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Nursing, obedience, and complicity with eugenics: a contextual interpretation of nursing morality at the turn of the twentieth century.

This paper uses Margaret Urban Walker's "expressive collaborative" method of moral inquiry to examine and illustrate the morality of nurses in Great Britain from around 1860 to 1915, as well as nursing complicity in one of the first eugenic policies. The authors aim to focus on how context shapes and limits morality and agency in nurses and contributes to a better understanding of debates in nursing ethics both in the past and present.

Attitude of Health Personnel↗

Disability, gene therapy and eugenics--a challenge to John Harris.

This article challenges the view of disability presented by Harris in his article, "Is gene therapy a form of eugenics?" It is argued that his definition of disability rests on an individual model of disability, where disability is regarded as a product of biological determinism or "personal tragedy" in the individual. Within disability theory this view is often called "the medical model" and it has been criticised for not being able to deal with the term "disability", but only with impairment. The individual model of disability presupposes a necessary causal link between a certain condition in the individual and disablement. The shortcomings of such a view of disability are stated and it is argued that in order to have an adequate ethical discourse on gene therapy perspectives from disability research need to be taken into consideration.

Achondroplasia↗

Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion.

The attitudes of Australian practitioners working in clinical genetics and obstetrical ultrasound were surveyed on whether termination of pregnancy (TOP) should be available for conditions ranging from mild to severe fetal abnormality and for non-medical reasons. These were compared for terminations at 13 weeks and 24 weeks. It was found that some practitioners would not facilitate TOP at 24 weeks even for lethal or major abnormalities, fewer practitioners support TOP at 24 weeks compared with 13 weeks for any condition, and the difference in attitudes to TOP between 13 weeks and 24 weeks is most marked for pregnancies which are normal or involve a mild disorder. It is argued that a fetal abnormality criterion for late TOP is inconsistently applied, discriminatory and eugenic. Four possible moral justifications for current practice are examined, each of which would require significant changes to current practice. I argue in favour of a maternal interests criterion for any TOP.

Abortion, Eugenic↗

Reproductive genetic testing and eugenics.

The situation concerning reproductive genetic testing in Switzerland is briefly described. Growing awareness of eugenic implications especially by women is reported. This is also true for all the other German-speaking countries in Europe to a higher extent than in the other European countries. Better professional education and public information are required.

Attitude↗

[Collective health, the new genetics, and market eugenics].

Due to constant advances in genetic manipulation, the field of public health is faced with the possible emergence of a reductionist genomic emphasis, beyond socio-cultural influences. Under such circumstances, the main focus of public health interventions would shift towards a genomic approach to "individuals" and their "families", to the detriment of their consecrated object - "populations", thereby moving away from the current central priority of efforts (and resources) aimed at reducing ill-health due to socioeconomic inequalities. Even admitting the benefits of genetic knowledge, a new eugenic practice may emerge from the availability of genetic tests on the marketplace aimed at individuals that can afford to consume them.

Bioethics↗

[As the twig is bent, so is the tree inclined: children and the Liga Brasileira de Higiene Mental's eugenic programs].

Created in the early 1920s, at a moment when the country's psychiatric field was embracing the preventive outlook, the Liga Brasileira de Higiene Mental included within its members the elite of Brazilian psychiatry, along with a number of physicians and intellectuals. The article discusses the institution's proposals for intervention among children. The league ended up incorporating into its theoretical arsenal the basic themes of mental hygiene and eugenics as part of its general goal of collaborating in Brazil's process of "racial sanitation". With this objective in mind, and viewing the child as a "pre-citizen" who is a "fundamental part within the man of the future", league members included the children's issue in their projects and saw an imperative need for mental health care from early ages on.

Brazil↗

[Starvation, eugenics and the development of nutrition in Pernambuco according to Gilberto Freire's, Josué de Castro's and Nelson Chaves' analyses].

The purpose of this article is to examine the contribution of the studies Gilberto Freyre, Josúe de Castro and Nelson Chaves produced for the development of the Pernambuco nutrition field, from 1930 to 1940. The article attempts to demonstrate that both subjects--starvation and eugenics--are the central categories that express tension and communion in these three authors' approaches to this field of knowledge.

Brazil↗

Who decides? The connecting thread of euthanasia, eugenics, and doctor-assisted suicide.

Throughout recorded history, a series of seemingly unrelated ideas have been consistently intertwined: suicide, euthanasia, infanticide, eugenics, genocide and, most recently, the practice termed physician-assisted suicide. From Plato and Hippocrates to a pair of twentieth-century American physicians named Haiselden and Kevorkian, an examination of history shows these disparate notions always involve two troublesome questions: Which lives are not worth living? And who will decide? The same examination of history teaches that separating the worthy from the not worthy is a very dangerous proposition, especially for those whose lives are deemed marginal.

