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Summary

margauxf

Sabina Vaught’s Compulsory challenges conventional understandings of state schooling through an ethnographic exploration of the juvenile prison school system in the United States. Vaught examines the ways in which juvenile prison and prison school are shaped by legal and ideological forces working across multiple state apparatuses. Vaught depicts these forces vividly through her ethnographic focus on Lincoln prison school, a site serving “as a window onto the massive institutional practices of juvenile schooling, knowledge production, and incarceration in the United States” (19). Her ethnography maps the network of relations converging through this site—between prisoners, teachers, state officials and mothers. In doing so, her ethnography captures an illustrative account of the institutional assemblages at work in constituting the state through material and ideological practices of dispossession and education of young Black men. She demonstrates the ways in which the state disproportionally displaces young Black men from home and subjects them to abuse, captivity, and forced submission through its educational apparatus.

 In her approach, Vaught highlights distinct spaces of interest: inside and outside the juvenile prison school system. She works with these designations to map institutional powers across different spaces, arguing that “Inside and Outside are places just as Seattle and Canada are proper nouns with distinct features, bounded space, governing rules, sociocultural symbology, and so on” (12). In mapping these spaces, Vaught is also attentive to who is present and who is absent, both discursively and materially. Absences are recognized as shaping the field in which Vaught is working—for instance, her ethnographic focus on young men in prison schools is largely an outcome of institutional practices of hiding young black women from view. In the logic of prison administrators, “girls were too vulnerable to be exposed to research” (17)—despite paradoxically deemed “dangerous” in justifying their captivity.

Vaught’s attention to absence is also explicit in her examination of removal, as a practice aimed at disrupting the private spheres of people of color through prisons and schools. Removal entails the physical relocation of students from their homes to schools, where “they are subject to meaningless or hostile captive educational performances” (321). Removal, as Vaught demonstrates, is essential to the continuous construction of the US as a White, heteropatriarchal nation.

More specifically, removal disables the possibility of a Black private sphere by disrupting kinship relations between young Black men and their families and making young Black men into prisoners. Removal acts as an assault “on Black women as custodians of the house of resistance, on Black boys as figments of White criminal imaginations who antithetically define White male innocence and citizenship, and on Black girls as both hyperaggressive and broken ghost victims” (321). The state works to supplant other social and family relations with carceral kinship relations, which normalize and legitimize the removal process. This process is further reinforced with the psychological manipulation of young men through state-imposed “treatment,” which corrodes their sense of free will and promotes feelings of internal, individual culpability for their exclusion from citizenship.

Vaught argues that this disruption of Black private spheres is significant because these are important spaces of resistance, in which counter publics are formed. In the United States, “the public” is leveraged as a tool of white supremacist control in limiting the power of some. Rights themselves are exclusive and private—limited to those possessing property, a condition of whiteness dependent on the exclusion of people of Color. Dispossession and education are practices that maintain and rationalize this exclusivity, as young Black men are denied the possibilities of citizenship. These practices serve to protect the interests of the White state, to which the potential emergence of private Black citizens (and their potential publics) act as threats: “White freedom, will, and fitness for self-governance exist only through the ideological and structural denial of those very things in Black people” (322).

In her attention to the interrelations between the white supremacist state, prison schooling, and critical scholarship, Vaught offers direction for activists and scholars invested in social justice and education—particularly in her critique of the school-to-prison pipeline, which draws attention to the limitations of reform. As an apparatus of the state, schools are meant to function as prison pipelines. Scholars and activists applying the prison-to-pipeline logic in advocating for education reform overlook this essential fact and “unintentionally confirm the principal, most damaging misconception of school: that it is good” (37). Vaught’s Compulsory supports and gives life to alternative theoretical approaches focused on the racist organization of schools in relation to prisons. In this, Vaught exemplifies her approach to theory as stewardship: theory is “a stewardship of a kinship network of meaning. It is not just an abstraction we take up and give life to page by page but rather a living force that in some ways takes us up” (41). Ultimately, Vaught’s theoretical stewardship offers meaningful direction for scholars and activists: “State schooling … is the beating heart of a supremacist state. … To take on the heart of the state requires further mapping its reaches” (323).

 

 

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Sara_Nesheiwat

The 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_Nesheiwat

EMTALA 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.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

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Sara_Nesheiwat

This 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_Nesheiwat

This 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_Nesheiwat

This 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_Nesheiwat

This 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.

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Sara_Nesheiwat

It is said that EMTALA doesn't apply to ambulance services, technically this would be true. Yet, EMTALA does indeed effect our patients, and anything that effects our patients can effect us and should be a concern of ours as EMS providers. If EMTs are spending time in the hospital sorting out insurance issues and payment, that is more time they are out of service. Also, if the patient's treatment time is delayed, not only will the hospital be blamed, but so will EMS. If a patient is in cardiac arrest, EMTs will not be stopping and wasting time to find out insurance and payment issues from family members, that will be the last thought on their mind. They will be transporting and attempting to stabilize the patient. EMTs and EMS will not compromise the health of a patient due to insurance or payment issues, just like hospitals are now mandated to do.