Sexuality and Medicine: Volume II: Ethical Viewpoints in Transition PDF
Preview Sexuality and Medicine: Volume II: Ethical Viewpoints in Transition
SEXUALITY AND MEDICINE Volume II PHILOSOPHY AND MEDICINE Editors: H. TRISTRAM ENGELHARDT, JR. Center for Ethics, Medicine, and Public Issues, Baylor College of Medicine, Houston, Texas, U.S.A. STUART F. SPIeKER School of Medicine, University of Connecticut Health Center, Farmington, Connecticut, U.S.A. VOLUME 23 SEXUALITY AND MEDICINE Volume II: Ethical Viewpoints in Transition Edited by EARL E. SHELP Institute of Religion, and Center for Ethics, Medicine, and Public Issues, Baylor College of Medicine, Houston, Texas, U.S.A. D. REIDEL PUBLISHING COMPANY ACADEMIC PUBLISHERS GROUP DORDRECHT/BOSTON/LANCASTER/TOKYO Library of Congress Cataloging-in-Publication Data (Revised for voI. 2) Sexuality and medicine. (Philosophy and medicine ; v. 22-23) Includes bibJiographies and index. Contents: v. 1. Conceptual roots - v. 2. Ethical viewpoints in transition. 1. Sex (Psychology)-Collected works. 2. Medicine and psychology-Collected works. 1. Shelp, Earl, E., 1947- . II. Series. BF692.S4347 1987 306.7 86-26201 ISBN 978-1-55608-016-6 ISBN 978-94-015-3943-2 (eBook) DOI 10.1007/978-94-015-3943-2 Published by D. Reidel Publishing Company, P.O. Box 17,3300 AA Dordrecht, Holland. Sold and distributed in the U .S.A. and Canada by Kluwer Academic Publishers, 101 Philip Orive, Norwell, MA 02061, U.S.A. In ali other countries, sold and distributed by Kluwer Academic Publishers Group, P.O. Box 322, 3300 AH Dordrecht, HolIand. AII Rights Reserved. © 1987 by D. Reidel Publishing Company, Dordrecht, Holland Softcover reprint of the hardcover ist edition 1987 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, inc1uding photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner. TABLE OF CONTENTS Volume II CHRISTIE HEFNER / Foreword ix NANCY N. DUBLER / Preface Xlll EARL E. SHELP / Introduction xxi SECTION I: REPRODUCTION, MEDICINE, AND MORALS MARY ANN GARDELL / Sexual Ethics: Some Perspectives from the History of Philosophy 3 SARA ANN KETCHUM / Medicine and the Control of Repro- duction 17 LISA SOWLE CAHILL / On the Connection of Sex to Repro- duction 39 H. TRISTRAM ENGELHARDT, JR. / Having Sex and Making Love: The Search for Morality in Eros 51 SECTION II: SOCIETY, SEXUALITY, AND MEDICINE JOHN DuFFY / Sex, Society, Medicine: An Historical Comment 69 ROBERT BAKER / The Clinician as Sexual Philosopher 87 FREDERICK SUPPE / The Diagnostic and Statistical Manual of the American Psychiatric Association: Classifying Sexual Disorders 111 JOSHUA GOLDEN / Changing Life-Styles and Medical Practice 137 v vi TABLE OF CONTENTS NELLIE P. GROSE AND EARL E. SHELP / Human Sexuality: Counselling and Treatment in a Family Medicine Practice 155 J. ROBERT MEYNERS / Sex Research and Therapy: On the Morality of the Methods, Practices and Procedures 171 SECTION III: RELIGION, MEDICINE, AND MORAL CONTROVERSY PAUL D. SIMMONS / Theological Approaches to Sexuality: An Overview 199 JAMES J. MCCARTNEY / Contemporary Controversies in Sexual Ethics: A Case Study in Post-Vatican II Moral Theology 219 ROBERT H. SPRINGER / Transsexual Surgery: Some Reflections on the Moral Issues Involved 233 RONALD M. GREEN / The Irrelevance of Theology for Sexual Ethics 249 NOTES ON CONTRIBUTORS 271 INDEX 273 TABLE OF CONTENTS Volume I WILLIAM H. MASTERS AND VIRGINIA E. JOHNSON-MASTERs/Foreword ix ALAN SOBLE / Preface: Changing Conceptions of Human Sexuality xi EARL E. SHELP / Introduction xxv SECTION I: HUMAN SEXUALITY ROBERT C. KOLODNY / Medical and Psychiatric Perspectives on a 'Healthy Sexuality' 3 TABLE OF CONTENTS VB FREDERICK SUPPE / Medical and Psychiatric Perspectives on Human Sexual Behavior 17 STEPHEN B. LEVINE/The Origins of Sexual Identity: A Clinician's View 39 LESLIE M. LOTHSTEIN / Theories of Transsexualism 55 VERN L. BULLOUGH / Sex Research and Therapy 73 FRITZ K. BELLER / A Survey of Human Reproduction, Infertility Therapy, Fertility Control and Ethical Consequences 87 SECTION II: SEXUALITY AND SEXUAL CONCEPTS ALAN SOBLE / Philosophy, Medicine, and Healthy Sexuality 111 JOSEPH MARGOLIS / Concepts of Disease and Sexuality 139 JEROME NEU / Freud and Perversion 153 SANDRA HARDING / The Politics of the Natural: The Case of Sex Differences 185 ROBERT C. SOLOMON / Heterosex 205 ELI COLEMAN / Bisexuality: Challenging our Understanding of Human Sexuality and Sexual Orientation 225 PETER ROBERT BREGGIN / Sex and Love: Sexual Dysfunction as a Spiritual Disorder 243 NOTES ON CONTRIBUTORS 267 INDEX 268 FOREWORD It may be unnecessary to some to publish a text on sexuality in 1986 since the popular press speaks of the sexual revolution as if it were over and was possibly a mistake. Some people characterize society as too sexually obsessed, and there is an undercurrent of desire for a return to a supposedly simpler and happier time when sex was not openly dis cussed, displayed, taught or even, presumedly, contemplated. Indeed, we are experiencing something of a backlash against open sexuality and sexual liberation. For example, during the '60s and '70s tolerance of homosexual persons and homosexuality increased. Of late there has been a conservative backlash against gay-rights laws. Sexual intercourse before marriage, which