Permanent Birth Research Articles

The characteristics of risks of major disasters

The quantification of risk requires measures of consequences and of frequency. Serious personal consequences are expressed as a ‘disaster profile’ giving the numbers of early deaths, late deaths, serious incapacity, forced permanent evacuation and serious birth defects. Profiles from the disasters at Bhopal and Chernobyl are quite different. In addition, there is a financial measure of harm that can include the personal measure if a value is assigned to a human life or adverse health effect. Timescales of disasters from earthquakes to long-term pollution are discussed; if they are long enough, the risk can be transferred from one of death or injury to one of evacuation and cost. This applies to most nuclear risks, which are better quantified by cost measures rather than by the unobservable hypothetical number of late cancer deaths. Measured by evacuation or cost, nuclear risks increase more than linearly with the size of the radioactive source term. Factors leading to risks are examined, and that of knowledge and its transmission is emphasized. The causes of only a few disasters, e. g. hurricanes, are wholly stochastic in nature; for others, their frequency can be reduced, possibly at some expense. Statistics is inferior to probabilistic safety analysis as a predictor of risk where knowledge is involved. Several recent disasters are listed, together with some others that have a high probability of occurrence in the near future. Those from long-term large-scale pollution, e. g. climatic change induced by the greenhouse effect, may pose the largest risk.

Depo-Provera and Contraceptive Risk: A Case Study of Values in Conflict

Although the injectable contraceptive Depo-Provera (medroxyprogesterone acetate) is currently being used by 1.25 million women worldwide and is available commercially in over 60 countries approval for marketing in the U.S. has not been granted after 12 years of debate. Possibly the final installment in what has become a controversy will probably take place later this year when a special FDA board of inquiry meets to consider the issue. More is at stake than the licensing of a particular drug. The Depo-Provera case represents a clash of political social and ethical values. The author reviews the drugs risks and benefits to support the conclusion that the FDA should continue to withhold approval of Depo-Provera as a contraceptive and that Congress should continue the current ban on exporting drugs not licensed for use in the U.S. Although Depo-Provera is a contraceptive that works is convenient to use simple to administer and does not have any immediate life-threatening side effects risks include disturbed menstrual patterns weight gain delayed return of fertility after discontinuance or possible permanent infertility birth defects and carcinogenicity. Studies with laboratory animals have related the appearance of carcinomas with high doses of the drug. Perhaps the most accurate conclusion is that Depo-Provera does present a certain degree of risk in some respects higher and in many respects unknown that is not present in other approved contraceptive methods. Other factors considered include the claim that Depo-Provera is intended for poor women or 2d-class citizens; protection against abuse; exporting of the drug to the Third World; and ethical problems. It is concluded that rather than change the current legislation to make Depo-Provera available for export U.S. policy ought to be to encourage and support the kind of broad social change that will ultimately make Depo-Provera unnecessary in the Third World.

Changing Profiles in Vasectomy Subjects in the Past Decade

Two groups of vasectomy patients were reviewed: 376 men operated upon between 1968 and 1971 and 608 between 1974 and 1978. Average age, length of marriage, and number of living children prior to vasectomy were greater in the first group (P less than 0.01). The results are compatible with the idea that couples are planning smaller families and turning increasingly to vasectomy as a reliable permanent birth control method immediately following the completion of their families.

Differential fertility by intelligence: the role of birth planning.

Abstract In a sample of urban white U.S. women, an inverse relationship is demonstrated between fertility and IQ and is shown to come about because low‐IQ women have more unwanted births than high‐IQ women. The excess of unwanted births among low‐IQ women is caused by their elevated failure rate with temporary physician‐administered contraceptive methods. In order to control their fertility according to their own desires as well as do high‐IQ women, low‐IQ women require increased use of permanent birth control methods.

Vasectomy as a Vehicle for Prevention of Family Disorders

Because of changing values on population growth the nature of the family and male-female relationships there is a growing desire among couples for permanent birth control through sterilizaton. Vasectomy is the simplest and safest operation to achieve this end but is often resisted by the male which may indicate significant marital discord caused by a supermasculine identity. Attitudes of such a male include feelings that the wife should have the operation because it is her problem that he is afraid his wife could die leaving him incapable of having other children or that the operation will make him less of a man. These attitudes can be a source of major marital conflict with todays increasingly liberated woman and if the psychiatrist can recognize these attitudes and provide proper therapy not only will the male accept vasectomy but the marriage itself will be significantly improved.