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PubMed1989

[Surrogate motherhood as a question in the context of a biomedical research ethic].

The most important question in biomedical ethics is really whether a researcher should do what he can do. The interventional model of modern medicine, which makes medical decisions on medical grounds, can threaten human values. In a Christian perspective we are responsible to God for our humanity. Surrogate motherhood is a very complicated question which concerns the problem of childlessness. Biomedical ethics, in the Christian context, cannot merely condone surrogate motherhood as a human and standard medical procedure. Ethically speaking, an unqualified no or an unqualified yes cannot be given. The parents' motives for their decision and the quality of their marriage are of the greatest importance before a decision about surrogate motherhood can be reached. The position of the woman who undertakes to be a surrogate mother is also questionable. Pregnancy is not just physical fact, it is an existential and human concern. The human womb is thus more than just an organ--it is a part of a woman's identity.

Ethics, Medical↗
PubMed1988

Plant life in cold climates.

Structural and functional features of plants from cold regions such as high mountain and tundra environments are characterized. Cold climates are not necessarily cold for plants at all times and influences of plant-growth form on canopy climate are substantial. Extreme low temperatures can cause temporal cessation of metabolic processes or partial tissue losses, but rarely represent an existential problem for plants native to cold regions. Low temperatures induce drastic changes in plant physiognomy and leaf anatomy, but dry matter allocation to the different plant compartments does not show a uniform trend. This suggests that generalizations of optimization and adaptation theories are not appropriate in this respect and that the functional importance of carbohydrate budgets is commonly over-estimated. Inconsistent with widespread beliefs, photosynthetic capacity in plants from cold regions is not essentially different from that in temperate regions, when comparable life forms are considered. Prevailing leaf temperatures exert minor limitations to seasonal photosynthetic carbon gain. Low temperatures come into play primarily in two ways: indirectly, via the length of the growing season and perhaps mineral nutrient availability, and directly, through influences on the growth process per se. Inherited slow or temporally restricted growth resembles an evolutionary response to long-term expectations of low resource availability. Within these genetic constraints the mitotic rate seems to be an essential point of action where low temperature determines the growth of an individual under respective local climates. Evidence is provided to support this view of an overruling significance of developmental processes in plant performance under cold conditions.

Climate↗
PubMed1988

[Homesick in Capricorn's Woods. Remarks on the 300th anniversary of the dissertation on nostalgia and the 700th anniversary of "dolor de dampno"].

Nostalgia (homesickness) was introduced to the domain of medicine only in 1688, but mental suffering corresponding to it was described already in ancient poetry; in Central Europe, it appeared for the first time 700 years ago in the Chronicle of the Zdár monastery, written by Henry the Woodsculptor (= von Heimburg?). In the woodlands between Moravia, Lower Austria and Bohemia, mentioned by Ptolemaios under the Celtic name "Gabreta" (wild goats' wood, cf. Irish "gabrach"), also other behaviour patterns reflecting unusual mental anchorage patterns of the inhabitants appeared between the 13th and 17th centuries. Even if the content of the term "nostalgia" nowadays dissipated to vague "spleen" feelings, its descendant concepts flourish in modern philosophical ("thrownness", "alienation"), psychoanalytical ("existential frustration", "birth trauma," "object loss"), psychiatrical ("agoraphobia", "deprivation", "anaclitic depression") and social psychological ("cataclysmatic fears and anxieties") thought.

Anxiety, Separation↗
PubMedDate not supplied

Development of an instrument to measure hope.

