Fill in the blank: ____ is NOT a priority for most men.

Alright, it's not strictly a bioethics issue or controversy, but it is an article in a medical journal and the article did grab my attention:

The Journal of Sexual Medicine interviewed 28,000 men in Europe and the Americas and found, when assessing their priorities, that males between the ages of 20 and 75 ranked "honor" and "getting respect from their peers" ahead of having sex.

According to the FoxNews article, "About one-third of respondents said being healthy was the most important factor, 26 percent valued a happy family and 19 percent said they most valued being in a good relationship. Only 2 percent placed a satisfying sex life as their top priority."

The real problem with our health care system: Female doctors ...

... now there's a Women's Bioethics Blog equivalent headline equivalent of those "Free Beer" postings on college campus bulletin boards. I only wish it was as facetious a headline.

What am I referring to? Why, an article in the April 28, 2008 issue of Businessweek, which you can hopefully read online here (although you may need a subscription). The take-home message: the looming shortage of doctors in the United States, estimated to be a deficit of 50-100K physicians by 2020, may be partially a result of the fact that female doctors work less than their male counterparts. They also see fewer patients, take time off to have children, and have the nerve to ask to work flexible schedules so they can actually nurture those kids they so unwisely produced. Thank god we've still got a couple of upstanding men who can pick up the slack. As one anonymously courageous male internist from New York so righteously complained: "The young women in our practice are always looking to get out of being on-call ... The rest of us have to pick up the slack."

On the plus side, women are more likely to go into understaffed, low-pay specialties like family practice, pediatrics and obstetrics. 

So who's at fault here I wonder? Could it be those selfish women who want: 1) to provide high quality and attentive preventive care, something our current system neglects; and 2) make sure that their kids aren't raised by Sesame Street and Nintendo? Or, could it be the current system that rewards those men (and women) who: 1) enter high paying and lucrative specialties; and 2) only see their kids on weekends during court-ordered and -supervised visits? Guess we'll have to choose ...

Clinical Trials Miss Many Populations

A new report by the Chronic Disease Prevention & Control Research Center at Baylor College of Medicine, in conjunction with the Intercultural Cancer Council, brings the grim but not unexpected news that clinical trials for testing new drugs has routinely excluded or under-represented a broad category of people, including women, minorities, the disabled, elderly, and those who don't live near major research hospitals/urban areas. (And in fact, this very subject is one of the first conversations I remember having with Kathryn Hinsch - the fact that even animal research is done on male models.)

According to the report, there are about 80,000 clinical trials run in this country every year, and only about 1% of the population participates in them (working out to around 2.3 million people). The report didn't limit its critique to the statistical information of those participating in the trial, but also criticised wasted resources and duplicate efforts between government and private funding and the lack of training of IRB members. But the major focus of the report was on the constituencies of trial populations:

The research looked at cancer clinical trials and found that only 25 percent of patients in such trials were over the age of 65. In addition, older people were often excluded from studies focused on Alzheimer's, arthritis and incontinence... As evidence of the problem, [the researchers] honed in on a study of clinical trial composition that found that, between 1995 and 1999, blacks, Asian-Pacific Islanders, Hispanics and Native Americans together made up for less than 10 percent of patients included in new cancer drug trials. Under-representation of this sort, they say, leads to results that do not account for a host of factors -- genetic, cultural, racial, religious, linguistic, as well as variables related to age and gender -- that could have a huge impact on how well new drugs do in the real world.

The researchers also acknowledge that while there has been a lot of discussion about clinical trial populations and their make-up in recent years, very little has been done to redress the issue. To that end, the report actually also offers nine concrete policy suggestions to fix/improve clinical trials in the United States:

• government regulatory changes


• increased collaboration between government and private industry on clinical trial design


• increased community involvement in patient participation


• scientific journal oversight of patient breakdowns


• new, specialized training for review boards


• reallocation of research funding to avoid duplication and address disparities


• increased public education


• increased focus on easing the patient participation process


• guaranteeing insurance coverage for all related costs.

And on a personal note, we'd like to extend congratulations to friend of the blog (and fellow blogger) Daniel Goldberg, one of the researchers on this project and the leading quote in the Washington Post coverage of the story. Daniel's off enjoying the cherry blossoms in DC right now, but perhaps when he's back from his conference, he'll step over here and talk to us a little bit more about his research.
-Kelly Hills

Postgenderism: Transcending the Dualistic Notions

A few months, some of our colleagues over at IEET had drafted a paper about overcoming gender, about which we had blogged and which provoked some criticism. Many of our readers, in response to our poll, felt that gender should be either embraced or transcended, but very few felt that gender should be overcome. Authors Dvorsky and Hughes took said criticism to heart and revamped their paper, and came up with something more balanced -- I really think this article is so much better than the previous draft and I like the philosophically monistic, wholistic approach (dare I say, Buddhist?). The essay is forthcoming in an edited book on gender and reproductive technologies and here is the abstract:

Postgenderism is an extrapolation of ways that technology is eroding the biological, psychological and social role of gender, and an argument for why the erosion of binary gender will be liberatory. Postgenderists argue that gender is an arbitrary and unnecessary limitation on human potential, and foresee the elimination of involuntary biological and psychological gendering in the human species through the application of neurotechnology, biotechnology and reproductive technologies. Postgenderists contend that dyadic gender roles and sexual dimorphisms are generally to the detriment of individuals and society. Assisted reproduction will make it possible for individuals of any sex to reproduce in any combinations they choose, with or without “mothers” and “fathers,” and artificial wombs will make biological wombs unnecessary for reproduction. Greater biological fluidity and psychological androgyny will allow future persons to explore both masculine and feminine aspects of personality. Postgenderists do not call for the end of all gender traits, or universal androgyny, but rather that those traits become a matter of choice. [Emphasis added] Bodies and personalities in our postgender future will no longer be constrained and circumscribed by gendered traits, but enriched by their use in the palette of diverse self-expression.


