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PubMedDate not supplied

Who decides? The connecting thread of euthanasia, eugenics, and doctor-assisted suicide.

Throughout recorded history, a series of seemingly unrelated ideas have been consistently intertwined: suicide, euthanasia, infanticide, eugenics, genocide and, most recently, the practice termed physician-assisted suicide. From Plato and Hippocrates to a pair of twentieth-century American physicians named Haiselden and Kevorkian, an examination of history shows these disparate notions always involve two troublesome questions: Which lives are not worth living? And who will decide? The same examination of history teaches that separating the worthy from the not worthy is a very dangerous proposition, especially for those whose lives are deemed marginal.

Decision Making↗

PubMed1981

The capitalist world-system and international health.

A number of world health problems which have been discretely considered in the past are viewed in this paper as interwoven with each other and with the functioning of the capitalist political-economic world-system. Thus, climactic explanations ("tropical medicine"), and even poverty when conceived in cultural terms or as a structural problem resident entirely within a single nation, are seen as inadequate for understanding any or all of the problems discussed briefly here: poor general health levels in peripheral and semi-peripheral nations, especially rising infant mortality rates in countries such as Brazil; comerciogenic malnutrition; dumping and exploitative sale of drugs, pesticides and other products banned or restricted in core nations; genocidal and other threatening approaches to population control; export of hazardous and polluting industry to peripheral and semi-peripheral nations; similar export of human experimentation; the sale of irrelevant, high medical technology to countries lacking basic public health measures, the "brain drain", and medical imperialism. Also discounted are moralistic inveighing, complaints about inadequate information and its transfer, discussions of bureaucratic bumbling or inter-agency politics and professional rivalries, various forms of victim-blaming, and other explanations and corrective approaches which ignore class structure and the control, distribution, and expropriation of resources in nations and the world-system. The framework suggests the importance of a worldwide cultural hegemony, including a medical cultural hegemony, established by and in the service of the ruling classes. Socialist-oriented nations which are quasi-independent of the capitalist world-system are seen as suffering less from its effects. This suggests that we should conceive of world socialist health and world capitalist health, rather than any kind of unified phenomenon called "international health".

Drug Industry↗

PubMed1988

Rehabilitation of refugee victims of torture and trauma: principles and service provision in New South Wales.

A number of recently-arrived refugees who are suffering from psychological disturbances and physical injuries that have resulted from torture or severe trauma has come to the attention of welfare workers and health personnel in New South Wales. A tentative estimate of more than 2000 refugees in New South Wales who are so affected, and clear evidence of extensive human rights abuses in the countries from which they came, indicate an urgent need for specialized care for the victims. Organized violence, including detention, torture and severe deprivation, is a tool of governments in many countries of the world. The varied forms of torture are all designed to destroy the trust, personality and self-esteem of the victims and to foster dependency, debility and dread, both in the victims and in the societies in which they live. Those persons who survive torture and detention often are affected severely in body, mind and spirit. Many victims exhibit acute and chronic symptoms that are described commonly by the diagnostic categories "post-traumatic stress disorder" and "torture syndrome". Their kin, especially spouses and children, also suffer psychological and familial disturbances frequently, as a result of the arrest, detention and torture of the victim. Their suffering is compounded by the distress of fleeing their home country and the stresses of adjusting to a new country and way of life. In Europe and North America, services have been established to treat and to rehabilitate sufferers of these disorders. Treatment programmes differ in structure and size, but include commonly psychotherapy, physiotherapy, specialized medical care and parallel assistance with resettlement and social adjustment for both the patients and their families. This article cites illustrative case material from New South Wales and summarizes the recommendations for a community-based rehabilitation service for victims both of torture and of other forms of organized violence, such as detention in "re-education" camps or the genocide in Kampuchea.

Health Services↗

PubMed1996

A Historical Survey of Humanitarian Action.

Humanitarian medical associations emerged in France in the 1970s, working first in the developing world and then within their own country. Médecins Sans Frontières (Doctors Without Borders) and Médecins du Monde (Doctors of the World) have been active in the debate concerning the boundaries of international humanitarian law. Some of the many associations which now exist around the world have put the "right of interference" redefined by the United Nations as "the right of access to victims" (Resolution 43-141) into practice, while others strongly oppose it. This article, contributed by a witness to some of the most severe crises in recent history, from Biafra to Rwanda, provides a history of humanitarian action and examines the roles of states, churches, and nongovernmental organizations both with respect to their humanitarian missions, and in the interpretation of international humanitarian law. How can "interference" in the face of the unacceptable be reconciled with the concept of state sovereignty? How can genocide be prevented and ruthless dictators barred from disposing of their populations with impunity? This article suggests the current limits, and perhaps even a retreat in humanitarian thinking given the context of a new world order.

