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Thesis of Chapter:
p. 220 "...the goals of this chapter are to raise and to answer, some questions relevant to health and human rights; to explore the promise of pragmatic solidarity as a response to structural violence; and to identify promising directions for future work in this field."

p. 213 "Article 25 of the Universal Doctrine of Human Rights: 'Everyone has the right to a standard of living...'"

Play into thesis of the book:
p. 215 "In fact, from the perspective of the poor- and most of these prisoners are poor- neither legal nor conventional human rights approaches have even began to understand the nature of the problem."

p. 246 "The argument of this book has been that it is time to take health rights as seriously as other human rights, and that intellectual recognition is only a necessary first step to pragmatic solidarity, that is, toward taking a stand by the side of those who suffer most from an increasingly harsh 'new world order.'"

Significant Quotations:
p. 217 "One of the central points of this book is that public health and access to medical care are social and economic rights.."

p. 219 "...the destitute sick are increasingly clear on one point: making social and economic rights a reality is the key goal for health and human rights in the twenty-first century."

p.219 "Whereas a purely legal view of human rights tends to obscure the dynamics of human rights violations, the contextualizing disciplines reveal them to be PATHOLOGIES OF POWER."

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"This chapter discusses tuberculosis as punishment" (179 Farmer).

"Little public outcry was heard, however, until prison wardens, health professionals, and other such "innocent" parties began to fall ill. Then, as Laurie Garrett describes, "panic broke out" (185).

"The three major problems facing our correctional system are underfunding, overcrowding, and tuberculosis. Simply being in prison is one of Russia's biggest factors for TB" (187).

"Let us remember that MDRTB treatment is available for the fortunate few; others, including most prisoners, are summarily informed that their affliction is incurable" (180).

How does this chapter relate to the rest of the book?
--> It looks at the injustices in the prison system.

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Thesis of the Chapter: The bioethics of medicine is directly related to social justice - while we practice medicine of any sort, we must remember human rights.

How the Thesis relates to the book as a whole: This chapter's thesis relates to the book's thesis though the impact of the medical practices and research on the poor and the necessity of bio ethics and how important human rights are to take into account.

Notable Quotations:

207-Can medical ethics, necessarily grounded in the dilemmas faced by patients, develop a broader view of who gets sick and why? Of who has access to care and why?

p.210- "the greatest challenge for medical ethics is to resocialize the way we see ethical dilemmas in medicine"

p.-210-"To return to questions of accountability, I would also warn that the so-called “gray areas” of medical ethics are becoming more black and white with time. "
p. 201-"The good news is that even though the poor are not mentioned in the document, something just as important is: the first of the ethical principles enumerated states that health care is a human right.17 Of course, this has all been said before—health care is certainly featured as a human right in the Universal Declaration of Human Rights— but the Tavistock document is a statement on professional ethics and, like most such statements, was formulated by members of the profession"

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Chapter 6 "Listening for Prophetic Voices"

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Chapter 6 "Listening for Prophetic Voices"

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1. What is the thesis of each chapter? "We thus find ourselves at a crossroads: health care can be considered a commodity to be sold, or it can be considered a basic social right. It cannot comfortably be considered both of these at the same time" (175).
2. How does the chapter contribute to the overall thesis/argument of the book? "These inequalities could be the focus of our collective action as morally engaged members of the healing professions, broadly conceived. For we have before us an awesome responsibility - to prevent social inequalities from being embodied as bad health outcomes" (178).
3. Significant quotations/passages?
"Where will healers stand in struggle for health care as a human right?" (178).
"Edmund Pellegrino argues that...the highly championed view of market forces as the ideal mechanism driving the distribution of goods and services in a democratic society cannot be extended to the medical profession. The ends and purposes of medicine are unique, since they are linked to issues of individual trust and common good" (162).
"The health care system should 'help people buy what they want...Therefore, people should be allowed to purchase health care packages that provide limited or less than optimal care. As as matter of justice, they should also be allowed to received only the health care services that their coverage allows'"(163). Comment from person championing investor-owned health plans.
"Attempting to provide a 'basic minimum package' for the poor is something that should be done apologetically, not proudly" (177).

