Hospice and Palliative Care

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STUDENT VOICES | CHYNN PRIZE THIRD-PLACE WINNER

By Maia Lauria

I first stumbled upon the issue of palliative care during a particularly hard time in my life. I was twenty years old, and for the first time having to confront the realities of watching a loved one die. Up until then, death had been a decently abstract concept to me. My grandmother had passed away when I was a child, but I was too young to be exposed to any part of the process. My uncle had also passed away when I was a teenager, but due to the suddenness of the death and geographical distance, I did not play a role in the event. I had never attended a funeral, let alone seen a corpse. The case of Monica was very different. For the first time, I became intimately involved in the dying process; and through this, became aware of the workings of the hospice and palliative care system that has become incredibly common throughout the country.

Monica was my mother’s best friend, and a pseudo-mother to my sister and I. In 2007, doctors found a malignant tumor in her colon, leading to multiple surgeries and the administration of rounds of chemotherapy. After some years of remission, the cancer returned in 2011, spreading to more of her internal organs. Once again, different treatments were administered, with waves of optimism and pessimism. Ultimately, in the summer of 2015, after attempting a failed experimental treatment, she was told that there was no more the doctors could do, and that she probably only had a couple more weeks to live. Receiving this news, she opted for in-home hospice care, to be able to spend her last days comfortably with family and friends.

Hospice care is becoming an increasingly common end of life plan in the United States. In the past decade, the number of hospice patients has more than doubled. In 2009, 42 percent of all deaths were under the care of a hospice program.1 According to the National Hospice and Palliative Care Organization, hospice care “ involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support” to help allow the patient to succumb to death in best way possible.2 The phrase they use is that they are shifting the focus from curing to caring. Typically, this involves a family member serving as the primary caregiver, with members of the hospice staff making regular visits and providing 24 hour on-call assistance.2 Central to hospice care is the idea of palliative care, which makes sure the patient is able to die in the most pain-free and dignified manner.

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“She Can’t Help The Choices She Makes”

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STUDENT VOICES | CHYNN PRIZE FIRST-PLACE WINNER

By Madeleine Cardona

I will never forget the day my mother got diagnosed. I could swear that just yesterday I was thirteen years old waiting anxiously to be called in from the waiting room of some fancy New York State doctor’s office. I was young, but I had some idea of what was going on. I knew my parents and I were there because they were going through a divorce and fighting for custody of me. What I did not know was that we were about to endure a court-ordered psychiatric evaluation and that the results were going to change my life forever.

“Madeleine, your mom is very sick,” the psychiatrist attempted to explain to me. I did not understand. I did not know a sick person could look perfectly healthy. “It’s not a physical sickness, it’s in her head. She has a mental disorder called Paranoid Schizophrenia.” She went on using big words to explain how my mother’s brain “wasn’t like other people’s brains.” I sat there listening closely, hanging on every word the woman was saying to me. “She can’t help the choices that she makes, it’s not her fault that she is the way that she is. She needs help.” Every day since that day in the doctor’s office, that remark replays in my head over and over. “She can’t help the choices she makes.”

That is what gave me the most trouble. I sat around for years and years watching the choices that my mother was making, unable to intervene. If she cannot help the choices she makes, why could my dad or my mother’s other family not make the choices for her? Why could nobody make her take medication? I eventually learned that it was because my mother was sick, but “not sick enough.” The court ruled in favor of autonomy and said that my mother still had the right to make her own medical decisions. According to them she was functional and was not posing an immediate danger to herself or others. I understand autonomy. Autonomy is defined as “a principle in which a person should respect the rights of other individuals to freely determine their own choices and decisions” (Jonas). I understand how important free will and the ability to make choices about your own body are. It is hard for me, however, to understand how you can continue to honor a person’s right to make their own decisions, when every decision they make is only hurting them. It is hard to sit there, as a loved one, and not want to just make them take the medication they need to get better, or force them participate in that research study that just might help.

