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At least 883 records · Page 49Linked to original sources
PubMed2004

Medicolegal issues in paediatric practice: proceedings of the 4th Northern Regional Paediatric Colloquium.

Ethical dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are pertinent to both the medical and legal professions. It is of potential benefit for the professions to meet and discuss such cases outwith the immediate clinical setting. A series of such meetings have been held in the Northern region. We report the proceedings of the fourth meeting. Four cases were presented and the issues arising were debated. The key points from each discussion are described.

Adolescent↗
PubMed1991

Morality in flux: medical ethics dilemmas in the People's Republic of China.

The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia... More research and discussion among people from various fields is needed. Progress will be made one step at a time, and I recommend that we proceed now to win acceptance of brain death criteria; to make clear the distinctions between passive and active euthanasia,...to encourage the use of living wills; and to protect the interests of newborns who are not terminally ill, including those with mild defects. In the changing context of modernization, in which different and even incompatible value systems must coexist, it is best for us to approach the ethical dilemmas facing us with mutual respect and understanding.

Abortion, Eugenic↗
PubMed2002

Fraught with the utmost danger: the object relations of mothers who kill their children.

The author explores the psychodynamics of maternal filicide from an object relations perspective. Among psychotic women, the murder of the child reflects a critical interplay among the mother's neurobiology, constitution, developmental experiences, and complex internal object world. Two types of personality structure are discussed. For the disorganized type, the psychodynamic scenario involves attempts to contend with the danger of massive internal breakdown. For the organized type, the scenario involves attempts to contend with the danger of persecution and annihilation. For these women, physical violence is used because of failures in mentalization, and is an enactment of catastrophic internal anxieties.

Adult↗
PubMed2001

Female-selective abortion in Asia: patterns, policies, and debates.

Since the early 1980s, the use of sex-selective abortion increased in many Asian contexts. Estimates indicate that several million female fetuses were aborted in the last two decades of the twentieth century. This article takes a currently unusual approach for a cultural anthropologist in pursuing cross-national comparisons of trends in sex-selective abortion. The risks involved in such an approach are taken in the hope that it will yield insights not gained through localized analysis. After reviewing the available evidence on female-selective abortion, I discuss features of Asian culture that support strong son preference. Next I review the related issues of increased technological availability for prenatal sex selection and national policies about sex selection. Last, I consider several positions on female-selective abortion and how cultural anthropology may contribute to understanding the global context and consequences of prenatal gender discrimination.

Abortion, Eugenic↗
PubMed1998

SIDS or murder?

Explore the source record for details and available documents.

Asphyxia↗
PubMed1999

Deaths attributable to injuries in infants, United States, 1983-1991.

OBJECTIVE: To describe risk factors for injury death among infants in the United States by the specific external cause of death. METHODS: Data were analyzed from the US-linked birth/infant death files for the years 1983-1991. Potential risk factors for injury death were identified from birth certificate data and included both maternal and infant factors. Injury rates were calculated by external cause of death. Characteristics of infants who died from an injury were compared with those of the entire birth cohort. The independent effect of potential risk factors was assessed in multivariate analyses using a case-control study design. RESULTS: A total of 10 370 injury deaths were identified over the 9-year study period (29. 72/100 000 live births). The leading causes of death were homicide, suffocation, motor vehicle crashes, and choking (inhalation of food or objects). There was no significant temporal trend in the overall rate of injury death; however, this was because significant increases in the rates of death from homicide (6.4%/year) and mechanical suffocation (3.7%/year) were offset by decreases in rates of death from fires (-4.7%/year) and choking (-4.6%/year). In adjusted analyses, infants born to mothers with no prenatal care, <12 years of education, two or more previous live births, Native American race, or <20 years of age were at twice the risk of injury death compared with the lowest risk groups (initiation of prenatal care in the first trimester, >/=16 years of education, no previous live births, white, or >/=25 years of age). When analyzed by the specific cause of death, the factors that were associated most strongly with death varied. For example, Native Americans were at greatest risk of a motor vehicle related death (compared with whites: OR: 3.6; 95% CI: 1.8-7.1), and infants with birth weights of <1500 g were at greatest risk of death attributable to inhalation of food (compared with >/=2500 g: OR: 9.6; 95% CI: 3.3-28.0) or objects (OR: 11.8; 95% CI: 4.5-30.5). CONCLUSION: A number of sociodemographic characteristics are associated with an increased risk of injury-related death in infants. The strength of associations between specific risk factors and death varies with the external cause of death, thus identifying high-risk subgroups for targeting of cause-specific interventions and simultaneously increasing our understanding of the individual and societal mechanisms underlying these tragedies.

