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PubMed1990

Overview of bioethics in Mexico.

In Mexico, as in many other countries, there are numerous situations involving bioethics that are not necessarily covered by officially sanctioned policies or guidelines. In such cases, it is reasonable to describe commonly accepted rules, opinions, and practices in a general way so as to illustrate how bioethical questions are being managed. This article describes certain goals and practices relating to education in bioethics in Mexico. It then outlines Mexican laws and procedures governing research on human subjects, cites certain official rules and activities relating to regulation of human reproduction, quotes literature dealing with intervention in human procreation, discusses artificial prolongation of life, describes laws and practices governing organ transplants, considers ethical issues relating to such transplants, reviews the AIDS situation, and describes how the need for confidentiality is dealt with in managing AIDS cases and related data. In this manner it indicates how bioethical questions in these various areas are being handled and points out certain priority areas needing work.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Bioethics and the 21st century, the physician's point of view].

In the field of human procreation, the problems raised by bioethics are multiple and complex. First, there is the request from couples and individuals with regards to the management of procreation, not only the negative requests, be it contraception or abortion, but also the positive requests concerning medically assisted procreation. Then there is the practitioner's response to the request, particularly for assisted procreation. The practitioner is at the heart of conflicting interests between the needs or desires of the patients and the reluctance, legitimate or not, of society, with the implication of a third person, embryo, fetus or newborn. And here again we are confronted with the aims of researchers wishing to obtain information concerning the efficacy, possibilities of application and potential dangers. The legists and magistrates are concerned with the legal status of the embryo and the fetus. However, if the fact of giving a legal status can solve many legal problems, it does not solve the problem of the eventual use of an embryo, and of its interpretation by philosophers and moralists. Moreover, public opinion should not be forgotten, including the attraction of rapid anathema, without recourse. Finally, there is also the role of the legislator who, here again, is confronted with several controversial conceptions.

Abortion, Induced↗
PubMed2001

Domesticity in Middle Dutch 'secrets of men and women'.

This is an introductory analysis of a group of Middle Dutch texts about the 'Secrets' of female health and human procreation, which date from the fourteenth and fifteenth centuries. Although at first sight little more than translations and adaptations of two Latin treatises widely known as Trotula and Secreta mulierum, the texts afford glimpses of their cultural context. They reveal a variety of traits which converge on the ordinary home, rather than on the castle, church, or university. The notion of secrecy was not a mere cliché but connected, perhaps more deeply than in other languages, with the intimacy of the family. In their phraseology as well as in their manipulations of the sources, by which they shaped the treatment of sexual issues, the writers appeared relatively unencumbered by gender polarities, heavy moralizing, and scholastic rationalization. They addressed women and men, not only readers but also illiterate listeners, and they seemed particularly attuned to the household both in the practicality of gynaecological guidelines and in the earliness of sexological information. Many hints yield a cumulative impression - inviting further thought - that the Middle Dutch 'Secrets' illuminate a special appreciation for the 'domestic' values of sexual harmony, enjoyment, and privacy.

Belgium↗
PubMed1972

Compulsory sterilization. (Letter to the editor).

Angela R. Holder's conclusion (221: 229, 1972) that a decline in forced sterilization cases exists because "any system of compulsory sterilization is too near naziism to be acceptable in a democratic society" ignores present realities. At no time in American history has there been greater acceptance of the idea that human procreation must be regulated by coercive means. Many leaders of the movement for population control, for example, openly advocate mandatory sterilization, abortion, and birth control as part of their crash program for population stabilization. Simultaneously, a growing number of those concerned with genetic "quality" demand that individual rights be subordinated or destroyed for the good of society and the species. Meanwhile, the increasing minimization of the enormous complexities of the abortion issue to a morally and medically neutral therapeutic procedure, threatens to make abortions, as well as sterilization, innocu ous public health measures that could be forced on society if circumstan ces dictate. Moreover, as the public is conditioned to believe that these measures lack ethical ramifications, the day is hastened when they can be imposed without significant opposition.

Coercion↗
PubMed1990

[Human rights and procreation].

Assisted procreation raises several problems in relation to Human Rights. The first owes to gamete donation which introduces foreign genetic material into the family. In this respect, conflicting rights of the child, the parents and the donor, are diversely perceived in different cultures. Another difficulty concerns the status of the human embryo cultured in vitro. An analysis based on a relational definition of the human person indicates that the embryo cannot reasonably become endowed with legal rights, if it does not represent the project of having a child. Assisted procreation, moreover, raises the question of the right to parenthood, not only of sterile couples but also of female homosexuals and women without partners. It also reactivates the debate on Human Rights in relation to technocratic power.

Child Advocacy↗
PubMed1990

[Human rights and procreation].

The impact of procreation on freedom, health and welfare of human beings, is considerable. This relationship, however, is not mirrored in texts devoted to Human Rights. This omission obviously implies a neglect of women's and children's rights. The history of anticonceptive methods exemplifies the struggle for these rights. This conquest, which has lasted two hundred years, is far from completed. Because of the demographic outbreak in Third World countries, an ideological conflict has appeared between first generation Human Rights concerned with individual freedom ("rights of") and those of second generation aiming at social fairness ("rights to"). Adequate political and economic adjustment between North and South is a prerequisite to any balanced compromise that would resolve this conflict through democratic, albeit intensive, birth control.

