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Religion and Contraception

When discussing contraception with a patient, in may be useful to understand a little about the patient’s religious background.   Obviously, it is not the medical professional’s position to advise on any religious aspects, but only to advise on the medical basis of contraceptive methods, and their use and efficacy, thus that the patient may make their own informed decision. It can be a difficult decision for patients, when their Religious beliefs and personal views on contraception are at odds.    
almostadoctor.com - free medical student revision notes
over 5 years ago
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27

Island ( 1962 ) by Aldous Huxley

In his last major work, the Island, the evils that Aldous Huxley has been warning us about in his earlier works - over-population, coercive politics, militarism, mechanization, the destruction of the environment and the worship of science will find their opposites in the gentle and doomed Utopia of Pala. (Woodcock,18) Aldous Huxley used his books to explore his struggles against personal tragedy and to search for the meaning of human existence. His interest in eastern philosophies and mysticism began in the early twenties with the study of Blake and Bohme. His fascination with eastern religion was one of the reasons he departed on a world tour in 1925. The island of Pala is probably one of the islands of the Indonesian Archipelago. In Island, Huxley's portrayal of the Palanese beliefs demonstrate principles of Buddhism, Taoism, Hinduism and Confucianism. The beliefs, values and struggles of a lifetime are combined to form this culmination of his life's work.  
huxley.net
over 5 years ago
Foo20151013 2023 13vodzp?1444774194
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Is ADHD a difficult diagnosis?

