Mandatory Organ Donation

Mandatory organ recovery when an individual is announced dead would increase the opportunity for other patients to receive organs more efficiently; "Research shows that there would be an increase of between 16 percent to 50 percent in the availability of organs (Carney)." Carneys article, "The Case for Mandatory Organ Donation" argues that by making organ donation mandatory it would curb the illegal trade of valuable organs and make it more accessible to receive an organ. The illegal organ market will continue as long as organs are a limited resource and the profits attainable are high (Carney). Current trends indicate that there is a growing consideration that "harvesting from cadavers should be a routine procedure just like autopsies in murder investigations (Carney)." Some ethicists and doctors argue that it would be more effective to have a routine organ procurement procedure, Carney presents Aaron Spital's, Mount Sinai School of Medicine, and James Stacey Taylor's paper on Routine Recovery of Cadaveric Organs for Transplantation, "Routine recovery would be much simpler and cheaper to implement than proposals designed to stimulate consent because there would be no need for donor registries, no need to train requesters, no need for stringent government regulation, no need to consider paying for organs, and no need for permanent public education campaigns." This approach obviously presents ethical problems, especially in the United States where autonomy over the body is an innate human right, however it would reduce the extensive waiting list for organs such as liver. According to Carney "Roughly half a million people around the world suffer from kidney failure and many are willing to pay any price for a donor organ. They have two options: wait on impossibly long donation lists or pay someone for a live donor transplant (Carney)." Even though there are an extensive amount of people who opt to donate their organs when their are brain dead "even willing donors often end up not donating because families raise objections or there is a question about consent (Carney)."In addition to this the "bureaucratic shuffle" and hoops to jump through cause organs to lose their vitality. According to Carney and other medical professionals and ethicists implementing routine procedures would dramatically increase the organ supply and may serve as a domino effect to prevent illegal procurement or reduce the need for kin to donate their organs as a means to live longer.


Kaufman, Russ and Shim's article "Aged Bodies and Kinship Matters: the ethical field of kidney transplant" discusses the relationship between life extension and kin obligation for organ donation. Procedures such as kidney transplants are now routine procedures because of their less invasive qualities, thus "when techniques become less invasive and associated with lower mortality risk, consumer demand for them and ethical pressure to make them available both increase (Kaufman, Russ, Shim 82)." The expectations for longer life expects medical to cure in for the means of life extension, thus organ transplantation offers a now morally acceptable procedure to be done in order to extend life. This expectation also leads to the expectation that family and friends will provide the means of life extension, thus "love is actualized often through the commitment to a longer life and by doing things to prolong life (Kaufman, Russ, Shim 83)." In relation to Carney's explanation for the need for more organs Kaufman, Russ and Shim also argue that the growing demand for organs "emerges from the broad expectation that end[stage kidney disesase need not be fatal and from acceptance of kidney transplantation as a standard medical treatment for end-stage disease (84). It is therefore evident that because of changing technologies in the medical field and ethical acceptance of body modification there comes a higher demand for kidneys and other organs. Technoligizing medicine has brought on new implications for doctors, patients and donors to participate in life-sustaining and extending technologies (84). However, it is also important to note that the affluent middle class and insured people have primary access to these legal kidney sources. In correlation, Carney presents Nancy Scheper Hughes argument that "the current system of organ donation breeds inequalities (Carney)." The inequality of organ donation and receival has encourage patients to ask kin members to offer their kidneys, for the elderly younger generations are expected to "unnaturally" offer the gift of a kidney (85). Kaufman, Russ and Shim argue that ultimately the moral implication is "a sacrifice of the wholeness of the body and a nonreciprocal bargain (85)." Carney argues that this wholeness of the body would also be sacrificed without question by medical practitioners that support routine recover of organs at death with or without consent. Furthermore, he argues that procuring organs as routine would eliminate "kin obligation" for the older generation (Kaufman, Russ and Shim 86). "The potentiality of offering, giving, accepting, and receiving a kidney puts pressure on parent-child, spousal, and other meaningful bonds. Within those bonds, offering is a sign of unconditional love, sacrifice, and the strength of the bond (Kaufman, Russ and Shim 87)." These social and familial obligations could potentially be eliminated if organ donations exceeded what was needed.


The commodification and increasing monetary value of organs in the market economy has increased the trade of organs and has given increased value to poorer populations. The exchange of goods between patients needing a new organ and poverty ridden populations who need money exemplifies the global market economy and supply and demand, "the uninhibited circulation of bought and sold kidneys exemplifies a neoliberal political discourse based on juridical concepts of the autonomous individual subject, equality, radical freedom, accumulation, and universalism, expressed in the expansion of medical rights and medical citizenship (Scheper-Hughes 148). The exploitation of the poor living bodies to supply organs to an affluent class creates a kin relationship between the buyer and seller, "new forms of 'social kinship' must be invented to link strangers, even at times political enemies from distant locations who are described by the operating surgeons as 'a perfect match--like brothers' (Scheper-Hughes 150)." The kin relationship is made evident by a seller who said, "the money I paid him was 'a gift of life' equal to what I received (Scheper-Hughes 151)." The necessity to seek the illegal organ trade is founded in the limited organ availability due to the "expansion of the organs waiting lists...to include patients from medical margins--those over 70 years, infants, those with hepatitis C and HIV seropositivity, and those proven to be immunologically prone to organ rejection (Scheper-Hughes 154)." If the medical field limited the expansion of the medical margins there may not be a need to require mandatory donation and consent that is presented by Carney. The organ trade and market illustrates a dyer need for more organs that are easily accessible by legal hospitals, however to do so would mean to initiate a mandatory organ donation that presents ethical problems for the dead, living and doctors.


