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Stakeholders:

Children and families vulnerable to asthma

Cattle ranchers

CALTrans

Almond farmers

NOAA

EPA

SJV Air Pollution Control

Kern River Oil Field

Central California Asthma Collaborative

 Teve Brown of NOAA said the valley suffers from cows + cards. At Harris Ranch a large industrial cattle farm trucks drive 6,000miles/day for 60 loads of feed producing nitrogen oxides (NOx). NOx combines with the ammonia from cow manure and urine to from ammonium nitrate which accounts for more that 1/2 of the areas most polluted days of PM2.5.

In addition, Interstate is a major thorough bringing more traffic pollution and farming practices including nitrogen fertilizer contributes 1/3 of NOx in California air.  The SJV also holds 9000 oil wells and because all the light oil has been drilled, the current production is described as the "thickest, dirtiest petroleum" in the nation.

Intersecting factors: landscape (bowl shape of the Valley); economic (agriculture that contributes to PM2.5); transportation corridor that add more traffic pollution; and state-wide wildfires that bring more particulate pollution which is trapped; and political environment in which area elects representatives  (ex: Devin Nunes) who deny global warming and reject environmental protection.

Air pollution--the result of cows+cars--is the focus of this multimedia article. One in six children in the SJV suggest from asthma. It is estimated that air pollution costs SJV as much as $11 billion annually the result of emergency room visits, lost school days, and other public health impacts.

The setting for this article is the San Joaquin Valley which encompasses 2/3rds of the Central Valley CA. Because of it's fertle farmland, it supplies 1/4 of the food to "American plates."

In terms of setting, like other valley's in CA (ex: San Gabriel Valley) and the whole LA Basin, the SJV's bowl-like landscape (mountain ranges on 3-sides) results in temperature inversion that traps smo closer to the ground during Wintertime.

The article explains how a team of medical staff treated (and consequently killed) a number of patients following the flooding of a hospital in New Orleans. The staff in question overdosed the patients to put them out of their pain as they saved other patients who were more likely to survive. The article calls into question the process of triage and how we go about it. Who has the authority to make these decisions, and what lines do we draw between ethics and compassion. The article provides a play-by-play of the events leading up to the flooding, and relevant policies that existed and have been created related to this incident. 

“The smell of death was overpowering the moment a relief worker cracked open one of the hospital chapel’s wooden doors.”

“The physician, Anna Pou, defended herself on national television, saying her role was to “help” patients “through their pain,” a position she maintains today.”

From the links provided within the article, relevant information about Hurricane Katrina can be viewed with the commentary and archival articles that published in The New York Times that written by other authors.

Also the author has made in contact with Memorial Medical Center in Uptown New Orleans to focus on the investigation into the detail situations happened with the floodwaters. Afterwards, gained more information on the lethal injection issues.

[http://www.nytimes.com/topic/subject/hurricane-katrina?inline=nyt-class…]

[http://www.nytimes.com/topic/subject/hurricanes-and-tropical-storms-hur…]

The article has first emphasis the number of death and corpses during and after the Hurricane Katrina, then with further investigation and research, the issue related to the lethal injection to the patient has raised. From the physician’s perspective, the lethal injection in this case is a way to relief the patient’s pain, as it is a “for” for the lethal injection, which not seems to be violating the medical ethical. From the conclusion parts of the article, the author provided the evidence that “that more medical professionals were involved in the decision to inject patients — and far more patients were injected — than was previously understood.”     

The main focus group of the article is the physicians that involved in the injection decision to the patients. The discussion to the article questioned on the ethical issue towards overdose injection in order to “help” the patients to relief their pains that causes the death to the patients.  

"Anna Pou, defended herself on national television, saying her role was to “help” patients “through their pain,” a position she maintains today"

"The laws also encourage prosecutors to await the findings of a medical panel before deciding whether to prosecute medical professionals. Pou has also been advising state and national medical organizations on disaster preparedness and legal reform; she has lectured on medicine and ethics at national conferences and addressed military medical trainees"