Tag: spouses

Bioethics News

Hunting a Killer: Sex, Drugs and the Return of Syphilis

August 24, 2017

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OKLAHOMA CITY — For months, health officials in this socially conservative state capital have been staggered by a fast-spreading outbreak of a disease that, for nearly two decades, was considered all but extinguished.

Syphilis, the deadly sexually transmitted infection that can lead to blindness, paralysis and dementia, is returning here and around the country, another consequence of the heroin and methamphetamine epidemics, as users trade sex for drugs.

To locate possible patients and draw their blood for testing, Oklahoma’s syphilis detectives have been knocking on doors in dilapidated apartment complexes and dingy motels, driving down lonely rural roads and interviewing prison inmates. Syphilis has led them to members of 17 gangs; to drug dealers; to prostitutes, pimps and johns; and to their spouses and lovers, all caught in the disease’s undertow.

… Read More

Image: By Nydorf, Seymour, 1914-2001, Artist (NARA record: 8467706) – U.S. National Archives and Records Administration, Public Domain, https://commons.wikimedia.org/w/index.php?curid=17203998

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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

Web Round Up: Time to Chill? Egg Freezing and Beyond by Moira Kyweluk

A focus on age-related fertility decline, and exploration of ways to expand the timeline and options for biological parenthood have been consistent cultural and web-wide fixations. The $3 billion United States fertility industry was in the headlines once again this month including coverage of the launch of Future Family, a service offering  a “fertility age test” to women and negotiated-rate infertility medical care, alongside newly published research on ovarian tissue preservation, an alternative to oocyte cryopreservation or “egg freezing”, both procedures aimed at potentially extending a woman’s fertility window.

In the wake of findings presented in July 2017 at the European Society of Human Reproduction and Embryology conference in Geneva, Switzerland by Marcia Inhorn, Professor of Anthropology and International Affairs at Yale University, popular media headlines blared:  “Why are women freezing their eggs? Because of the lack of eligible men”  and “Women who freeze their eggs aren’t doing it for career reasons.” The study analyzed interviews from 150 women in their late 30s and early 40s who opted for egg freezing in Israel and the United States. Results “show that women were not intentionally postponing childbearing for educational or career reasons, as is often assumed in media coverage of this phenomenon, but rather preserving their remaining fertility because they did not have partners to create a family with. The researchers conclude that women see egg freezing as ‘a technological concession to the man deficit’, using it to ‘buy time’ while continuing their search for a suitable partner to father their children.”

The American Society of Reproductive Medicine, the regulatory board that governs the safe and ethical use of fertility technologies, reclassified egg-freezing technology from “experimental” to standard-of-care in 2012.

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

Ethics, sexuality, and dementia in long-term care

Alisa Grigorovich and Pia Kontos suggest that long-term care residents with dementia can benefit from leisure and social activities that are supportive of sexual expression and the formation of intimate and romantic relationships.

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Recently, media stories on dementia have focused on the sexualities of persons living with dementia in residential long-term care settings, such as nursing homes. This media attention has been predominantly negative, consisting of descriptions of sexual violence, and apocalyptic warnings of the legal, ethical, and moral dangers of allowing persons with dementia to express their sexuality.

Often the primary criterion used to determine whether sexual encounters between residents with dementia are involuntary is the cognitive ability of the female resident. Frequently, she is characterized as globally incapable of agreeing to sexual activity because of cognitive impairment.

Consider, for example, the now infamous case of Henry Rayhons. He was accused (and ultimately acquitted) of sexually assaulting his wife who had dementia. As well, there is the lawsuit filed in a case involving two residents with dementia who had intercourse while living in Windmill Manor. While such stories highlight the importance of protecting vulnerable persons from sexual abuse, they ignore the need to also ensure that persons with dementia have opportunities to pursue intimate and romantic relationships.

Sexual expression is a universal human need that transcends age and disability. It has many positive health and wellness benefits, including the opportunity to experience pleasure, decreased pain sensitivity, and increased relaxation. However, older persons living in nursing homes often experience reduced sexual freedom.