The central issue that must be illustrated is the necessity to utilize kinship ties in "Aged Bodies and Kinship Matters" in order for the elderly generation to obtain organs from younger family and friends because of the extensive waitlist for organs from brain dead patients. "The Last Commodity" presents the give and take relationship between the seller of the organ and the person buying the organ for health purposes. In this situation a kin relationship is created in order to describe the give and take relationship and the "perfect match" described by the doctors regarding blood type and other factors. The kin relation and necessity for organs for the livelihood of patients is also illustrated in Carney's article on a possible transformation to mandatory organ donations, "curbing the illegal trade in humans just might mean scrapping the way we think about the rights of brain-dead donors (Carney)," for example. However the elimination of the illegal organ trade would have a profound effect on those selling their organs for monetary value in a global market economy.

Is mandatory organ donation feasible in the United States and what would this mean for the illegal trade of organs?




Portrait: A Land Ravaged by Tsunami and Kidney Brokers
This link will take you to Scott Carney's pictorial on kidney donors, and brokers in a poverty ridden area.


Organs for Sale: Where in the World Can I Buy a Heart?
This link shows the pricing and location options for buying organs.

Sources
Carney, Scott. "The Case for Mandatory Organ Donation." Wired, May 8, 2007. http://www.wired.com/medtech/health/news/2007/05/india_transplants_do`1norpolicy (accessed March 4, 2011).

Kaufman, Sharon R. , Ann J. Russ, and Janet K. Shim. "Age bodies and kinship matters: the ethical field of kidney transplant." American Ethnologist 33, no. 1 (2006): 81-99.
Scheper-Hughes, Nancy. "The Last Commodity: Post-Human Ethics and the Global Traffic in "Fresh" Organs." In Global assemblages: technology, politics, and ethics as anthropological problems. Malden, MA: Blackwell Pub., 2005. 145-167.

Driver's License and Organ Donation

At the age of 15 1/2, when most of us have just learned to drive correctly we are asked to make the decision whether we want to be an organ donor. If we choose yes it is indicated on our driver's license with a red heart (refer to the license to the left). The Washington State Department of Licensing includes organ donation as a part of "Getting Your License" on their government sponsored website. This portion of the website indicates why you should donate, what it means on your license, what organs can be donated, how to register and what happens if you change your mind. In addition to this, it also indicates where to register for organ donation besides at the department of licensing, what to include in registration, as well as sites for more information and donating money to the organ donation registration. This site also provides a brochure that promotes organ donation to the fullest extent, for instance one of the headlines is "You have the power to DONATE LIFE (WA DOL)." On the first page of the brochure the benefits of donating organs, eyes, and tissue is represented through a mans survival story, through statistics and the overarching theme that with becoming an organ donor and indicating it on your license you can contribute to saving someone's life, "it provides hope to thousands of people with organ failure (WA DOL)." The second page of the brochure presents everything that can be donated to help others. One of the section caught my attention in particular, "How the donation process works":

"Your commitment to donation will not interfere with your medical care. Organ, eye, and tissue donation becomes an option only after all lifesaving efforts have been made. Consent for donation is confirmed, and your family is asked to participate in the process by providing your medical history. Surgical procedures are use to recover donated organs, eyes and tissue. The body is always treated with great care, respect and dignity."

The brochure and website information provided by the Washington Department of Licensing tends to glorify the heroism of organ donation, but does not present the very real issues that doctors, patients, and family members are faced with the reality of deciding when personhood has passed and the person is considered dead.

"To Be Freed from the Infirmity of (the) Age" by Krakauer presents the new technologies of sustaining life and what it means for defining death in modern science. Because there is the opportunity to sustain life through artificial means it has presented the issue of trying to figure when sustaining life will bring suffering, More recently "patients, surrogates, and physicians have agreed that sometimes withholding or withdrawing life-sustaining treatments is best (382)." However, laws and government policies also play a role "for allowing life-sustaining technologies to be withheld or withdrawn under certain circumstance (Krakauer 382)." Organ donation and use also indicates how an individual can conquer death or contribute someone else's desire to live longer; "the body is composed of disposable and potentially replaceable parts," this indicates the replacement of organs to promote a longer life (388). Organ transplantation is thus performed to help achieve a optimal living standard, the goal of modern science is to master the human body so when disease effects organs they can be replaced, "the Cartesian dream is manifested in the organ-replacement and life-sustaining technologies applied to gravely ill people (Krakauer 388)."

The organ donation indication on a drivers license gets much more complicated after considering that the technologies that are in place are to sustain one's life rather than announce death and harvest the organs. Furthermore, the promotion of donating organs by the department of licensing in Washington also ignores belief systems that disagree with organ transplantation and removal of body parts. In relation, Krakauer states that "the fundamental technological goal of mastery displaces traditional cultural and religious values, meanings and goals (Krakauer 390)." Modern medicine prides itself on technology that presents knowledge and answers but it also presents several problems because "all mastery displaces and thereby conceals the unmasterable (Krakauer 392)."

In the brochure on the Washington State Department of Licensing they state that, "Your commitment to donation will not interfere with your medical care." Lock's article, "Living Cadavers and the Calculation of Death" indicates the complexities of medical care and organ donation when the calculation of death is required. She states, "Brain-dead patients remain betwist and between, both alive and dead, breathing with technological assistance but irreversibly unconscious (136). The patient is surviving because of technology and the person has left the body, the trouble here is though are they really seen as dead or just brain dead; In Japan, "it is impossible to procure organs from the brain dead in Japan (136)." Culturally implications make it incredibly difficult for family members to decide if there family member is dead so that the organs can be harvested, thus "together with official and popular discourse and valued tactic knowledge, work in associations to compound medical judgement and influence the meanings that are associated with a diagnosis of brian death (Lock 138). So even though an individual might indicate they are an organ donor on their license, this symbol gets convoluted when the question of when to get the organs is presented; "If organs are to be transplanted then they must be kept alive and functioning as close to 'normal' as is possible (Lock 140)." Although the person has left that body, the biologically organism is treated as a live to maintain the value of the organs so when family members are approached it makes it difficult to differentiate dead and a life, especially if a doctor does not know their religious/spiritual beliefs (Lock 141)

The trouble with indicating organ donation on your drivers license as such an easy process at the Washington Department of Licensing indicates that it is simple to prepare for procurement. Krakuer indicates that life-sustaining practices such as receiving an organ can help a person avoid age but getting to the point, presented by Lock, is not just a matter of life or death. It is a matter of doctors, the law and family members finding a happy medium in order to decide when and if it is appropriate. The slogan sponsored by the WA DOL is, "You have the power to GIVE LIFE," I argue that once the individual is unconscious and personhood as left the power (i.e. brain dead) it is the ultimate decision of the doctor and family to decide on death for procurement.

