Tanya Matthan: environmental justice and epistemic violence
tanyamatthanIn their introduction, Vermeylen's argument for a particularist and decolonial approach to justice through a recognition of plural ontologies and epistemologies that decenters Western liberal discourse and its theory of justice. How does bringing the lens of coloniality into environmental justice literature alter our visions of energy futures? Can we make appeals to environmental justice without recourse to liberal theories of individual rights and property ownership? More specifically, I am wondering how our team can study and address this dynamic plurality of ways of understanding and experiencing in/justice in this site, and how can we engage this plurality in productive ways? What axes of difference and inequality should we be looking for/at (race, gender, class, sexual orientation, citizenship, housing status, etc)? If the Anthropocene is coloniality by another name, how can we foreground this in our approach?
Settler Colonialism in Texas
kguptaEnvironmental justice narratives in the U.S. often fall into "sacrifice zone" narratives that universalize experiences on the community-level, reproducing specifically bounded narratives about American lives and livelihoods, relationships to nature and capital, and the kinds of knowledge and authority that matter. Vermeylen's article disrupts this idea, rightfully arguing that environmental justice requires a more upfront confrontation with the socio-historical causes of oppression brought about by coloniality, as well as the fact that we need to question the righteousness of EJ discourses that rely on white settler logics.
For the Austin Field Campus, how can we bring attention to Anglo-American settler colonialism in our approaches to EJ and gentrification? And thinking back to the NOLA Field Campus, what Texas histories should we be drawing from to understand energy transitions in the city?
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Sara_NesheiwatThe Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.
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Sara_NesheiwatEMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.
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Sara_NesheiwatThis policy applies to American law and patients who are in need of emergency medical treatment and is to be followed by all emergency departments and personnel alike.
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Sara_NesheiwatThis was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.
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Sara_NesheiwatThis policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.
http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…
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Sara_NesheiwatThis policy was explicitly made for vulnerable populations who couldn't afford or for whatever reason did not have health insurance. The vulnerable parties that did not have health insurance were at risk of being turned away at hospitals during crucial times of need and emergency situations. This act completely absolved the worries and fears of this vulnerable population without health insurance by making it a law that these ED patients were to receive care and stabilization. This act was made for this specific vulnerable population, to prevent discrimination.
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Sara_NesheiwatThis policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.