Are women's requests for aid in dying honored more often than men's, or less? Feminist arguments can support conclusions either that gendered perceptions of women as self‐sacrificing predispose physicians to accede to women's requests to die — or that cultural understandings of women as not fully rational agents lead physicians to reject their requests as irrational.

In the last two decades there have been many critics of western biomedicine's poor integration of social and psychological factors in questions of human health. Such critiques frequently begin with a rejection of Descartes' mind-body dualism, viewing this as the decisive philosophical moment, radically separating the two realms in both theory and practice. It is argued here, however, that many such readings of Descartes have been selective and misleading. Contrary to the assumptions of many recent authors, Descartes' dualism does attempt (...) to explain the union of psyche and soma - with more depth than is often appreciated. Pain plays a key role in Cartesian as well as contemporary thinking about the problem of dualism. Theories of the psychological origins of pain symptoms persisted throughout the history of modern medicine and were not necessarily discouraged by Cartesian mental philosophy. Moreover, the recently developed biopsychosocial model of pain may have more in common with Cartesian dualism than it purports to have. This article presents a rereading of Descartes' mental philosophy and his views on pain. The intention is not to defend his theories, but to re-evaluate them and to ask in what respect contemporary theories represent any significant advance in philosophical terms. (shrink)

Accumulated research findings show that women tend to express higher levels of concern toward technology and the environment than do men, but that the tendency is not universal. The findings are particularly clear-cut for local facilities and/or nuclear and other technologies that are often seen as posing nisks of contamination; findings appear to be more mixed for broader patterns of environmental concern. Although the differing patterns have been reported with enough consistency to be considered relatively robust, less progress has been (...) made to date in explaining the underlying dynamics. Five main hypotheses can be identified. One hypothesis, the expectation that increased knowledge will lead to decreased concern, has received so little support, despite repeated examination, that it can be discarded. Another, that women tend to express greater concern than do men about the health and safety implications of any given level of technological risk, has received consistent support. The remaining 3 hypotheses require additional empincal examination. (shrink)

Are there sex differences in pain? For experimentally delivered somatic stimuli, females have lower thresholds, greater ability to discriminate, higher pain ratings, and less tolerance of noxious stimuli than males. These differences, however, are small, exist only for certain forms of stimulation and are affected by many situational variables such as presence of disease, experimental setting, and even nutritive status. For endogenous pains, women report more multiple pains in more body regions than men. With no obvious underlying rationale, some painful (...) diseases are more prevalent among females, others among males and, for many diseases, symptoms differ between females and males. Sex differences in attitudes exist that affect not only reporting, coping, and responses to treatment, but also measurement and treatment. So many variables are operative, however, that the most striking feature of sex differences in reported pain experience is the apparent overall lack of them. On the other hand, deduction from known biological sex differences suggests that these are powerful sex differences in the operation of pain mechanisms. First, the vaginal canal provides an additional route in women for internal trauma and invasion by pathological agents that puts them at greater risk for developing hyperalgesia in multiple body regions. Second, sex differences in temporal patterns are likely to give rise to sex differences in how pain is and stimuli are interpreted, a situation that could lead to a greater variability and wider range of pains without obvious peripheral pathology among females. Third, sex differences in the actions of sex hormones suggest pain-relevant differences in the operation of many neuroactive agents, opiate and nonopiate systems, nerve growth factor, and the sympathetic system. Thus, while inductive analysis of existing data demonstrate more similarities than differences in pain experience between females and males, deductive analysis suggests important operational sex differences in its production. (shrink)