Journal Article↗

PubMed1999

Challenge of Goodness II: new humanitarian technology, developed in croatia and bosnia and Herzegovina in 1991-1995, and applied and evaluated in Kosovo 1999.

This paper presents improvements of the humanitarian proposals of the Challenge of Goodness project published earlier (1). In 1999 Kosovo crisis, these proposals were checked in practice. The priority was again on the practical intervention - helping people directly - to prevent, stop, and ease suffering. Kosovo experience also prompted us to modify the concept of the Challenge of Goodness. It should include research and education (1. redefinition of health, 2. confronting genocide, 3. university studies and education, and 4. collecting experience); evaluation (1. Red Cross forum, 2. organization and technology assessment, 3. Open Hand - Experience of Good People); activities in different stages of war or conflict in: 1. prevention (right to a home, Hate Watch, early warning), 2. duration (refugee camps, prisoners-of-war camps, global hospital, minorities), 3. end of conflict (planned, organized, and evaluated protection), 4. post conflict (remaini ng and abandoned populations, prisoners of war and missing persons, civilian participation, return, and renewal). Effectiveness of humanitarian intervention may be performed by politicians, soldiers, humanitarian workers, and volunteers, but the responsibility lies on science. Science must objectively collect data, develop hypotheses, check them in practice, allow education, and be the force of good, upon which everybody can rely. Never since the World War II has anybody in Europe suffered in war and conflict so much as peoples in Croatia, Bosnia and Herzegovina, and Kosovo. We should search for the meaning of their suffering, and develop new knowledge and technology of peace.

Altruism↗

PubMed1999

African Americans and the medical establishment.

The African American community's response to the AIDS epidemic has reflected the profound mistrust of the medical establishment which many African Americans feel. Among African Americans, the belief that the epidemic originated in a genocidal plot is widespread. It is thought that organized medicine has been significantly involved in this plot. If we look at African Americans' historical relationship to the medical establishment from the era of slavery to the recent past, the suspicious attitudes which make such beliefs possible can be seen as an intelligible response to a new disease which disproportionately affects African Americans. Successful medical and public health responses to the epidemic have depended and will continue to depend upon overcoming the historical legacy of suspicion and gaining the trust of the community.

Acquired Immunodeficiency Syndrome↗

PubMed1999

[The role of Islam in the therapeutic rehabilitation process in raped women].

This paper is based on the author's experience from the psychotherapy group of raped women. The paper will present the flow of psychotherapeutic process of the group of women who were the victims of the massive rape during the aggression on Bosnia and Herzegovina. The rape of the women in B&H by the aggressor was a part of the strategy of the genocidal war that occurred recently. The role of Islam in our tradition is seen through the whole psychotherapeutic process. The Islam was the strongest therapeutic factor in the process of reintegration of the raped women's personalities.

Bosnia and Herzegovina↗

PubMed2001

[Psychotherapeutic testimony be refugees from Bosnia-Herzegovina: a pilot study].

GOAL: The authors wished to describe the need of the psychotherapy by the witnessing in the group of the adult refugees who have survived the genocide in B&H. METHODOLOGY: The subjects of the study were 20 refugees from B&H with the residence in Chicago, which gave the written assent for participation in the study of the psychotherapy by witnessing. All the participants were this method, what in the average were 6 sessions, the approximative duration 90 minutes, once a week or once in two weeks. The participants were tested by the application of the standardized instruments for PTSP, depression, traumatic events, the global functioning and the previous therapy, after the last seance and after 2 and 6 months. RESULT: The estimations done after the therapy showed significantly the decrease in the percentage of the diagnoses of PTSP (repeated living, escaping, increase arousing attention). The symptom of the depression have also significantly lower, and the estimation of the global functioning was significantly higher. To the testing after 2 and 6 months showed that the further significant decreasing of the symptoms and the significant increase of the functioning. CONCLUSION: This pilot study offers the preliminary proves that psychotherapy by the witnessing of the symptoms of PTSP and also the depression as well as to the improvement of the functioning in the survived political and war violence.

Adult↗

PubMed2002

New formulae for estimating stature in the Balkans.

Recent studies of secular change and allometry have observed differential limb proportions between the sexes, among and within populations. These studies suggest that stature prediction formulae developed from American Whites may be inappropriate for European populations. The purpose of this investigation is to present more appropriate stature prediction equations for use in the Balkans to aid present-day identifications of the victims of genocide. The reference sample totals 545 white males obtained from World War II data. The Eastern European sample totals 177 males and includes both Bosnian and Croatian victims of the recent war. Mean stature for Eastern Europeans was obtained from the literature. Results show that formulae based on Trotter and Gleser systematically underestimate stature in the Balkans. Because Eastern Europeans are taller than American Whites it is appropriate to use this as an "informative prior" that can be applied to future cases. This informative prior can be used in predictive formulae, since it is probably similar to the sample from which the Balkan forensic cases were drawn. Based on Bayes' Theorem new predictive stature formulae are presented for Eastern Europeans.