In a recent article in the BMJ the author wonders about the reasons beyond the rising trend diagnosing Attention Deficit Hyperactivity Disorder (ADHD). The article attempts to infer reasons for this. One possible reason was that the diagnostic criteria especially DSM may seem for some to be more inclusive than ICD-10. The speculation may explain the rise of the diagnosis where DSM is used officially or have an influence. In a rather constructive way, an alternative to rushing to diagnosis is offered and discussed in some details. The tentative deduction that the Diagnostic Statistical Manual (DSM) may be one of the causes of rising diagnosis, due to raising the cut-off of age, and widening the inclusion criteria, as opposed to International Classification of Diseases, 10th revision (ICD-10), captured my attention. On reading the ICD-10 diagnostic criteria for research (DCR) and DSM-5 diagnostic criteria, I found them quite similar in most aspects, even the phraseology that starts with 'Often' in many diagnostic criteria, they seem to differ a bit in age. In a way both classification, are attempting to describe the disorder, however, it sounds as if someone is trying to explain a person's behaviour to you, however, this is not a substitute to direct clinical learning, and observing the behaviour, as if the missing sentence is 'when you see the person, it will be clearer'. El-Islam agrees with the notion that DSM-5 seems to be a bit more inclusive than ICD-10. A colleague of mine who is a child psychiatrist and she is doing her MSc. thesis in ADHD told me, that DSM-5 seems to be a substantial improvement as compared to its predecessor. The criteria - to her - though apparently are more inclusive, they are more descriptive with many examples, and she infers that this will payback in the reliability of the diagnosis. She hopes gene research can yield in biological tests for implicated genes and neurotransmitters in ADHD e.g. DRD4, DAT, gene 5,6,11 etc. One child psychiatrist, regretted the fact that misdiagnosis and under-diagnoses, deprive the patient from one of the most effective treatments in psychiatry. It is hoped the nearest forthcoming diagnostic classification (ICD-11), will address the issue of the diagnosis from a different perspective, or else converge with DSM-5 to provide coherence and a generalised newer standard of practice. The grading of ADHD into mild, moderate, and severe seem to blur the border between disorder and non-disorder, however, this quasi-dimensional approach seems realistic, it does not translate yet directly in differences in treatment approaches as with the case of mild, moderate, severe, and severe depression with psychotic symptoms, or intellectual disability. The author states that one counter argument could be that child psychiatrists are better at diagnosing the disorder. I wonder if this is a reflection of a rising trend of a disorder. If ADHD is compared to catatonia, it is generally agreed that catatonia is less diagnosed now, may be the epidemiology of ADHD is not artefact, and that we may need to look beyond the diagnosis to learn for example from environmental factors. Another issue is that there seems to be significant epidemiological differences in the rates of diagnosis across cultures. This may give rise to whether ADHD can be classified as a culture-bound syndrome, or whether it is influenced by culture like anorexia nervosa, or it may be just because of the raising awareness to such disorders. Historically, it is difficult to attempt to pinpoint what would be the closest predecessor to ADHD. For schizophrenia and mania, older terms may have included insanity, for depression it was probably melancholia, there are other terms that still reside in contemporary culture e.g. hypochondriasis, hysteria, paranoia etc. Though, it would be too simplistic to believe that what is meant by these terms was exactly what ancient cultures meant by them, but, they are not too far. ADHD seems to lack such historical underpinning. Crichton described a disorder he refers to as 'mental restlessness'. Still who is most often credited with the first description of ADHD, in his 1902 address to the Royal College of Physicians. Still describes a number of patients with problems in self-regulation or, as he then termed it, 'moral control' (De Zeeuw et al, 2011). The costs and the risks related to over-diagnosis, ring a warning bell, to enhance scrutiny in the diagnosis, due to subsequent stigma, costs, and lowered societal expectations. They all seem to stem from the consequences of the methodology of diagnosis. The article touches in an important part in the psychiatric diagnosis, and classifications, which is the subjective nature of disorders. The enormous effort done in DSM-5 & ICD-10 reflect the best available evidence, but in order to eliminate the subjective nature of illness, a biological test seems to be the only definitive answer, to ADHD in particular and psychiatry in general. Given that ADHD is an illness and that it is a homogeneous thing; developments in gene studies would seem to hold the key to understanding our current status of diagnosis. The suggested approach for using psychosocial interventions and then administering treatment after making sure that it is a must, seems quite reasonable. El-Islam, agrees that in ADHD caution prior to giving treatment is a recommended course of action. Another consultant child psychiatrist mentioned that one hour might not be enough to reach a comfortable diagnosis of ADHD. It may take up to 90 minutes, to become confident in a clinical diagnosis, in addition to commonly used rating scales. Though on the other hand, families and carers may hypothetically raise the issue of time urgency due to scholastic pressure. In a discussion with Dr Hend Badawy, a colleague child psychiatrist; she stated the following with regards to her own experience, and her opinion about the article. The following is written with her consent. 