Jana Pochop on Death and Dying (in song)

For most of human history, it was ordinary for families and even close friends to be present for the death of a loved one. People knew the sights, sounds, and smell of death. For a sick person to die alone would be considered an extreme misfortune. But the 20th century moved death from home to hospital. As Philippe Aries wrote, “The hospital is the only place where death is sure of escaping a visibility—or what remains of it—that is hereafter regarded as unsuitable and morbid.” While it was once a great tragedy to die alone, many now consider it a tragedy when one must be present for the death of a loved one.

To be sure, no one who witnesses the death of a loved one escapes trauma. Death is painful, and even those who are prepared for it often panic at the last moment. When people plan to die at home but end up dying in a hospital, caregiver panic is frequently the reason. The last moments of life can be excruciating to watch, and caregivers often call an ambulance to bring relief for their loved ones.

Caregivers who have a home healthcare provider to reassure them do much better. When the family knows the process is normal and unavoidable, they are able to brace themselves against the pain and endure it to the end. The advantage of hospice over home death is that professionals are responsible for all medical decisions, and the family can focus on comforting their loved one, grieving, and saying farewell.

I’ve thought a great deal about this process and how it may improve our society if we once again become familiar with death and dying in a more personal manner. I honestly believe this experience gives people a deeper experience of life, grief, love, and loss. I’ve read about it, and I’ve written about it, but I was surprised to hear so many of my thoughts on the subject expressed in a folk song of just a few minutes.

Last night I went to see a performance by Susan Gibson, an extremely talented singer/songwriter. During the second set, Gibson invited Jana Pochop on stage to sing two songs. The first was about what you will do in the moment when your soul leaves your body. The imagery was compelling and profoundly sad. When this song is available, I would recommend it to help families prepare for the imminent death of a loved one. I also believe the song will be appropriate for a medical humanities curriculum.

I didn’t intend for this blog to ever have anything to do with folk music, but I also did not anticipate folk music intersecting my interests in medical humanities, caregiver narratives, home/hospice death, and survivor stories. The following video is not of the song in question, but it gives you an idea of Jana Pochop’s talents.

Citizens United, Unions, and Corporate Persons

We’ve all heard that the Citizens United v. Federal Election Commission ruling by the Supreme Court opened the door to unlimited and undisclosed spending to influence elections. It is widely presumed that the court’s decision granted first amendment rights of free speech to corporations by declaring them to be “natural persons.” But corporations have had rights as persons for a long time. By most accounts, the court has recognized corporations as having all the rights of natural persons since 1886. For a detailed discussion of the 1886 ruling, see Thom Hartmann’s Unequal Protection: How Corporations Became “People” and How You Can Fight Back.

The Citizens United ruling did not establish corporations as people but declared that spending on speech cannot be limited because such limits would deny flesh and blood people the right to hear all points of view. For an in-depth discussion and analysis of the ruling, see “The problem with Citizens United is Not Corporate Personhood” by Rob Hager and James Marc Leas.

Further, if the ruling established corporations as person, it also established unions as persons, given that it removed any restrictions on what unions could spend. People on the right are quick to point this out. The Facebook group called Individual Rights and Government Wrongs wrote:

“According to OpenSecrets.org, twelve of the top twenty donors to political campaigns since 1989 are unions. And their donations have overwhelmingly gone to Democrats—only one union donated as much as 10 percent to Republicans, and eight gave less than 5 percent to Republicans. Further, of the top twenty donors, OpenSecrets ranks only one as leaning towards Republicans in their donations. Apparently, donations from unions do not ‘drown out the voices of everyday Americans,’ even though less than 12 percent of the American workforce is unionized.”

The rightwing sees hypocrisy on the left for decrying the ruling without offering any criticism of the influence of unions, which the right feels is as pernicious as what the left fears from corporate influence.

At least one person on the left sees Citizens United as part of an elaborate union-busting scheme. Douglas Webster wrote on Daily Kos, “the next step after Citizens United — giving more freedom to use more money more clandestinely to business and unions — is to launch a full-scale attack on unions…and especially those in the public sector.” Indeed, since the time he wrote that (February 2011), attacks on unions seem to have grown more intense.

This discussion does not answer the question of whether the speech of unions is equivalent with the speech of corporations. I once heard an explanation of why corporations had the right to spend money to exercise their free speech rights that claimed corporate speech was analogous to a group of people pooling their money to buy a megaphone to amplify their voices. My immediate reaction to that claim was that some corporations were using money they got from me to promulgate speech I find highly objectionable. I do not expect corporations to speak for me. I do not want corporations to speak for me. They are not extending my right to free speech.

On the other hand, I join a union precisely because I do want the union to speak on my behalf. When I pay money to a union, I am hoping to amplify my speech to help balance what I perceive to be unfair corporate control of almost all media in the world. If the union begins to express views I find objectionable, I can and will withhold my money. I would like to withhold my money from corporations that express views I find objectionable, and I do withhold most of it from such corporations, but, like you, I buy products and services from people who do not always share my values and views.

So, I do not find the speech of unions and corporations to be equal. I am not saying the activities of unions should not be regulated and monitored, but I do feel our obligation to regulate corporations is greater. In either case, I believe spending on elections should be disclosed. Transparency promotes more ethical behavior generally, and I cannot think of an instance where transparency would harm the function of democracy when it comes to financing elections. If you can think of exceptions, please let me know.

What is the value of ethics courses?

New students in my ethics classes are often either pleasantly surprised or disappointed to learn that I will not be teaching them which behaviors are ethical and which are unethical. Some of my colleagues in other disciplines also seem to think I should tell people how to behave; when they see someone behaving badly, they will say, “That person needs to take your class.” I hate to disappoint, but my classes probably won’t make your unethical students and colleagues do what you want. My only hope is that it will help the ethical ones (and most people strive to be ethical) analyze their own behavior and ethical dilemmas more deeply and constructively.

Several people have told me it is impossible to teach ethics (they’ve said the same of logic and even philosophy in general). I was generally baffled by their statement until I had a slightly more in-depth discussion with a European while I was teaching in China. Rather than simply saying it is impossible to teach ethics, he specified that it is impossible to teach Chinese students ethics. When I asked him why, he said it was because they have no framework to understand ethical concepts. With a little more discussion, it became clear to me that he thought only Christians could understand ethics and morality. I’m happy to report that Chinese students (some are Christian and some are not) are quite competent to explore ethical theory and application. I am confident that students in every part of the world have the same ability.

I don’t teach ethical codes of conduct; my focus is on meta-ethics, ethical theory. I can think of nothing more horrifying than to have my students go out into the world and declare some action unethical with no more evidence than the fact that I said it was unethical. In fact, I would not want them to arbitrarily follow any code of ethics without any idea of why something might be either good or bad. Would you want to find out that someone didn’t steal from you or kill you only because it is in some code of ethics? (Blog that is soon to come: What is the purpose of an institutional ethics committee?)

What I hope I can teach my students, instead, is how others have analyzed what it means to be a good person or what it means for an action to be good. By doing so I hope my students can better understand their own methods for analyzing whether an action or a person is good or bad. As it happens, I don’t teach any courses in a field where it is important for students to remember a particular code of ethics (psychotherapy, for example), but even in such courses, I would hope instructors would help students understand the process of ethical analysis, rather than merely memorizing normative pronouncements. A useful education in ethics will demand that students examine their own ethical beliefs and the customs of their society with both openness and critical scrutiny. It is the only way moral progress is possible.