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PubMed1991

Sadomasochism in the perversions: some thoughts on the destruction of reality.

The author summarizes and develops some of her viewpoints on the perversions (outlined in several of the books and articles she has written). For her all the perversions, whatever their content, develop against an anal sadomasochistic backdrop. Their aim is to destroy reality. Reality, from a psychosexual perspective, may be defined as resulting from the existence of the father separating the mother and the child. This may be formulated in another way: reality is recognition of sexual and generational differences. Or, yet again: mother and father have a procreative sexuality, whereas the child does not. This leads to the idea that the destruction of reality is equivalent to destruction of the paternal universe. Clinical case illustrations are provided, one of which centers on the assassination of an old man who, besides representing a paternal oedipal image, also represents reality itself. This case illustrates in concrete form the murder of the father, and hence of reality, accomplished by the pervert when he eradicates the paternal dimension of psychosexuality by regressing to the anal sadomasochistic dimension.

Fantasy↗
PubMedDate not supplied

[Drugs for "well-being". Drugs and biotechnology as instruments of self-programming?].

New drugs are being released on the market with the alluring promise of a better quality of life. Together with the "magic" pills already available, as amphetamines, benzodiazepines and antidepressants, Viagra and new compounds to control lipid metabolism, appear to open new avenues to individual self-determination and self-improvement. Also new biotechnological resources allow today a far more manipulated control of procreation. Designed to target specific groups of patients with well-defined psycho-physiological problems, these new drugs and biotechnologies are becoming available to the larger public. Incorrect information by the mass media, insufficient control by some physicians and self-promoting attitudes in healthy subjects may combine into a powerful cocktail, creating confusion and leading to an incorrect use of these drugs. Can individuals really improve themselves in this fashion or are they just abusing drugs for their own purposes? Are the costs of these drugs and procedures socially justified?

Biotechnology↗
PubMed2002

Gender selection: cultural and religious perspectives.

OBJECTIVE: To review the current developments in the field of preconceptual sex selection and to discuss the cultural and religious perspectives as that accompany the scientific progress. DESIGN: A survey of the major publications in Judaism, Christianity and Islam regarding the issue of gender selection. Examination of current methods of preconceptual gender selection revealed that in vivo methods such as timing of intercourse, the use of ovulation induction medications, and artificial insemination do not appear to affect the sex ratio to a clinically significant degree. In vitro separation of X- and Y-bearing spermatozoa by gradient techniques have been reported to alter significantly the sex ratio at birth. However, these trials were not controlled, and molecular biological techniques could not validate that these methods indeed change the Y- to X bearing spermatozoa ratio sufficiently for clinical use. Nevertheless recent scientific advances have made highly reliable preconceptual sex selection possible by using preimplantation diagnosis (PGD) or sperm separation by flow cytometry combined with AIH or IVF. At present, these methods have been used to avoid sex-linked disorders. Both involve the invasive procedure of IVF and thus are held by most as inappropriate for nonmedical indications. However, improvement in flow cytometry output of sexed spermatozoa might provide in the near future sufficient sorted gametes for artificial insemination. It may be that in the near future, an improvement in flow cytometry output of sexed spermatozoa will provide sufficient sorted gametes for artificial insemination. In such a case, the medical community will be forced to take a stand, whether this reliable noninvasive method of sexing will be allowed for social purposes and even if the practice of PGD should be allowed for nonmedical indications. CONCLUSION: The requirement for a man to procreate by having a minimum of two children-a boy and a girl-is obligatory according to Jewish law. According to both schools, Beit Shamai and Beit Hillel, in order to fulfill the obligation of procreation at least one son is required. Therefore the application of sex preselection for nonmedical indications may by of practical importance using the method of sperm separation or sex selection of pre-embryo by PGD. According to Christian view, especially the one of the Catholic Church, gender preselection even for medical indications is forbidden. Islamic legal viewpoint is that fetal sex selection is lawful when it is practiced on an individual basis, to fulfill the wish of a married couple to have a boy or a girl through available medical means.

Christianity↗
PubMed1989

The incompetent developmentally disabled person's right of self-determination: right-to-die, sterilization and institutionalization.

