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California, USA

Misria

In this poster, we share preliminary reflections on the ways in which hermeneutic injustice emerges and operates within educational settings and interactions. Hermeneutic injustice is a type of epistemic injustice that occurs when someone’s experiences are not well understood by themselves or by others, either due to unavailability of known concepts or due to systemic barriers that produce non-knowing (Fricker 2007). In 2021, we entered into a collaborative project to design a high school curriculum on environmental injustice and climate change for California’s K-12 students. Although the project convenors aspired to support the diversity of California’s K-12 student population through representational inclusivity across the program participant, they reproduced essentialized notions of what it means to be an “included subject”. In our first inperson meetings, activities intended to invite difference in the curriculum writing and design community were encountered by participants as an opportunity to point to the margins of that community. Who was in the room and who was not? Initial counts excluded some writers whose identity was not readily apparent by race, ethnicity, or age. Some individuals who, to their consternation, were assumed to be white, revealed themselves as people of color. The project chose the “storyline model” of curriculum design to bring coherence across the teams. The model was developed by science educators to promote student agency and active learning. Lessons start with an anchoring phenomenon, which should hook students and produce enough questions to sustain inquiry cycles that culminate in consensus making. As a result, each grade-level unit of our curriculum was intended to focus on a single environmental phenomenon, like wildfire. However, informed by Gregory Bateson’s theory of learning, we sought to foreground complexity by recursively analyzing environmental injustice through case study analysis of many hazards, injustices, and places. It took multiple meetings over several months to arrive at an articulation of environmental injustice as our central phenomenon that recognizes the compounding impacts of both climate change and toxic pollution. It also required restructuring the working relationships between the project's administrative arm, the curriculum consultants, and the writing team. The image we include is a photograph of an exercise done together with another HS team as we were tasked to clarify the aims and goals of our imagined lessons. As is evidenced in the photograph, each writing team found it difficult to articulate learning outcomes as a series of checklists, or goals, separate from skill-development that represented the dynamic need for curriculum capable of examining climate change and the environmental justice needs for California’s students.

Tebbe, Margaret, Tanio, Nadine, and Srigyan, Prerna. 2023.  "Reflections on Hermeneutical Injustice in K-12 Curriculum Development." In 4S Paraconference X EiJ: Building a Global Record, curated by Misria Shaik Ali, Kim Fortun, Phillip Baum and Prerna Srigyan. Annual Meeting of the Society of Social Studies of Science. Honolulu, Hawaii, Nov 8-11.

Songs as artifacts

sharonku

There are manu artifacts mentioned in your fieldnote--songs, stories, fishing tools, grocery stores, etc. How do you analyze these artifacts--why and how were they constructed, used? What are the social, economic, cultural meanings/functions of these artifacts? And how have these artifacts helped construct the sense of place and identity of the Naluwan people?

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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.