Adult↗

PubMed2002

Misperceptions about HIV transmission among heterosexual African-American and Latino men and women.

This research was conducted to identify myths and misperceptions about HIV/AIDS and barriers to risk reduction among heterosexual African-American and Latino-American men and women in Houston, Texas. Sixty four Latino-American and 69 African-American men and women, aged 13 to 59 years, participated in 10 and 11 focus groups, respectively. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. The data confirmed the existence of myths and misperceptions among both groups about HIV/AIDS, specifically that HIV is an agent of genocide, suspicion of government information, belief that one can identify risky partners by odor and appearance, that partners' reported histories are accurate, significant misperceptions as to the meaning of "safe sex" (particularly in women), and belief that specific classes of people (not including oneself) are at risk for HIV. These data strongly suggest that concentration on narrow targeting of misinformation common in particular minority populations is important in the development of HIV/AIDS prevention programs.

Adolescent↗

PubMed1975

La operacion.

At long last we have some official information regarding that troublesome statistic often used by persons implying a genocidal plot in Puerto Rico: "35% fo all Puerto Rican women have been sterilized." According to a letter received by Mrs. Mary Morain, AVS board member, from Dr. Maria Teresa Berio, president of Puerto Rico's Commission for the Improvement of Women's Rights: Sterilization is a favorite method of the Puerto Rican women for family planning. It began in 1943 and its rate among women of reproductive age increased until 1968 when, according to a study done by Dr. Jose Velasquez Calzada, professor of demography of the University of Puerto Rico, School of Public Health, it reached 35%. The government had never officially offered these services through its family planning progra. In february 1974, when the leadership of the program was reorganized and the socioeconomic composition of that 35% was analyzed, it was found that the majority, almost 66% of the women, were of the upper class and the upper middle class, denying the concept that only the poor are sterilized and at the same time indicating an injustice in regard to the accessibility of these services. Only women of means or those who could pay were being sterilized, and those with lower incomes had no access to these services although they wanted and needed them as much as those who could pay. It was in order to correct an injustice in the offering of sterilization services that we decided to offer this operation free of charge to all strata of society. The poor did not have the same access as the rich to these serviecs. The Puerto Rican Family Planning Program is strictly voluntary. In no way are people convinced or coerced to use these services. The people of Puerto Rico have enthusiastically endorsed the family planning program. In a study carried out in 1974 by the Department of Health, 83% of the population believes that sterilization should be offered by the program and should be free of charge.

Americas↗

PubMed1998

The Nazification of German physicians, 1918-1937.

Physicians were the most over-represented academic profession in the Third Reich. They participated in the Nazi programs of forced sterilization, systematic euthanasia, human experimentation, and mass genocide. Recent research has shifted from documenting the atrocities committed by medical professionals to elucidating the process by which the German medical community became integrated into the Nazi state. The Nazi doctrine attracted a profession in economic and political distress during the Weimar Republic. It drew physicians into its movement by appealing to the medical profession's pride and prosperity in the context of a philosophy that glorified contemporary medical practice. Physicians were attracted to the Nazi party's biologically based tenets that championed biomedical solutions to social problems. They perceived the Nazi regime as instrumental in improving their incomes, reducing unemployment by purging the profession of Jewish physicians, neutralizing the insurance bureaucracy, and re-structuring the profession. The Nazi government's popularity among doctors peaked in 1937, by which time physicians had already played an integral role in the orchestration of the Nazi state.

Complicity↗

PubMed2002

Environmental and occupational medicine and injury prevention: education and impact, classroom and community.

The core value guiding the work of physicians and health workers, including those in Environmental and Occupational Epidemiology and Medicine and Injury Prevention, is to protect the health of the public, especially its most vulnerable individuals. In these fields, we emphasize teaching the use of epidemiology, the core discipline of public health, as a tool for early detection and prevention of disease and injury, as well as an instrument for hypothesis testing. The classic core topics are toxic and physical exposures and their effects, and strategies for their prevention; emerging issues are child labor, mass violence, and democide. In environmental health, students need to be prepared for the reality that the most important and severe problems are often the most difficult to investigate, solve, and evaluate. The following are some recommendations for producing graduates who are effective in protecting communities from environmental hazards and risks: (1) Teach the precautionary principle and its application; (2) Evaluate programs for teaching environmental and occupational health, medicine and epidemiology in schools of public health by their impact on the WHO health indicators and their impact on measures of ecosystem sustainability; (3) Develop problem-oriented projects and give academic credit for projects with definable public health impact and redefine the role of the health officer as the chief resident for Schools of Public Health and Community Medicine; (4) Teach the abuses of child labor and working conditions of women in the workplace and how to prevent the hazards and risks from the more common types of child work; (5) Upgrade teaching of injury prevention and prevention of deaths from external causes; (6) Teach students to recognize the insensitivity of epidemiology as a tool for early detection of true risk; (7) Teach the importance of context in the use of tests of statistical significance; (8) Teach the epidemiologic importance of short latency periods from high exposures as sentinel events for later group risk for cancer and stating the case for action; (9) Protect students and colleagues who are whistleblowers in environmental health from harassment and punishment; (10) Develop curricula and workshops that promote the use of epidemiologic tools for preventing genocide, democide, and their precursors. Schools of Public Health and Community Medicine are at the interface between the resources of academic power and the major problems of community health. Implementing the above recommendations will strengthen academic investigation and impact.