Decision Making↗

"More than just boots! The eugenic and commercial concerns behind A. R. Kaufman's birth controlling activities".

A. R. Kaufman (1885-1979), founder of the Kitchener-based Kaufman Rubber Company, was nicknamed "Canada's Mr. Birth Control" because he established the Parents' Information Bureau (PIB)-a birth control information centre that functioned out of his factory office. Besides creating mail order/home visiting services, Kaufman also funded birth control clinics. Because he was a rubber manufacturer, it was widely believed that commercial concerns were behind his activities. This article examines recently archived material, local newspaper accounts, and court transcripts to connect A. R. Kaufman and the PIB with the manufacture of contraceptive products. It also outlines Kaufman's involvement with the eugenics movement, especially his dealings with medical practitioners who carried out sterilization procedures for the PIB.

Canada↗

[UNESCO's bioethical norms to avoid eugenic practices].

The author, member of the UNESCO Bioethics Committee, participated in the preparation of the Universal Declaration about Human Genome and Human Rights, in 1997. The aim of this work is to analyze the initial articles of such Declaration, defining the bioethical principles that defend human dignity, freedom and rights, against the madness of the present biotechnological revolution. The development of genetics for the benefit of mankind will be guaranteed if these principles are honored. Genetic discrimination, reductionism and determinism, are identified by the author as perversions that, if used by biotechnologists, can lead to the rebirth of eugenism and racism, that were condemned by the Code of Nuremberg, in 1947. Investigators must assume their responsibility, respecting the principles of human dignity, the real freedom of research and solidarity among people. This attitude will avoid the use of genetics for purposes other than the welfare of mankind.

Bioethics↗

Constructing the pediatric nurse: eugenics and the gendering of infant hygiene in early twentieth century Berlin.

This article explores the connections between infant mortality, eugenic thinking, and the professional development of pediatricians and pediatric nurses in the early twentieth century. It argues that the goal of the physicians affiliated with Germany's National Hospital to Combat Infant Mortality was to create and disseminate a centrally-controlled message about infant hygiene, and to transform infant care into a medically-managed event. The deeply gendered ways in which both the hygienic program, and the medical division of labor were constructed, had the ambiguous result of expanding training opportunities for pediatric nurses, while at the same time, severely limiting their professional autonomy.

Eugenics↗

[Eugenics and human cloning].

Because of legislative bans there are still no reports of human cloning. However eager public debate is currently running, concerning medical, legal, social and ethical aspects of human cloning. Arguments for and against human cloning are presented. An important argument against cloning is the danger of eugenic tendencies connected with cloning, which could lead to genetic discrimination.

Bioethics↗

Nervous diseases and eugenics of the Jews: a view from 1918.

The Jewish physician, specializing in psychiatry in Warsaw, Poland, Shneor Zalman Bychowski (1865-1934) was deeply involved in public affairs, and especially in Zionist activity. Although he supported the need for eugenic means to avert the degenerative trends among Eastern Jewish populations, he insisted that the notorious neuropathies of these Jews were not hereditary, but rather induced by the social and economic conditions to which these individuals were exposed. An abridged and annotated trans- lation of Bychowski's Hebrew article in the periodical Ha-Tekufah is presented.

Eugenics↗

The revival of eugenics in American popular culture.

This paper explores the possibility of a "new eugenics" from the perspective of American popular culture. Several related ideas have been expressed in recent popular sources: differential rates of reproduction among different groups are threatening the future; there are "lives not worth living"; and the threats of disability are sufficient to justify limiting reproductive rights. These beliefs draw on assumptions that the future will depend on controlling the genetic constitution of the species. Popular ideas about the powers of the gene, we argue, are laying the basis for policies controlling reproduction for the common good.

Attitude to Health↗

[The "Psychopathologic laboratory" at Burghölzli. Development and termination of the working relationship of C.G. Jung and Eugen Bleuler].

C.G. Jung was on the staff of the University Psychiatric Clinic in Zurich ("Burghölzli"), headed by Eugen Bleuler, from 1900 to 1909; he became a senior physician in 1905. In correspondence with Sigmund Freud, Jung claimed that he had informed Bleuler about the subject of psychoanalysis and had recruited him for the movement. In fact, it can be shown that Bleuler was familiar with Freud's publications even before Jung came to Burghölzli and that he had written a very positive review of the hysteria study. Jung received his doctorate (1902) and postdoctoral qualification as university lecturer based on Bleuler's reports to the Department of Medicine and continued to give lectures on certain recurring topics, such as the theory of hysteria, until the summer semester of 1914, well after his resignation. Minutes of department meetings that have not previously been evaluated appear to indicate that the department's rejection of the founding of a "psychopathologic research laboratory," expected by Jung,was a major factor leading to his resignation on March 7, 1909. The importance of other events for Bleuler's relationship with Jung--the unsuccessful attempt at an analytical treatment of Otto Gross or Jung's relationship with Sabina Spielrein--cannot be demonstrated based on current sources.

