Tuesday, November 01, 2011

Health as a Community

Though I am getting ready to venture into the world of nursing and western healthcare, I am learning more and more some of the qualms I have with western medicine.

Don't get me wrong. The United States is renowned for their acute healthcare abilities. But we practice and propagate sick care, not health care. The United States is not known for prevention, rather for treating once we are sick.

When it comes to health care, the biggest question for me is just because we can, or just because we have the capabilities, should we?

I have a dual approach to health care. I believe in education and prevention. I believe in taking from the earth, and following the natural practices that have worked for thousands of years. I believe in being resourceful and adequate, yet being lean and efficient. And I recognize the need for advanced health care and its benefits. But there comes a point where just because we can, should we? Should we save neonates at 20 weeks and should we prolong the end of life, simply because we can? Should we continue to cure cancer? Or is disease the earth's way of controlling our increasing overpopulation?

Healthcare in America focuses on patient autonomy and the individual. In a world of private insurance (don't even get me started on all that venture), we deny universal health care access yet expect to emphasis individualization and equality.

It's all a catch-22. The healthcare field is not black or white, but a million shades of grey.

In my bioethics book, we are reading about health care, ethics, environment, and sustainability. I strive to be a green person. I wish more of us did. But I enjoyed the following passage that addressed the need to view healthcare not as belonging to an individual, but health as a membership in a community:

"Potter was strongly influenced by ecologist Aldo Leopold and geneticist C.H. Waddington. For Leopold, land was a collective organism - not merely soil, but a "fountain of energy flowing through a circuit of soils, plants, and animals." People, he said, are "plain members of the biotic community." Leopold argued that a thing was right when it tends to preserve the integrity, stability, and beauty of the biotic community. It was wrong when it did otherwise. He thought that ethics and beauty should play an important role in deciding how to live on the earth."

"It is increasingly clear that the world of the twenty-first century requires a new bioethic that bilds on and recontextualizes twentieth century medical and public health ethics. Ethics may embody what we believe and value, but surely must also be informed by what we know to be true. If people are to survive on earth with lives of quality, all institutional sectors, including health care and public health, will need to take a hard look at objective wisdom, give moral consideration to entire ecosocial systems as well as their human participants. A new bioethic will emphasize interdependence and interconnectedness, duties and responsibilities as well as rights, and will celebrate humans as members of complex communities. The alternative is to plan for a past that no longer exists, while ignoring a future that will not be denied."
-Ted Schettler Toward an Ecological View of Health: An Imperative for the Twenty-First Century

I think that our healthcare system would highly benefit if we started looking at it from a community perspective, not from the perspective of "every man for himself." For when we look at healthcare, we look at the whole person. It's not an isolated and personal possession, but rather is something that connects us with others. Wendell Berry (in his essay Health Is Membership) says, "I believe that community - in the fullest sense: a place and all its creatures - is the smallest unit of health and that to speak of the health of an isolated individual is a contradiction in terms." We can't ignore the problems that exist within a community, let alone the health of a community. So why do we? Why do we treat it as an individual event when part of what makes us healthy isn't simply the non-existence of disease but our mental, emotional, and spiritual well-being as well...all of which are shaped by the community within which we live?!

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