Finding Identity

The aspect of finding yourself and in turn identifying who you are is an obvious aspect of everyday life. Being able to ascribe an identity to yourself is complicated because there our so many components that contribute to how we are who we are; among the contributing factors to self are gender, body, consumption, education, and food. In this cartoon it speaks to many different levels of identity and the search for self through a global positioning system (GPS). In this comic a middle age women seeks out the electronics department in hopes to find herself. She appears to have gone down a long journey to discover herself; she has tattoos all over her body, several piercings, a choker necklace and what seems to be a mohawk. These traits she reveals physically tend to match the traits of an adolescent teen that is considered punk-rock or rebellious. The important point to note here is that although some sort of identity is expressed she is still on the road of self discovery internally as well as externally. The comic here represents a variety of pressures that human beings feel because of the struggle to represent the real you when your physical identity is not congruent.

In Elliot's "The Face Behind the Mask" he describes the medicalization of social phobia and how it effects ones ability to live life. The question he greets the reader with is why is "medicalizing a personality trait called shyness" so plausible in America and why do we need to (Elliot 58)? Personality is a way of presenting yourself to the rest of the world, "and you want your personality to be 'dazzling' (Elliot 60)." Self-presentation attracts others to and is what makes you appealing within our society, for instance being out-going, opinionated or creative versus being shy. As Elliot says personality is "to make yourself interesting and attractive to other people, how to make them like you and respect you and want to be around you (60)." Thus, the next step if people are not attracted to your personality is to seek self-improvement. This point is, as Elliot addresses, "You might have been given a certain kind of personality but with the right kind of help you could change it (61)." In the comic above the women is seeking to find her true identity, therefore in Elliot's notion her personality creates her social identity and how she is viewed but she can develop and change to improve herself to become socially acceptable. There is a constant desire to claim an identity, to be somebody, "We must master and control the qualities we already possess in order to gain the good opinion of others (61-62)." Therefore, it is crucial to overcome poor traits with medication because it allows the individual to master the desire traits as well as control them to the point where society is attracted to the personality. Elliot argues that the self-presentation in social spaces are a performance because of the social expectations involved which cause humans to regulate what they do and don't do. In the situation of social phobia and creating a better representation for society we are compromising our own feeling of self-identity.

In Elliot's article, "Amputees by Choice," he discusses amptemnophilia or the desire or attraction to become an amputee (209). The people desiring to amputate a body part often do so because they feeling that they are "stuck in the wrong body" or their "body is incomplete with their normal complement of four limbs (211)." Elliot recognizes though that in their description of their feelings they reflect "through language of self and identity to explain why they want these interventions (211)." Although their physical bodies are indicate our form of normalcy they do not feel fully connected. Therefore when the person loses a physical extremity they are actually gaining so much more of who they feel they are. The true self is thus "produced by medical science (211)." Identity in this is seen as self-improvement but not a societal norm of self-presentation. However, the amputees want their self-presentation to portray how they are feeling inside, as Elliot puts it there is "A struggle between the impulse toward self-improvement and the impulse to be true to oneself (211-213)." It seems to be implied that after the amputees reach their limbless destination that they have a sense of achievement or well-being that they lacked before, as one amputee proclaims "You have made me the happiest of all men by taking away from me a limb which put an invincible obstacle to my happiness (114)." Whether one was the amputated for desired it the social space available for them was invaluable in creating a subculture which they could be a part of, one individual who wants to be amputated even says to Elliot, "The internet was, for me, a validation experience (217)." The common experience here allows these individuals to publicly validate their identity, in turn.

A common theme between the two articles in the importance of feeling less stigmatized by society to seek out one's true identity. In the comic, there is an evident identity search going on that has materialized on the women through tattoos, piercings, and clothing. In "The Face Behind the Mask" a pill allows the people suffering from social phobia to reveal who they are in a matter of self-presentation to others. And in "Amputees by Choice" individuals are trying to creating a symbiosis between their internal self and how others perceive them, thus taking it one step further by going surgical to embody what embody's them.

"Eating and Thinking"

“Thinking and Eating at the Same Time: Reflections of Sistah Vegan” by Michelle R Lloyd-Paige illustrates Lloyd-Paige’s point of view on animal products and her quest to be spiritually sound as a result of the evident correlation, she found, between her academic work and the treatment of animals and humans. In this chapter of Sistah Vegan Lloyd-Paige portrays her identity as a black woman through food knowledge. Lloyd-Paige began her veganism through a spiritual movement at her church, her and many other church goers, predominantly black women, began a fast at the beginning of each year where participants were not permitted to eat meat, sugar or dairy (Lloyd-Paige 3). “The fast was voluntary and supposed to detoxify the mind, body and spirit (Lloyd-Paige3).” Routinely after the fasting, Lloyd-Paige would reintegrate body, meat and sugar back into her diet; however in 2005 she found that her body was reacting poorly to the reintegration and her doctor recommended that she reintroduce soy products (a staple during the fast) into her diet (4). In November of 2005 she recognized “how the food [she] ate contributed to social inequalities, and it “marked [her] transformation to eating like a vegan (4).” Lloyd-Paige states earlier in her realization of the need to eat vegan is that her lifestyle did not match up with what she believed and taught. She recognized that being able to choose what to eat was a privilege by middle to upper class citizens and when she made a choice in her food she was partaking in “patterns of indifference and oppression (2).” Thus, Lloyd-Paige came to the realization that her eating habits were radically different than what she taught and practiced, she states that “the contents of a lecture I had just presented four days prior on the global inequities in food distribution; a vague recollection of a statement from PETA about the cruelties associated with chicken production; the remembrance of how surprisingly good I felt physically while on a forty-day spiritually motivated fast from meant and dairy at the beginning of the year; and my own desire to live an authentic lie—yanked me into an uncomfortable realization that…I was not living according to my beliefs (1-2).” Her awareness of the mistreatment of animals also related to how she felt people of color were treated historically and in the present. She argues that the blatant disregard for how animals are treated is inhumane and we have no valid right to treat them this way. She states that although humans feel they have some sort of “dominion” over animals “we were [not] given the right to be cruel, brutal and heartless (Lloyd-Paige 4).” She compares this treatment and domination over animals to the treatment of Native Americans in the European conquest of Northern America (5). Although she does link her vegan practice to healthy living standards and the remarkably increasing number of obese African Americans and Hispanics (6), she mostly correlates it to her belief in the innate human and animal right that all are worthy to be treated humanely and with respect. Thus, her eating habits are recognition of how animal products are produced and marketed as a direct correlation to the treatment of people of color throughout time and she has continued a spiritual journey of veganism as a means to resist being a contributor for inequality and oppression. Therefore, her eating habits are also a representation of her ideology of social standards.

