The Decades of Life: Relocating Erikson's Stages

Erik H. Erikson's life cycle schema consists of eight stages. Three are located in infancy and early childhood (ages 1–5), one in childhood (5–12), one in adolescence, and three in adulthood. This essay proposes a relocation of the stages in terms of decades. The eight psychosocial crises in Erikson's model are retained, but each crisis and its resolution is the central theme of a decade of life. This relocation of Erikson's stages orients the life cycle schema more toward adulthood than to early childhood, as six of the stages now occur in the adult years. It also reflects Erikson's theoretical shift in emphasis from the ego to the sense of I in his later writings. A proposal for how the ninth and tenth decades fit into the schema is also offered.     

The Ethics of Type 1 Diabetes Prediction and Prevention Research

There are approximately one million cases oftype 1 diabetes in the US, and the incidenceis increasing worldwide. Given that two-thirdsof cases present in childhood, it is criticalthat prediction and prevention research involvechildren. In this article, I examine whethercurrent research methodologies conform to theethical guidelines enumerated by the NationalCommission for the Protection of Human Subjectsof Biomedical and Behavioral Research, andadopted into the federal regulations thatprotect research subjects. I then offer twopolicy recommendations to help researchersdesign studies that conform to these ethicalrequirements.     

Emotionally arousing pictures increase blood glucose levels and enhance recall

Arousal enhances memory in human participants and this enhancing effect is likely due to the release of peripheral epinephrine. As epinephrine does not readily enter the brain, one way that peripheral epinephrine may enhance memory is by increasing circulating blood glucose levels. The present study investigated the possibility that emotionally arousing color pictures would improve memory and elevate blood glucose levels in human participants. Blood glucose levels were measured before, 15 min, and 30 min after male university students viewed 60 emotionally arousing or relatively neutral pictures. Participants viewed each picture for 6 s and then had 10 s to rate the arousal (emotional intensity) and valence (pleasantness) of each picture. A free-recall memory test was given 30 min after the last picture was viewed. Although the emotionally arousing and neutral picture sets were given comparable valence ratings, participants who viewed the emotionally arousing pictures rated the pictures as being more arousing, recalled more pictures, and had higher blood glucose levels after viewing the pictures than did participants who viewed the neutral pictures. These findings indicate that emotionally arousing pictures increase blood glucose levels and enhance memory, and that this effect is not due to differences in the degree of pleasantness of the stimuli. These findings support the possibility that increases in circulating blood glucose levels in response to emotional arousal may be part of the biological mechanism that allows emotional arousal to enhance memory.     

The ‘redefinition of death’ debate: Western concepts and western bioethics

Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the “dying”. This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises. Ms. Jones is an intensive care clinical nursing specialist. Dr. Kessel is a public health physician and medical ethicist.     

Ronald Dworkin on Abortion and Assisted Suicide

In the first part of this article, I raisequestions about Dworkin's theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers' Brief on AssistedSuicide', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide.     

The ‘Medical Body’ As Philosophy's Arena

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: (i) as a salutary reminder of the extent to which thereality even of the human body is constructed; and (ii) as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy's traditional (and traditionally abstract) questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the body familiar in daily experience. Toulmin's epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate.     

God and Contemporary Science: Philip Clayton's Defense of Panentheism

Philip Clayton's God and Contemporary Science is summarized and discussed. Clayton presents a theological reading of biblical texts. In my opinion, science-and-religion studies should deal more substantially with insights of secular studies on the situated character of these texts. Clayton uses the relationship between mind and brain as analogy for the relationship between God and the world. This runs the risk of understanding God as analogous to the mind and hence secondary and emergent relative to the world. Besides, Clayton's arguments for “mental causation” are wanting. But then, why should a defender of panentheism decouple the mental and the material?     

Quality of Life and Neurological Illness: A Review of the Literature

This article highlights some of the conceptual and methodological problems associated with quality of life (QoL) measurement in individuals with neurological illness. It is suggested that these problems have contributed to the underdeveloped status of QoL research in neurological settings. Many of the existing QoL measures that have been used, or show potential for use with individuals with neurological illness, are reviewed in terms of their theoretical basis, content, and practicality. A large proportion of these measures fail to meet adequate psychometric standards and/or have rarely been psychometrically tested. The confusion that surrounds adequate psychometric standards is discussed, and the dynamic nature of QoL is highlighted as a factor that requires further attention. Research addressing the discrepancies between proxy and patient ratings of patient QoL is also warranted. More focused research in these areas may contribute to a clearer understanding of how to assess QoL in individuals with neurological illness.     

Inequalities in Health and Intergenerational Equity

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require systematic discrimination against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context.     

Keeping Up with the Cloneses -- Issues in Human Cloning

The advent of cloning animals has created a maelstrom of social concern about the ethical issues associated with the possibility of cloning humans. When the ethical concerns are clearly examined, however, many of them turn out to be less matters of rational ethics than knee-jerk emotion, religious bias, or fear of that which is not understood. Three categories of real and spurious ethical concerns are presented and discussed: 1) that cloning is intrinsically wrong, 2) that cloning must lead to bad consequences, and 3) that cloning harms the organism generated. The need for a rational ethical framework for discussing biotechnological advances is presented and defended.