Accidents↗
PubMed2002

National underascertainment of sudden unexpected infant deaths associated with deaths of unknown cause.

OBJECTIVE: To investigate underascertainment of unexpected infant deaths at the national level as a result of probable classification as attributable to unknown cause. METHODS: Using linked birth and death certificates for all US birth cohorts from 1983-1991 and 1995-1996, we identified 53 470 sudden infant death syndrome (SIDS) fatalities, 9071 unintentional injury deaths, 3473 injury deaths classified with intentional or suspicious intent, and 8097 deaths with unknown underlying cause. For these deaths, we compared relative risks (RRs) for maternal and infant variables available on birth certificates known to be predictive of SIDS, unintentional injury, and homicides. Variables available on death certificates were compared for unlinked and linked records. Factors related to state and national management of cases pending final cause determination are reviewed. RESULTS: For deaths from unknown cause, rates were consistently high among the same risk groups that have been shown to be at increased risk for SIDS, unintentional injury, and homicides. For most risk factors, RRs for deaths attributable to unknown causes were somewhat lower than for RRs for intentional/suspicious injury deaths but higher than for SIDS or unintentional injury, indicating combined contributions from all causes. For example, age at death from unknown cause includes RRs that more strongly resemble patterns of intentional/suspicious injuries than SIDS or unintentional injury. Deaths from unknown cause were more likely to occur during the first week of life for unattended births occurring outside clinical settings or when birth certificates were not found, similar to intentional/suspicious injury deaths. CONCLUSIONS: Risk profiles indicate that deaths of unknown cause are likely to represent a mixture of unexpected deaths. The process for determination of cause of unexpected death affects national underascertainment of SIDS and injury deaths. Better coordination among child fatality review teams and local, state, and national officials should reduce underascertainment and improve documentation of circumstances surrounding deaths for prevention efforts.

Adolescent↗
PubMed1990

Difference and danger: the cultural dynamics of childhood stigma, rejection, and rescue.

This paper presents a brief overview of some cultural, ecologic, and demographic influences on the treatment and maltreatment of infants and children with congenital anomalies. Based on research on the selective neglect of infants leading to death in parts of the developing world, it is suggested that such practices be viewed as "ethno-eugenic" survivalist strategies altogether distinct from malicious child abuse and neglect in the modern, industrialized world. Caution with respect to heroic (and not so heroic) medical interventions and "child saving" in the contexts of both developing and modern societies is stressed.

Attitude to Health↗
PubMed2004

Methods of filicide: stepparents and genetic parents kill differently.

Stepparents commit filicide at higher rates than do genetic parents. According to M. Daly and M. I. Wilson (1994), motivational differences generate differences in the methods by which stepparents and genetic parents kill a child. Using Canadian and British national-level databases, Daly and Wilson (1994) found that stepfathers were more likely than genetic fathers to commit filicide by beating and bludgeoning, arguably revealing stepparental feelings of bitterness and resentment not present to the same degree in genetic fathers. Genetic fathers, in contrast, were more likely than stepfathers to commit filicide by shooting or asphyxiation, methods which often produce a relatively quick and painless death. We sought to replicate and extend these findings using a United States national-level database of over 400,000 homicides. Results replicate those of Daly and Wilson (1994) for genetic fathers and stepfathers. In addition, we identified similar differences in the methods by which stepmothers and genetic mothers committed filicide. Discussion addresses stepparental psychology in light of the current research, limitations of the current study, and future directions for research on this topic.

Child Abuse↗