what our country is now and can become in the future.

Of course, one must be careful not to read too much into these lyrics and song choices. Still, there is no doubt that President Obama and those working on his reelection campaign thought long and hard about which songs to release. Ultimately, song choice is an important consideration for presidential campaigns. The right song can become a memorable way to express important political messages. On the other hand, the wrong songs can muddle a campaign message, and key song omissions can lead to hurt feelings among those who were musically snubbed.

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About the authors: Benjamin S. Schoening and Eric T. Kasper are the authors of Don't Stop Thinking about the Music: The Politics of Songs and Musicians in Presidential Campaigns.  Benjamin Schoening is Assistant Professor of Music at the University of Wisconsin-Barron County and music director of the Red Cedar Choir in Rice Lake.  Eric T. Kasper is Assistant Professor of Political Science at the University of Wisconsin-Barron County and the municipal judge in Rice Lake.

The “College is For All” Debate: Addressing a Lot of Maybes

By Frank Burtnett, author of the Bound-for-Career-Guidebook and Bound-for-College Guidebook.

Maybe college…maybe not…maybe a 4 year college or university…maybe a 2 year community or technical college….maybe right after high school…maybe not until later in life. There are a lot of “maybes” that need to be tossed into the “college for all” discussion.

President Obama and Secretary of Education Duncan weighed into the discussion a while back by stating that the nation’s ability to compete on a global playing field requires an increase in the awarding of college degrees. The President has set a goal of sixty percent of Americans earning a postsecondary education degree by 2020. Counter arguments, however, are being bantered about saying that college graduates are finding it difficult to find jobs in current economy and students should be more focused on workplace knowledge and skills training that are immediately adaptable and marketable for the current and future crop of jobs. They argue that many of those careers and jobs simply do not require college.

What does this conflict in mission mean for American education? Should our schools place greater emphasis on the preparing students to succeed in postsecondary education? Should “college for all” be the mantra of the times? Should career and workplace skills receive greater attention? Can K-12 education do both?

The experiences of the economic downturn and recession have added fuel to the incendiary debate as many are saying that the college degree is no longer as attractive as it may have been five or ten years ago. Allow me to argue for education. Regardless of what the high unemployment figures are telling us, the fact remains that college graduates are less likely to be unemployed or underemployed and stand the best chances for achieving their career aspirations when the recession is finally over. They even fare better in other demographics like physical and mental health.

Allow me to suggest a middle ground. Schools, in my estimation, should be about the business of helping students achieve their full educational and career potential. No more….no less. Of utmost importance is the need to recognize and facilitate individual differences. College immediately after high school, whether it is the transition to an Ivy League college, a public university or a local community college, is a reasonable step for many who are enrolled in our schools. Others may wish to work and engage in more self-awareness and option exploration before taking that crucial next educational step. Quite possibly a stint in the military can serve to clarify the future and point the graduate in the right direction. There are multiple educational routes to the world of work and K-12 students need to learn about the viability of all of them.

In many respects it is about helping young people outline options while getting a better handle on the characteristics and traits that define each individually. When you have a better understanding or who you are and a clearer view of the future and the options it affords you, you’re better equipped to make good educational and career decisions.

K-12 education needs to prepare students with a kind of “readiness” for future study and entry into and about the workplace. Make no mistake---education is going to be a part of that future. Knowledge and skill acquisition will be necessary for everyone prior to their entry into any occupation or career in the workplace, and will be just as important for maintenance and growth in one’s work and the mobility to move about their chosen career.

Americans cannot escape the inevitable fact that one day, for many---sooner than later, they are going to find themselves in a college classroom. Stopping out of education after high school is the equivalent of career suicide. But let’s consider the outside chance that some of our current K-12 students never find themselves on a college campus. Is being “career and college ready” not a great parenting skill, one that they might utilize with their own children?

Essential to being “college or career ready” is a sense of self-awareness and being able to comprehend all of the options that lie before you. Equally important is having a life plan---a set of short and long term goals that will lead step-by-step toward a goal or set of goals out there that will become clearer with each move forward.

Teachers, counselors and all educators, along with parents, can play a critical role in helping students set realistic educational and career goals and then take the action steps that are needed to make those aspirations come true. Students need to have experiences in school and in life that will help them structure their exploration and decision-making and more effectively engage them in the transitions that take them from school-to-college and school-to-work.

The more students know about the educational and career development process---the more “ready” they will be to control those parts of it that are the most controllable. There are no “one size fits all” solutions or answers. There are just a lot of “maybes” that need to be addressed, today, tomorrow and way off in the future.

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Dr. Frank Burtnett, President and Principal Consultant of Education Now, splits his life between Rockport, Maine and Fairfax County, Virginia. He is the author of the Bound-for-College Guidebook and Bound-for-Career Guidebook (Rowman & Littlefield Education).