The developmentally disabled, specifically those mentally incompetent from birth, are entitled to a full panoply of constitutional rights and protections. These rights include the right to terminate life-sustaining treatment, the right of procreative integrity and the right not to be involuntarily institutionalized. However, the mentally incompetent developmentally disabled are generally unable to exercise these rights. This Note asserts first that proper procedural safeguards are necessary to guarantee the exercise of these constitutional rights by the incompetent disabled individual. Second, the Note focuses upon how best to preserve the disabled person's autonomy. The Note subsequently rejects the substituted judgment standard as a legal fiction, and endorses the best interest test which necessarily comports with the evidence, and properly accounts for the disabled person's incompetency.

Humans↗
PubMed1993

[What are the medical limits on the desire for pregnancy in the woman at risk?].

Quite a few medical situations are as difficult as the ones where the desire of procreation and the risks associated to it are in conflict. The practitioner's opinion is grounded on his experience, on statistical data, but also on his own sensitivity and subjectivity. His role is not to give the patient the medical data and to leave her deciding alone. He must involve himself in the process of reflexion and decision, recognize and appreciate the depth of the motivations and finally respect them. He must remember that the female intuition bears sometimes more value than the so called scientific knowledge.

Clinical Competence↗
PubMed1997

Semen quality and fertility of men employed in a South African lead acid battery plant.

Previous studies of the associations of measures of occupational lead exposure with measures of semen quality and infertility among male workers have produced conflicting results. The current study was undertaken to examine these associations among a population of workers with a broad range of measures of current and historical lead exposure. Ninety-seven lead-exposed workers from a South African lead acid battery facility provided semen samples that were analyzed for sperm density, sperm count, sperm motility, sperm morphology, and presence of antisperm antibodies. Questionnaire data were collected for reported histories of sub- or infertility. Current blood leads ranged from 28 to 93 micrograms/dl. Semen lead ranged from 1 to 87 micrograms/dl. Reasonably consistent and significant associations were found between an increased percentage of sperm with abnormal morphology and higher measures of current blood lead, cumulative blood lead, and duration of exposure. An increased percent of immotile sperm was associated only with zinc protoporphyrin (ZPP) among the lead exposure measures. There were no associations of sperm density or sperm count with any of the lead exposure measures. A weak association of increased percent of sperm with antisperm antibodies with increased semen lead was present. There were no consistent associations of measures of lead exposure with measures of fertility or procreativity. This study, while supporting the association of lead exposure with increased risk of abnormal sperm morphology seen in some previous studies, does not lend support to previously reported associations of sperm density or count or infertility with measures of lead exposure. However, the relatively high range of current blood leads, high prevalence of abnormalities in semen quality, and the lack of a control population, suggest that these negative findings should be interpreted with caution.

Cross-Sectional Studies↗
PubMedDate not supplied

[Endometriosis with ascites and pleural effusion: a case report].

Massive ascites associated with pelvic endometriosis is an uncommon combination. Pleural effusion may rarely occur. Fourteen cases are reported in the literature. We report the case of a black nulligravida woman followed for a primary infertility. Endometriosis was suspected in presence of increasing dysmenorrhea, cystic adnexal masse, umbilical nodes and ascites. The diagnosis was confirmed at exploratory laparoscopy. The patient had been followed for assisted procreation for six years and had undergone a conservative laparoscopic surgery never described. After several ascites recurrences, the pathology was resolved by Gonadotropin-releasing hormone agonist therapy. But a right pleural effusion with ascites occurred following a bad therapeutic observance. This complication reveals an early pregnancy never reported for this exceptional pathology. A conservative management allowed this unique case of well outcoming pregnancy. The possible pathogenesis of ascites and pleural effusion are explored and recommendations for diagnosis and treatment options are discussed.

Adult↗
PubMed2004

What causes seasonality of birth in schizophrenia?

An excess of winter-spring births (and/or a decrease of summer births) has consistently been observed in schizophrenia (SCZ). This observation may provide a significant clue about the causes of the disease if specific factors which cause the phenomenon can be determined. This paper reviews several studies which investigated factors correlated with this observation in SCZ, in an attempt to determine which factors more likely cause the seasonality. Among the candidates of the factors are meteorological variables (such as ambient temperature), several infections, maternal hormones, sperm quality, nutrition and external toxins. A variation of procreation might also have an effect. Among the factors, the most extensively studied are temperature and viral infections. Some of them have appeared promising, but further studies are definitely required. Several challenges, including complicated correlations of the factors and determination of the susceptible period during pregnancy, need to be overcome. Comparisons of the data from areas and cohorts with different patterns of the candidate factors may be helpful. Animal studies may also help investigate the molecular and physiological mechanisms of the phenomenon.