'ADHD is a clinically based diagnosis that has three core symptoms, inattention, hyperactivity and impulsivity in - at least - two settings. The risk of over-diagnosis in ADHD is one of the potentially problematic, however, the risk of over-diagnosis is not confined to ADHD, it can be present in other psychiatric diagnoses, as they rely on subjective experience of the patient and doctor's interviewing skills. In ADHD in particular the risk of under-diagnosis is even more problematic. An undiagnosed child who has ADHD may suffer various complications as moral stigma of 'lack of conduct' due to impuslivity and hyperactivity, poor scholastic achievement, potential alienation, ostracization and even exclusion by peer due to perceived 'difference', consequent feelings of low self esteem and potential revengeful attitude on the side of the child. An end result, would be development of substance use disorders, or involvement in dissocial behaviours. The answer to the problem of over-diagnosis/under-diagnosis can be helped by an initial step of raising public awareness of people about ADHD, including campaigns to families, carers, teachers and general practitioners. These campaigns would help people identify children with possible ADHD. The only risk is that child psychiatrists may be met with children who their parents believe they might have the disorder while they do not. In a way, raising awareness can serve as a sensitive laboratory investigation. The next step is that the child psychiatrist should scrutinise children carefully. The risk of over-diagnosis can be limited via routine using of checklists, to make sure that the practice is standardised and that every child was diagnosed properly according to the diagnostic criteria. The use of proper scales as Strengths and Difficulties Questionnaire (SDQ) in its two forms (for parents SDQ-P and for teachers SDQ-T) which enables the assessor to learn about the behaviour of the child in two different settings. Conner's scale can help give better understanding of the magnitude of the problem. Though some people may voice criticism as they are mainly filled out by parents and teachers, they are the best tools available at hands. Training on diagnosis, regular auditing and restricting doctors to a standard practice of ensuring that the child and carer have been interviewed thoroughly can help minimise the risk of over-diagnosis. The issue does not stop by diagnosis, follow-up can give a clue whether the child is improving on the management plan or not. The effects and side effects of treatments as methylphenidate should be monitored regularly, including regular measurement height and weight, paying attention to nausea, poor appetite, and even the rare side effects which are usually missed. More restrictions and supervision on the medication may have an indirect effect on enhancing the diagnostic assessment. To summarise, the public advocacy does not increase the risk of over-diagnosis, as asking about suicidal ideas does not increase its risk. The awareness may help people learn more and empower them and will lead to more acceptance of the diagnosed child in the community. Even the potential risk of having more case loads for doctors to assess for ADHD may help give more exposure of cases, and reaching more meaningful epidemiological finding. From my experience, it is quite unlikely to have marked over-representation of children who the families suspect ADHD without sufficient evidence. ADHD remains a clinical diagnosis, and it is unlikely that it will be replaced by a biological marker or an imaging test in the near future. After all, even if there will be objective diagnostic tests, without clinical diagnostic interviewing their value will be doubtful. It is ironic that the two most effective treatments in psychiatry methylphenidate and Electroconvulsive Therapy (ECT) are the two most controversial treatments. May be because both were used prior to having a full understanding of their mechanism of action, may be because, on the outset both seem unusual, electricity through the head, and a stimulant for hyperactive children. Authored by E. Sidhom, H. Badawy DISCLAIMER The original post is on The BMJ doc2doc website at http://doc2doc.bmj.com/blogs/clinicalblog/#plckblogpage=BlogPost&plckpostid=Blog%3A15d27772-5908-4452-9411-8eef67833d66Post%3Acb6e5828-8280-4989-9128-d41789ed76ee BMJ Article: (http://www.bmj.com/content/347/bmj.f6172). Bibliography Badawy, H., personal communication, 2013 El-Islam, M.F., personal communication, 2013 Thomas R, Mitchell GK, B.L., Attention-deficit/hyperactivity disorder: are we helping or harming?, British Medical Journal, 2013, Vol. 5(347) De Zeeuw P., Mandl R.C.W., Hulshoff-Pol H.E., et al., Decreased frontostriatal microstructural organization in ADHD. Human Brain Mapping. DOI: 10.1002/hbm.21335, 2011) Diagnostic Statistical Manual 5, American Psychiatric Association, 2013 Diagnostic Statistical Manual-IV, American Psychiatric Association, 1994 International Classification of Diseases, World Health Organization, 1992  
Dr Emad Sidhom
almost 6 years ago
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Dementia: A reflection from an Egyptian Perspective