The purpose of this study was to develop an instrument to measure hope in adults and to evaluate its psychometric properties. A 40-item Miller Hope Scale (MHS) was developed based on critical elements of hope revealed in a comprehensive review of the literature and on an exploratory study of hope in persons who survived a critical illness. The instrument was critiqued by measurement and content experts, and content validity was established. The MHS was pretested on 75 subjects. The refined instrument was next evaluated using 522 healthy adults. The intent was to establish norms on the instrument before using it on ill subjects. The range of scores on the MHS is 40 to 200, with high scores indicating high hope. Mean hope score for this healthy sample was 164.46 (SD = 16.31). A leptokurtic curve, skewed to the left, was noted in these responses. As expected, the instrument detected high hope in individuals who were screened to have no physical or mental health problems. The internal consistency alpha coefficient was .93 with a 2-week test-retest reliability of .82. Criterion-related construct validity was established by correlating the MHS to the Psychological Well-Being Scale, r = .71, the Existential Well-Being Scale, r = .82, and a 1-item hope self-assessment, r = .69. Divergent validity with the Hopelessness Scale was established, r = -.54. Maximum likelihood factor analysis with oblimin rotation resulted in a three-factor solution: I, Satisfaction with Self, Others, and Life; II, Avoidance of Hope Threats; and III, Anticipation of a Future.

Adolescent↗
PubMed1986

[Fear of death: fear of life?].

This paper analyzes death as it is perceived and experienced in psychotherapeutic contexts: as a future possibility, as a loss of loved persons and as the near end as it happens with terminal patients. After a distinction between biological and psychological death, the hermeneutics of Heidegger, Sartre, Feifel and Krishnamurti are discussed. It is then suggested that death becomes more actual as a threat the less the individual profits from his existential possibilities.

Attitude to Death↗
PubMed1986

[Fear and anxiety].

By means of a phenomenologic-existential approach, the author presents a summarized study on anguish, taking into account the descriptions Schelling, Kierkegaard and Heidegger wrote about. He considers that, inspired by different problematics and thanks to their respective investigations, those philosophers represent a comprehensive 'model' for the clinico-psychological and psychiatric understanding of every kind of development where anguish is the 'axial' symptom.

Anxiety↗
PubMedDate not supplied

[Awareness of death and interpersonal relations in induced abortion].

So far no research has been carried out into the way in which women come to terms with abortion. There are four levels of experience. First, normal psychological experience, with feelings of guilt, reproach, stability, indifference; deeper awareness is suppressed with the aid of forms of defense such as scientific objectivism, positivism, and reductionism. This level is sociopsychologically well documented. Second, breakthrough of destructive deep awareness, with chaos and panic, revulsion and hate-this level is being researched by psychoanalytic methods. Third, acceptance of existential reality, experiencing guilt at having been party to killing a child. Fourth, responsibility and a feeling of guilt toward the dead child; it is here that the interhuman relationship is fulfilled, because the mental image of the child becomes like and independent being. Only at this point does full awareness of death occur. "He who knows the invisible, which has no material substance, but nevertheless an effect, is a physician."

Abortion, Induced↗
PubMed1987

[On medical responsibility in geriatric psychiatry].

In recent years, three new disciplines have progressively emerged, namely geriatric psychiatry, psycho-geriatrics and psycho-gerontology. At this time, problems of responsibility in geriatric psychiatry have tended to make physicians hesitate between two extremes: one the one hand, a refusal to take seriously the care of the elderly mentally ill, and on the other hand, a tendency towards activism and a medical ideology characterized by globalization and reductionism. It must be said, in the physician's favour, that, not only had he to learn to free himself from the ideological strangle-hold of a pseudo-scientific line of thought, but also he was having to cope with the reemergence of his own existential preoccupations as a result of his own contact with the elderly patient. It is in this difficult endeavour that a number of situations are described and discussed; these situations are of interest to psychiatry in general from the point of view of medical responsibility. Some of these are to do with the use the physician makes of concepts he has created and diffused without controlling their implementation. Others cast doubt on care management. Finally, others enable us to question more effectively the current drift in thinking amongst professionals and consumers.

Aged↗
PubMed1986

[Contradiction, incitement or hindrance to the development of knowledge].

Based on sequences of psychological examinations and the analysis of mental functioning of school children with learning difficulties, the authors propose a discussion around the concept of contradiction, such as envisaged by Piaget as having a fundamental role in the process of access to knowledge. The manner in which the dysfunction is manifested leads them to define different forms of reactions to the contradiction which compromises more or less seriously the development of knowledge. Finally, faced by the quasi existential confrontation which the contradiction represents for these children, they weigh the extent of its consequences on thought mechanisms.

