Motherhood and Ethics with Sarah LaChance Adams

Overview & Shownotes We’re discussing motherhood with philosopher and director of the Florida Blue Center for Ethics Sarah LaChance Adams. She argues that we romanticize mothers, and in so doing ignore the pain and failure that come with caregiving. In her work, she explores the ambivalence of motherhood and what it can teach us about ethics. We discuss the ethics of parenting, Simone de Beauvoir, and much more on this episode of Examining Ethics. For the episode transcript, download a copy or read it below. Contact us at [email protected] Links to people and ideas mentioned in the show Sarah LaChance Adams, Mad Mothers, Bad Mothers, and What a “Good” Mother Would Do: The Ethics of Ambivalence Care ethics Credits Thanks to Evelyn Brosius for our logo. Music featured in the show: “Single Still” by Blue Dot Sessions “Etude 7” by Blue Dot Session

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

The Maternal Tug: Ambivalence, Identity, and Agency

While the existence of maternal ambivalence has been evident for centuries, it has only recently been recognized as central to the lived experience of mothering. This accessible, yet intellectually rigorous, interdisciplinary collection demonstrates its presence and meaning in relation to numerous topics such as pregnancy, birth, Caesarean sections, sleep, self-estrangement, helicopter parenting, poverty, environmental degradation, depression, anxiety, queer mothering, disability, neglect, filicide and war rape. Its authors deny the assumption that mothers who experience ambivalence are bad, evil, unnatural, or insane. Moreover, historical records and cross-cultural narratives indicate that maternal ambivalence appears in a wide range of circumstances; but that it becomes unmanageable in circumstances of inequity, deprivation and violence. From this premise, the authors in this collection raise imperative ethical, social, and political questions, suggesting possibilities for vital cultural transformations. These candid explorations demand we rethink our basic assumptions about how mothering is experienced in everyday life