had been considered healthy and good, has been, of late, characterized as promiscuous. In fact, numer ous articles have appeared about the growing popularity of sexual abstinence. There is a renewed vigor in the fight against sex education in the schools, and an 'anti-pornography' battle being waged by those on the right and those on the left who organize under the guise of such worthy goals as deterring child abuse and rape, but who are basically uncomfortable with diverse expressions of sexuality. One would hope that such trends, and the ignorance about sex and sexuality that they reflect, would not touch medical professionals. That Dr. Earl Shelp has spent years gathering these essays on sexuality and medicine only goes to underscore the sad reality that medicine is not immune to these regressive trends. Professor Shelp's interest in this collection grew out of observations during clinical work that many concepts of human sexuality were poorly understood by faculty and, consequently, students were either kept in ignorance or misinformed. Moreover, he found that historical and conceptual judgments concern ing human sexuality tended to be myopic as clinicians perpetuated the received tradition uncritically. Consequently, what are taught as medi cal truths may actually be religious, philosophical, or cultural precepts, not based on scientific reality. ix Earl E. Shelp (ed.), Sexuality and Medicine, Vol. II, ix-xi. © 1987 by D. Reidel Publishing Company. x FOREWORD This comprehensive text calls to the attention of physicians the relationship of conceptual understandings to normative judgments in the area of sexuality. In spite of the sexual revolution, it appears that in the main today's medical students and practicing physicians perpetuate arbitrary judgments about normal and abnormal sexuality; they are highly judgmental about practices that do not conform to their own; and they are ignorant of the variety of possible human sexual expression. The devastating results of these attitudes are obvious throughout our culture. Moral judgments about sex should not be expressed as scientific absolutes in a pluralistic society that values self determination and individual freedom. This fundamental American belief in individual freedom is one that has concerned my father, Hugh Hefner, for thirty years. It is expressed in Playboy magazine and in the work of the Playboy Foundation. In the early 1960s, a series of editorials penned by him and termed the 'Playboy Philosophy' offered a historical overview of individual free dom, particularly sexual freedom, and argued passionately for the right of individuals to be free of governmental or religiously imposed moral ity. Through the Playboy Foundation, Hefner put his money where his mouth was. It made the initial grant to establish an Office of Research Services of the Sex Information and Education Council of the U.S. (SEICUS) in the late '60s. And in 1971, Playboy awarded a grant to establish a pilot program at the University of Minnesota to develop curricula for changing the attitudes of men and women medical students. The premise of the program, as stated in the grant proposal, was: While the physician is most frequently consulted in sexual matters, he is woefully ill-prepared to handle them. The recent graduate of medical school is often in the difficult position of an 'expert' who knows less about his subject than his patient. Medical students, by nature of their social and economic background, personality types, and scientific training, are traditionally among the most inhibited, threatened, naive and anxiety-ridden of professional students. Unfortunately, even the physician who is factually knowledge able about human sexuality is often unable to use the information he possesses due to his emotional response to the subject. Our premise is that much of any attitude toward sexuality is based on myths regarding sexual behavior, and that perpetration of these myths leads, at best, to unsound therapy and counseling, and at worst, to failure of the M.D. to even acknowledge sexual problems. The rationale for these volumes suggests that the state of medical practice today is not much better than it was in 1971. Perhaps this is due FOREWORD Xl to a still present uncomfortable titillation that permeates medical inter est in sexuality. In the '60s, when the Playboy Foundation became the major research sponsor of the Masters & Johnson Institute, we did so, not only because of the importance of the work, but also because it was virtually impossible for the Institute to attract more traditional support due to this attitude toward sexuality. Tragically, the Institute's situation remains substantially similar today. This superstition and embarrassment, which continues to cloud our understanding of human sexuality, makes it critically important that medical professionals, as well as social scientists, philosophers, theo logians, and the general public be exposed to the insights and informa tion on human sexuality that Professor Shelp has developed in this book. I hope that this text is widely used, since its subject is so important to each of us. Playboy Enterprises, Inc., CHRISTIE HEFNER Chicago, illinois, U.S.A.
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