Refusing to Force Treatment

Author(s):  
Katie Watson

Abortion is illegal after viability in most US states. However, the law permits, and ethics require, clinicians to respect pregnant people’s refusal of medical treatment throughout pregnancy and delivery even when it might prevent fetal demise or harm. This chapter explains why these seemingly contradictory standards are in fact consistent. It contextualizes pregnant people’s right to refuse medical intervention within the history of the legal and moral status of women, viable fetuses, and women pregnant with viable fetuses, and argues that the principle of justice breaks the tie that some people perceive between autonomy (of women) and beneficence (to fetuses), pushing the scales in favor of women. Finally, it offers ethically sound steps that obstetricians confronted with refusals should take to maximize care, and it considers the moral distress these unusual cases invariably invoke.

2021 ◽  
pp. 097206342110115
Author(s):  
Feryad A. Hussain

Integrative models of health care have garnered increasing attention over the years and are currently being employed within acute and secondary health care services to support medical treatments in a range of specialities. Clinical hypnosis has a history of working in partnership with medical treatments quite apart from its psychiatric associations. It aims to mobilise the mind–body connection in order to identify and overcome obstacles to managing symptoms of ill health, resulting in overall improved emotional and physical well-being. This article aims to encourage the use of hypnotherapy in physical health care by highlighting the effectiveness of hypnosis as an adjunct to medical treatment and identifying barriers preventing further integrative treatments.


2018 ◽  
Vol 67 (6) ◽  
pp. 93-99
Author(s):  
Roman V. Kapustin ◽  
Natalia V. Borovik ◽  
Ekaterina V. Musina ◽  
Olga N. Arzhanova ◽  
Maria I. Yarmolinskaya ◽  
...  

Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.


2020 ◽  
Vol 10 (2) ◽  
pp. 35
Author(s):  
Jun Wang

The Plain of White Deer, known as a “secret history of China”, unfolds the historical changes of Weihe Plain in more than half of the last century. Based on the fates of different females, the novel tries to disclose the cruel oppression of the feudal clan system on women and the low status of women as a child-bearing tool in the patriarchal society. This paper will analyze the miserable fates of the three main females Tian Xiao’e, Lu Lengshi and Bai Ling in the novel and also the reasons for their tragic fates.


Author(s):  
Dora Vargha

Concerns over children’s physical health and ability were shared experiences across post–World War II societies, and the figure of the child was often used as a tool to reach over the Iron Curtain. However, key differences in how children with polio were perceived, and as a result treated, followed Cold War fault lines. Concepts of an individual’s role in society shaped medical treatment and views of disability, which contributed to the celebrated polio child in one environment and her invisibility in another. Thus, through the lens of disability, new perspectives have emerged on the history of the Cold War, polio, and childhood.


2019 ◽  
Vol 130 (2) ◽  
pp. 435-442
Author(s):  
Aymeric Amelot ◽  
Remy van Effenterre ◽  
Michel Kalamarides ◽  
Philippe Cornu ◽  
Anne-Laure Boch

OBJECTIVEMeningiomas confined to the cavernous sinus (MCSs) are benign tumors. Due to the high risk of severe complications, the intracavernous surgical procedure was abandoned in favor of radiotherapy. However, the choice of treatment remains complicated due to the fact that the natural history of this lesion has not yet been described.METHODSThe authors studied the natural history of this lesion using a prospective series of 53 consecutive patients suffering from MCSs. The median follow-up duration was 10.2 years (range 2–25 years), from 1990 to 2016.RESULTSPatients ranged in age from 30 to 72 years (mean 53 years). The meningiomas were diagnosed by major symptoms (mainly oculomotor palsy and neuralgia experienced in 28 patients), minor symptoms (headache, intermittent diplopia in 15 patients), or incidental findings (10 patients). Simple symptomatic treatment (short courses of corticosteroids and carbamazepine) allowed patients to become asymptomatic in 19 (67.9%) of 28 cases experiencing major symptoms, and for 12 (80%) of 15 patients with initial minor symptoms (p < 0.0001). All patients with incidental findings remained asymptomatic. Forty four (83%) of 53 MCSs did not show any significant growth and 42 (80%) of 53 patients were not symptomatic at the end of follow-up (p < 0.001). The radiographic progression-free survival rates (± SD) at 5, 10, and 20 years were 90% ± 4.2%, 82% ± 5.7%, and 70% ± 10.2%, respectively. Five patients (9.4%) with no evidence of any effect of the initial medical treatment desired additional conventional radiation therapy.CONCLUSIONSBecause of the capricious, unpredictable, and slow growth of MCSs, together with high growth variability from one patient to the next, the symptomatic medical treatment of these tumors is a highly effective method. This series shows that these lesions are naturally, clinically, and radiologically indolent.