____________________

This message appeared originally in the Portland Press Herald on July 3, 2011. It has been modified for presentation here. FB

 

 

Too Big to Disclose

By Raymond Vickers

     Prior to the financial meltdown of 2008, America had the most elaborate bank regulatory system in the world. Despite eight decades of ever-increasing authority and regulatory agencies, the sheer magnitude of the recent banking crisis proved that the regulatory system, relying exclusively on regulators operating behind closed doors, cannot police the largest banks, which continue to threaten the global economy with a systemic banking collapse. The passage of the Dodd-Frank Wall Street Reform and Consumer Protection Act in July 2010 merely added to the already sweeping regulatory power.

     But once again the muscular lobbying of the banking industry continued to impose the prohibition of   transparency in the bank regulatory system. As Senator Richard Durbin, Democrat of Illinois, observed in a moment of unusual candor, in April 2009, “the banks—hard to believe in a time when we're facing a banking crisis that many of the banks created—are still the most powerful lobby on Capitol Hill. And they frankly own the place.”

     Soon after the S&L crisis of the 1980s and then again after the Enron debacle of 2001, Congress reorganized the bank regulators and increased their power. During the most recent speculative mania, regulators were armed with the power to stop the corrupt practices at the nation’s largest banks. Because Congress failed to provide regulatory transparency, the bankers were able to continue the plunder in secret.

     The banking secrets of the 1930s, which are now public records, reveal how bankers and businessmen violated their fiduciary duties in a desperate effort to save their personal fortunes. Those records contain many lessons for today, the most important of which is the urgent need to provide transparency in the bank regulatory system. The bank regulatory records should be available to the public through the Internet, so that a depositor or investor has only to type in the name of a bank to have immediate access to its regulatory records.

     Fully disclosing reckless financing schemes and dubious loans immediately after bank regulators criticize them would accomplish far more than the Sarbanes-Oxley Act of 2002, which failed to sound the alarm bell before the 2008 collapse. Posting their banks’ examination reports on the Internet would have a chilling effect on freewheeling executives who would breach their fiduciary obligations to their stockholders and creditors in order to enrich themselves.

     In this moment of anxiety, taxpayers have the power to force openness in the banking industry. Transparency would strike at the alliance between banks and politicians, and provide the necessary information to make the markets function properly. There is no doubt that releasing the secrets of the banking industry would provide a wrenching adjustment among insiders. But secrecy and the lack of information about the fraud and insider abuse in the financial system led to the 2008 fiasco, which caused the worst recession since the depression in the 1930s. Not addressing this problem now invites financial upheavals in the future.

 

Raymond B. Vickers, an attorney and economic historian, is the author of  Panic in the Loop: Chicago's Banking Crisis of 1932. He was formerly the top appointed banking and securities regulator for the state of Florida. As an attorney, he has represented more than a hundred financial institution.

DUST: the Inside Story of Its Role in the September 11th Aftermath

By Paul J. Lioy

Memorial Day 2011 has just passed, and during the Spring of 2011 another page in the fight against terrorism and the need to be prepared for the unknown. Tom Kean, who has commented widely about preparedness, is still correct because even with the death of Osama Bin Laden threats remain high against our country’s people and infrastructure, and his words should be a reminder that being prepared for terrorist events is an important part of our country’s responsibility to protect and defend. The 10th Anniversary of the deadly attacks on the WTC, United flight 93, and the Pentagon is also just around the corner. They will be solemn occasions that will provide an opportunity to educate those who were too young to remember or are part of the next generation. Since the publication of Dust: the Inside Story of Its role in Role in the September 11th Aftermath, I have talked to many individuals and groups, and recorded interviews, about the reasons for writing the book. In my discussions, it became clear that people wanted to know how the results of our analyses of the dust were used to understand exposure and health response relationships. In reviewing what has been written since publication of my book, the actual health effects experienced by the workers/volunteers remain highly correlated with the time of a person’s arrival at Ground Zero, and whether or not he or she was wearing a respirator during their completion of Ground Zero related activities over time. Based upon all my conversations with physicians and other environmental health professionals, my hypotheses remain consistent: the unknown or unquantifiable gases released during the jet fuel fires were part of the etiology of the diseases derived from the aerosol that contained the WTC Dust and inhaled by the workers/volunteers during the first days after the collapse of the towers. However, they cannot be realistically reconstructed in toxicological tests because they would have to include both the WTC Dust and combustion gases released by “uncontrolled” fires caused by the burning jet fuel.