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Incidental White Privilege

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STUDENT VOICES

By Jade Reyes

Not every issue of morality that we are faced with is easily discernible— with an easily ascertainable correct action. Many of these issues are nuanced and multifaceted, affecting every person differently and involves a weighing process between imperfect alternatives. One of those issues is race or ethnicity and furthermore the perceptions and assumptions that come hand in hand. Race and racial prejudice are intricately woven into the fabric of American history. While the most prominent struggle between Whites and Blacks is entrenched in the legacy of slavery, another more subtle battle persists. This battle, in my personal experience, blurs the line of ethical and moral behavior in many settings; particularly social and business relations. This struggle is the plight of those who pass for another race– specifically those non-Whites who may be perceived as White, such as myself. This presents a unique moral and ethical challenge: having to toe the line between my ‘by chance’ white privilege and allegiance to my ethnic background.

Often the struggle to which I refer is given the name of colorism, in which light skin tones are preferred and fare better in arbitrary categories when compared to darker skin tones. There is this persistent trend; according to the historical record that having lighter skin regardless of your racial or ethnic origin is a good thing— a door opener if you will. For fair-skinned Latinas like myself, the identifier of white is available to me, but it comes as a powerful oxymoron to define myself as a white-Latino. The rich history of Latino and Hispanic people is tinged with repression and marginalization, while placing white race as the perpetrators of that oppression, laden with privilege from the get-go. There are many studies, both scientific and academic, exhibiting the inherent ‘benefits’ of white-passing not limited to better marriage prospects, better socio-economic standing, and better employment opportunity only in correlation to having lighter skin regardless of any other identifying factors including gender or age. In my own experience, the vast majority of people who are not Hispanic or Latino themselves believe that we are to a certain extent homogenous: small in stature, darker in tone, with straight black hair. When one does not fit into the cookie cutter mold that has been cast, there is a sequence of events that can only be described as unsettling to the receiver. At first, there is the glossing over of who you are to accept your external whiteness at face value, allowing you to race-pass should you choose to. Then, should your true ethnicity become known; there is always disbelief or a shot taken at your credibility—somehow you must not know what you’re talking about or you must really be from somewhere else. In my case, I am privileged by my skin color and I have had to learn to navigate a world that consistently mistakes me for something I’m not and only accepts me based on that misconception.

I am the color that white people want me to be, but I am not the person they want me to be nor do they want to be me. It is often just the literal color of my skin that makes me appealing to them. Being labeled as white is problematic because identifying as white ignores all of the struggles that my ancestors went through, and because quite simply, I do not fit into the overarching white historical narrative. My people’s genesis is not located in that kind of whiteness. Often, discerning that I am not actually white is greeted with a sense of unsettlement, like I have somehow upset the natural balance. Colorism can be fickle that way. To offer a small social example, I’ve had others approach me and inquire as to how I keep just the perfect tan over the winter months. The first time this occurred I could not have been older than eleven or twelve. For me, the question did not even make sense because I was not “keeping” a tan—I was not doing anything to my skin, that was just the color that it always was, and I did not know how to respond. Do I admit to being Latina? Do I declare that my unique tone is the physical enduring evidence of the rape of indigenous Puerto Rican women long ago until the blackness faded from my family tree to create me? Do I laugh and play it off? The moment that I own up to being Puerto Rican, the admission is accompanied by varying levels of disbelief, demands for explanations (as if this was really some method designed to hoodwink them!), and requests to speak Spanish as if I need to prove who I am.

People do not like hearing that the preconceived notions they have developed are wrong, especially if they hold unfavorable points of view toward races associated with dark skin tones. This unsettlement can especially manifest itself when expanding business or social circles. I once sat in a job interview for close to half an hour until the manager realized I was not white like her and there was a definite downturn in her attitude toward me—the disappointment in my non-whiteness was palpable. I could not relate to the plight of going on vacation to Mexico and not understanding the natives and getting sunburned. It was almost as if she took personal offense to me severing the imaginary link she had formed between us, like I had deceived her by presently outwardly as a white woman. For her, the idea of who she wanted me to be was preferable to reality.

This extends further into my working experience, where my first name does not betray my Latino lineage but my last name does, leading me to have ‘fooled’ coworkers and managers that assumed me to be white and thus bestowed the ever complicated benefits of white privilege on to me. This is just one instance of the ethical crossroads I find myself at because of the presumptions of others before I have had the chance to self-identify. Working at a sports arena, I have never had my bag searched upon entry, but my ‘brown’ friends have frequently and I am acutely aware that if I wasn’t naturally fair with blonder hair and green eyes things may be different. I once had a fellow Latina coworker, darker skinned then me, tell me that I was only made the team lead during a high profile event because I had a white name and white features and thus would appeal more to the visiting corporate management. In hindsight, she may have been correct.