Child↗
PubMed1979

[The physician faced with the mentally handicapped and his family].

In his work in the field of mental retardation, the physician is exposed to his vivid emotive reactions. He risks either to withdraw in a scientific relation or to identify himself with either family's members. The physician must learn to join with a pluridisciplinary team, to build up his emotional impulses, to answer to the needs of the mental handicapped and his family and to estimate the evolutive potential rather than the deficits. He must be conscious that the handicapped and his family are called, in an imperative manner, to resolve many tasks: they must not only confront themselves with many specialists (doctors, teachers, educators, logopedists, physiotherapists) and many Services, but also overcome the shock of the diagnosis and build, on the existential plan, a new life.

Adaptation, Psychological↗
PubMed1983

[Psychodynamic understanding of anxiety].

Anxiety as a state of arousal--Is it the same thing in pathology as in the ordinary experience of every human being? The outward show of anxiety is evidently the same, but what exactly do we mean by anxiety? Anxiety is one of the less welcome sides of man's superiority over the animals, stemming from a consciousness of one's own being, the freedom to make choices about the future and to plan ahead, the need to develop one's own personality, to create an identity for oneself in an environment where the means for such self-fulfillment appear always to be insufficient. This existential anxiety becomes pathological through symptoms; it manifests a specific weakness for each psychopathological structure. There are two different, but not irreconcilable approaches to understanding the mechanisms of anxiety: one biodynamic , the other psychodynamic. These two approaches should complement rather oppose one another. Anxiety is the cry of a self in the process of becoming, it is expressed through language. Administration of an anti-anxiety drug has a biochemical impact, but this should not be sufficient in itself. When a doctor prescribes an anti-anxiety drug, he should always encourage the patient to talk. Drug therapy thus becomes a means rather than an end in itself: It enables the patient to find the words to express his anxiety.

Anti-Anxiety Agents↗
PubMed1983

Religion and religious studies in health care and health education.

Throughout history religion and medicine have been closely intertwined. This essay outlines some of the bases for cooperation between religious studies and the education and practice of allied health professionals. Four themes are identified in which religious perspectives encourage critical scrutiny of values and assumptions that shape health care: (1) definitions of health and sickness; (2) the relation of health as a human value to other human values; (3) attitudes toward the aged, incurable, deformed, or retarded individual; and (4) attitudes toward nature. Three areas are discussed in which religious studies may make specific contributions to the allied health curriculum: (1) preparing students for the encounter with pluralism; (2) supplying an existential focus on the experience of illness to supplement the technical focus of professional training; and (3) emphasizing the common humanity that links patient and health care provider.

Allied Health Personnel↗
PubMedDate not supplied

[Social perception of arterial hypertension from a transcultural perspective].

From ethnological and psychological inquiries, during an ordinary elaboration of methodology (between France and West Africa that took place in Ivory Coast) the author emphasizes the differential value of the terms hypertension or hypotension with a systematic claim of a take of blood pressure in Europe. This uncommon fact in West Africa becomes integrated into the notion of a medical technology and raises the problem of evolution of society (non migration, new forms of alimentation, work and urbanization...). While in France the inquiry is dependent on an image of an hypertensive, his body, his personality, his problems; in Ivory Coast people refer to a body language, the psychosomatic damage including the existential malaise politics, cultural confrontations, stress pathology ... all this with periods of high or low tension internal or external pressures, getting out of the medical act consisting in a take of blood pressure or a particular psychic state testing, the nervous break down or anxiety for example. In a methodological field, the author from different levels of view points (sociological, statistical, ethnological and clinical) is in search of an adapted synthetic formula in anthropology for situations of substitution and social differences.

Attitude↗
PubMed1984

[Physician-patient relations in endogenous psychoses].

The doctor-patient relationship is described as a specific form of interaction also in patients with endogenous psychosis. In this relationship the characteristics of the basic personality structure underlying the disease process are being revealed. The schizophrenic psychotic patient can thus experience a revival of the specific human - the mortal nature transcending - theme of existential philosophy and the aspect of aggression as part of man's social existence. This can lead to a higher level of sophistication and enhance his healing process. Thymoleptic and neuroleptic drugs are viewed as helpful in the establishment of a solid doctor-patient relationship which is a precondition to recognize and possible solve the structural problems underlying the disease process. Insights derived from the rehabilitation of endogenous psychotic patients specially of social psychiatric departments are used as heuristic models also for the every-day praxis.