The reader response to other important aspects of my story has come as sort of a surprise. Many were associated with the content of Chapter 12 which deals with the lessons learned and the lessons that still need to be learned from 9-11. These are linked specifically to the 5 Rs + 1: Rescue, Re-entry, Recovery, Restoration and Rehabitation. The Plus 1 is Resilience. Because of the natural events that have occurred since 9-11 (e.g. earthquake and Tsunami in Japan), and military actions overseas, I have had opportunities to describe the levels of completion or success using the 5 Rs for some of those incidents. As a member of the general public you can use my 5Rs to grade us all on the actions and the outcomes of those actions that can and do occur in natural and terrorist events.

Paul J. Lioy is a Professor and Vice Chair, Department of Environmental and Occupational Medicine at UMDNJ-Robert Wood Johnson Medical School. He is Deputy Director for Government Relations and Director of Exposure Science at the Environmental and Occupational Health Sciences Institute of Rutgers University and RWJMS-UMDNJ. Dr. Lioy is the author of Dust: The Inside Story of its Role in the September 11th Aftermath.

The Political Branding of Country Music: 10 Years Post-9/11

By Elizabeth Barfoot Christian

Some argue the sound of country music has become nearly indistinguishable from today’s pop---that it has lost in soul what it has gained in fan base over the last quarter-century. And that may be true when you listen to crossover country artists like Taylor Swift and Lady Antebellum (as well as rockers like Bret Michaels and Bon Jovi’s recent countrified-rock albums). Like many boundaries in postmodern culture, the lines between popular musical genres have been fading for quite some time.

But boundaries are a funny thing. Just when you think we’ve gotten past the need for labels… just when you think it’s OK to be a little bit country and a little bit rock ‘n roll, someone strikes a chord so offensive that lines must be drawn.

That boundary was recast in steel by country music following the world-altering events of Sept. 11, 2001.

As the molten metal of the Twin Towers melted, many hearts in the U.S. hardened. A new, angrier country was born. And from it emerged a new, angrier brand of country music as well.

Perhaps in hindsight “angry” is not a fair term to describe the artists who put to lyrics the pained, raw emotions that millions of Americans were feeling immediately after 9/11. Toby Keith, already branded a country outlaw, reportedly penned his No. 1 hit “Courtesy of the Red, White & Blue (The Angry American)” in about 20 minutes as his response to the 9/11 attacks on America. Keith’s father, a U.S. military veteran who taught him the importance of patriotism, had died unexpectedly just six months before the terrorist attack, and Keith took out his anger at both events in song. One for honor, the other, ire.

Keith was not alone. Country music saw a huge and almost immediate economic windfall following 9 /11. County Music Television sponsored the first Freedom Concert one month after the attack and raised $5 million for victims. Keith and Alan Jackson, who wrote and recorded “Where Were You (When the World Stopped Turning”), both achieved worldwide recognition for their patriotic ballads.

Jackson and Keith, already two of the more traditional country artists, were instrumental in returning country to its more populist, working-class roots. The sound of many of today’s popular country artists may not carry the same twang it did back in the day of Haggard and Jones, but 10 years post-9/11 the message is as political and patriotic as ever—and more Americans than ever are listening.

And while the musical qualities between country and mainstream pop many have merged somewhat, the message couldn’t be more distinguishable in post-9/11 America. If you don’t believe me, just ask Natalie Maines, whose career as darling of country radio took a drastic downhill slide with one poisonous political remark. While the Dixie Chicks—whose name you dare not speak in Lubbock, Texas—will forever be outcasts to true country fans, the group has experienced a rebirth in a more mainstream market with a much more liberal-thinking fan base.

Country has definitely come to town, and people who had never listened to it are listening to and loving it on both crossover and pop radio stations in growing abundance. Country stars have swarmed the Grammys. The last two entertainers of the year have been country singers. Both top finalists in this year’s American Idol were country singers, and the quasi-partnership with Fox News, the most popular cable news channel, which continues to host annual Freedom Concerts nationwide, isn’t hurting things either. Many of Fox News’ commentary programs regularly feature country artists singing and oftentimes offering personal political opinion.

The Hollywood left entered the political arena decades ago. The “Mom and apple pie” patriotic crew is catching up through the medium of country music and conservative cable news.

Elizabeth Barfoot Christian is assistant professor of journalism at Louisiana Tech University and the editor of Rock Brands: Selling Sound in a Media Saturated Culture.

Next blog: Has MTV helped kill the music industry?

Celebrities, "Extravagant Expectations" and the Love Life of Americans

By Paul Hollander

The recent ending of Oprah Winfrey’s talk show that ran for a quarter century is a reminder of the importance and prominence of celebrities in American society. The reverence shown toward them prompt reflections about the social, psychological and cultural conditions which underlie their cult.

Celebrities differ from the famous people of the past because their prominence depends to a very large extent on publicity - on the successful projection (or marketing) of a certain image or a "trademark" by the media. They also differ from the culture heroes of the past because their accomplishments, talents, skill or moral stature are more questionable. Most celebrities are entertainers, or known for some personal quality the public considers entertaining that may include forms of misbehavior or scandalous aspects of their personal lives.