Adjusting food intake habits as a means to represent a particular ideology is a common practice among not only black female vegans but also in American Christianity (Griffith). In “Don’t Eat That” Griffith explains the Christian discipline of historically fasting, or obtaining thinness as a means to receive “true nourishment” from Christ (Griffith 36). Within the Christian doctrine the body should be perfectly modeled because the body was also seen as “central for pushing the soul along the path to progress (Griffith 38).” Thus, excessive weight from food intake would limit the progression of the soul and Christ’s workings within the Christians body. However, the Christian diet also influenced eating purposely and embracing the food one ate, “the pleasures of eating, like other physical pleasures, were to be savored and taken very seriously…lest one fall into gluttony (Griffith 39).” Thus the Christian dieters believed that they should eat foods that would replenish the bodies and eat with care because too much was a bad thing (Griffith 39). Griffith states, “The advice to eat only such foods as were individually pleasing was followed by a lengthy exposition of the proper and most spiritual diet (Griffith 39).” This concept of food intake is similar to Lloyd-Paige’s refusal of animal products because it is shaped by an ideology or spirituality that makes the individual or group pay particular attention to what they put in their body. In both situations the individual cannot consume what conflicts with their belief systems; for Lloyd-Paige she is a vegan because of the treatment of animals and the Christian dieters, Griffith speaks of, must control their eating and weight to take pleasure in their food experience as well as acquire a closer relationship to Christ.

On the same note Macrobiotics also shapes eating habits through a spiritual ideology of yin and yang, furthermore it allows women to balance gender inequalities, similar to Lloyd-Paige’s lifestyle to stop eating animal products to make an attempt to balance societies social inequalities. Macrobiotics is part of the “diet culture” that always pushes the practitioners to “do the right thing” because there are so many constraints on the individual to follow the right eating habits and attain balance (Crowley 37). Crowley argues here that Macrobiotics “in fact offers practitioners a fluid gender identity, and that this is one sources of its lasting popularity (Crowley 38).” Therefore Macrobiotics offers the individual the opportunity to “manipulate how the spiritual essences of yin and yang manifest themselves in the body (Crowley 38).” Different types of food can either be masculine or feminine and how they are prepared for instance “grilling a (yin) celery stalk changes the structure and quality of the celery’s gender—from female to male, from passive to strong (Crowley 40).” By identifying gender through food women are capable of adjusting sexist gender roles, as woman proclaims, “I could not be teaching or have published books, if it weren’t for the power macrobiotics gave me (Crowley 46)!” The practices of Macrobiotics enables these women to change the roles of gender practices so they are able to have a balanced spirituality, like Lloyd-Paige’s veganism as a means to stand up for social equality and increase the respect between humans as wells as animals.

Unfortunately though Nutritionism has become nationally accepted as a way to view food and in turn has affected consumption patterns in terms of what people think they should eat. Scrinis argues that the “focus on nutrients has come to dominate, to undermine, and to replace other ways of engaging with food and of contextualizing the relationship between food and the body (Scrinis 39).” The problem with this re-contextualization is it limits people to interacting with their food that allows for social identity, spiritual identity and gender identity. Furthermore reducing food into nutrients and numerical symbols limits its functionality and forces it to move on from “food discourses and consumption practices (Scrinis 42).” In the case of Macrobiotics the problem is that food here represents so much of being able to balance an entire gender identity—by limited foods to nutrient based ideology it ignores the cultural constructs that my enable a women to empower herself through use of yin and yang. Furthermore, Scrinis presents the marketing of food as a means to “distract attention from both the overall nutrient profile of a food” but by doing this it also takes food out of a political context, such as the political ties that Lloyd-Paige explains with meat products and the treatment of people of color. Food practices varying but in these situations it seems that food is tied to a spiritual belief or social order that enables the individual.

Ascribed and Achieved Status

Ascribed and achieved status tends to be a critical discussion in social science courses, especially sociology due to Ralph Linton, a sociologist who coined the term when discussing social structures. I’ve incorporated a short you tube video that discusses the basic meanings to supplement the article, "A Clarification of 'Ascribed Status' and 'Achieved Status' " by Irving S. Foladare.