Contraception↗
PubMed2002

The physiology of sexual arousal in the human female: a recreational and procreational synthesis.

Changes induced by human sexual arousal serve reproductive and recreational functions. The current sexual phase model (desire, excitation, orgasm, and resolution) conveys little about this duarchy. Lack of spontaneous sexual desire in a third of nonclinic females indicates that the D phase needs splitting into D1 (the spontaneous [endogenous] activation of desire) and D2 (desire activated by sexual excitation at and during the E phase). Attempts to link D1 with reproduction by studies monitoring it over the menstrual cycle revealed a D1 peak just before or at ovulation, but its reliability is criticized because of the poor identification of the time of ovulation. Sexual arousal initiates enhanced genital blood flow, leading to the formation of a neurogenic transudate, lubricating the vagina, partly buffering its acidity, and increasing its oxygen tension all features that enhance spermatozoal function and survival. Orgasm occurs with vaginal and uterine contractions. The latter have been misinterpreted as powering rapid sperm transport to facilitate fertilization, but such fast transport would lead to the tubal deposition of noncapacitated, incompetent spermatozoa. Vagino-cervico elevation, however, delays rapid sperm transport and allows the initiation of decoagulation and sperm capacitation before the elevation resolves. The fastest transport of spermatozoa from cervix to the fallopian tubes occurs in the nonaroused female by uterine/subendometrial smooth muscle peristalsis. There is some evidence that even this may be reduced for a time after coitus, adding to the transport delay. If a number of the changes induced by sexual arousal are inadequately expressed, sexual as well as reproductive dysfunctions could arise.

Coitus↗
PubMed1975

[Psychiatry and the control of procreation].

Natural human reproduction is now controlled by medical means -contraception, surgical sterilization, free abortion-but for some couples (with a sterility problem) procreation is assisted by biological artifices-heterologous artificial insemination-or simulated by legal artifices = adoption (in France adopted children are officially notified as born from their adopting parents). These new biological methods and customs may create emotional disturbances and problems of identity. Psychiatrists have to know, to prevent or to treat them. This is a new pathology and there is a new role for psychiatrist.

Adoption↗
PubMed2002

[Humanism and medicine].

WITH THE PROGRESS MADE IN KNOWLEDGE AND TECHNIQUES: Therapeutic efficacy has advanced. However, interrogations concerning the control of the power that is conferred and the new obligations towards patients that stem from this progress have emerged and, further to the sinister ethical deviations in medical research and testing, and the supreme temptation that is represented by the money involved, questioning has increased. THE NUREMBERG CODE: Promulgated in December 1947, is the founder text of modern biomedical ethics. Subsequently completed by numerous other international conventions, it established the principle of voluntary, informed consent, therefore confirming the autonomy of the patient and the respect that is due from the physicians. However, questions arise not only regarding the foetus and embryo, but also regarding those reaching the end of their lives. CONCERNING EMBRYOS: No contradiction is apparent between the singularity of the human embryo and the use of embryos destined to be destroyed in highly scientific and moral quality research projects. With regard to the development of methods for producing cloned human embryos, it appears to be associated with greater risks than establishing urgent and necessary steps towards fulfilling the promises of regenerating medicine. Last but not least, deviations in reproductive biology and clinical trials conducted in this field, with relentless procreation and "human studies", must be denounced. AT THE OTHER END OF LIFE: It is worrying to note the apparent facility with which our societies consider that old age is an indignity. To call knowledge a 'power' is to consider that such power can be used not only to relieve suffering but also to manipulate others. The humanistic finality of an intention is not sufficient to guarantee neither its benignity nor its morality.

Conflict of Interest↗
PubMed1992

Towards a new legal regulation of medically assisted reproduction: the Austrian approach.

At long last Austria, too, has come round to a more or less final draft law on assisted reproduction (at the third attempt). It portrays a compromise of liberal and conservative views, which in some points has led to inconsistencies in its logical conception. The donation of semen, for instance, will be permitted, whereas ova donation will be strictly forbidden, the law will allow AID and at the same time prohibit heterologous IVF. The leading principles throughout this law, viz human dignity, procreative autonomy, and the best interests of the child, undoubtedly vital in this context, are sometimes applied to justify regulations, for example, those that deny single women access to assisted reproduction, violating the principle of equality. In this respect, the draft law definitely does not bear a closer examination.

Austria↗
PubMed1992

Regulating "the artificial family": an Austrian compromise.

Finally Austria, too, has come round to a more or less final draft law on assisted reproduction (at the third attempt). It portrays a compromise of liberal and conservative views, which in some points has led to inconsistencies in its logical conception. The donation of semen, for instance, will be permitted, whereas ova donation will be strictly forbidden; the law will allow AID and at the same time prohibit heterologous IVF. The leading principles throughout this law, viz. human dignity, procreative autonomy, and the best interests of the child, surely vital in this context, are sometimes applied to justify regulations -- e.g. those that deny single women access to assisted reproduction -- violating the principle of equality. In this respect, the draft would definitely not bear a closer examination.

Austria↗