I suggest that some of the conditions which underlie and promote the rise and cult of celebrities also play a part in the difficulties large numbers of Americans experience when trying to establish and maintain long term, intimate personal relationships. "Relating" to celebrities is a fantasy relationship stimulated by the shortage of genuine, face-to-face, one-on-one relationships - a futile attempt to personalize an impersonal world. When there is a scarcity of sustaining, intimate personal relationships and a decline of closely knit, durable communities, people seek substitutes. Celebrity worship is one of them. The endless browsing of dating sites is another one.

People admire celebrities because they seem to possess everything most ordinary people do not have: wealth, fame, huge amounts of attention, excitement and physical attractiveness.

Not unlike the difficulties many young people have in distinguishing a "soulmate" from a date or a "hook-up," fans of celebrities have an impaired capacity to distinguish between what or who is truly admirable and what or who is not. Confused values cast their shadow over the search for an ideal partner as they do on the attention and affection lavished on celebrities of questionable accomplishments and often even more questionable moral character. What seems to matter is that most celebrities are an integral part of popular culture that satisfies the enormous demand for entertainment.

In my recent book (Extravagant Expectations: New Ways to Find Romantic Love in America) I reported that the majority of a large sample of people (using a popular dating website) considered the most important human quality the sense of humor. These people were looking for somebody who would make them laugh, who are entertaining. Honesty, sincerity, integrity, intelligence, sense of responsibility were far less often mentioned as desirable qualities. I also found that conflicting and unrealistic expectations contribute to the difficulties many Americans experience in the pursuit of intimate personal relationships. It seems that Americans incline to believe that all good things are compatible, as for example adventure and security, excitement and stability, the capacity for self-promotion and authenticity, being rich and charitable, self-realization and dedication to some community.

In the final analysis the worship of celebrities and the haphazard pursuit of intimate personal relationships have similar sources.

Paul Hollander is professor emeritus of sociology at the University of Massachusetts, Amherst, and author or editor of 15 books. His most recent book is Extravagant Expectations: New Ways to Find Romantic Love in America.

Shopping for an Organ Transplant?: The Pitfalls of Medical Tourism

By Katrina A. Bramstedt

In the US, thousands of patients are waiting for a kidney or liver transplant. Sometimes, they get so desperate, they contemplate traveling to a foreign country to buy an organ. In their desperation, patients often don’t think about the pitfalls and ethical problems of organ tourism, and there are many. Some organs are known to come from prisoners who did not give informed consent. Some organs are taken from women who are forced by their husbands to “donate” a kidney or liver tissue to pay a debt. Is this the setting for ethical medical care?

Other problems with organ tourism are issues such as the lack of medical records, or records which are written in a foreign language and unhelpful upon return to the US. Organs are sometimes also contaminated with viruses such as HIV and hepatitis. And what about these medical complications? Who pays for the treatment? What if there is malpractice? Can the patient obtain any recourse? The complexity of organ tourism is immense, clinically, ethically, and legally. So is there another option for patients who need a kidney or liver transplant?

Enter the Good Samaritan. These are people, right here in USA, who are ready and willing to give an organ to a stranger. They have no goal other than “to help”. Their organ gifts are “no strings attached” and often, they never even meet the person who receives their organ. For the Good Samaritan, all that matters is that they have something extra and they want to share it with someone who needs it. In the new book, The Organ Donor Experience: Good Samaritans and the Meaning of Altruism, 22 donors were extensively studied to learn their personalities and motivations for organ donation. In general, these givers are normal, everyday folk, of average means, with a genuine desire to serve their community. Often, they have a lengthy history of volunteerism and their parents did as well. They originate from all fields, law, law enforcement, health care, education, you-name-it. A Good Samaritan could be your neighbor down the street, the clerk at the grocery store, a local taxi driver, or even your bank teller. These people want to give, and with medical, surgical, and psychosocial screenings, they can be lifesavers.

References:

• Bramstedt K.A., Xu J. Checklist: passport, plane ticket, organ transplant. Am J Transplant. 2007 Jul;7(7):1698-701.
• Bramstedt K.A. Ethical minefields in medical tourism. Sonoma Medicine 2011.
• Bramstedt K.A. Steering clear of organ tourism. Kidney Review 2007.

Dr. Katrina A. Bramstedt is a noted medical ethicist associated with California Transplant Donor Network in Oakland, California. She also has a private practice in Marin County where she has performed over 800 ethics consultations and published over 75 articles in medical and bioethics journals. She lectures nationally and internationally and has made numerous appearances on television and radio discussing transplantation and donation. She is the co-author of The Organ Donor Experience: Good Samaritans and the Meaning of Altruism.