"Moral distress - knowing what is ethically appropriate but being unable to act on it because of obstacles inherent in a situation - was first described in 1984 in a book on nursing ethics. Subsequent researchers focused primarily on the experiences of nurses and found that those who suffered from moral distress often became reluctant to interact with patients and other providers. In one recent study, 15 percent of nurses left their jobs because of moral distress."
"Those who work in geriatric care are among the worst paid in the health care system. Is the time I spend as a surgeon excising a patient's cancer worth 10 times more than the time the primary care doctor spent finding the cancer in the first place?"
Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time." "People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit." Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time.... People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit."
from "Experiencing Death" (Advent-&-Passion?)
I had imagined being there beneath sunlight/ with the procession of martyrs/ using just the one thin bone/ to uphold a true conviction/ And yet, the heavenly void/ will not plate the sacrificed in gold/ A pack of wolves well-fed full of corpses/ celebrate in the warm noon air/ aflood with joy . . . .
"Africa is everywhere, so pervasive in our lives that we barely see it. Since it is in all likelihood the continent where human evolution began, it is literally in the bloodstream of everyone. DNA aside, huge portions of everyday life and cultural achievement are unthinkable without Africa."
The insistence of conservative leaders that patriotism be defined by a believe that the US is INTRINSICALLY EXCEPTIONAL strikes me as the very form of IDOLATRY attacked by both Hebrew prophets and Jesus - who pointed out that God's chosen Israel was guilty of many wrongs (social injustice and spiritual pride & hypocrisy). The prophesies about the fall of Jerusalem and Temple - and the insistence that God preferred merciful hearts and justice toward the poor over orthodox beliefs, rituals and nationalism - were seen at the time as anti-religious and unpatriotic, and resulted in persecution. But the protests of political leadership and "false prophets" ("Calamity won't come upon you!" - Jer. 23:17) did not prevent the ACTUAL destruction of the Temple,& political entity, in both the 6th C. BCE & the 1st C. CE. America has many great things to its credit: its Constitution, its guarantee of civil liberties including religious freedom, its traditional welcome of immigrants & prohibition of discrimination against them (14th Amendment!), the Civil Rights movement. But the Constitution came at the expense of legitimizing chattel slavery; & reconciliation of the South after the Civil War came at the expense of segregation, loss of black voting rights and KKK terror. Much of what some citizens have seen as exceptional - expansion to the Pacific (much of it through a questionable war with Mexico, and slaveholding occupation of much of the Louisiana Purchase, addition of territories through deceptive use of force against Spain in 1898, Hawaii's rulers in 1899 and Colombia in 1903 (to obtain Panama Canal) - as well as violent suppression of Philippines independence movement in first decade of 20th C.) - can hardly be things that God facilitated. If we want to be "exceptional" in a good way (competition isn't always bad, when it doesn't hurt the Other, and when it strives for excellence), shouldn't it be through our VALUES and how we PRACTICE them? - for instance, opposition to violence as a first resort for solving disputes and our efforts at genuine peace-making, our push for civil rights abroad as well as at home (think Jimmy Carter), our valuing of each other as fellow citizens (instead of trying to "take back 'OUR' country" from people of the party who are almost demonized as near-traitors), our willingness to compromise for the sake of the overall, long-term good of the country? The Republican insistence on sticking to ideological purity, to seeing as Obama's defeat as their primary goal (therefore, non-compromise on most substantive legislation) represents the kind of idolatrous, exclusive nationalism Jeremiah faced in 600 BCE and Jesus did about 30 CE. I fear that the US WILL decline as a nation - relative to China, for instance - primarily because the thinking of one of its 2 major parties (one essential to cooperative good governance) has ossified and is consumed only with the idea of power, and to exclude the Other (which our half-African President seems to emblemize for them) from any influence. We have been blessed as a country, but I am convinced God did not ordain us to be THE exceptional nation. Only Israel has any Scriptural claim to that title, and much of their example as a "light to the Gentiles" has been in how the Jewish people have suffered (Isaiah's original "suffering servant": the very role Jesus took on himself as the Christ: humility, mercy & inclusion - not pride and a harsh exclusive attitude.) What is the definition of idolatry? To worship at the altar of ANY human construct - whether thing or idea - rather than to bow to God's mystery - in Micah's words: "God has told you, O mortal, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly with your God?" ( Micah 6:8)
Republicans attack Obama for seeing US as no more (intrinsically) exceptional than other nations, & suggesting that what is exceptional is the goals citizens strive for, not a pre-ordained status.
Niece defends JFK's 1960 speech to Houston ministers as better defining 1st Amdmt's meaning & application than Sarah Palin's recent critical construction.
Happiness is as much intellectual as emotional - it results from "flourishing" in one's interaction with life, not just from "feeling pleasure." It may even result from dealing directly and courageously with pain.