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"He won't be my son": Middle Eastern Muslim men's discourses of adoption and gamete donation.

In the Sunni Muslim world, religious mandates prohibit both adoption and gamete donation as solutions to infertility, including in the aftermath of in vitro fertilization (IVF) failures. However, both of these options are now available in two Middle Eastern countries with significant Shi'ite Muslim populations (Iran and Lebanon). On the basis of fieldwork in multisectarian Lebanon, I examine in this article attitudes toward both adoption and gamete donation among childless Muslim men who are undertaking IVF with their wives. No matter the religious sect, most Muslim men in Lebanon continue to resist both adoption and gamete donation, arguing that such a child "won't be my son". However, against all odds, some Muslim men are considering and undertaking these alternatives to family formation as ways to preserve their loving marriages, satisfy their fatherhood desires, and challenge religious dictates, which they view as out of step with new developments in science and technology. Thus, in this article I examine the complicated intersections of religion, technology, marriage, and parenthood in a part of the world that is both poorly understood and negatively stereotyped, particularly in the aftermath of September 11, 2001.

Adoption↗

The enigma of Darwin.

Darwin's theory of evolution by natural selection on the basis of inherited random individual variation and excessive offspring remains controversial. Arguments derive from religion (creationism)--disagreement with the Darwinian reduction of teleology to physical causation, from science--nonselective mechanism, and from logic--negation of the possibility of proof of any scientific theory allowing only for validity thusfar. Experimentation on Darwinism is beset with a practical obstacle--unattainable duration, and a logical one--nonpredictability inherent in the randomness of variation. Evolution and creationism need not be contradictive if viewed in their separate domains--rational versus miraculous.

Biological Evolution↗

Religion and health: public health research and practice.

Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.

Adaptation, Psychological↗

Life-sustaining technology and the elderly. Prolonged mechanical ventilation factors influencing the treatment decision.

In 1985, the Office of Technology Assessment (OTA) was requested by the House and Senate Aging Committees (US Congress) to study implications of life-sustaining technology and the elderly. One concern was mechanical ventilation of patients with critical illness or terminal conditions. Information was requested concerning the factors that influence treatment decisions. This report brings together opinions from medical experts in focus groups about a variety of issues raised by the OTA. The answers to those questions represent the therapeutic dilemma facing the decision-maker dealing with the elderly patient and a condition of prognostic uncertainty. Although a variety of responses is presented, some uniform trends among experts are evident. Considering the current public policy debate concerning catastrophic and long-term care of the elderly, the need is apparent to establish a clearing-house of information providing documentation, education, and networking. A documentation center would serve as a resource for public policy and program planning to serve the population that requires prolonged mechanical ventilation.

Age Factors↗

Theory and practice in epidemiology.

Scientific and ethical theories are examined in terms of the practice of epidemiology, the study of the determinants and distributions of disease, and the application of the knowledge gained to prevent disease and improve the health of populations. Scientific theories provide explanations and predictions for epidemiologic studies of disease etiology and prevention. Causal theory is the key example for epidemiologic science, although theories of selection processes, theories of health, and theories of probability and statistics are also core. Theories of ethics provide principles, warrants, and methods for acting upon the knowledge gained in the scientific pursuits of epidemiology and for obtaining that knowledge appropriately. Ethical theories guide practitioners in making justified decisions about when and under what conditions public health interventions should be undertaken and how research participants should be treated. Theories of midlevel bioethical principles have received the most attention in epidemiology, but other theories, such as virtue theory and communitarian theory, are also relevant. Many theories matter to the practice of epidemiology: theories of biology, aging, evolution, and medicine; theories of history, religion, law, economics, and politics, as well as the theories of the physical, behavioral, and social sciences. These theories matter because epidemiologists study many different biological and social phenomena, and preventive interventions occur at many different levels of explanation. Development of theory is not a high priority in contemporary epidemiology. Identifying the responsibilities of the discipline to be public health intervention and rigorous science is a first step toward developing and applying theory in epidemiology.

Causality↗