The paper summarizes recently published data and recommendations about healthcare disparities experienced by African Americans who have Medicare or other healthcare coverage. Against this background the paper addresses the ethics of such disparities and how disadvantages of vulnerable populations like African Americans are typically maintained indecision making about how to respond to such disparities. Considering how to respond to disparities reveals much that vulnerable populations would bring to the policy-making table, if they can also be heard when they get there. (...) The paper argues that vulnerable populations like African Americans need fair representation in bodies deciding what to do about such disparities and that fairness requires proportional representation at all levels of decisions that affect healthcare – a radical change. In this decision setting, howto provide adequate protection of minorities needs much further attention. The most attractive decision-making model is deliberative democracy. The paper shows that in deliberation, fair representation requires not only having a voice in decisions, but a fair hearing of those voices. Achieving a fair hearing requires changes in norms of communication and training of all to give importance to greetings and other measures of civility and trust building, and to be open to diverse forms of expression. Decisions about how to respond to healthcare disparities would include what programs to initiate for whom, howto evaluate the programs, and what to do in response to such evaluations. Conclusions are that achieving such goals will take a sea change in how healthcare institutions and providers do their business, and that social activism at every level will be needed to effect these changes. The discussion highlights many ethical issues that need much greater attention. (shrink)

Dominant social theories have rarely placed migration at the center of our understanding of society and social change. Classical theories in the Western tradition have been more preoccupied with the impact of economic and political revolutions on social change, stratification and class conflict, and have paid far less attention to other important aspects of society. Contemporary theories have expanded the theoretical gaze to include a much wider set of issues, from racial and gender divisions to warfare and the environment. In (...) an era of globalization, we argue that such a marginalization of the migrant, and the failure to better integrate both internal and external migration into a more nuanced interpretation of social change, is a significant shortcoming. By examining some of the key elements linked to such human movement in Europe, North America and China -- in the light of five recent studies in this field -- we argue that migration is a vital factor in changing the world as we know it and consequently a central concern for social theory. This is a review essay on. (shrink)

Three years' experience in teaching a course in Literature and Medicine is reviewed. Examples of the Laboratory or in vitro functions of art are given, as they relate to and benefit both medical students and practitioners. The usefulness of literature (especially) in the medical setting is underscored, together with the need for medical personnel to be more aware of their heritage in this area. Examples of well-known physicians who have excelled in the arts (literature, music, painting/sculpture) are given and their (...) major contributions discussed. There are some surprises. (shrink)