Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, (...) could create new ways to conceive a child possible. After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made in this area. (shrink)

Since the publication of a critical review on ADHD neuroimaging in a past issue of this journal , several relevant studies have appeared, including one study that had a subgroup of unmedicated ADHD children . In this update to our earlier review we comment on this last study’s failure to report on the crucial comparison between unmedicated and medicated ADHD subjects. The issue of prior medication exposure in ADHD subjects constitutes a serious confound in this body of research, and still (...) continues to be dismissed and willfully obscured by researchers in this field. (shrink)

Cotard's syndrome is a psychotic condition that includes delusion of a supernatural nature. Based on insights from recovered patients who were convinced of being immortal, we can (1) distinguish biographical experiences from cultural and evolutionary backgrounds; (2) show that cultural significance dominates biographical experiences; and (3) support Bering's view of a cognitive system dedicated to forming illusory representations of immortality.

Most writers now recognize that mental health policy and the mental health system are extremely resistant to real changes that reflect genuine biopsychosocial paradigms of mental disorder. Writers bemoaning the intransigence of the mental health system tend to focus on a small analytical level, only to find themselves mired in the rationalities of the existing system. Problems are acknowledged to be system-wide, yet few writers have used a method of analysis appropriate for systemic problems. Drawing upon the General System Theory (...) (GST) analytical perspective, this article advances a systematic approach to understand the mental health system and to facilitate the development of reform strategies that recognize the system's complexity and changing nature. The article first discusses the failure of major reform efforts in the mental health system and the limitations of mainstream analysis of mental health politics and policies with respect to the objectives of analysis and reform. This article describes how systems thinking has thus far influenced the study of the mental health policy and politics system, and argues that a systemic perspective is profitable for reconceiving the mental health system, enabling a fresh basis for the development of reform strategies. The mental health system should be seen as a social system influenced by larger political and economic dimensions, not just as a 'delivery system' scientifically constructed by neutral experts. Furthermore, the policy planning process should be viewed as part and parcel of a mental health system modeled as complex and dynamic. The systemic perspective outlined here should help both to clarify the value-based objectives that we hold for the system and, consequently, to plan for the strategic reforms that have so far eluded us. (shrink)

The business community has failed to act on a fundamental given: a healthy political system is essential to a healthy economic system. A competitive economic system requires a competitive political system. Good citizens — motivated and informed — make effective leadership possible.Its ingredients require ending the escalating arms race among PACs in congressional races by reducing the amoung legislators may accept from PACs; by making small individual contributions count by matching them with the voluntary tax check off; disclosing direct and (...) indirect lobbying expenses; and systematically reviewing our subsidy system by review spending, regulatory and tax preferences. (shrink)

A review of over thirty neuroimaging studies on children diagnosed with Attention Deficit/Hyperactivity Disorder by Giedd, Blumenthal, Molloy, and Castellanos is organized around tables listing the main findings of studies using different types of neuroimaging. Like most researchers in this field, Giedd et al. conclude that the evidence supports the involvement of right frontal–striatal circuitry with cerebellar modulation in ADHD. However, Giedd et al. do not report on a confounding variable of crucial interest in this field of research — whether (...) subjects had been previously treated with stimulants or other psychotropic drugs. In the present paper, we have redone five of the tables from the Giedd et al. review, adding information on the subjects’ prior medication exposure, as reported in the individual studies included in the review. We found that most subjects diagnosed with ADD or ADHD had prior medication use, often for several months or years. This substantial confound invalidates any suggestion of ADHD-specific neuropathology. Moreover, the few recent studies using unmedicated ADHD subjects have inexplicably avoided making straightforward comparisons of these subjects with controls. (shrink)