Foladare's article concerns the misrepresentation of these terms to represent "individual variation" rather then the representation of social structure as a whole, which may be culturally variant but not individually subjective. Thus, he states that "the concepts of 'ascribed status' and 'achieved status' are designed to indicate structural properties of social systems" and individuals cannot determined if their status will be shifted (Foladare 54). Therefore, what he is ultimately saying is it is not up to the individual to give themselves a self-ascribed status because it is not socially recognized; the 'ascribed' or 'achieved' status muse be recognized by the given social structure. Foladare brings to light the misuse of Leo F. Schnore's further development of these terms in his use of 'reversible status' and 'irreversible status'. Schnore has deviated from Lipton's terminology because according to Foladare his "conceptualization is both empirically inaccurate and an additional source of departure from the social structural significance of the concepts (Foladare 54)." With this in mind though I have found comparative themes between Foladare's explanation of 'achieved status' and 'ascribed status' and Schnore's concept of 'reversible status' and 'irreversible status' to compliment "Medicalizing Homosexuality" and "Regulated Passions: The invention of inhibited sexual desire and sexual addiction."

The medicalization of homosexuality and experiences such as inhibited sexual desire (ISD) and sexual addiction are applied by medical authority, the historical context and theoretical approach have changed but the similar theme is that the medicalization has often reverted to an explanation of social status as well as self-identity. In the case of "Medicalizing Homosexuality" medical practitioners have been interested in homosexuality because of the 'abnormal desire' man had for another man (41), furthermore the homosexual body has been seen for centuries as "like savage bodies (40-41)." Ulrichs explained homosexuality as a "inborn benign anomaly" or as a third sex. Terry noted that his concept of homosexuality "was an attribute of a particular type of person, marked by the paradoxical presence of characteristics of both sexes (Terry 43). She also noted that the scientific approach he offered would be helpful in decriminalizing homosexuality because it was "inborn." Ulrichs concept represents ascribed status in the sense that he argues homosexuality is assigned prior to living in a given environment. According to Schnore biological sex is ascribed irreversible however he doesn't present sexuality or gender which in Ulrichs understanding of homosexuality would be ascribed reversible (Foladare Figure 1, 55).

Furthermore, the concept of nervous degeneration represents achieved status and how homosexuality can be achieved and reversible with increased maturity. According to Krafft-Ebing "The medical investigator is driven to the conclusion that this manifestation of modern life [homosexuality] stands in relation to the predominating nervous condition of later generations, in that it begets defective individuals (Terry 45)." The homosexual in this case has presented a achieved reversible status because with the struggles of modern life they have supposedly turned to homosexuality but have a means of reversing this sexual orientation. Foladare confirms that " 'Achieved statuses' are those in categories of statuses for which the society accepts change by individuals and, in many cases, expects efforts toward change in given directions (58)."

Krafft-Ebing correlates homosexuality with primitive human beings who are have not evolved as modern human beings (Terry 46). Terry states that to Krafft-Ebing "sexual dimorphism and monogamous procreative heterosexuality were taken to be indicators of evolutionary progress and maturity (46)" Likewise, Foladore states that " 'Achieved statuses' are those in categories of statues for which the society accepts change by individuals and, in many cases, expects efforts toward change in given directions (58)." A key term used in this statement is "expects" because as society expects these changes that are in term accepted by society, it is also expected that homosexuals eventually mature into acceptable human beings, in Krafft-Ebing's concepts.

Foladore's discusses in depth the change and fluidity of status with collective societies approval, he comes to the conclusion that "the essential point is that in their status categories change is not acceptable to the society. People are expected to be heterosexual males or heterosexual females, assigned one or the other on the basis of their biological characteristics (59)." Deviant statuses therefore illustrate a contradiction between societies ascribed status to the individual (Foladore 58-59). Therefore what is acceptable and unacceptable is determined collectively by the society however it is also decided by the popular authority. In the case of "Regulated Passions" it is the medical practitioner that assigns authority and meaning; "...The discursive elaboration of disease is shaped by myriad and complex factors, including the ideological and economic imperatives of the defining professions (Irvine 317)."

In Irvine's article he argues that "Diseases are artifacts with social history and social practice (314)" and they have created "medically legitimated boundaries of acceptable contemporary sexual experience (315)." These statements have forced me to turn to the concept of achieved status and how whole populations can be transformed due to class labeling and/or medicalization of experiences. The disease described in "Regulated Passions" as inhibited sexual desire and sexual addiction are admitted as being subjective to the individual and unable to medically define and apply universally (Irvine 322). With this in mind, subjective diseases correlate more so with the individualized theme behind "irreversible" and "reversable" statues to compliment "ascribed" and "achieved". Foladore argues that the first noted states are dependent on "individual variation" (53) rather then part of social structures.

The main point that I have strived to achieve is that according to Foladore "achieved statuses" and "ascribed statuses" are fundamental to understanding human behavior and therefore this may be the reasoning behind ascribing homosexuality to a type of status (i.e. primitive). These statues also represent the concept behind medicalization, and that is attempting to apply a universal notion to a very diverse population. On the individual level, which is subjective, it should be looked at after considering "reversible" and irreversible" statuses because it does not properly incorporate the social structures in place. In order to understand why these theories were formed and how even passion was medicalized it is essential to look a social structures in place.

Artificial Insemination, Pleasure and Reproduction

Artificial insemination is relatively common today for single women or lesbians. In the dramatic television series “The L Word” the lesbian couple, Bette and Tina, decide to use this procedure to have a baby together. After much consideration they have chosen to use their friend’s sperm in order to have their own biological child, instead of seeking adoption. The most common method of artificial insemination in referred to as intracervical insemination, which mimics male and female sexual intercourse. For instance, the sperm is injected by a syringe into the cervix compare to the sperm is injected in the cervix pathway by a penis. The replication of sex can be done with the assistance of doctor, but also in the home. Bette and Tina decide to do this procedure after a sexual night together; it is referred to as intravaginal insemination when taking place outside of a doctor’s office. In this excerpt from the episode “Let’s Do It!” of “The L Word” Bette and Tina have their own syringe of their friends sperm and insert it after a intimate night together, later you see Tina with her legs together making sure that the sperm has reached the inside of the cervix in order to impregnate her. These scenes illustrate two sides of intravaginal insemination; first a steamy sex scene by Bette and Tina to open up the cervix for sperm followed by a scene where Tina is trying with all her might to make sure that the sperm has reached its destination, the second scene representing the trials and tribulations of not having a penis handy for impregnating Tina.