Download the whole essay here in PDF form and let George and Jay know what you think!

On Sex-Segregated Schooling

NYT has an in-depth article on
teaching boys and girls separately in school based on proposed differences in everything from artistic preferences to optimal operating temperature.

While I have blogged previously on using scientific input to improve educational methods, I am somewhat skeptical of the extent to which segregation is advocated. A large reason is that while the mean may show a slight differential between the sexes, the spread has significant overlap and we regularly see a healthy number of outliers. I, for example, took a Thundercats lunchbox to school and read all the books in the library on "creepy-crawlies" like ants, spiders, and snakes, and I know I would have been utterly miserable in an all-girls' classroom.

Assuming that these differences are scientifically provable (or non-disprovable) for a majority of the population, we are left with a naturalistic/normative conflict between what is "optimal" now and what we forsee as future needs (such as the need to interact comfortably with males and females).

One thing we can take away from this is that we ought to exercise caution when advocating extreme changes in schooling to avoid backlash effects (as are becoming apparent in the marked decrease of boys' success in school). Also, there is no clear-cut answer on how to improve our education system, but there are many academic disciplines we ought to access in order to enrich the discussion.

Addendum: A few more thoughts on this. First, an important question inherent in any push for change the question must be asked: "Are we running away from something, or running towards something?" In other words, in segregating boys and girls, are we avoiding a harm, or seeking a benefit?

Second, I observe that while girls suffered in school in previous generations due to overly low expectations, the current hypothesis for boys is that they suffer from overly high or unrealistic expectations. I'm sure a gender theorist would have some interesting comments on this.

Third, I have noticed that a majority of problems develop at the interfaces between contrasting systems or paradigms. In this case, it will be when we make a shift from a school system that adapts to the strengths and weaknesses of girls and boys to an adult world where people are expected to adapt to the needs of society ("including a competitive workplace that was designed around men's strengths and is only slowly changing," the feminist in me notes). Assuming that such an education system presents significant benefits, I am concerned with how we will help children make the transition to adulthood.

Quote of the Day: Does the Sex of Your Surgeon Matter?

In response to an article in the NY Times online today about a report from The Journal of the National Cancer Institute that suggest that whether a woman receives radiation treatment after breast cancer surgery may be influenced by the gender of her surgeon, a reader made the following provocative comment:

“It's a generalization, I know, but of all the different kinds of doctors I have had, the females have had overwhelmingly far better bedside manner. And better bedside manner makes for better treatment--it's the difference between being treated like human being and being treated like a GalaxoSmithKlineMerckProctor&Gamble Inc. pinata.”

Full article here; all the comments here.

Why Sex Matters for Neuroethics...

There is a provocative article in the American Journal of Bioethics Neuroscience today which asks: "Why should we pay special attention to the neuroscience of sex differences? " Authors lay out a plethora of directions in which such research could go, posing such as questions as "How ought we disseminate this information into a sensitive social environment that has a history of bias and discrimination against women? What are the implications of this work for our understandings of what makes us women and men? How should this research be applied in educational, medical, and legal contexts, if at all?... In considering the neuroscience of sex differences, we confront a fundamental issue: how do science and society understand female-male differences, or rather, women and men?"

A little different approach than the previous post we had on Gender: Love it or Kill it?.

The full article can be accessed here, subscription required.

"We" not "She" had an abortion

(This follows nicely from the post on gender.)

blog.bioethics.net reports on a new movement to involve men in outlawing abortion.

According to the article by the L.A. Times:

Abortion is usually portrayed as a woman's issue: her body, her choice, her relief or her regret. This new movement -- both political and deeply personal in nature -- contends that the pronoun is all wrong.

I think that it is great that there is an effort to involve men more in the process of sex and pregnancy. But let's encourage a genuine effort to empower men and give them a voice in this process - let's advocate for men to become more aware of all the processes related to sex, pregnancy, and birth. The archaic "predatory" model of men and sex needs to be fully rejected, and parents need to stop raising their boys to "go get 'em!" while relying on intimidation and threats to foist the burden of chastity only onto their daughters.

It is a good start that men are beginning to realize the emotional impacts of pregnancy termination, but our society ought to come together to share the emotional impacts of all aspects of intimacy and reproduction, aspects that until recently have been shrouded in mystery and shame (and just a bit of possessiveness by women) and withheld from men.

Let's truly forge new respect for life by bringing in both sides of the equation into this effort.

Gender: Love It or Kill It?

Colleague George Dvorsky sent me a recent blog post of his, thinking that I might be interested -- the title is "Overcoming Gender", and it's a quick summary of a formal paper he and James Hughes are co-authoring on postgenderism. Perhaps it is my feminine nature, but I had to laugh when I read the summary because one of my first thoughts was, "how typically male it is to see gender as something that has to be overcome, rather than something to be embraced or even transcended." (a more tame version of what Ken Wilber said about men and testosterone in A Brief History of Everything) -- so dualistic, rather than integrated.

But then again, I suppose one could argue that that just proves his point?