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

Elizabeth Barnes, The Minority Body, Oxford University Press, 2016

Professor Elizabeth Barnes has produced a tightly and carefully reasoned philosophical examination of the significance of disability. It provides a clear defense of certain core principles of the disability rights movement in contrast to the many professional philosophers (those which I will term ‘mainstream bioethicists’) who consider that movement to be ill-conceived. An example of this tradition can be seen in the volume From Choice to Chance: Genetics and Justice, coauthored by four of the most prominent bioethicists of the turn of the century (Buchanan, Brock, Daniels, & Wikler 2000). (For discussion see Amundson & Tresky 2007, 2008.) I confess to the prejudice implied by my label of ‘mainstream bioethicists’ as those beset by the prejudice of ableism. The late Adrienne Asch considered herself a mainstream bioethicist even though her progressive views of disability were rare among her colleagues.

Disability rights is a serious civil rights movement, equal in significance to gay rights, feminism, resistance against discrimination on the basis of ‘race,’ and a number of other such movements. Just as earlier generations of philosophers assumed the legitimacy of the social prejudices of their own times, mainstream bioethicists have assumed the correctness of prevailing assumptions about disability. In this tradition, disabilities are conceptualized as inimical to well-being, they essentially involve suffering, and any civic ameliorations of the problems of disability are seen to result only in slight improvements to the essentially low quality of a disabled life. Barnes argues the contrary. Disabilities should be conceived as mere differences, not bad differences. Her neutral model of disability comports with a great deal of testimony from disabled people themselves.

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

Means to an End December 16, 2016 According to a recent survey of nearly 8,000 Americans, ov…

December 16, 2016

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

Means to an End

My mother passed away last Wednesday. She was found unresponsive on the floor of her kitchen early Tuesday, in severe septic shock from untreated peritonitis and a perforated intestine. Although she was admitted to the intensive care unit and given aggressive medical treatment, she never regained consciousness. Because of her age and her poor health – exacerbated by the fact that she had ignored the signs and symptoms of sepsis for nearly a month – her body was simply not strong enough to fight the infection. Less than thirty-six hours after she was admitted to the hospital, we let her peacefully and painlessly slip away.

I’m telling you this story not to garner sympathy, but rather to share with you a lesson that I learned. Because my mother was unmarried and because she was unable to consent for treatment, according to the laws of the state in which she lived I was the de facto decision maker about her medical care. This is quite common. Unless otherwise indicated, family members – usually the spouse, adult children, adult siblings and parents, in that order – are assumed to be the surrogate decision makers for a patient who cannot provide consent.

The decisions that I had to make, most of which were made at 2:30 in the morning after chatting briefly with the clinical care team, included the decision to make my mother DNR (‘do not resuscitate’) after her heart stopped for the third time.

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

Hospital Companions Can Ease Isolation For Older People

Loneliness can be a problem for older people, especially when they’re in the hospital. Their children may have moved away. Spouses and friends may themselves be too frail to visit. So a California hospital is providing volunteer companions in the geriatric unit

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

Dutch will probably legalise assisted dying for people tired of living

The Dutch government plans to create a new end-of-life law for elderly people who are tired of living. Health Minister Edith Schippers told Parliament that a new kind of assisted suicide is needed for people who are not terminally ill or suffering, but who want to die (link to letter to Parliament, in Dutch).

She said that the proposed law would come into effect next year. It would cater for “older people who do not have the possibility to continue life in a meaningful way, who are struggling with the loss of independence and reduced mobility, and who have a sense of loneliness, partly because of the loss of loved ones, and who are burdened by general fatigue, deterioration and loss of personal dignity.”

The process will be thoroughly documented and carefully organized, Ms Schippers told a TV prorgram. “It should not involve lonely or depressed people. Not for people with problems you can solve in a different way.” She said that life must be protected, but some people wake up every morning disappointed that they did not die in their sleep.

The government’s decision ignores an independent committee of experts who said earlier this year that a “completed life” should not make people eligible for euthanasia (link here in Dutch). A committee headed by a well-known sociologist, Paul Schnabel, was established after the acquittal of a man who helped his 99-year-old mother to die because she thought that her life was at an end.

New legislation will break new ground for end-of-life laws.

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

"Vulnerable" participants may have the most to gain from talking

Seven qualitative researchers forcefully argue that IRBs mislead research participants when they demand consent forms stating that interview research has “no known benefits.” In fact, people labeled “vulnerable” by IRBs often gain a great deal by participating in projects the IRBs deem “risky.”