Through different periods of the Egyptian history from Pharaonic, Greco-Roman, Coptic, Islamic and Modern Era; Egyptians tend to respect, appreciate and care for elderly. There is also a rich Eastern Christian tradition in respecting and taking care of old people that has continued since the first centuries of Christianity. Churches used to develop retirement homes served by monastic personnel and nurses. Egyptian culture traditionally linked some aspects of mental illnesses to sin, possession of evil, separation from the divine and it is usually associated with stigmatisation for all family members. However, forgetfulness with ageing was normalised. Until now, it seems that the difference between normal ageing and dementia is blurred for some people. Recently, the term 'Alzheimer' became popular, and some people use it as synonymous to forgetfulness. El-Islam, stated that some people erroneously pronounce it as 'Zeheimer' removing the 'Al' assuming it is the Arabic equivalent to the English 'the'. In 2010, a film was produced with the title 'Zeheimer' confirming the mispronunciation. Elderly face many health challenges which affect their quality of life. Dementia is one of these challenges as it is considered to be one of the disorders which attack elderly and affect their memory, mental abilities, independence, decision making and most cognitive functions. Therefore, the focus on dementia has increased around the world due to the rapid spread of the syndrome and the economical and psychosocial burden it cause for patients, families and communities. (Grossber and Kamat 2011, Alzheimer’s Association 2009, Woods et al. 2009). In recent years, the proportion of older people is increasing due to the improvement in health care and scientific development. The demographic transition with ageing of the population is a global phenomenon which may demand international, national, regional and local action. In Egypt the ageing population at the age of 65 and older are less than 5% of the Egyptian population (The World FactBook, 2012), yet, the World Health Organization (WHO) asserts that a demographic shift is going to happen as most of the rapid ageing population will transfer to the low and middle income countries in the near future (WHO, 2012). Egyptian statistics assert this shift. The Information Decision Support Center published the first comprehensive study of the elderly in Egypt in 2008. According to the report, in 1986, 5 percent of Egyptians were age 60 and older. In 2015, they will make up to 11 percent of the population and in 2050; over a fifth. Caring of older persons constitutes an increasing segment of the Egyptian labor market. However, nation wide statistics about number of dementia sufferers in Egypt may be unavailable but the previous demographic transition is expected to be accompanied by an increase in dementia patients in Egypt and will affect priorities of health care needs as well. The Egyptian society may need adequate preparation with regards to health insurance, accommodation and care homes for the upcoming ageing population (El-Katatney, 2009). Although the number of care home increased from 29 in 1986 to be around 140 home in 2009; it cannot serve more than 4000 elderly from a total of 5 million. Not every elderly will need a care home but the total numbers of homes around Egypt are serving less than 1% of the elderly population. These facts created a new situation of needs for care homes besides the older people who are requiring non-hospital health care facility for assisted living. The Egyptian traditions used to be strongly associated with the culture of extended family and caring for elderly as a family responsibility. Yet, in recent years changes of the economic conditions and factors as internal and external immigration may have affected negatively on elderly care within family boundaries. There is still the stigma of sending elderly to care homes. Some perceive it as a sign of intolerance of siblings towards their elderly parents but it is generally more accepted nowadays. Therefore, the need for care homes become a demand at this time in Egypt as a replacement of the traditional extended family when many older people nowadays either do not have the choice or the facilities to continue living with their families (El-Katatney 2009). Many families among the Egyptian society seem to have turned from holding back from the idea of transferring to a care home to gradual acceptance since elderly care homes are becoming more accepted than the past and constitutes a new concept of elderly care. Currently, many are thinking to run away from a lonely empty home in search of human company or respite care but numbers of geriatric homes are extremely lower than required and much more are still needed (Abdennour, 2010). Thus, it seems that more care homes may be needed in Egypt. Dementia patients are usually over 65, this is one of the factors that put them at high risk of exposure to different physical conditions related to frailty, old age, and altered cognitive functions. Additionally, around 50% of people with dementia suffers from other comorbidities which affect their health and increases hospital admissions (National Audit Office 2007). Therefore, it is expected that the possibility of doctors and nurses needing to provide care for dementia patients in various care settings is increasing (RCN 2010). Considering previous facts, we have an urgent need in Egypt to start awareness about normal and upnormal ageing and what is the meaning of dementia. Moreover, change of health policies and development of health services is required to be developed to match community needs. Another challenge is the very low number of psychiatric doctors and facilities since the current state of mental health can summarised as; one psychiatrist for every 67000 citizens and one psychiatric hospital bed for every 7000 citizens (Okasha, 2001). Finally the need to develop gerontologically informed assessment tools for dementia screening to be applied particularly in general hospitals (Armstrong and Mitchell 2008) would be very helpful for detecting dementia patients and develop better communication and planning of care for elderly. References: El Katateny, E. 2009. Same old, same old: In 2050, a fifth of Egyptians will be age 60 and older. How will the country accommodate its aging population?. Online available at: http://etharelkatatney.wordpress.com/category/egypt-today/page/3/ Fakhr-El Islam, M. 2008. Arab culture and mental health care. Transcultural Psychiatry, vol. 45, pp. 671-682 Ageing and care of the elderly. Conference of European churches. 2007. [online] available at: http://csc.ceceurope.org/fileadmin/filer/csc/Ethics_Biotechnology/AgeingandCareElderly.pdf World Health Organization. 2012 a. Ageing and life course: ageing Publications. [Online] available at : http://www.who.int/ageing/publications/en/ World Health Organization. 2012 b. Ageing and life course: interesting facts about ageing. [Online] available at: http://www.who.int/ageing/about/facts/en/index.html World Health Organization 2012 c. Dementia a public health priority. [online] available at: http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf World Health Organization. 2012 d. Why focus on ageing and health, now?. Department of Health. 2009. Living well with dementia: a national dementia strategy. [Online] available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058 Andrawes, G., O’Brien, L. and Wilkes, L. 2007. Mental illness and Egyptian families. International Journal of Mental Health Nursing, vol.16, pp. 178-187 National Audit Office. 2007. Improving service and support for people with dementia. London. [online[ Available at: http://www.nao.org.uk/publications/0607/support_for_people_with_dement.aspx Armstrong, J and Mitchell, E. 2008. Comprehensive nursing assessment in the care of older people. Nursing Older People, vol. 20, No. 1, pp. 36-40. Okasha, A. 2001. Egyptian contribution to the concept of mental health. Eastern Mediterranean Health Journal,Vol. 7, no. 3, pp. 377-380. Woods, R., Bruce, E., Edwards, R., Hounsome, B., Keady, J., Moniz-Cook, E., Orrell, M. and Tussell, I. 2009. Reminiscence groups for people with dementia and their family carers: pragmatic eight-centre randomised trial of joint reminiscence and maintenance versus usual treatment: a protocol. Trials Journal: open access, Vol. 10, [online] available at: http://www.trialsjournal.com/content/10/1/64 Grossberg, G. and Kamat, S. 2011. Alzheimer’s: the latest assessment and treatment strategies. Jones and Bartlett, publisher: The United States of America. Alzheimer’s Association. 2009. 2009 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, Volume 5, Issue 3. [online] Available at: http://www.alz.org/news_and_events_2009_facts_figures.asp Royal College of Nursing. 2010. Improving quality of care for people with dementia in general hospitals. London. National Audit Office. 2007. Improving service and support for people with dementia. London. [online[ Available at: http://www.nao.org.uk/publications/0607/support_for_people_with_dement.aspx Authors: Miss Amira El Baqary, Nursing Clinical instructor, The British University in Egypt 10009457@qmu.ac.uk Dr Emad Sidhom, MBBCh, ABPsych-Specialist in Old Age Psychiatry-Behman Hospital e.sidhom@behman.com  
Amira El Baqary
over 5 years ago
Foo20151013 2023 1n8q51t?1444774287
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Email Gone Astray

