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Decision-Making for Adolescents with Gender Dysphoria. 为患有性别焦虑症的青少年做决定。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a929021
Armand H Matheny Antommaria
{"title":"Decision-Making for Adolescents with Gender Dysphoria.","authors":"Armand H Matheny Antommaria","doi":"10.1353/pbm.2024.a929021","DOIUrl":"10.1353/pbm.2024.a929021","url":null,"abstract":"<p><p>Legislation banning gender-affirming medical care (GAMC) for minors is inconsistent with the Consensus Recommendations for Pediatric Decision-Making (Salter et al. 2023). Gender dysphoria is a medical condition, and GAMC promotes adolescents' health interests. The evidence for GAMC is comparable to the evidence for other types of pediatric medical care. Parents are permitted to consent for similar risks in the treatment of other conditions. Evaluation of the potential benefits, risks, and treatment alternatives is contingent on individual patients' clinical conditions and adolescents' and their parents' values and preferences. Such decisions are within the scope of parental discretion and should be made through shared decision-making with health-care providers. Parents' declining GAMC does not inherently create a significant risk of serious imminent harm required to justify state intervention. Usurping parental discretion for GAMC is unjust: it treats this medical care differently than other comparable types of medical care without sufficient justification.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 2","pages":"244-260"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biologic Correlates and Consequences of the Social Determinants of Health and Disease. 健康与疾病的社会决定因素的生物学相关性及其后果。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a936212
Alan Leviton, Olaf Dammann, Anup D Patel, Tobias Loddenkemper
{"title":"Biologic Correlates and Consequences of the Social Determinants of Health and Disease.","authors":"Alan Leviton, Olaf Dammann, Anup D Patel, Tobias Loddenkemper","doi":"10.1353/pbm.2024.a936212","DOIUrl":"https://doi.org/10.1353/pbm.2024.a936212","url":null,"abstract":"<p><p>The consequences of experiences and exposures suffered by those living in poverty can last a lifetime and can even be passed on to the next generation. The challenges associated with poverty have been labeled the \"social determinants of health\" (SDoH), but this is something of a misnomer. A more appropriate label would be the \"social determinants of disease.\" This essay is a broad overview of the processes, including allostatic load and epigenetic aging, that might contribute to prolonging the adverse effects of the social determinants of disease.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 3","pages":"305-324"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telling Time: Patient Experiences of Temporality in Brain Tumor Comics. 讲述时间：脑肿瘤漫画中患者对时间性的体验。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a936221
Neal Curtis
{"title":"Telling Time: Patient Experiences of Temporality in Brain Tumor Comics.","authors":"Neal Curtis","doi":"10.1353/pbm.2024.a936221","DOIUrl":"https://doi.org/10.1353/pbm.2024.a936221","url":null,"abstract":"<p><p>This article explores three different comics by creators with brain tumors: Rick, written and drawn by Gordon Shaw; Going Remote, written by Adam Bessie and drawn by Peter Glanting; and Parenthesis, written and drawn by Élodie Durand. It examines how the affordances of the comics medium enables the creators to present an experience of subjective time that is multiple, diffuse, and contradictory, in contrast to the regular apportioning of time via calendars, schedules, and pathways essential to institutional neuro-oncology. The question of time here is significant because the side effects of brain tumors can include blackouts, seizures, and periods of extreme fatigue, during which the experience of time can be significantly disrupted. The title of the article therefore evokes a temporal duality: on the one hand, it refers to the common phrase used to describe what clocks do, as well as our ability to read them; on the other hand, it speaks to one of the most important qualities of graphic medicine, which is that it allows patients dealing with medical or health issues to tell time differently. The article explores the representation of personal time in Rick, social time in Going Remote, and lost time in Parenthesis.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 3","pages":"449-469"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wonder with Care: How "Crip Participation" Engages Activism. 用心创造奇迹："瘸子参与 "如何参与激进主义。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a942083
