Tag: divorce

Bioethics Blogs

“She Can’t Help The Choices She Makes”

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By Madeleine Cardona

I will never forget the day my mother got diagnosed. I could swear that just yesterday I was thirteen years old waiting anxiously to be called in from the waiting room of some fancy New York State doctor’s office. I was young, but I had some idea of what was going on. I knew my parents and I were there because they were going through a divorce and fighting for custody of me. What I did not know was that we were about to endure a court-ordered psychiatric evaluation and that the results were going to change my life forever.

“Madeleine, your mom is very sick,” the psychiatrist attempted to explain to me. I did not understand. I did not know a sick person could look perfectly healthy. “It’s not a physical sickness, it’s in her head. She has a mental disorder called Paranoid Schizophrenia.” She went on using big words to explain how my mother’s brain “wasn’t like other people’s brains.” I sat there listening closely, hanging on every word the woman was saying to me. “She can’t help the choices that she makes, it’s not her fault that she is the way that she is. She needs help.” Every day since that day in the doctor’s office, that remark replays in my head over and over. “She can’t help the choices she makes.”

That is what gave me the most trouble. I sat around for years and years watching the choices that my mother was making, unable to intervene.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Luhrmann and Marrow’s Our Most Troubling Madness by Murphy Halliburton

Our Most Troubling Madness: Case Studies in Schizophrenia Across Cultures

T.M. Luhrmann and Jocelyn Marrow, editors

University of California Press, 2016, 304 pages

 

A key premise of this volume of ethnographic case studies is that schizophrenia, or the various conditions we label as schizophrenia and related psychoses, varies in crucial ways in terms of experience, prognosis and outcome in different sociocultural contexts. Tanya Luhrmann’s introduction to the volume, which features twelve articles presenting twelve individuals diagnosed with schizophrenia (including three cases presented by Luhrmann), casts doubt on the biomedical model of schizophrenia, or at least the strong biomedical model where an individual’s biology is the determining factor in the pathogenesis of schizophrenia. Support for this critique comes from within the fields of psychiatry, psychology and related disciplines, and not just from anthropology, the disciplinary home base of many of the authors in this compilation. This supports the volume’s efforts to speak to an audience beyond the contributors’ own disciplines and “serve as a positive catalyst for change” in how we treat psychosis, especially in European and North American settings (5).

The introduction also briefly traces the history of theories of schizophrenia in psychiatry and anthropology, including moments when the two fields overlapped as with Gregory Bateson’s theory that schizophrenia results from a “double bind” that develops in a person’s psyche from conflicting social cues. This theory, put forth by an anthropologist, had a significant place in psychiatrists’ understanding of pathogenesis until the rise of the medical model deflected the blame from families toward “random bad genetic luck” (16).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

On Slippery Slopes

In a recent commentary ethicist Arthur Caplan discusses the difference between physician-assisted dying (which he finds morally permissible) and physician-assisted suicide (which he finds troubling). He notes that “there are some very disturbing developments” in Belgium and Holland. Instead of having a terminal illness as a trigger, these countries have a different standard: “Are you suffering and is it irremediable?”

Caplan notes, “During the past year, people in Belgium and Holland have been given access to lethal doses of medication by doctors for things like a bitter divorce, losing their job, going blind, and very severe depression. People who are not dying and healthy persons are requesting help in dying from a doctor—and getting it—on the grounds that their life has lost meaning or that they do not want to go on because of their suffering.”

Caplan correctly finds this troubling. I wholeheartedly agree with his warning about the potential slippery slope that America is facing. If the past is any indication of the future, it will not be long before a seriously depressed person files suit challenging a state’s assisted-suicide law, arguing that they too have the “right to die.” Interestingly, however, he offers no solutions to prevent this from happening. Perhaps that is because slippery slopes seldom have off-ramps.

Indeed, those who have argued against all physician-assisted suicide (whether for terminal diseases or deep depression) have often utilized the ‘slippery slope’ argument that Caplan now employs. Opponents of PAD have consistently argued that once physicians move away from their role as healers to the role of assisting in suicide, slippery slopes are bound to follow.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Egg Freezing in China: Liberty or Despair?

Jing-Bao Nie comments on how, in different ways, inadequate social supports for reproduction and parenting, and the prohibition on social egg freezing by single women in China limit women’s reproductive liberty.

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A recent article in The New York Times reports that some Chinese women, wishing to postpone motherhood, are traveling to North America to freeze their eggs. While the technology for this procedure is available in China, Chinese regulations currently prohibit unmarried women from accessing this and other assisted reproductive technologies, such as IVF.

In a Western context, some of the ethical issues surrounding ‘social’ egg freezing have been discussed in recent Impact Ethics posts. For example, Angel Petropanagos points out problems with the social biases in favour of pregnancy and motherhood. Lucy Morgan has questions whether egg freezing is a genuinely autonomous decision or just “an illusory choice.” Both argue that ethical discussions should move beyond individual reproductive autonomy.