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Review #3

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Review #2

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Review #1

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Chapter 9 "Rethinking Health and Human Rights" (Group 5)

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Chapter 9 "Rethinking Health and Human Rights" (Group 5)

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Chapter 7 "Cruel and Unusual" (Groups 2 and 3)

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Chapter 7 "Cruel and Unusual" (Groups 2 and 3)

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Chapter 6 "Listening for Prophetic Voices" (Group 1)

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Chapter 6 "Listening for Prophetic Voices" (Group 1)

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Chapter 5 "Health, Healing, and Social Justice"

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Chapter 5 "Health, Healing, and Social Justice"

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Chapter Thesis:

"...this chapter explores the implications--so far, almost completely overlooked--of liberation theology for medicine and health policy" (141).

How it contributes to overall thesis:

Liberation theology emphasizes that "the condition of truth is to allow the suffering to speak." (153). Emphasis on listening to the poor themselves.

Significant Quotations:

140--"To those concerned with health, a preferential option for the poor offers both a challenge and an insight. It challenges doctors and other health providers to make an option--a choice--for the poor, to work on their behalf."

140--"...a simple methodology--observe, judge, act."

145--"How would a health intervention inspired by liberation theology be different from one with more conventional underpinnings?" ("Pragmatic Solidarity")

152ff.--"A Social Justice Approach to Addressing Disease and Suffering" (not "charity" or "development")

158--"A preferential option for the poor . . . analysis must be historically deep. . . geographically broad."

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Chapter 2 "Pestilence and Restraint" (Group 2)

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Chapter 2 "Pestilence and Restraint" (Group 2)

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Chapter Thesis:

p.54 " The version offered here—that of the detainees, many of whom I interviewed in 1993—differs significantly from the accounts offered by journalists, U.S. government officials, and even the Haitians’ lawyers."

How it is related to the overall thesis:

Farmer uses the perspective of two people Yolande Jean and Jesus Balle. Both of these individuals are ill due to their socioeconomic status and their basic human rights are violated by their governments and the USA because they are considered diseased.

Significant quotes:

p.56 " We're treated like animals"

p.61 "We had been asking them to remove the barbed wire; the children were playing near it, they were falling and injuring themselves. The food they were serving us, including canned chicken, had maggots in it. And yet they insisted that we eat it. “Because you’ve got no choice.” And it was for these reasons that we started holding demonstrations."

p.75 "The promotion of equity—and thus of social and economic rights— is the central ingredient for respecting human rights in health care."

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Chapter 1  "On Social and Structural Violence"(Group 1)

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Chapter 1  "On Social and Structural Violence"(Group 1)

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Chapter Thesis: The lack of proper government intervention within the community  has created an environment that facilitates poverty violence, destructive behaviors, and overall suffering. This lack of support has allowed diseases like AIDS to take hold of the community, combining with the violence, to promote suffering.

How this chapter contributes to the overall thesis of the book: The foundation of this chapter is rooted in the poor's experiences and perspectives of suffering. From this aspect, we are able to better understand the implications of human rights.

Significant Quotations:

·         Page 42 - "Rather, simultaneous consideration of various social "axes" is imperative in efforts to discern a political economy of brutality."

·         Page 50 - "Today, the world's poor are the chief victims of structural violence - a violence that has thus far defied the analysis of many who seek to understand the nature of distribution of extreme suffering. Why might this be so? One answer is that the poor are not only more likely to suffer; they are also less likely to have their suffering notices…'A wall between the rich is being built, so that poverty does not annoy the powerful and the poor are obliged to die in the silence of history.'"

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Thesis of book:

”The central thesis of this book is that human rights abuses are best understood (that is, most accurately and comprehensively grasped) from the point of view of the poor. This too is a relatively novel exercise in the human rights community. In no arena is it more needed than in that of health and human rights” (17)

Significant Quotations:

5--“The images and events we experienced during these twenty-four hours -- rummaging Mexican soldiers, a martyred teenager and a martyred bishop, the workshop of well-meaning elites from the capital, a mental health project involving exhumation, a cry against neo-liberalism -- encapsulate as well as anything can the heart of what I hope to write about in these pages.”