Communication↗
PubMed1983

Desire of pregnancy and desire of motherhood. Its sociocultural evolution.

Nowadays pregnancy is considered a psychosomatic experience during which personal and existential factors interact with cultural and environmental ones. This very important event causes conflictual conditions. In fact as regards to become a mother a different psychological attitude corresponds to a social-cultural change (historical environment, contraception, geographical area, etc.) that has shifted the objectives and the duties giving the woman the "theoretical" possibility to decide of her nature autonomally. This problem issues from two desires: the pregnancy and the maternity ones. Taking into account this attitude in 1200 women attending the Obstetric Psychoprophylaxis classes in 1982 at the Obstetric and Gynecological Department of Padua University, the Authors have pointed out interesting aspects concerning the way the woman today considers the conception and the pregnancy.

Attitude↗
PubMed1983

[Superstition, faith, delusion].

The superstitious person makes use of various projective mechanisms and establishes a connection between two events or between an object and an event which are not causally related. Superstition can be understood as a narcissistic attempt at compensation by persons lacking self-confidence, who feel themselves to be under an existential threat. Religious belief can be defined as a commitment to an ultimate meaning in life. Absolute faith requires hope, in fact genuine faith is unthinkable without hope. A prerequisite, an underlying emotional substrate, of the development of faith is trust, in the sense of basic trust. A characteristic of genuine religious belief is orthopraxy, the practical application of faith in this world. The integrity of religious belief is in itself vulnerable, since, unlike delusion, it can be modified. Delusion is a disturbance of thought content which is maintained with absolute conviction. The deluded person is not capable of doubting or correcting the false belief. Transition from faith to superstition and vice versa is often fluid. Superstition can be the starting point for delusional ideas. It must be distinguished from delusion and in most cases it is easy to do so. The superstitious person feels secure in his world, while the deluded person breaks out of this security and places himself outside the community, outside the society that supports him.

Delusions↗
PubMed1983

[Concentration camp confinement in the light of a phenomenology of alienation].

Alienation is an integrational existential process. The concepts of alienation as used by various specialized scientific approaches: anomy , reification , depersonalisation , alienation (in a limited sense) refer to individual aspects of the process, which can only be understood with regard to their totality and structure. " Endt - fremdung " means the coming to be as well as the passing away of alienation within the field of integrational -anthropological understanding of "possibility" ( vide D. Wyss ) and the structural-ontological basic concept of " Veranderung " ( vide H. Rombach ), so that the " Endt - fremdung " and " Veranderung " are based on one another. The human tragedy of detainment in a concentration-camp, humiliation as well as human greatness in the radical " Entborgenheit " can well be described within integrational anthropological concepts.

Adaptation, Psychological↗
PubMed1984

Moods and the conservative process.

In summary, then, moods are ordinary psychic phenomenon which serve important unconscious functions. Like the dream, a mood has a kind of necessary autistic structure to it: people who are in a mood, like persons who are asleep, are inside a special state where a temporal element is at play. They will emerge, like the dreamer, after the spell is over. Some moods, particularly those that are a part of a person's character, are occasions for the expression of a conservative object, as a conservative object is that internal self state that has been preserved intact during childhood often upon some breakdown between the child in relation to his parents. When a person goes 'into' a mood he becomes that child self who was refused expression in relation to his parents for one reason or another. As such, moods are often the existential registers of the moment of a breakdown between a child and his parents, and partly notate the parent's own developmental arrest, in that the parent was unable to deal appropriately with the child's particular maturational needs. What was a self experience in the child, one that could have been integrated into the child's continuing self development, was rejected by the parents, who failed to perform adequately as ordinary 'transformational objects', thereby destining a self state to be frozen by the child into a conservative object that fated such a state of being to be subsequently represented only through moods.

Adult↗