As part of the South Carolina Law Review's symposium on the Roberts Court and Equal Protection, this essay looks at Justice Kennedy's sex discrimination jurisprudence. With the new Court, it's natural to be concerned with how the two new Justices might vote in upcoming sex discrimination cases. However, in this essay, I assume what has been the case so far from Chief Justice Roberts and Justice Alito - that they are reliable votes joining Justices Scalia and Thomas on the Court's (...) more conservative wing. The Justice most people should focus on now is Justice Kennedy, the new median Justice now that Justice O'Connor has retired. This essay seeks to analyze Justice Kennedy's sex discrimination jurisprudence and draw conclusions about his thoughts on sex and gender. First, it reviews the cases involving sex discrimination that Justice Kennedy has participated in while on the Court and shows that he has been a fairly consistent vote against sex discrimination claims. Second, it analyzes Justice Kennedy's votes and opinions in sex discrimination cases and attempt to summarize his views. Finally, the essay evaluates Justice Kennedy's conceptions of gender in his opinions and votes. The essay concludes that Justice Kennedy's new role as median Justice is troubling for sex equality jurisprudence generally and constitutional sex discrimination cases specifically, as Justice Kennedy has shown a tendency, in the many cases arising in the parent/child context, to adhere to traditional and paternalistic gender roles. (shrink)

In late 2006, the Department of Education changed the Title IX regulations to broaden the permissibility of single-sex education in primary and secondary schools. The changes took place in the context of a growing concern over the performance and well-being of boys in American schools. This article describes, dissects, and critically analyzes the narrative about boys, masculinity, and single-sex education that surrounded these changes. The public narrative about the need for single-sex education focused, in substantial part, on what I call (...) the essentialist myth of masculinity. This article catalogs the important components of this myth: heteronormativity, aggression, activity, sports-obsession, competitiveness, stoicism, and not being girls. The article then shows, using education and gender theory, that this conception of masculinity is harmful to both girls and boys. Instead of pushing this form of masculinity, the law and schools should make room for multiple and varied masculinities for boys (and girls). The article argues that the Title IX regulatory change that allows for the expansion of single-sex schooling can actually work to further empower and entrench the essentialist myth of masculinity, thus violating its own prohibition on sex stereotyping. By adopting strong interpretations of already-existing jurisprudence about gender stereotyping from both constitutional law and Title IX, the article shows how de-essentializing masculinity is possible and preferable in the law. The article concludes that schools that implement single-sex education must do so for reasons other than promoting an essentialized notion of masculinity and that the law must be vigilant in ensuring that schools' implementation not further reify dominant conceptions of what it means to be a boy. (shrink)

Tardive dyskinesia is a serious, well publicized adverse effect resulting from long-term neuroleptic drug use. However, little progress has been made during the last two decades in ensuring that these drugs are prescribed with necessary caution. Incentives and constraints operating on the major participants in the decision-making process leading to the prescription of neuroleptics increase the likelihood that the benefits of drugs will be exaggerated and their adverse effects minimized. When combined with imbalances of power, these factors ensure that persons (...) having little power and information to make the decision to prescribe will bear most costs of that decision. This points to the operation of an ineffective system which can be expected to yield sub-optimal results. We suggest ways to make the decision process more efficient by more closely aligning responsibility with cost. If those who hold power in the decision process are held accountable for the unwanted risks they impose upon others, both the use of neuroleptics and its inevitable iatrogenesis would probably be reduced. (shrink)

In Gebser v. Lago Vista Independent School District, the Supreme Court set an exacting standard for establishing institutional liability under Title IX for a teacher sexually harassing a student. That standard, rejecting the simple application of agency principles and instead requiring a student to notify the school of the harassment and then the school to be deliberately indifferent to the student's complaints, has been inconsistently applied by lower courts faced with other, non-harassment forms of sex discrimination under Title IX. In (...) other areas of the law, the Supreme Court has regularly applied well-established federal common-law agency principles to statutes when determining liability issues. This Article argues that, when faced with Title IX non-harassment claims, courts should do the same because the policy reasons that offer the only reasonable explanation of the result in Gebser are not present in cases of non-harassment sex discrimination in schools and because non-harassment sex discrimination lies at the heart of Title IX's prohibition of sex discrimination in federally funded educational institutions. (shrink)