An email gone astray can provide fascinating insights for an unintended recipient. Written correspondence has undoubtedly fallen into the wrong hands since homo sapiens first put pigment on bark, but never before has it been so easy to have a personal message go awry. No longer is it a matter of surreptitiously steaming open sealed letters or snooping around in wastepaper baskets. Finding out another's personal business is now just a click away. Even more conveniently, candid opinions can sometimes make an unscheduled landing in your inbox, making for intriguing reading -- as I discovered. Some time ago, I'd sent out feelers regarding possible new GP jobs and had emailed a particular practice principal a couple of times, expressing interest. When it looked likely that I was going to pursue a different path, I sent a polite email explaining the situation and telling him I wouldn't be seeking an interview for a job at his practice at present. An email bounced back saying that my not wanting to work for him may be "a relief" as I "sounded a bit intense". It was sans salutation but, based on the rest of the content, was obviously intended for one of his work colleagues. It had no doubt been a simple error of his pressing 'reply' rather than 'forward'. I was chuffed: I've never been called "intense" before, at least, not to my knowledge. Perhaps there are several references to my intensity bouncing around cyberspace but this is the only one my inbox has ever captured. I've never considered myself an intense person. To me, the term conjured up the image of a passionate yet very serious type, often committed to worthy causes. Perhaps I had the definition wrong. I looked it up. The Oxford Dictionary gave me: "having or showing strong feelings or opinions; extremely earnest or serious". Unfortunately, I couldn't reconcile my almost pathologically Pollyanna-ish outlook, enthusiasm, irreverence and light-heartedness to this description -- nor my somewhat ambivalent approach to politics, religion, sport, the environment and other "serious" issues. At least the slip-up was minor. Several years ago, I unintentionally managed to proposition one of my young, shy GP registrars by way of a wayward text message. He had the same first name as my then-husband. Scrolling through my phone contacts late one night, alone in a hotel room at an interstate medical conference, I pressed one button too many. Hence this innocent fellow received not only declarations of love but a risqué suggestion to go with it. Not the usual information imparted from medical educator to registrar! It took me several days to realise my error, but despite my profuse apologies, the poor guy couldn't look me in the eye for the rest of the term. If I was "intense", I would conclude on a ponderous note -- with a moral message that would resonate with the intellectually elite. Alas, I'm a far less serious kind of girl and, as a result, the best I can up with is: Senders of emails and texts beware -- you are but one click away from being bitten on the bottom. (This blog post has been adapted from a column first published in Australian Doctor). Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work here.  
Dr Genevieve Yates
over 5 years ago
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Religion and support for birth control health coverage can mix