6--”This book is a physician-anthropologist’s effort to reveal the ways in which the most basic right--the right to survive--is trampled in an age of great affluence, and it argues that the matter should be considered the most pressing one of our times. The drama, the tragedy , of the destitute sick concerns not only physicians and scholars who work among the poor but all who profess even a passing interest in human rights. It’s not much of a stretch to argue that anyone who wishes to be considered humane has ample cause to consider what it means to be sick and poor in the era of globalization and scientific advancement.”

19--”Pathologies of Power suggests that a broad biosocial approach, when anchored in careful examination of specific cases, permits a critical reassessment of conventional views on human rights.”

20--”Pathologies of Power draws on social theory--and even liberation theology--to reintroduce the concept of structural violence and to link it to the acute violence of war crimes and systematic assaults against human rights.”

22--”When it is a matter of telling the truth and serving the victims, let unwelcome truths be told. Those of us privileged to witness and survive such events and conditions are under an imperative to unveil -- and keep unveiling -- these pathologies of power.”

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Chapter 4 "A Plague on All Our Houses" (Group 5)

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Chapter 4 "A Plague on All Our Houses" (Group 5)

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Chapter Thesis:

“Curing the prisoners before their release is the best way to respect their rights and also the best way to prevent further transmission to prison staff and to the civilian population”(121).

“Opponents of universal tuberculosis treatment . . . fail to acknowledge that MDRTB is not exclusively a disease of poor people in distant places” (133).

How this chapter contributes to the overall thesis of the book:

Significant Quotations:

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Chapter 4 "A Plague on All Our Houses" (Group 4)

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Chapter 4 "A Plague on All Our Houses" (Group 4)

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Chapter Thesis

“Russian prisoners with an airborne disease have become yet another reminder of the “unsustainability” of any approach based on differential valuation of human life” (129)

How it is related to the overall thesis:

Those who are incarcerated have rights that are not the same as other civilians. Once they go to jail they are prone to getting TB, and it violates human rights that they are not getting the right and effective treatment. You can’t determine who gets treatment based on their criminal status.

Significant Quotations:

133--“Drug prices should not constitute the chief barrier to effective therapy for all patients, regardless of infecting strain."

119--“But the overall effect of a modern Russian TB colony is one of gloom, shabbiness, and desuetude, amid a stark lack of necessary supplies."

129--“But the case for prompt and effective therapy for all forms of active tuberculosis, everywhere, must also be made on human rights ground."

119--“An epidemiological catastrophe has come to pass inside Russia’s prisons and in many others throughout the former Soviet Union: ineffective treatment regimens have produced drug-resistant disease and since only the susceptible strains are being treated effectively, the proportion of drug resistant cases continues to grow.”

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Chapter 3 "Lessons from Chiapas" (Group 3)

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Chapter 3 "Lessons from Chiapas" (Group 3)

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Chapter Thesis:

“If Chiapas has a lesson for the rest of the world, it’s that the world’s resources  must be more evenly shared. Human rights are respected when everyone has food, shelter, education, and health care -- and the poor of Chiapas were claiming these rights.” (111)

How this chapter contributes to the overall thesis of the book:

It shows the human rights issues in Mexico from the point of view of the poor, specifically in Chiapas.

Significant Quotations:

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99--”It is not true that Chiapas is poor . . .who are poor.”

99-- “In a declaration made at the outset . . . existence the media recognized.”

103--”Although one hears much talk about the “Mexican bailout” . . . more visible inequalities.”

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Paul Farmer, Pathologies of Power. U. California Press, 2005

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Paul Farmer, Pathologies of Power. U. California Press, 2005

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1. What is the thesis of each chapter?
2. How does the chapter contribute to the overall thesis/argument of the book?
3. Significant quotations/passages?