The relationship between Title IX and the Equal Protection Clause is relevant to many areas of sex discrimination law. However, most courts that have addressed cases raising both provisions as well as scholars analyzing them have not developed or understood the relationship between the two. This Article does just that and develops the theory that Title IX has broader protections from sex discrimination than the Equal Protection Clause. To reach the conclusion that Title IX offers more protection, this Article proceeds (...) in the following way. In Part II, the Article surveys court decisions and commentary that have explicitly touched on the relationship between Title IX and the Equal Protection Clause. In Part III, the Article then develops its own analysis of the relationship between Title IX and the Equal Protection Clause, using the text and history of Title IX, the jurisprudential differences between Title IX and the Equal Protection Clause, and the theoretical differences between Title IX and constitutional sex discrimination law. Finally, in Part IV, the Article looks at some of the legal issues affected by an analysis of Title IX's relationship to the Equal Protection Clause and posits solutions based on the doctrinal and theoretical conclusions reached in Part III. (shrink)

This article contends that the enterprise of neuroleptic drug treatment of schizophrenia is conceptually and clinically - though not economically - bankrupt. Although new drugs spur hope and reinforce the dominant treatment paradigm, evidence from reports published during the last five years in leading psychiatric journals suggests that psychopharmacologists do not know what are the optimal doses of the most widely-used neuroleptics; that most patients do not "respond" to neuroleptic treatment; that toxic effects are routinely misdiagnosed; that prescribing guidelines may (...) have no impact on actual prescription patterns; that claims that the popular "atypical" neuroleptic clozapine is free of extrapyramidal symptoms are completely false; and finally, that penetration of the double-blind in studies of the effectiveness of psychotropics over placebos may be a common occurrence. In the light of these findings, it is argued that the field is in crisis and that major, paradigmatic change is absolutely necessary. (shrink)

The ninth-century treatises Musica and Scolica Enchiriadis are the first musical writings in the West to present a theory of organum, a mode of plainchant performance that is the earliest known form of Western medieval polyphony. The fundamental principle of this theory is that the intervallic relationship between the simultaneous melodic lines be one of "consonance" . Nevertheless, intervals arise between the voice-parts that are not symphoniae; the theory responds to this, not by explicitly invoking the concept of dissonance, but (...) by excluding these non-symphonic or non-consonant intervals from the concept of "organum." Through close analysis of the relevant texts, the dissertation seeks to explicate this concept of organum as symphonia in terms of a "metaphysics of consonance" that the Enchiriadis theorists took over from the most influential of the musical writings of late Antiquity, the De institutione musica of Boethius. ;The metaphysics of consonance projected therein is a particular development of the Pythagorean-Platonic conception of music, in which the symphoniae, because of their simple numerical ratios, represent the universal, divinely ordained rational principles of cosmic order and harmony. After a section devoted to showing that such "speculative" ideas about music formed the basis of the "practical" theory of the Enchiriadis treatises, the dissertation goes on in Part II to find that the relationship between consonance and dissonance in the Boethius Musica is structured as an unequal, hierarchized opposition, in which consonance holds the dominant position in particular because of its virtual identification with the metaphysical ideal of unity. Conversely dissonance, the opposed term of the hierarchy, represents the negative values of duality and difference, and hence discord, conflict, and disorder. Consequently, through various textual strategies, consonance is identified with "music" itself, while dissonance is effectively excluded from that domain. ;The concept of organum in the Enchiriadis treatises is found to be determined by this same metaphysics of consonance, with its consequent tendency to exclude or marginalize dissonance, a conceptual pattern that has resonated throughout the subsequent history of polyphonic theory and practice in the West. (shrink)

For a still undetermined number of people, entering the circle of psychiatric care begins a tragic process of disablement. Troubled or confused when they first contact officially accredited helpers for what are usually self-limiting and situational difficulties, their ensuing experiences with drugs or electroshock has a good chance of leaving them with diffuse stress syndromes and impaired cognition, sometimes for years. When this occurs, their injury is likely to be compounded because it is squarely denied or glossed over by those (...) who have inflicted it and by nearly everyone else who should know better. Lacking a clear vocabulary to articulate their worsened predicament, and floundering in a previous or new subordinated social status, they watch helplessly as their discourse is dismissed as "mental illness.". (shrink)