Tag: psychological stress

Bioethics Blogs

A Feminist Neuroethics of Mental Health

By Ann E. Fink
Ann Fink is currently the Wittig Fellow in Feminist Biology at the University of Wisconsin–Madison, with an appointment in Gender and Women’s Studies and concurrent affiliations with Psychology and the Center for Healthy Minds. Her research in cellular and behavioral neuroscience has appeared in the Journal of Neuroscience, Journal of Neurophysiology, PNAS and other journals. Ann’s interdisciplinary work addresses the ethics of neuroscience in relation to gender, mental health and social justice. 

Emotionality and gender are tied together in the popular imagination in ways that permeate mental health research. At first glance, gender, emotion, and mental health seem like a simple equation: when populations are divided in two, women show roughly double the incidence of depression, anxiety, and stress-related disorders1-3. Innate biological explanations are easy to produce in the form of genes or hormones. It could be tempting to conclude that being born with XX chromosomes is simply the first step into a life of troubled mood. Yet, buried in the most simplistic formulations of mental illness as chemical imbalance or mis-wiring is the knowledge that human well-being is a shifting, psychosocial phenomenon. Learning and memory research offers a treasure trove of knowledge about how the physical and social environment changes the brain. Feminist scholarship adds to this understanding through critical inquiry into gender as a mode of interaction with the world. This essay explores how a feminist neuroethics framework enriches biological research into mental health. 
Problems with “Biology-from-birth” stories 
What if understanding gender and health isn’t a tale of two gonads (or genitalia, or chromosomes)?

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

Celebrity Medicine: Ben Stiller’s Prostate Edition

by Kaitlynd Hiller

During an interview in early October, Ben Stiller spoke publicly for the first time about his successful battle with prostate cancer, and how, if it were up to the American Cancer Society (ACS), perhaps he wouldn’t have won. Stiller also published a same-day article on Medium[1] that detailed the care he received and the factors that guided those decisions. Although this public reveal is reminiscent of Angelina Jolie’s 2013 Op-Ed on genetic testing and prophylactic mastectomies, Stiller’s is more controversial. Not only did he pursue screening earlier than suggested and question the evidence-based national guidelines, he’s also gone on to advocate for a position that many public health experts today are trying to walk back on: that screening saves lives.

Unlike Jolie, Stiller had no family history of the disease he received screening for. At the time he began having his PSA levels routinely tested, Stiller was 48 years old with no other known risk factors. The ACS recommends starting the discussion of prostate screening with men like Stiller (counted as “average risk”) at age 50.[2] The American Urological Association’s guideline does not recommend annual screening in average risk men ages 40 to 55 years, and the US Preventative Services Task Force recommends against the use of the PSA test in all asymptomatic, average risk populations.[3] Stiller credits his cancer-free status to his “thoughtful internist,” who began discussing PSA testing multiple years ahead of what these guidelines suggest. Ben puts it into perspective: “If [my doctor] had waited, as the American Cancer Society recommends, until I was 50, I would not have known I had a growing tumor until two years after I got treated.

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

Hugs, Tweets, and Physician Reimbursement — A Problem for Pay-For-Performance

According to recent research, a hug a day could keep the doctor away. According to another study, twitter can predict the chance that people will experience heart attacks. A normal blogger would look at these two findings and tell a story about the relationship between stress and health. I’m not normal. I looked at these two studies and came to a different conclusion – that we need to change the way we reimburse physicians.

Want to know how I arrived at that view? Let’s start with a quick look at the two studies.

A research team headed by Sheldon Cohen from the University of Pittsburgh exposed volunteers to Rhinovirus particles and monitored them for signs and symptoms of illness, going as far as weighing their nasal mucus. (Isn’t research fun!) Consistent with previous research, they found that people under psychological stress were more likely to become sick, unless they reported having strong social support in their lives. You see, stress creates a neurohumoral cascade, a series of physiologic reactions in the body that impair the immune system. But social support can buffer the immune system.

Even more interestingly, Cohen discovered that hugs – the likelihood that a volunteer was hugged each day – further buffered people’s immune systems, reducing colds even after accounting for the other kinds of social support people received. Hugs are good medicine!

What does this hugging study have to do with physician pay?

In the old days, health care reimbursement was based primarily on the volume of services medical providers provided.

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

Should we intervene in nature to help animals?

Guest Post by Catia Faria

 

It is commonly believed that our obligations towards other human beings are not restricted to abstaining from harming them. We should also prevent or alleviate harmful states of affairs for other individuals whenever it is in our power to do something about it. In animal ethics, however, the idea that we may have reasons not only to refrain from harming animals but also to help them is not particularly widespread. Of course, exceptions can be found regarding companion animals. Most people agree that failing to assist them would be wrong if we could otherwise help them. But what about all other animals in need, shouldn’t we also help them? Consider, for example, a case that has recently caught the attention of social media. In Norway, a man rescued a duck trapped under the ice on the surface of a lake. Everyone is celebrating the intervention as a form of heroism. But wasn’t intervening in order to help the duck precisely what he ought to do?

The laissez-faire intuition

It is sometimes claimed that even though interventions like this seem beneficial, the best we can do for animals living in nature is simply to let them be. In other words, that we don’t have reasons to prevent or alleviate the harms that animals suffer in the wild. This has been referred to as the “laissez-faire” intuition. This intuition relies on two fundamental assumptions. Firstly, it is based on an idyllic view of nature, according to which wild animals have generally good lives, only threatened by occasional human interferences.

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

Stress Rx: Chant two Ommsss, with food, twice daily

How can and should meditation be used to restore physical and mental health in a clinical setting?  That is the question that Emory University neuroscience graduate student Jordan Kohn posed to begin the latest Neuroethics Journal Club.  The discussion thereafter centered on Black et al.’s 2013 Psychoneuroendocrinology paper entitled “Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial.”1 This paper laudably attempts to bridge the mind-body gap and suggests a biological, and perhaps more importantly, a genetic mechanism to explain how yoga can apparently help relieve stress, protect against depression, and restore immune function in caregivers.  The implications of this line of investigation could be widespread as the scientific and medical communities grapple with our fundamental understanding of the mind and body and how to integrate what used to be considered fringe or alternative approaches into the mainstream.

Caregivers for dementia patients have been widely studied because they experience high levels of chronic stress and in turn suffer high rates of depression and other mental and physical health problems.2 Both acute and chronic stress can drastically alter immune system function3 and, not surprisingly, dementia patient caregivers show marked impairments in immunological measures.4 The connection between the immune system and mental health is increasingly studied for its apparent bi-directionality.  Sickness behavior – characterized by fatigue, poor sleep, irritability, and lack of appetite – closely resembles major depression.  In fact, pro-inflammatory cytokines, which are up-regulated during an infection, can induce depression.

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.