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M B Mahowald

Publications and source records attributed to M B Mahowald.

17 recordsLinked to original sources

To be or not be a woman: anorexia nervosa, normative gender roles, and feminism.

This paper reviews the characteristics of anorexia nervosa described in the DSM-III-R, relates them to normative gender roles and adolescent development, and critiques those roles on feminist grounds. Two apparently contradictory explanations for the irrational pursuit of thinness are considered: a) the anorexic thus attempts to conform to a socially defined feminine ideal; b) the anorexic thus attempts to avoid the appearance and consequences of mature womanhood. I propose that both explanations are applicable, together emplifying the ambiguity that Simone de Beauvoir considers characteristic of female experience. Because both explanations suggest a gender identity disorder, I question the fact that the DSM-III-R fails to indicate this linkage. I argue further that therapeutic considerations require efforts to alter the socialization factors that are implicative in anorexia nervosa.

Anorexia Nervosa

Acute care research: is it ethical?

BACKGROUND: Research in acute care is a troubling area for Institutional Review Board (IRB) approval and informed consent. Confusion about ethical and legal requirements has hampered research efforts and subsequent patient benefits. ANALYSIS: Acute care patients are the relatively few critical care patients who have suffered unexpected events that carry a high probability of mortality or severe morbidity unless immediate medical intervention is provided. We argue that acute care research is justified if the usual ethical requirements for research are modified to reflect the uniqueness of the situation. CONCLUSIONS: Our recommendations are to: a) use an explicit definition of acute care as distinct from other modes of critical care; b) eliminate the requirement for informed consent (as it is usually understood); and c) require stringent IRB oversight, regarding the unique ethical problems raised by this area of research. We further suggest that IRB oversight includes review of the protocol by a panel of individuals who represent possible enrollees in the proposed study.

Beneficence

Neural fetal tissue transplantation. Should we do what we can do?

The following factors are relevant to ethical considerations regarding fetal tissue transplantation for treatment of neurological disorders: the empirical status of human fetuses or abortuses, different purposes and sites of tissue retrieval or implantation, the therapeutic potential of the technique, the means through which tissue becomes available, possible motives, and possible donors and recipients of transplant tissue. After examining each of these, the author concludes that (1) only dead fetuses should be used as tissue sources, (2) decisions regarding abortion and transplantation should be kept separate, (3) anonymity between donor and recipient should be observed, and (4) buying and selling of fetal tissue should not be permitted.

Aborted Fetus

Ethical dilemmas in fetal echocardiography.

Recent technology permits detection of congenital heart diseases as early as the 17th or 18th week of gestation. These detectable defects include hypoplastic left heart syndrome, Ebstein anomaly, and atrioventricular canal malformation. Surgical treatments for these problems raise ethical as well as medical questions regarding patients whose prenatal diagnosis reveals congenital heart disease. We report six cases of in utero diagnosis of hypoplastic left heart syndrome and other complex congenital heart anomalies. Empirical factors relevant to our management were gestational age, severity of the anomaly, degree of certainty of diagnosis and prognosis, possibilities for treatment, and parental wishes regarding the fetus or newborn. Each of these factors was examined in the context of the reported cases and correlated with ethical principles applicable to obstetrics and neonatology: 1) respect for parental autonomy, 2) promotion of the infant's welfare, and 3) fairness in distributing scarce medical resources. We maintain that the first two principles are paramount in ethical decisions regarding individual patients, while the third is foremost in policy decisions affecting others as well.

Adult

Baby Doe committees: a critical evaluation.

The origin, assumptions, functions, goals, similarities, and differences of infant ethics committees (IECs) are reviewed. Effectiveness of IECs is assessed through examination of cases involving parental refusal of treatment, and parental insistence on treatment. Specific steps for better facilitating committee goals are suggested.

Ethics Committees, Clinical

The ethical options in transplanting fetal tissue.

Fetal tissue transplants have now been successful in primates, raising the possibility of treatment for Parkinson's disease and other chronic illnesses. Whether or not abortion is morally justified, use of human fetal tissue for research or therapy is justified in certain circumstances. The rationale, both for permitting transplantation of fetal tissue and for limitations in exercising the technology, is based on the same set of ethical principles that supported restrictive legislation in the past: respect for autonomy and a balancing of harms and benefits that gives priority to those most affected.

Aborted Fetus

A pregnant fellow.

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Education, Medical, Graduate

Symbols and rights.

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Aborted Fetus