Animals↗
PubMedDate not supplied

[Infertility in a couple. Focus on the different techniques of medically assisted procreation].

In view of the advent of effective medically assisted procreation (MAP) techniques, it is now more necessary than ever to use the most strict and systematized methods in the management of couples who consult for infertility. The authors present the modalities of this management and review the present MAP techniques which are all based on bringing together the gametes in an optimal environment conditioned by the clinical situation of the couple. The main results obtained are presented under the headings: percentage of success, multiple pregnancies prevention policy and future of the children.

Embryo Transfer↗
PubMed2001

Gender differences in the reasons for participation in spouse sharing among the Okun in Nigeria.

This report examines the reasons for participation in spouse sharing among the Okun with a view to identifying some factors that may present particular obstacles to women and enhance their vulnerability to the practice. A total of 1029 sexually active respondents in 5 settlements where spouse sharing is being practiced participated in the questionnaire survey aspect of the study, while 82 respondents participated in the focus group discussions. About 65% of respondents reported having ale or alase and were involved in the practice of spouse sharing. Reasons for involvement in spouse sharing include the need for economic support, sexual satisfaction, increased social status, procreation, the problems of separation/divorce and widowhood. The focus group discussions revealed a possible exploitation of the gender-based economic weakness of the women by the men in the initiation and sustenance of the practice in the Okun communities. It is recommended that for any program to achieve a considerable reduction in the practice, differences in the reasons for participation in spouse sharing among the men and women must be documented with a view to solving those problems that compel women to participate.

Adolescent↗
PubMed1992

[Retinoma and phtisis bulbi: benign expression of retinoblastoma].

Systematic investigation of families of children suffering from retinoblastoma reveals more and more cases of retinoma or phthisis bulbi, cases which used to be called "spontaneous regression". Between 1975 and 1991, we have in this way discovered 11 cases (7%) certain to be carrying retinoma or phthisis bulbi, and a further 5 cases where the same diagnosis is highly probable. Of the 11 certain cases, 5 are unilateral, 6 bilateral, and 8 present family history of the disease. Of the total number of 17 eyes, 16 present retinoma, 1 phthisis bulbi. On clinical examination, all (100%) showed characteristic lesions in the form of greyish homogenous elevated masses in the vitreous cavity. 11 presented calcifications (69%) and in 14 disturbance of the pigment epithelium occurred (87%). The average follow-up is 4 years. Of the 11 patients, 8 are of procreating age and have up to now 25 offsprings. Amongst these, 15 have retinoblastoma (60%), 2 retinoma and phthisis bulbi (8%). All except one of the retinoblastoma cases are bilateral. This study would appear to show that retinoma occurs with a higher frequency than that which is usually given. The figures show clearly that retinoblastoma and retinoma derive from the same genetic disturbances, possibly at different times during cell maturation, and consequently require the same investigation and follow-up.

Adult↗
PubMed1992

AIDS, sex and condoms: African healers and the reinvention of tradition in Zaire.

Condoms offer considerable protection against sexual transmission of AIDS. Yet many Africans who are at risk of infection reject condoms as "unnatural." Data from Zaire have been used to examine this culturally constructed category in relation to sexuality, procreation, gender roles, class formation and international health and development policy. Much more than a simple transfer of biomedical technology is involved. Condom use with regular partners raises issues of cultural politics at many levels. "Traditional" African healers represent important social networks with considerable authority in poor urban communities. They are able to reinterpret cultural categories and endow behavior with new meanings. Action-research in Kinshasa was used to explore roles that healers might play in promoting change to safer sex practices.

Acquired Immunodeficiency Syndrome↗
PubMed2003

[The problems in France created by the HIV/AIDS epidemic at the onset of the third millenium].