“New Science, One Flesh” illustrates the theories behind pleasure and reproduction and the necessity for (or lack of) female orgasm. Columbus argues that the clitoris is the site of a women’s pleasure and that this is similar to how pleasure is exerted by the male penis—through sperm (66). He states, “…without these protuberances [the clitoris] which I have faithfully described to you earlier, women would neither experience delight in venereal embraces nor conceive any fetuses (66). However other claims argue that female orgasm is not necessary for conception, “the so-called female seed was essentially irrelevant to conception and that female orgasm was still more irrelevant…women purportedly told him [Giles of Rome] that they had conceived without emission and presumably orgasm (67).” As our studies show today and the author points out it is pretty evident that women do not need to reach orgasm in order to conceive and women who do not orgasm can still conceive (67). For Bette and Tina they emphasis in the this episode that the sexual interaction was crucial to their experience however Tina with her legs in the air trying to make sure the sperm gets to its reproductive home shows that orgasm was not necessary for her to get pregnant it was a matter of biology.

In the section ‘Orgasim and Conception’ from “New Science, One Flesh” Lacquer presents again the idea that the “sperm” of the female serves no purpose except to assist in the please making process. Laquer presents Lemnius’ point of view where “woman’s womb is not simply ‘hired by men’ (99).” In The L Word it is portrayed that the lesbian couple is actually hiring the male sperm to serve their needs. The fact that Bette and Tina share “delight and concussion” does not infer that they will conceive a child because they do not have the sperm inside their bodies however they are able to do so through artificial insemination. However, Bette and Tina also represent “The heat (orgasm) nexus” because they interact sexually in order to open the cervix for the sperm; this was recommended earlier in the episode when they were visiting the doctor.

In the introduction to the episode (I was unable to find a link to this portion) the doctor recommends that Bette pleasure Tina in order to have a better success rate with insemination because they were having problems with getting pregnant. Laquer states that:

“Since the statistical analysis of conception has evolved only very recently, and since doing nothing therapeutically has a remarkable chance of success in curing infertility, it seems probably that almost any advice Renaissance healers happened to give their patients regarding sexual heat and please must have appeared to work often enough to confirm the model on which it was based (Laquer 100).”

After this episode Tina does get pregnant using this method of insemination therefore reiterating the point that although there really is not inherent connection to orgasms and reproduction it happens in correlation often enough that it becomes engrained in reproductive knowledge like it did during the Renaissance. Many of the notions from the history of reproductive theories are actually reiterated in this episode of The L Word and artificial insemination; “To produce sufficient heat in women, talk and teasing were regarded as a good beginning (Laquer 100).” Hence, the episode illustrates the foreplay prior to inserting the semen using a syringe by Bette.

Although medical knowledge has changed drastically pertaining to women’s reproductive ability and the relation with orgasm. I found that this episode reiterates the historical notions of being able to conceive. However, I do believe that these past medical leaders would have scoffed at the idea of lesbians being able to conceive a child and the method of artificial insemination.

Validity behind PRS, PTSD and Brain Scans

United States medical officers who witnessed Puerto Rican soldiers going into states of “anxiety, rage, psychotic symptoms, and unpremeditated suicidal attempts (Gherovici 29)” originally coined the Puerto Rican Syndrome (PRS). The symptoms were applied to Puerto Ricans specifically because the medical officers believed it was a cultural phenomenon that was only exhibited by these soldiers returning from the Korean War. The United States medical officers ultimately placed Puerto Ricans in a zone as exhibiting hysteria from their cultural experiences prior to going into war; it was said to develop from “common folk beliefs,” multiple personality disorder and even “an indication of a higher rate of organic brain disorder among Puerto Ricans (Gherovici 30).” To the medical officials and psychoanalysts the application of this disease was considered a culture-bound syndrome that developed through their social environment, however Gherovici also notes “the syndrome taken globally is often described as a ‘normal’ reaction within Hispanic culture (31).” Thus, it is evident that there have been cases made that construct the symptoms of PRS as strictly Puerto Rican but also evidence that shows these symptoms as seen on a more global scale. Ultimately though, the definition of PSR by the U.S. medical officers “superficially stereotyped an entire national group and transformed a customary experience into a serious mental health problem with an eccentric location. Thus the Puerto Rican Syndrome was coined as a new illness category for an otherwise culturally accepted normal manifestation (Gherovici 35).” The invention of Puerto Rican Syndrome by Western ideology labeled Puerto Ricans exhibiting these symptoms as having a severe mental disorder that needed psychiatric treatment and ignored the same manifestations of symptoms in U.S. veterans and thus made the mental illness a cultural bound syndrome that was most certainly seen in other veterans as Post-Traumatic Stress Disorder (PTSD) (Gherovici 33-34).

The problem with applying this mental disorder to Puerto Ricans is that it redefines these once culturally accepted experiences. In “Picturing the Brain Inside, Revealing the Illness Outside” Cohn argues that for patients who are able to see their symptoms materialized through brain scan pictures “the images might instrumentally redefine patients’ everyday experiences of illness (Cohn 67).” As Cohn explains there are several meanings that can be attributing to these images, for instance the ability to provide “proof” to families and friends that there is a concrete reason for their mental illness. “The image both locates and contains the illness but consequently allows it to move to the external and in so doing can now be a social object (Cohn 77).” As Cohn exhibits applying an image to a mental disorder creates a different experience for the patient; thus applying a westernized mental illness to a culturally different group of people also changes their experience. PRS ultimately, “[accepted] the scientific validity of an ‘imported’ diagnoses for ‘domestic’ manifestation. [Puerto Rican physicians] readily adopted a new diagnosis that rendered pathological an experience that was socially normative and personally normal (Gherovici 36).”