[Tara Opsal, Jennifer Wolgemuth, Jennifer Cross, Tanya Kaanta, Ellyn Dickmann, Soria Colomer, and Zeynep Erdil-Moody, “‘There Are No Known Benefits …’ Considering the Risk/Benefit Ratio of Qualitative Research,” Qualitative Health Research 26, no. 8 (July 2016): 1137–50, doi:10.1177/1049732315580109.]

The researchers describe six qualitative social science projects they conducted over the past decade, in several countries. Three of the six projects secured IRB approval without seriously difficulty, but the other three were hampered by IRB constraints. Kaanta’s IRB demanded that she only interview inter-country Korean adoptees in places where she could find an on-call therapist in the event that her questions triggered “depression and emotional pain.” Nor was she allowed to interview pregnant women. Dickmann faced such a hassle getting permission to interview high school resource officers that she gave up on seeking permission to interview their spouses. And Opsal only got permission to interview women leaving prison after “many IRB challenges.”

The authors appreciate that the IRBs have the participants’ best interests in mind, though perhaps this concern was mixed with “institutional risk mitigation and management.” But they argue that the IRB conditions can have the perverse effect of denying a good experience to the very people they are meant to protect.

The fact is, people like being able to talk to a good listener.

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

Family life is what makes us happiest according to Harvard

Who is right about the benefits or harms of family life : Harvard University or the Catalan MP?

Recently, several media have reported statements made by the Catalonian member of parliament (MP) Anna Gabriel (CUP, a pro-Catalan independence party), who believes in having children in common “like in the tribes”, considering that this way there is no “sense of ownership” of a child but that they are “sons and daughters that you have had and given birth to with others”. She sees in the family a “perverse logic” and “unrewarding”.

It is curious that Anna Gabriel, however, was not brought up any other way than in a family, and she has always been a great defendant of it. Her own family at least. The MP has stated on numerous occasions that her family has been instrumental in her social and political development, and has even said that her greatest treasure is “the values inherited from my family”.

At the same time as the MP’s statements, and as if it were an ironic coincidence, the prestigious Harvard University has just revealed the conclusions of the Harvard Study of Adult Development , which began in 1938 and which has closely followed and examined the lives of more than 700 individuals, and in some cases their partners. The study aimed to investigate which factors will determine if a person will age well and live a happy, healthy life, or if in contrast, they will suffer a disease or mental illness, something that seems to have a lot to do with loneliness.

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 II: What’s Fixed, Changeable, Changing? by Constance Cummings

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

FPR-UCLA 2016 Conference Summary

Part 2 of the FPR-UCLA conference on sex/gender, which was chaired by cultural anthropologist Gilbert Herdt, explored aspects of brain and behavior that are “fixed” by evolution and biology and other aspects that create, reflect, and respond to human social and cultural environments. Speakers in the first session addressed, in Darwin’s phrase, the “entangled bank” of biological, evolutionary, and cultural contexts of sex/gender differences in brain and behavior, while the second session offered a closer examination of “intimacies”– partnerships, marriage, sexual orientations, desires, and practices. A common theme throughout was the instability of the sex/gender binary or, as Carol Worthman observed, the “loss of easy dichotomies” more generally. Perspectives varied widely depending on level of analysis, but there was a general willingness to “work with and speak across difference” (Worthman).

For neurobiologist Donald Pfaff, who presented experimental research focusing on autism, sex is a biological category/variable. Other speakers were more willing to extrapolate from biology, and in so doing, challenge what Sarah Richardson referred as our “essentialist” understandings. For social neuroendocrinologist Sari van Anders, even a “quintessential” male hormone like testosterone can be deconstructed (van Anders, 2013). Another common theme was gender-role and sexual fluidity, addressed from evolutionary (Fessler), hormonal (Rilling, van Anders), and situational/contextual (Diamond) perspectives. Finally, field research by anthropologists (Borgerhoff Mulder and Boellstorff) in non-Western and virtual settings underscored human flexibility and adaptiveness.

The talks revealed significant advances in our understanding of the underlying mechanisms and dynamic aspects of sex/gender-related behavior and their exquisite attunement to historically and culturally specific environments.

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.