UNANSWERED QUESTIONS: The HIV/AIDS epidemic represented a medical, social and political challenge to our society. It raises numerous questions, to which some replies have been partially proposed. In the context of less attention paid to AIDS, the epidemic continues to create problems in France and has led to the debates on medical and sanitary questions and other political, social and economical issues. FROM A THERAPEUTIC POINT OF VIEW: Among the issues concerning health management, those related to treatment are first-line: progress in therapeutic indications, choice of antiretroviral molecules and their combinations, particular aspects of treatments delivered in certain circumstances (pregnant women or primary-infection), difficulties in the assessment of the benefit/risk progress. The problems of compliance that occasionally induce severe side effects, provoke therapeutic failure in some patients and for whom rapid access to new antiretroviral molecules and new therapeutic strategies is mandated. THE CROSS-LINK WITH POLITICAL, SOCIAL AND ECONOMIC PROBLEMS: The resulting debates partly depend on the progress made in therapeutics. The latter have led to expectations of HIV-infected patients, who would like to benefit fully from the promise of a return to normal life (access to insurance and medically-assisted procreation). HIV/AIDS has led to new ethical debates on the rights of patients, such as those related to screening, clinical research or confidential access of under-aged patients to treatment. Some of these aspects involve political decisions: prevention measures to be taken against the possibility of a new epidemic, the risks and damages related to the use of drugs and the guarantee of access to treatment of patients living in under-developed countries.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Beacons, breasts, symbols, sex and cancer.

Since the 1950's effective control of conception has allowed modern men and women to differentiate procreational from recreational sexual exchange. What is considered highly erotic has differed widely through time and in various cultures. In the U.S. the female breast has come to mean far more than nurturing an infant. Sexuality symbolizes youth, attractiveness, desirability and as such is used for effective commercial marketing. The reality of cancer remains to be dealt with in health care at a physical level but more is needed to assist the emotional adjustment of affected women and their partners. Brief sex therapy for sex symptoms is outlined.

Body Image↗
PubMed1995

A philosopher looks at assisted reproduction.

The article first examines the various objections to IVF: religious, health and safety and feminist. It is argued that none of these objections provides good reasons for banning IVF, though certain controls and procedures to protect individuals from harm and exploitation may be appropriate. Next, the article critiques John Robertson's strong conception of procreative liberty, which entails a right to be a surrogate mother or serve as a sperm donor. Roberton's interpretation misconceives the nature and value of the right to reproduce. The righ to reproduce is best interpreted as a right to have one's own children to rear. Where there is no intent or ability to rear, there is no fundamental moral right to reproduce. However, since assisted reproduction is used to enable individuals to have their own children to rear, it should be available to infertile individuals who cannot otherwise reproduce.

Bioethics↗
PubMed2004

Attachment style and subjective motivations for sex.

The relation of attachment style to subjective motivations for sex was investigated in an Internet survey of 1999 respondents. The relations of attachment anxiety and avoidance to overall sexual motivation and to the specific motives for emotional closeness, reassurance, self-esteem enhancement, stress reduction, partner manipulation, protection from partner's negative affect and behavior, power exertion, physical pleasure, nurturing one's partner, and procreation were explored. As predicted, attachment anxiety was positively related to overall sexual motivation and to all specific motives for sex, with the exception of physical pleasure. Avoidance was negatively related to emotional closeness and reassurance as goals of sex and positively related to manipulative use of sex but minimally related to most other motives. Sexual passion was positively related to attachment anxiety and negatively related to avoidance, and anxiety was related to the maintenance of passion over time, whereas avoidance was related to loss of passion over time.

Adult↗
PubMed1989

[Pre-decision algorithms for the induction of ovulation in fertilization in vitro].

The success of medically assisted procreation techniques depends on the influence of numerous parameters and, especially the quality of ovarian hyperstimulation. The need of a homogeneous treatment within the medical team has led us to elaborate a system of assistance in decision making in terms of stimulation of ovulation. A first system was developed for a classical stimulation protocol, type clomiphene-gonadotropin. The limited number of decision making parameters (six) as well as the limited number of therapeutic decisions (six) has enabled us to developed a particularly performing algorithm system.

Algorithms↗
PubMed2002

Parental responsibility and the morality of selective abortion.

It is now a common opinion in Western countries that a child's impairment would probably place an unexpected burden on her parents, a burden that the parents have not committed themselves to dealing with. Therefore, selective abortion is in general a morally justified option for the parents. I argue that this view is based on biased information about the quality of life of individuals with impairments and their families. Also, a conscious decision to procreate should bring about conscious assent to assuming obligations as a parent. This implies a duty of caring for any kind of child. Consequently, if the child's condition is not such that it would make its life not worth living, and if the parents live in an environment where they are not able to provide their child and themselves an adequate well-being, they do not have a morally sufficient reason to terminate the pregnancy on the grounds of fetal abnormality.

Abortion, Eugenic↗