I live in a culture that values whiteness, even my imperfect whiteness, and seeks to assign privileges to that whiteness that I cannot morally accept. Ethically, I cannot disown my race when it suits me, or when I am hyperaware that my Latino brothers and sisters are victims of colorism that I escape by the happenstance of less melanin in my skin. I cannot stand by the fact that my whiteness means I will not get followed around a store, but my younger brothers will, or that my hair is enviable and my sister’s is unkempt and coarse. My whiteness is a product of history, where colonialism swooped in and somewhere along the line decided that white triumphed over brown. Even more down the line, it mixed with brown enough to create people who look like me: just white enough to be tangentially accepted so long as one plays the part well enough to go undetected. However, I do not want to be accepted that way— to turn one’s back on their identity is to turn one’s back on the heritage, culture, and history that informs the collective identity of all one’s people.

Jade Reyes ’17 is a student at Fordham College Lincoln Center. She is majoring in Political Science.

 

Projection NOT Promotion: Why the Violence of Sports is Ethical in Society

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STUDENT VOICES

By Maria Trivelpiece

It is quite difficult to get through a day without hearing or seeing some mention of sports or athletics in our world. They practically dominate society. Professional athletes are some of the highest paid people on the planet. They are the epitome of what children aspire to be, fans fawn over and television networks profit from. Yet, in the midst of all the glory of these games, the evident violence that accompanies them seems to be conveniently overlooked. But is it okay to simply ignore that the most watched event on television is a game of grown men tackling each other, beating each other and then celebrating the fact that they physically harmed another human being? Is it ethical to teach our children that the most exciting moment in ice hockey is when the defensemen drop their gloves and fist fight? I am here to say that it is. The violence of sports, in technicality, is ethical because sports are not promoting violence, but rather mimicking and projecting the society that we live in.

We want to rationalize and determine if an action is ethical. Just recently we have seen Colin Kaepernick kneel during the national anthem and cannot imagine why anyone would even condemn him for expressing his freedom of speech. But then, we see the war veteran without legs who so bravely defended our country and does not have the privilege to stand for the flag he fought for and our ‘ethical’ minds question, what is right and what is wrong?

The same dilemma happens in sports; however, we fail to see both sides. We see the violence of football, boxing and ice hockey, and automatically determine that this is affecting us, our children and the way our society functions. On the contrary, we do not look at the violence already in society and in some way see how it reflects itself and impacts sports.

Violence in the sporting arena has been around longer than historians may even know. Gladiators fought until the death and 20,000 people encouraged the fighters to slaughter each other. In 1930, Maximillian Adelbert Baer killed a man in the boxing ring and spectators cheered until they realized his opponent was not moving. It seems that we as fans love this ferocity. We watch in awe and anticipation, and almost thrive off of the viciousness within the arena.

But why does the violence make us feel invigorated, even happy? I believe the answer lies deep within the human soul. We all have our own opponents. Every single day we wake up there are obstacles we have to face, problems looking to crush us and the unstableness of life. This instability causes anxiety. It causes anger. We cannot always understand why bad events tend to happen. We cannot understand why they happen in general, not only to us, but to humanity. When evil attacks, our response is to fight it. We do not welcome it with open arms into our lives, but rather, we wish to eradicate it from ever coming near the people and things that we so love.

So we wrestle with the malevolence; we stand up for ourselves, we protest, we fight for our beliefs just as the gladiators looked to defend themselves and the defensive lineman looks to tackle the running back charging towards him. In sports the opponent is the evil, trying to invade our basket, our end zone, our goal line, which at that moment is the most valuable piece of life. When we defeat the challenger and win the passing of a particular job or make the game-winning basket, then, we feel alive. We have defeated that invasion, rising victorious.

The violence of sports is a projection of society, not a promotion of actions. Sports respond to the way that human beings act. Charles Darwin theorized about survival of the fittest in 1859. The animal, the human being, the plant, that knows how to adapt, knows how to defeat the other to survive. We cannot blame sports for influencing violence in the world, when there is an inherent desire to demolish the competition within all creatures of this earth. Sports project this tendency that already exists. If we are unhappy with the climate of the sporting arena then the only way to change it would be to change the climate of life.