It was evident that the U.S. army psychiatrists and medical officials relied on “the American scientific model that overemphasized the validity of the foreign diagnostic category and underestimated the interpretations of their [Puerto Ricans] own culture (Gherovici 38).” The U.S. army officials were able to medicalize their interpretative and ignored the cultural and political environment and implications (Gherovici 38). Cohn argues that when “patients who are committed to using the scans as way of radically rethinking their illness actually have new difficulties to face (Cohn 80).” In the same sense Puerto Ricans exhibiting hysteria, originally culturally acceptable, are forced to rethink their mental illness in terms of Western science and in turn effects how they perceive their experiences (as stated earlier). In Young’s article, “A Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder)” the same concept is evident in how the treatment program reshapes their illness to correspond to the ideology and therapeutic work. Young argues that although most patients say they have had positive behavioral changes this could be simply because of change in environment, “The point I [Young] want to underline is that these changes do not develop over the course of the treatment program, but appear at or soon after admission” and the “therapeutic changes…may be rooted in circumstances, especially abstinence, that are not specific to the treatment program (Young 112-123).” PRS has done the same to Puerto Rican soldiers because it has forced them to change their mentality of what they are experiencing and transforming it to a medical condition, which changes their “treatment program.”

Gherovici states that, “symptoms grouped under the label Puerto Rican syndrome produce antagonistic and inappropriate classification because they do not constitute coherent symptom sets. In fact, the invention of the Puerto Rican Syndrome has been purely ideological (Gherovici 70).” This is also evident in how patients receiving their brain scans view their mental illness afterwards. “The scans inescapably are an entanglement of both the moral and biological dimensions of what is identified as mental illness (Cohn 81).” Cohn argues that science places a meaning on the brain scans that in turn gives the patient a means of interpretation—their illness is more real if they can see it and show it to others, although this also presents many changes on how the validity of their illness is perceived by society. In the Institute for the Treatment of PTSD veterans are subject to a particular ideology that shapes how they enter the program, must acknowledge their issue and how it development and relive traumatic situations in order to cope with their mental illness. In this institute patients are suppose to get better through strict rules, running a program that places mental burdens on staff, uses staff that do not have a whole lot of training in order to produce and restructure the knowledge of the individual suffering from PTSD (Young 117-118). The institute uses their ideology to “medicalize the past” and in turn helps patients use this to take “moral responsibility” for the present. By medicalizing mental illness in these three situations it has ultimately changed the experience for Puerto Rican war veterans, bran scan viewers and male veterans at this specific institute for Vietnam veterans.

Dove for Public Health

Dove, commonly known for their soaps, also has become widely recognized as a company that campaigns for self esteem and claims the voice of "Real Women." The Dove "Campaign for Real Beauty" is basically a social movement to promote that the women in ad campaigns, on TV and in magazines should not be idolized or admired because they are not the best representation of women in our society, hence the notion of "Real Women." Their idea of "Real Women" tends to exclude the fact that supermodels, skinny girls, and icons feel stress to be perfect as well and live up to societies standards. Their slogan, "Real Women with Real Bodies and Real Curves" ignores that their our people that cannot relate to this idea of health and well being. The images above illustrate their campaign for their Dove firming products and using them on "Real Women with Real Curves" however I find this advertising to also point at the notion that a "Real Women" needs to firm up those "Real Curves" to in order to appeal to our society. It seems that they are using this campaign to sell products to a wider range of people and influence them that this product will really work because it works on "Real Women."

Chapter 1: The new public health: a new morality and Chapter 2: Epidemiology: governing by numbers in The New Public Health and Self in the Age of Risk by Alan Petersen and Deborah Lupton had various keys points that reminded me of the Dove campaign and the concepts behind the "Real Women Campaign." The introduction to Chapter 1 illustrates how there is a growing consciousness and attention to the physical body and regiments to control the body, "there is also a new consciousness of risks that are believed to lie belong the individual's control but which are viewed as, ultimately, a result of human activity (Petersen & Lupton 1)." In relation to the Dove ad campaign their has definitely been a growing consciousness of the body and how it should be portrayed, however the individual has the control to view popular images how they want although it is depicted by human activity. For example Dove recognized the growing discontent with women not be able to relate to mainstream medias portrayal of the perfect women and saw the opportunity to lower the risk of low self-esteem. Thus, the concept that the consciousness of attention to "body shape, diet and exercise" is beyond an individual's control but within the confines of a result of human activity.

Petersen and Lupton argues that "A properly managed environment is therefore essential, not only to improve health but indeed to ensure human survival (16)." I think Dove has attempted to change the environment (United States society) to ensure that no women experiences low self esteem or questions their beauty to improve self image and therefore in a sense ensure human survival. However, the values of being perfect (i.e. using firming skin lotion) overtake what Dove's original mission was instead they are reinforcing ideals they claim to be breaking down.

The section on "Self-Regulation and Body Management" illuminated many correlations with Dove's campaign for real beauty. Petersen and Lupton present the consumer culture as a struggle for self-identity and separating self from social norms (23). The authors argue that the "attention to the 'healthy body' " is also "concerned with how we present our bodies to ourselves and to others (Petersen & Lupton 23)." This is ultimately how the Dove campaign was shaped, primarily because they recognized the idea of the perfect body and then related it to how women have a negative body image therefore they developed how women were presented to change where the attention to the "health body" is placed. As I have stated previously the image of the body presented by Dove is changed but the ideology behind achieving the perfect body has not. This is illustrated too in the readings, "the body is continually shaped by social, cultural and economic processes," the conception of the body is continually changing but it is not just about a change of physical body through advertisement--the words needs to match the image.

The idea of firming thighs that are more REAL perplexed me because of the way Dove approached the word real, like those that are skinny and don't have cellulite aren't real people with a different form of real beauty. In the reading we see how the body is shaped differently during different time periods, "all testaments to changing notions of what is considered both attractive and health (Petersen & Lupton 23)." Dove should take this to heart and celebrate beauty in all shapes and during all timelines. It seems that health promotion with dove really concentrates on the power of body image and the body as a force to be reckoned with, hence the firming cream or even anti-aging soaps. Petersen and Lupton illustrate this theme, "the strategy of health promotion...Adopts the conceptualization of the body as a writing surface, subject to visible changes wrought by bodily practices (23). For claiming to promote self esteem Dove is really reiterating the theme that "the new public health [is] arranged around aesthetics" and thus people avoid certain behaviors to be aesthetically pleasing (Petersen & Lupton 24).