Study explores how religion affects women's attitudes toward reproductive health policies like contraceptive coverage under the Affordable Care ActNew research debunks the assumption...  
medicalnewstoday.com
over 4 years ago
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Yoga: What is yoga? How does it work?

Find out the potential health benefits of practicing yoga, including effectiveness for low back pain, increasing flexibility, improving cancer-related fatigue and aiding balance.  
medicalnewstoday.com
over 4 years ago
Www.bmj
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The complexities of charitable giving

Charitable giving allows people to give to perceived health priorities at home and overseas and is to be encouraged. The emphasis placed on it is one of the more attractive features of major religions. It also helps to foster the idea of a wider community, perhaps one reason why poorer folk are comparatively generous. Does McCartney believe …  
feeds.bmj.com
over 4 years ago
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Commencement 2015, 7 of 7: Prayer of Maimonides

http://www.einstein.yu.edu - Edward R. Burns, M.D., executive dean, leads the 2015 graduates in the Prayer of Maimonides at Einstein’s commencement ceremony,...  
youtube.com
over 4 years ago
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Yoga for secondary prevention of coronary heart disease | Cochrane

Coronary heart disease (CHD) is a major cause of early cardiovascular-related illness and death in most developed countries. Secondary prevention is a term used to describe interventions that aim to prevent repeat cardiac events and death in people with established CHD. Individuals with CHD are at the highest risk of coronary events and death. Lifestyle modifications play an important role in secondary prevention. Yoga has been regarded as both a type of physical activity and a stress management strategy. The physical and psychological benefits of yoga are well accepted, yet inappropriate practice of yoga may lead to musculoskeletal injuries, such as muscle soreness and strain. The aim of this systematic review was to determine the effectiveness of yoga for secondary prevention in CHD in terms of cardiac events, death, and health-related quality of life. We found no randomised controlled trials which met the inclusion criteria for this review. Therefore, the effectiveness of yoga for secondary prevention in CHD remains uncertain. High-quality randomised controlled trials are needed.  
cochrane.org
over 4 years ago
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Hospitals urge Muslims to donate organs - BBC News

Hospitals in the West Midlands are urging Muslims to consider donating their organs for patients waiting for a new kidney or liver.  
bbc.co.uk
over 4 years ago
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Transplant patient appeals for more Muslim donors - BBC News

Hospitals in the West Midlands are appealing for more Muslims to consider donating their organs.  
bbc.co.uk
over 4 years ago
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California ends vaccine exemptions on grounds of belief—will other states follow?

After a bitter battle, California has ended vaccine exemptions on the basis of religion or personal belief. Under the new law, signed by Governor Jerry Brown on 30 June, unvaccinated children in the state will not be allowed to attend school, day care programs, and nurseries, unless they have a medical reason, such as an allergy, for not receiving a vaccination. Previously, just two other US states, West Virginia and Mississippi, limited exemptions to medical reasons.  
feeds.bmj.com
over 4 years ago
Www.bmj
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Patient commentary: social media provides patients with support, information, and friendship

When I was diagnosed with systemic lupus erythematosus 32 years ago, aged 15, social media did not exist. After months of diagnostic tests, I was happy to find out that my condition had a name. Six months after diagnosis, I attended my first lupus support group, where the topic for discussion was funeral planning. Questions posed included “what prayers and flowers do you want?”  
feeds.bmj.com
over 4 years ago
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FAMILY PLANNING. A DILEMMA FOR THE CATHOLIC PRACTITIONER.