Jessica A Cooley, Ann M Fox
{"title":"Wonder with Care: How \"Crip Participation\" Engages Activism.","authors":"Jessica A Cooley, Ann M Fox","doi":"10.1353/pbm.2024.a942083","DOIUrl":"https://doi.org/10.1353/pbm.2024.a942083","url":null,"abstract":"<p><p>This essay explores how the authors' curatorial process has roots in wonder: how it is one of inquiry, beginning and ending with open questions. The authors describe how their \"crip\" curatorial methods can be used to refuse extractive practices that might result from a disengaged wonder and to generate exhibitions that hold both the viewers and the artists with the care necessary to move passive viewing into a reciprocal engagement that can lead to an activist turn. These curatorial methods acknowledge and embrace medical professionals as potentially fellow disabled people and view them as current or potential allies. Through the participatory nature of the art in the exhibitions, the gallery becomes a space of encounter, one that creates support structures for people to build out from their individual, personal experiences and to become part of something shared across people, objects, memory, and experience. However, this shared space is not intended to collapse into ever fully knowing or understanding another person's experience. Critically, it is also a shared engagement where access to someone else's story, or body, or memories is not freely granted. Crip curation takes seriously the intentional omissions of both viewers and artists that upend not only what we get to know but how we get to know it and emphasizes that what we get to know and how we know it necessarily remains incomplete; viewers and artists alone retain full access to their own experiences.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 4","pages":"604-618"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Isenheim Altarpiece and the Virtue(s) of Wonder. 伊森海姆祭坛壁画与 "奇迹的美德"。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a942082
Lydia S Dugdale
{"title":"The <i>Isenheim Altarpiece</i> and the Virtue(s) of Wonder.","authors":"Lydia S Dugdale","doi":"10.1353/pbm.2024.a942082","DOIUrl":"https://doi.org/10.1353/pbm.2024.a942082","url":null,"abstract":"<p><p>With reference to imagery from Matthias Grünewald's masterpiece, the Isenheim Altarpiece, this essay considers how health-care practitioners especially- but all of us in practice-can learn to wonder in a way that does not objectify the differently abled but instead honors them. Wondering at the images in Grünewald's work requires humility, curiosity, patience, compassion, and grit-virtues that all health-care professionals would do well to cultivate.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 4","pages":"595-603"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The World Turned Upside Down: Wonder, Disgust, and the Alienation Effect. 颠倒的世界：惊奇、厌恶和异化效应》（The World Turned Upside Down: Wonder, Disgust, and the Alienation Effect）。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a942085
Stephen Unwin
{"title":"The World Turned Upside Down: Wonder, Disgust, and the Alienation Effect.","authors":"Stephen Unwin","doi":"10.1353/pbm.2024.a942085","DOIUrl":"https://doi.org/10.1353/pbm.2024.a942085","url":null,"abstract":"<p><p>History shows alarming shifts in the way that people with intellectual disabilities have been regarded. Locke doubted whether they could be counted among the human, while Rousseau hailed them as unspoiled children who could help us be better; the eugenicists despised them as perpetuating \"feeble-mindedness,\" while the religious praised them as holy innocents. Throughout, however, they have been seen metaphorically, as symbolic figures who incite hatred or inspire wonder, but rarely as real people. This article, written by the father of a young man with severe disabilities, rejects such thinking. The author explains how intellectual disabilities work as a Brechtian \"alienation effect\" and challenge our core system of values and explores how they make us reconsider much of what we take for granted.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 4","pages":"631-641"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Childhood Interests: what they are and why it matters. 童年兴趣：童年兴趣是什么？
IF 1 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a929018
Johan C Bester, Jeffrey Blustein