Correspondence as Topic↗

[Fundamentals of scientifically based ethics in the works of Eugen Bleuler].

The name Eugen Bleuler is almost exclusively linked with matters concerning the nosology of schizophrenia, general psychopathology, and the relationship of clinical psychiatry with psychoanalysis. His bibliography lists various works dealing with contemporary themes about legislation, the fight against alcoholism, and, for the most part from later years, with themes about general psychology. In this article, material from Bleuler's texts are reviewed, including some which have been inaccessible up to now, which either allow interpretative conclusions on ethical grounds or have this explicitly as a topic. In particular, the analysis focuses on Bleuler's work "The Scientific Fundamentals of Ethics", published in 1939. Written in a time widely viewed as disorientated, the author coherently and systemically comments on the issue of a 'new' ethic. The anti-religious and anti-philosophical positions already demonstrable in some of his earlier works will be shown. According to his conception of a scientifically based ethic, the idea of social suitability is of utmost importance and also recognisable in the animal world as a general principle of nature. Bleuler perceives the ethical 'instinct' as inherent; its absence characterises the image of an 'moral idiot', which was already a theme in his earlier works. His statements about matters concerning euthanasia are presented and, furthermore, it will be attempted to construct from his texts an underlying global view. Concerning these ethical issues, it also can be shown once more that the elderly Bleuler was hardly influenced by psychoanalytical perspectives.

Ethics, Medical↗

Eugen Bircher (1882-1956) the first knee surgeon to use diagnostic arthroscopy.

Eugen Bircher was a strong advocate of diagnostic arthroscopy as shown in several papers on the topic of internal derangements of the knee published between 1921 and 1926. During that time, he performed about 60 endoscopic procedures, which usually preceded a meniscectomy. We believe that this was the first time arthroscopy was used in a large scale for clinical purposes. Bircher was the head surgeon of the busy provincial Aarau General Hospital, a right-wing politician, and a highly ranked army officer. His interest in knee surgery was supported by his friend Fritz Steinmann, who was the "man of the pin" and an early promoter of skeletal traction for fracture treatment. Bircher believed in the early surgical treatment of meniscal lesions and, later, in the reconstruction of cruciate ligament lesions. He used the Jacobaeus thoracolaparoscope for arthroscopy, but it had poor endoscopic qualities. The electric lamp at the tip of the optical device was not mechanically protected and was therefore endangered by every manipulation within the joint space. Also, the 90 degrees optical system delivered a dark image. By the late 1920s, Bircher had developed the technique of double-contrast arthrography, and he gave up endoscopy by 1930. In 1935, he left surgery and took a military command in the Swiss army; later he was a representative of the Farmers Party in the National Parliament until his death.

Arthrography↗

Epistemological aspects of Eugen Bleuler's conception of schizophrenia in 1911.

Eugen Bleuler, in 1911, renamed the group of mental disorders with poor prognosis which Emil Kraepelin had called "dementia praecox" "group of schizophrenias", because for him the splitting of personality was the main symptom. Biographical, scientific and methodological influences on Bleuler's concept of schizophrenia are shown with special reference to Kraepelin and Freud. Bleuler was a passionate and very experienced clinician. He lived with his patients, taking care of them and writing down his observations. Methodologically he was an empiricist and an eclecticist with a wide reading knowledge. In an impaired association of ideas, in disordered affectivity, in marked ambivalence and autism Bleuler saw the main symptoms of schizophrenia. For him these so-called pathological phenomena actually seemed to be only exaggerations of normal psychic functions. So there were only a quantitative, not a qualitative difference between schizophrenia and normal psychic processes and studies on schizophrenic "pathology"--seen as a disturbance, not as a disease--might analogously illustrate normal psychic reactions and vice versa. In etiology as well as in therapy Bleuler took into account psychological and (neuro)physiological (somatic) mechanisms--thus combining organicism and dynamic psychiatry and coming very close to modern concepts, e.g. the one of stress and vulnerability. Bleuler's main merit is the stressing on an idiographic "understanding" of the patient and a plausible and subtle explanation of schizophrenia which helped to reduce the alienation of the affected persons.

History, 20th Century↗