Curriculum↗

PubMed2003

Healing our planet: physicians and global security.

Health professionals, through their knowledge of medical ethics, public health models, and direct advocacy may suggest treatment of the vexing new problems of the 21st century. The evolving concept of Peace through Health encapsulates such activities, and Croatian Medical Journal's activities in the 1991-1995 war in Croatia is one example of such work. The Responsibility to Protect report, on the duty of the international community to prevent genocide and ethnic cleansing, shows the congruence of medical ideas with the domain of international affairs. Collateral Damage, a report on potential health consequences of war on Iraq, is a recent example of the increasing involvement of physicians in the direct conduct of world affairs. Prevention and healing on a global scale require clear ethical principles for action, just as they do in the personal practice of medicine.

Croatia↗

PubMed2002

[World microbiological unification according to Woodrow Borah].

Now that developments in communication media are turning the world into a "global village" and there are risks of global epidemics due to infectious agents spread by possible terrorist attacks, this article aims to remind us of what happened in the "New World", where in the space of a few decades the indigenous civilizations disappeared. When, following the geographical discoveries of the 15th, 16th and 17th centuries, millions of people met European sailors, soldiers and traders, the outbreak of pathocenosis was destructive--the intensity of this effect was directly related to the degree of isolation of the indigenous populations colonised by the Europeans. The author of this article recalls the Woodrow Borah thesis. Borah, a former History Professor at Berkeley University, elaborated a theory according to which the microbiological unification of the world is the prime cause of the genocide of the indigenous population in America and Oceania. The author emphasises that the events following the discovery of the American continent are very similar to the plague epidemic which started in 1348 in Europe.

Global Health↗

PubMed1964

THE MUSHROOM CROWD: SOCIAL AND POLITICAL ASPECTS OF POPULATION PRESSURE.

The meaning of population pressure is discussed and, with the help of a formula, its five main components (people, rate of increase of people, food-producing acreage, protein nutrition and industrialization) are analyzed.Factors which have eased population pressure in the past are considered under the headings of political violence (war and genocide), natural disaster (famine and disease), and social action (increased local protein supply, emigration, industrialization and birth control).Birth control is the first prerequisite to an easing of population pressure; the effectiveness of the Japanese and the Indian programs is discussed.The crippling burden of preventable disease, shown to be a major obstacle to the development of sophisticated industries, presents a challenge to Western medical men who so far have done little to meet it.

Agaricales↗

PubMed2003

Nuremberg and Tuskegee: lessons for contemporary American medicine.

The activities of German doctors during the Nazi regime are well known and documented. They include efforts at eugenic sterilization and euthanasia, gruesome medical experimentation, and contributions to genocide. The German medical profession embraced the Nazi ideology of racial superiority. Nazi doctors enthusiastically perverted traditional medical mores of viewing each patient as a full individual towards a misguided sense of protecting the racial well-being of the nation from the perceived threat of certain groups of people. Similarly, some 20th-century American physicians engaged in activities prompted by a misguided sense of patients' worth as individuals. This essay will examine the ethical problems of Nazi medicine and ethical missteps in the United States in the context of challenges for contemporary physicians, particularly the way in which we refer to our patients.

Black or African American↗

PubMed2001

Humanitarian aspects of health support in operations other than war.

The decade of the 1990s proved to be very busy for health personnel serving in the Australian Defence Force (ADF). During this time, they deployed to areas as far away as Africa, after the genocide in 1994, and areas closer to home. There have been missions in Indonesia, Bouganville, and Papua New Guinea. In more current times, the most significant deployment has been to East Timor where health personnel remain today. Furthermore, there have been a number of deployments on short missions to various areas within Australia's strategic area of interest. Every mission has a mission statement. In all cases involving health personnel, the statement outlines their primary tasking, which will be the provision of health support to the troops in force. The secondary tasking, which inevitably follows, is the provision of health support to the local community from within any spare capacity. It is this spare capacity that this article will discuss. The primary focuses of this article are what care should be provided and the limitation of such care, how health care should be provided, what training is required for health personnel who will provide this care, and the policies that are required to be in place to monitor this care.

Altruism↗