{"title":"Childhood Interests: what they are and why it matters.","authors":"Johan C Bester, Jeffrey Blustein","doi":"10.1353/pbm.2024.a929018","DOIUrl":"https://doi.org/10.1353/pbm.2024.a929018","url":null,"abstract":"<p><p>This paper examines the concept and moral significance of \"childhood interests.\" This concept is important in medical decision-making for children and more broadly in the field of pediatric ethics. The authors argue that childhood interests are identifiable components of childhood well-being that carry moral weight. Parents have a special role in protecting and promoting these interests and special obligations to do so. These parental obligations are grounded by the independent interests of the child, as well as the good of society more generally. Because parents have these child-rearing obligations, they must also have the authority and wide discretion necessary to fulfill them. However, while parental discretion is wide, it is not unlimited, for it must be used to safeguard and advance childhood interests.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 2","pages":"197-208"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How We Found Consensus on Pediatric Decision-Making and Why It Matters. 我们是如何就儿科决策达成共识的？
IF 1 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a929017
Erica K Salter, Lainie Friedman Ross, D Micah Hester
{"title":"How We Found Consensus on Pediatric Decision-Making and Why It Matters.","authors":"Erica K Salter, Lainie Friedman Ross, D Micah Hester","doi":"10.1353/pbm.2024.a929017","DOIUrl":"https://doi.org/10.1353/pbm.2024.a929017","url":null,"abstract":"<p><p>This article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in Pediatrics entitled \"Pediatric Decision-Making: Consensus Recommendations\" (Salter et al. 2023). This article next compares the six recommendations to existing statements about pediatric decision-making (specifically those developed by the American Academy of Pediatrics), highlighting similarities and differences. Finally, the article discusses the value of finding consensus in the field of pediatric bioethics.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 2","pages":"186-196"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scans and Prints. 扫描和打印
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a942071
Devan Stahl
{"title":"Scans and Prints.","authors":"Devan Stahl","doi":"10.1353/pbm.2024.a942071","DOIUrl":"https://doi.org/10.1353/pbm.2024.a942071","url":null,"abstract":"<p><p>This essay reflects on occasions when images of the author's body stirred wonder and challenged the author's understanding of her relationship to her body. Wonder is not a sentimental or romantic feeling, but an intermingling of both admiration and fear. Wonder is perhaps closest to awe, which has connotations of both reverence and terror. Wonder holds together both the negative and positive emotions that awe once elicited. Finding wonder in your own body, therefore, can be both a fearful and exhilarating experience, one that demands a kind of reconstitution of the self, since the body that was once taken for granted has now become alien.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 4","pages":"496-506"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"First, Do No Harm?": Metaphysical Harm and the Need for Iconic Perception. "首先，不要伤害？形而上学的伤害与标志性感知的必要性。
IF 0.8 4区 医学
Perspectives in Biology and Medicine Pub Date : 2024-01-01 DOI: 10.1353/pbm.2024.a942086
Kimbell Kornu
{"title":"\"First, Do No Harm?\": Metaphysical Harm and the Need for Iconic Perception.","authors":"Kimbell Kornu","doi":"10.1353/pbm.2024.a942086","DOIUrl":"https://doi.org/10.1353/pbm.2024.a942086","url":null,"abstract":"<p><p>\"First, do no harm\" has been cited so often as the fundamental principle of medical ethics that the entailed harm appears self-evident: intentional or unintentional physical harm. This article makes a case for a different kind of harm that physicians can commit against patients: metaphysically harming them by reducing them to mere objects to be fixed or manipulated, instead of persons to be known. Drawing on the history of medicine, theological reflection, and clinical practice, the author compares two ways of regarding the patient: (1) the medical dissective gaze, which knows the patient by mentally cutting her up and reducing her into parts; and (2) iconic perception, which encounters the patient as a living icon. While the medical dissective gaze describes an important dimension to scientific medicine, treating a patient purely as a medical object defaces her human personhood. To address and prevent these kinds of harms, the author proposes that regarding the patient with iconic perception fosters wonder and reaffirms the patient's humanity.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"67 4","pages":"642-653"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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