Chapter 2 reiterates the problems I found with Doves ad campaign that they are generalizing real women to women who feel uncomfortable about themselves and don't appreciate the variety in body image we have in our culture. On various articles I read on Dove's ad campaigns for Real Women with Real Beauty I found that they focused on arbitrary numbers to prove that it is so rare for a women to feel comfortable with themselves after looking at mainstream media (which may be true but still). Epidemiology emerged as a way to classify characteristics of populations and as a way to define people in specific way to measure theories about people (Petersen and Lupton 28-29). In a way Dove is using the same structure to categorize real women against fake.

The authors identify that numbers are related to how culture changes through time and ignoring this will achieve little (Peterson & Lupton 34-35). This is relevant the view that the perfect body image has also been the same and isn't evolving. It is crucial to note that Dove is taking all perspectives with a grain a salt and influencing women to build their confidence through products that fit the type of individual they are, rather then the type of people we see in billboards or magazine. Peterson and Lupton argue in relation to epidemiology that "changes in perception are...Tied to broader social, cultural and political changes that shape what kinds of knowledges are considered to be important and which 'facts should be pursue and publicized (36)." Dove should recognize the variety of aspects that play into body image and self-esteem; rather then placing the blame on fake women we can also blame commodification of goods that are suppose to make us feel beautiful.

The Race Exhibit and Biomedicine

http://www.understandingrace.org/

“Understanding Race: Are We So Different” is a museum exhibit constructed by the American Anthropological Association based on the cultural conception of race and the biological relationship to human variation and differences in skin color. According to biologists, anthropologists, historians and many other academics involved in the project everybody shares a similar ancestry but the differences we see are formulated from “migration, marriage and adaption to different environments (Race: Are We So Different).” As the website for the exhibit presents race has been a part of our society for quite some time and only relatively recently has it being exposed as cultural rather than a biological difference adapted from different environments. Thus, racism had also been an infamous part of our society, for instance using race as a measure of social hierarchy. Unfortunately the concept of race had been embedded so deeply into our culture the exhibit put on by the American Anthropological Association still cannot eliminate the mainstream understanding that race makes us biologically and culturally different.

Points from “Tenacious Assumptions in Western Medicine” reminded me of some similar concepts with the fundamental idea of race, in terms of biology and society, in the exhibit “Understanding Race”. Biologically the variation in skin color comes from the variation in environment from the beginning of human evolution. Jablonski, contributing anthropologist on the race exhibit, states that “strong sun exposure damages the body…the solution was to evolve skin that was permanently dark so as to protect against the sun’s more damaging ways (Race: Are We So Different).” Furthermore, the difference in skin color also evolved to balance the body’s absorption of Vitamin D and promote folate based on proximity to the sun. Thus human variation in terms of skin color developed due to the idea of survival of the fittest: adapt or die (Race: Are We So Different). In turn, African Americans have the darkest skins because their ancestors were closest to the equator (i.e. Africa).

Socially though, according to geneticist Richard Lewontin “race was imported into biology…from social practice.” Society attempted to use race to understand biological differences. This was because we wanted to be able to explain skin color in terms of placing people in a hierarchy to use for white peoples advantage. As the exhibit explains, “Linking race to biology led to a “race science” that attempted to legitimize race as biological face and account for differences in peoples (The Race Exhibit Homepage).” Our society’s has attempted to apply various meanings to different skin colors in order to explain biological differences throughout history.

In Gordon’s article she argues that biomedicine measures and maps out the objective world; she categorizes it into naturalism and individualism. We can relate the basic interpretation she uses for biomedicine to race concepts. She states that, “Biomedicine speaks beyond its explicit reductionist reference through the implicit ways it teaches us to interpret ourselves, our world, and the relationships between humans, nature, self and society (Gordon 19).” We can compare this to how the American Anthropological Association interprets how race has been conceived culturally. Like biomedicine interprets how we see self, society and different relationships race has constructed how we view the people around us, different societies and relationships based on class, location, and of course the unavoidable color of our skin. In Gordon’s essay she presents that biomedicine “claim[s] neutrality and universality ,” however studies do reveal that it is ultimately a social contract (Gordon 20). Alike with human skin variation it is also upheld in a social contract that shape how we are perceived and even shapes how we choose to behave.

Gordon presents a fundamental concept of naturalism, a concept within biomedicine, which argues that “Nature is Separate from Culture (Gordon 27).” She argues that nature is “independent from culture but prior to it (Gordon 27).” This immediately sparked my attention in relation to the race exhibit because the human body should be independent from race and it was before it. Furthermore, she also argues in this same concept on page 27 that “Culture is a superficial, some-times thing” and also that “diversity is really only skin deep.” If we look at these two statements in relation to the race exhibit and the meaning of race versus human variation, I find that in naturalism culture is superficial however in terms of humans, culture is deeply rooted and how mainstream society looks at skin color is superficial.

The goal of the exhibit is to help us understand that race is a cultural construct that has been internalized through movements in the United States (i.e. slavery, the search for equality). Gordon argues that “From a healing model [biomedicine] is rapidly expanding into a moral and engineering one, increasingly ‘remaking’ humans not in natures image but in its own (Gordon 20).” To sum up this concept in comparison with my argument in relation to race; I find that the ultimate relationship between the exhibit and how Gordon explains biomedicine as continuously evolving through our culture. Although we say race is strictly culturally and human skin variation is biological it has shaped many movements in our history and continues to shape the language we use to describe or discriminate against various populations. Likewise, Gordon’s overarching argument is that biomedicine is actually argued as becoming cultural due to how it is used and who accepts it in Western medicine.