As I see it, the fact that single Chinese women who want egg freezing must travel overseas to do so calls attention to a state violation of reproductive liberty as well as inadequate social supports for childbearing and child-raising in China.

Air China Boeing 777-200 Photo Credit: Duan Zhu (2011)

While obvious political and socio-cultural differences exist between China and western countries like Canada, New Zealand, and the United Kingdom, some fundamental ethical issues concerning human reproduction are similar. Most importantly, in both contexts there are underlying issues about women’s reproductive liberty and the lack of sufficient social supports related to reproduction and parenting.

Too often current global debates on women’s reproductive rights are regarded as merely Western ideas.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

A-list clash over embryos

The acrimonious fight over frozen embryos between Hollywood celebrities Sofia Vergara and Nick Loeb is due in court again in January in California and could set an important legal precedent.

The Modern Family TV star and the financier created frozen embryos in 2013 when they were living together. They signed an agreement that both had to agree if the embryos were placed in a surrogate mother. However, they split up in 2014. When Loeb proposed the surrogate mother option, Vergara refused. She was content to leave them frozen. “More than a mother, a baby needs a loving relationship of parents that get along, that don’t hate each other,” she said in a TV interview. “I wouldn’t want to bring kids to the world that is already set against them. It would be so selfish.” 

Ever since Loeb has been waging a legal and public relations battle to get custody of the embryos. At the moment Loeb’s lawyers have asked a judge to fine Vergara for refusing to sit for a deposition.

Loeb is desperate to make his case plausible. “I think the misconception is that people don’t know the difference between an embryo and an egg,” Loeb explained earlier this year. “A lot of people think I’m trying to steal her eggs and they don’t realize that an embryo is half mine — half my DNA and half her DNA. It’s actually a human being.”

The legal status of frozen embryos differs from state to state. At the trial in January, Loeb’s lawyers will claim that the agreement the couple signed is invalid.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Age of the Superbug September 22, 2016 Just yesterday, the United Nations General Assemb…

September 22, 2016

by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai

With all of the media hullaballoo about Hillary Clinton’s pneumonia, Donald Trump’s physical exam, Brangelina’s impeding divorce, and poisoned Skittles, you may have missed one of the biggest and most important health stories of this year.

Just yesterday, the United Nations General Assembly held a day-long meeting in New York City to discuss one of the most deadly threats to human health since the bubonic plague: antibiotic-resistant bacteria. This is only the fourth time in history that the General Assembly has met to address a health issue, having met twice in 2011 to talk about HIV/AIDS and chronic diseases, respectively, and again in 2014 to discuss the West African Ebola outbreak.

Antibiotic-resistant bacteria pose an even greater threat than Ebola, HIV/AIDS, and heart disease combined. According to the US Centers for Disease Control and Prevention (CDC), antibiotic-resistant forms of common bacteria like E. coli, Staphylococcus aureus, Streptococcus pneumoniae, andMycobacterium tuberculosis – among others – infect nearly 2 million people a year in the United States, killing at least 25,000.

Worldwide, the number of people infected is several magnitudes greater; an estimated 750,000 people died from antibiotic-resistant infections in 2015. Within just a couple of decades, that number is expected to increase by nearly 1500%, yielding over 10 million “superbug”-related deaths annually by 2050.

Antibiotic-resistant infections will soon account for one-third of all deaths globally, a startling turnabout from 1967. That year, thanks to the widespread use of antibiotics and still effective public immunization programs, then Surgeon General William Stewart famously stated that, “the time has come to close the book on infectious diseases.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

A satisfied customer at American University

Patricia Aufderheide, University Professor of Communication Studies at American University, reports her satisfaction with the IRB at that institution. It’s great to hear some good news, and Aufderheide’s essay points to the importance of having the right people in positions of power. But it also raises questions about how good and how replicable AU’s experience is.

[Patricia Aufderheide, “Does This Have to Go Through the IRB?,” Chronicle of Higher Education, August 17, 2016.]

Aufderheide writes that the AU IRB, “which primarily deals with social-science and humanities research, has been more helpful to me than I ever expected it to be.” IRB staff review, she writes, helped her and a colleague think through reasons why the people they interviewed might hesitate to be interviewed, and the protocols they worked out gave them “a clear signal at the start of our work together that we were conscientious and considerate professionals.”

Aufderheide credits the people involved. The IRB includes faculty in marketing, public opinion research, government, psychology, international relations, as well as a librarian. This is a far larger range of disciplines than most social scientists can hope to face, and AU is to be applauded for securing such intellectual diversity. Moreover, Aufderheide credits the unfailing patience of Matt Zembrzuski, the research compliance manager, who directs IRB operations.