While in school, training, or practice, medical doctors, nurses, nurse practitioners, physician assistants or any health care worker for that matter, will be dealing with issues of family planning almost on a daily basis. They may also encounter these issues in their personal lives. While most religions allow artificial methods of family planning, the Roman Catholic Church has been steadfast in opposing any form of such artificial methods. The only method allowed is the so called "fertility awareness" method. This is based on the premise that avoidance of sexual intercourse during the fertile time of a woman's menstrual cycle will avoid pregnancy. Medical advances have certainly made the fertility awareness method more accurate, but determining this fertile time of the cycle still requires some effort and dedication by the woman and her partner. Nevertheless these natural methods work well and with a great deal of effectiveness when applied by such dedicated and educated couples and when the woman has relatively regular menstrual cycles. However, in less than these ideal circumstances, like in developing countries or refugee camps, where people often live in squalor and poverty, lack food and basic necessities, have no or little medical care, and where women do not have regular menstrual cycles, these natural methods have a high failure rate. A high failure rate results in unwanted pregnancies which add to the family's burden and are a factor in increasing even further their poverty status. Thus creating a vicious cycle. Under the conditions just described, families need highly effective contraceptives measures. On his return from a visit to the Philippines Pope Francis recently advocated catholics to limit the size of their families to a manageable number. This is great and welcome advice but in the same interview he reaffirmed the church's opposition to any artificial means of contraception. This seems rather unfair to me. On the one hand he tell catholics to limit their family size and on the other hand he denies them the effective methods of doing so. Ever since Francis became Pope he has indicated that he is willing to listen to the pressing needs facing, not only catholics but all people and possibly consider bringing the teaching of the Church into the twenty first century. There are certainly a number of indications that changes may be in the offing. First he has organized a Synod of the hierarchy of the Church in Rome last year to discuss all matters related to the family. When that Synod of "fizzled" out he has call for a follow up Synod later this year. He has made a number powerful statements and overtures towards homosexuals and divorced people and has strongly supported a strive for women's equality. He has even made some overtures to women who have had an abortion. Why not also open up the issue of contraception, so sorely needed in the world as I argued above? If the catholic church were to allow artificial methods of family planning, catholic medical practitioners and in fact all catholics, would no longer face the dilemma in their daily activities: adhere to the teaching of the church and deny their clients the effective means of limiting the size of their families and in doing so risk an unwanted pregnancy; or ignore the teaching and continue to use, prescribe, advice, insert, inject, operate to provide their clients with the effective contraception they want and need, but thereby feel marginalized by the church they love. There is already much evidence that a majority of catholics in the world follow this latter path. We can only hope that the Pope will listen to the experiences of couples from all walks of life and that he will solicit the input of catholic medical providers. May be, just may be, common sense and desperate needs will prevail, but do not hold your breath. Submitted by: William J. LeMaire MD Emeritus professor of Obstetric and Gynecology University of Miami Miller School of Medicine Miami, Florida USA 33155  
DR William LeMaire
about 4 years ago
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Multiple factors affect vaccination status among Indian children, finds study

Vaccination status of children in India is influenced by where they are born, their caste and religion, antenatal care, and whether their mother has been vaccinated against tetanus, a study has found.  
feeds.bmj.com
about 4 years ago
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Multiple factors affect vaccination status among Indian children, finds study

Vaccination status of children in India is influenced by where they are born, their caste and religion, antenatal care, and whether their mother has been vaccinated against tetanus, a study has found.  
feeds.bmj.com
about 4 years ago
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Religion and Critical Care - Intensive Care Network

Liz Crowe talks on the role of religion in coping with devastating life events, such as those whitnessed in critical care  
intensivecarenetwork.com
about 4 years ago
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Religion and Critical Care by Liz Crowe at SMACC Chicago

In memory of Dr John Hinds  
prehospitalmed.com
about 4 years ago