So, in the most literal and figurative way, the ball is in your court to decide if this violence is ethical or not. But before you decide, look at the world around you. See the wickedness that occurs every day in many different ways and then determine whether this is because of sports or if sports are simply a slightly more manageable way of projecting this wickedness in ways that are more controlled than most acts of vice in the society of our time.

Maria Trivelpiece ’19 is a student at Fordham College Rose Hill. She is double majoring in psychology and journalism. 

Stoking the Flames of Competitiveness on an Overheating Planet

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STUDENT VOICES

By: Michael Aprea

This essay is in response to the Carnegie Council for Ethics in International Affairs video “Climate Protectionism and Competitiveness.”  

Steam put the world in motion. It lit up the night, and tightened humanity’s grasp on the forces of nature. Nature, however, has eluded the human race and has forced civilization to reconsider its power in the most fundamental sense. Scientist, politicians, and citizens now face the heat as they scramble to address a cycle of global warming spawned by the progress of the industrial revolution that threatens to unhinge the fragile balance of Earth’s ecosystems. Reducing carbon emissions has been the answer to the problem. This standard that has taken hold in developed nations has morphed into a global economic crusade against carbon emissions through regulation, taxation and sanctions seeking to curb the emissions of the developing world. Although consumer responsibility and global collaboration in an endeavor to reverse global warming trends are laudable, it is important to recognize the risks these steps pose on global trade, the citizens of developing countries, and the debt developed nations have as beneficiaries of the first fruits of fossil fuels.

The United States owes its status as an economic superpower to the progress of the industrial revolution; a revolution fueled by carbon emitting fossil fuels. The rapid growth of nations such as Unites States reliant on fossil fuels came at price–rising global temperatures. Carbon doesn’t only heat up cold economies, it also has the ability to raise average global temperatures as it gets trapped in the atmosphere and captures solar radiation. These shifts in temperature have precipitated evident changes in the environment. Recent glacial melting, super storms, and inflated and more rapid extinction rates can all be traced to these rising temperatures. In response, the United States and other developed nations have sought alternative fuels to reduce carbon emissions. These measures entail large investments of capital, and higher costs of production–a reality that makes production in underdeveloped nations more cost effective and foreign products cheaper. This reality, coupled with policies and regulations that seek to reduce carbon emissions through taxation and sanctions on developing nations still very dependent on fossil fuels, raises a host of ethical questions–particularly regarding the right and motive a developed nation has in enforcing such measures.

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Ethics, Undocumented Immigrants and the Issue of Integration: Making a Better Life for Everyone in New York City

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STUDENT VOICES

By: Yohan Garcia

This essay is in response to the Carnegie Council for Ethics in International Affairs video clip “Nisha Agarwal: IDNYC & the Undocumented Community.”  

According to a study conducted by the Migration Policy Institute (MPI), an estimated 643,000 undocumented immigrants live within the five boroughs of New York City. Advocates of the New York City Municipal ID card hoped that government-issued photo identification would bring many of those undocumented immigrants out of the shadows. With the newly elected President of the United States, Donald Trump, many are wondering whether the NYC Municipal ID was the right thing to do as the cards can put undocumented cardholders at greater risk of being harassed by government authorities and even of deportation.

Nisha Agarwal, Commissioner at the NYC Mayor’s Office of Immigrant Affairs, argues that the NYC Municipal ID card has helped many undocumented immigrants do things such as pick up their kids from school, access public and government buildings, interact more easily with police officers, and open bank accounts. Furthermore, the Commissioner argues that the Municipal ID has helped many undocumented immigrants increase their sense of belonging to New York City and to the United States. Given that sixty percent of NYC’s population is foreign born and less than half of the city’s population has a driver’s license, the Municipal ID proves to be an effective legal response to cope with the need for identification in NYC.

One of the biggest misconceptions about undocumented immigrants is that they take job opportunities away from American citizens. Many believe that immigrants do not pay any taxes and that they do not want to assimilate to the United States. However, studies conducted by the Pew Research Center suggests that these opinions are a product of anti-immigrant context which has been sustained and reproduced by the political climate. It is both unethical and immoral to punish individuals for choosing to migrate to another country without having the proper documents. The United States takes in a certain number of refugees per year, would it not be morally wrong to ignore and punish those already living in the country?

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