But Aufderheide’s raises some troubling issues as well, which suggest that not everything is as rosy at AU as she suggests, and that other universities may have trouble replicating the experience.

Why is Aufderheide destroying records?

The only research project that Aufderheide describes in any detail is an ongoing collaboration with Peter Jaszi to interview “creative colleagues on how they did their work, given their understanding of copyright.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Sex/Gender: Part III: What Counts as Adequate Function? by Constance Cummings

A Critical Moment: Sex/Gender Research at the Intersections of Culture, Brain, and Behavior

FPR-UCLA 2016 Conference Summary

The sex/gender conference succeeded in bringing together people “with different ideas and skills, different ways of thinking, that are actually transforming the field,” observed Carol Worthman, chair of Part 3 (“What’s at Stake?”). The earlier sessions (see Parts 1 and 2) provided us with a better sense of the complexities of sex/gender; we also learned some ways to usefully deconstruct – and form new ideas about – old questions. But there’s a lot at stake, Worthman continued. In the following session, speakers addressed the theme (“What counts as adequate function?”) from a variety of perspectives and from individual to macro levels of analysis. The question regarding adequate function is critical, Worthman reminded the audience, “because a lot of what is lurking in the background is frequently this question of ‘not good enough’ or ‘not a real person,’ both exogenously, in terms of how people are viewed, and endogenously, in terms of how they view themselves” by internalizing cultural norms. This suggests the importance of recognizing culture-mind-brain “intra-actions” (Barad, 1998, p. 96, noting “the inseparability of ‘objects’ and ‘agencies of observation’”) that can perpetuate shame, fear, and other forms of suffering.

This post reviews two films shown at the conference (Bitter Honey and Tales of the Waria) and three talks by neuroscientist Melissa Hines and anthropologists Hillard Kaplan and Marcia Inhorn.

Bitter Honey

On Day 1 and 2 of the conference, FPR founder and president, Robert Lemelson, a documentary filmmaker and psychological anthropologist on the UCLA faculty, screened Bitter Honey.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Love by design: when science meets sex, lust, attraction and attachment

A version of this post was originally published in the Conversation 

You are on holiday with your partner of several years. Your relationship is going pretty well, but you wonder if it could be better. It’s Valentine’s Day and you find a bottle on the beach. You rub it. A love genie appears. He (or she) will grant you three special Valentine wishes. Here are some of your choices:

  • to have more or less sexual desire (lust);
  • to remain always as “in love” as you were when you first fell in love (romantic attraction);
  • to be more or less bonded to your partner emotionally (attachment);
  • to be (happily) monogamous or polygamous.

What would you choose? What should you choose? What would your partner choose? Would you choose together, if you could? What would you choose for your partner?

In August 2015, the US Food and Drug Administration (FDA) approved the first drug to specifically increase sexual desire. While not yet available from doctors in Australia, it is available on the internet. Flibanserin or “Addyi” is used to “treat” hypoactive sexual desire disorder (HSDD), or low libido, in premenopausal women.

Addyi acts on neurotransmitter receptors in the brain (serotonin receptors – the same receptors targeted by some antidepressants like Prozac which themselves lower libido). The beneficial effects are modest. Prior to treatment, these women experienced about two or three satisfying sexual events over a month. After a course, they got around one extra sexually rewarding experience a month, though in some individual cases the effects would have been greater.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Forgotten Stories of the Eugenic Age #5: Creating Super-People

The Birth of Venus by Sandro Botticelli, 1480s

[Forgotten Stories of the Eugenic Age is a blog series exploring the lesser-known ways that eugenics affected and engaged American lives during the first half of the twentieth century.]

“Can science produce a superman?” science writer Waldemar Kaempffert wondered in the New York Times in 1928. “What kind of a superman do we want? And who shall dictate his specifications?”

In the early twentieth century, new genetic discoveries prompted supporters of eugenics to ponder the potential creation and characteristics of a superior human race. Many believed that encouraging the eugenically “fit” to mate and isolating or sterilizing the eugenically “unfit” would yield over time a superior population. They argued that breeding a better race represented the next step in human evolution. After all, careful husbandry had improved crops and livestock. Surely the production of “human thoroughbreds” could not be much different.

“Scientific” Creation
With new scientific knowledge and technologies, eugenists believed that they at last had the tools to create improved people. They were particularly interested in developing technologies for assisted reproduction, including the human application of animal husbandry techniques like artificial insemination. Dr. Julian Huxley, grandson of champion of the theory of evolution T. H. Huxley, predicted that such techniques would allow eugenically fit men and women to marry whomever they chose, but—regardless of their partners’ fertility—have children with third parties who had been specially selected for their genetic qualities. (Those who might object to this cold calculation were merely exhibiting “outworn sentimentalism,” said Huxley.)

Exhibiting similar thinking, Dr.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.