Author(s):  
Sue Donaldson ◽  
Will Kymlicka

Western political theorists have largely ignored the animal question, assuming that animals have no place in our theories of democracy, citizenship, membership, sovereignty, and the public good. Conversely, animal ethicists have largely ignored political theory, assuming that we can theorize the moral status and moral rights of animals without drawing on the categories and concepts of political theory. This chapter traces the history of this separation between animals and political theory, examines the resulting intellectual blind spots for animal ethics, and reviews recent attempts to bring the two together. Situating animal rights within political theory has the potential to identify new models of justice in human-animal relations, and to open up new areas of scholarship and research.


Author(s):  
Brian Doak

The book of Job is the longest and most thematically and linguistically challenging of the “wisdom books” in the Hebrew Bible/Old Testament. In the book’s prologue (Job 1–2) the narrator introduces readers to a man named Job (Hebrew ‘iyyōb; etymology unclear). Job’s prosperity extends into all areas of his life, and seems at least potentially linked to his moral status as completely righteous and blameless before God. The earthly scene then gives way to a heavenly setting, where a figure called “the accuser” (literally “the satan”; haśśātān) appears before God. God boasts about Job’s righteousness, but the accuser counters, suggesting that Job’s moral achievement has been merely the byproduct of God’s protection. The accuser and God enter into a bet: Job’s children will be killed, Job’s possessions stripped, and Job’s body afflicted with a painful disease—all to see whether Job will curse God. Job initially responds to the distress with pious statements, affirming God’s authority over his life. In a state of intense suffering, Job is joined by three friends—Eliphaz, Bildad, and Zophar, and then eventually a fourth, Elihu—who offer rounds of speeches debating the reasons for Job’s situation (Job 3–37). Job responds to the friends in turn, alternately lamenting his situation and pleading for a chance to address God directly and argue his case as an innocent man. The friends accuse Job of committing some great sin to deserve his fate; they urge repentance, and defend God as a just ruler. God enters the dispute in a forceful whirlwind (Job 38), and proceeds for several chapters (Job 38–41) to overwhelm Job with resounding statements on creation (38:1–38), animal life (38:39–40:14), and visions of two powerful creatures, Behemoth (40:15–24) and Leviathan (41:1–11). The book ends with Job acknowledging to God the fact that he is overmatched in the face of divine power. God condemns the friends for not speaking “what is right, as my servant Job has” (42:7), and then restores Job’s lost possessions and children (42:10–17). Job has enjoyed a rich reception history in Judaism, Christianity, Islam, and, perhaps more than any other book in the Bible except Genesis, as a world literary classic in its own right. Within the Bible, it is the most bracing statement on the problem of suffering, as it presents a situation wherein a clearly righteous person suffers immensely—putting it at odds with more straightforward descriptions of why people suffer in Proverbs, Deuteronomy, and other texts. Scholarly research on Job has focused on the book’s place among other ancient Near Eastern wisdom materials, on questions of language (given the large amount of difficult Hebrew terms in the book), on historical-critical concerns about authorship and the way the book may have come together in its present form, and on the history of the translation of the text into Greek and other ancient languages. In the 21st century, interpreters have increasingly taken up readings of Job that situate it among concerns related to economics, disability, gender, and the history of its reception in many different eras and communities.


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