A Philosophy of Nursing Forum
Wednesday, August 12, 2009
Some readers of this blog have, perhaps, been watching the United States try to devise a rational health care system. I imagine reactions around the globe have varied along a spectrum, from amusement on one end to the sort of pity, mixed with horror, that a classic Greek tragedy produces, on the other. The most vocal opponents over here of any sort of systematic health care planning and reform are being labeled “deathers.” Deathers claim that, under any sort of nationally mandated health care scheme, a lot more old peopled will die a lot sooner than they otherwise would. Those who have been watching from (lucky you!) afar will enjoy this bit of “tongue in cheek” about the “deather” position from the U.S.A. Blogosphere:

'When Obama and the Democrats try to explain how America's health care crisis can be fixed, they often point to our neighbors to the north.

"Canada provides health care to all its citizens, we can too," say the optimists.

Sounds good until you consider this scary fact: at some point after Canada instituted its national health care program, everyone in the country died.

This startling truth emerged today when a group known as the "Deathers" -- sponsored by a consortium of health insurance companies and endorsed by Senator Mitch McConnell (R-KY) -- held a press conference exposing a surprising statistic: according to the most recent census reports, Canada's population is currently zero.

"Near as we can tell, some of them dropped dead right away and some of them were horribly disfigured and stumbled around for awhile and then died," Jordan Gipple, a spokesman for the Deathers, reported "but the bottom line is, from Newfoundland to British Columbia, there's not one single person up there. It's like The Omega Man only without Charlton Heston."

A reporter asked why it was that so many Canadians do seem to be alive and perfectly healthy today. Wayne Gretsky, Seth Rogan and Nelly Fertado were cited as examples. Mr. Gipple responded that these so called "Canadians" actually reside outside of Canada in places like Arizona, Los Angeles and New York. "They're like refugees from the Titanic. Sure, every once in awhile you'll find one floating around, but I bet you five bucks not one person here has seen a real Canadian in the past 24 hours. They've all gone to the great beyond. And you can thank national health care for that!"

"Canada's not the only place. There used to be plenty of people in Norway and Sweden and France. There were even some people in England. But then they went and instituted national health care. And now they're gone too."

Mr. Gipple ended with an impassioned plea that brought tears to the eyes of the press members present, "Yes, America's health care costs are spiraling upwards. Yes, 46 million Americans are uninsured. And yes, about 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs. But seriously, what are the options? Just look at what happened to these other countries when they tried to "fix" the system. I know I speak for all Deathers when I say we must keep the system we have, absolutely. Don't touch it. We don't want to wind up like Canada or Holland or Denmark or Germany. They're all gone. Now it's up to us, us fortunate few, to keep the candle of mankind burning." '

Recently, a U.S. reichwing opinion writer stated:

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.”

Of course, other bloggers jumped on this, and one of them pointed out the blindingly obvious:

... "Stephen Hawking was born and raised in the UK and has lived there all his life. He teaches at Cambridge. That's in the UK. This ranks up there with the French not having a word for entrepreneur."

In sum, the combination of galactic ignorance, Harry Frankfurt Bull Shit, and out and out thuggery (our own Kay Lundy's apt and pithy term) going on over here is truly astounding, until you remember that this is happening in America, where knife fights on the floor of state legislatures happened once upon a time, today's college freshmen can't find Wales on a map, and Sarah Palin thinks she can see Russia when she opens her front door.

Sooner or later, it will occur to someone to look at statistics. The following numbers come from our CIA, so they must be pretty good, right? Canada =81.23 years, Norway =79.95, UK=79.01,USA = 78.11. The US only beats Albania, hands down the poorest country in Europe, by a few months.

So, how are you perfidious Cannucks, Norskies and Brits managing this? Do you come up with a closely guarded secret “target” age, fixed upon by NHS gnomes, to keep the “life expectancy” numbers up to a level that reassures the gullible public, and THEN do granny in? Or, could it be that here in the US of A we are, in fact, doing granny in ourselves, in various and sundry (and often unpleasant) ways, but just lying to ourselves about what really goes on here?

Perhaps, for example, we make routine care out of reach for Granny for most of her life, so that her type II Diabetes, and hypertension, go undetected for years. Then, when we finally do detect it, we prescribe expensive meds she can't begin to afford, when over the counter Humulin R and Lasix, coupled with some patient education, would have done very nearly as well. Or even better. Then, when her kidneys fail, we put the tax payers (and Granny) through the oiive press with dialysis. The cost of the dialysis, it should be noted, will far exceed what a lifetime supply of Humulin R, generic brand Walmart insulin syringes, a few home health visits, and generic lasix would have cost.

After months of this misery, Granny refuses dialysis and dies. Painfully. This happens. In 15 years as a long term care nurse, I have held "Granny's" hand, under exactly these circumstances, more times than I care to remember. I cry each and every time it happens. Sometimes, the Director of Nursing has to send me home. “Pay no attention to the man behind the screen, Dorothy.” Could it be that “deathers,” heaven help us, are right to look, but are looking in the wrong direction?


The grey-haired Americans need to speak up...there is strength in voices, especially ones that loudly spoke of 'peace, love, unity, and 'no war' in their youth. The Obama health care plan has its major faults and could cause as much damage as a major earthquake if it somehow becomes a reality.
The current state of health care policy in the U.S. is faulty...but Obama, like those that have tried before him, does not have the answers/the fix for what ails America.
The majority of health care providers in the U.S. are nurses...where are we in this grand plan??
Philosophical Inquiry in Nursing

My name is Tina McDyess and I am a student at USM in Dr. Lachel Story's class NSG 701-Philosophy of Nursing

Do you agree and disagree with Pesut & Johnson's assertion that "philosophical inquiry has yet to be positioned as contributing substantially to the field of nursing's inquiry. Why or why not?

Philosophical Inquiry in Nursing

After reading the article by Pesut and Johnson, I do agree that philosophical inquiry has yet to contribute substantially to the field of nursing. While agreeing with Pesut and Johnson, I believe that philosophy and theory needs to be more clearly defined as they relate to nursing. Philosophy has been defined as a love for wisdom. Nurses love wisdom and are in search for it. However the thoughts and ideas displayed by nurses if brought forth in another discipline would be considered philosophical. But due to substantial amount of objectivity in nursing, the thoughts and ideas were considered theories. Philosophy seeks to understand what is good and right as does nursing. Edwards (2001) characterization of the three strands of philosophical inquiry: philosophical presuppositions; philosophical problems; and scholarship (Pesut & Johnson, 2008) allow individuals to see how various aspects of nursing are threaded throughout philosophy. Philosophy seeks to challenge and refine knowledge gathered through scientific means. Therefore regardless of the scientific background and reliability of certain nursing knowledge the inquiry of philosophy seeks to answer the question ‘is this method good and right for the patient'. Furthermore, Florence Nightingale’s ideas of sanitation and implementation thereof was considered a theory but it possesses the characteristics of the tools of philosophical inquiry. In an effort to eradicate cholera, Nightingale made an assumption that clean water and cleanliness of the hospital would help. Then through her intellectual processing, she made a judgment and began to show reasoning behind her idea. The tool of wonder led to the practice of her initial assumptions about sanitation. Although philosophy has a stance in nursing, it has not taken a solid position that distinguishes certain ideas and thoughts clearly as nursing philosophy. After reading this article the evidence of philosophical inquiry is present but not always referred to as such.

Pesut, B. & Johnson, J. (2008). Reinstating the ‘Queen’: understanding philosophical inquiry in nursing.

Journal of Advanced Nursing 61(1), 115-121.
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