Race, Kidney Transplants, Immunosuppression Research, and White Supremacy under Apartheid, 1960-80.

This paper uses the history of kidney transplantation in South Africa as a lens through which to write a racialized, micro history that illustrates the politics of medical discoveries and medical research at one of South Africa's most prestigious medical research universities, the University of the Witwatersrand (Wits) in Johannesburg. Between 1966 and the 1980s, the Wits team became the most advanced and prolific kidney transplant unit in the country. Yet the racist, oppressive Apartheid system fundamentally shaped these developments. Transplantation, as this paper shows, became an elite medical procedure, performed by a select group of white doctors on mostly white patients. For these doctors, transplantation showed their medical prowess and displayed the technical advancements they were able to make in research and clinical practice as they strove to position South Africa as a significant international player in medical research, despite academic boycotts and increasing sanctions. Transplantation became a symbol of white supremacy in a country where the black majority were excluded from anything but the most basic health care.

Travestismo y transexualidad en las revistas argentinas de medicina, 1971-1982 / Transvestism and transsexuality in Argentine medical journals, 1971-1982

Resumen El presente artículo aborda los discursos producidos por el campo médico argentino en torno a las iniciativas de corporización de travestis y transexuales en Argentina entre 1971 y 1982. A través del relevamiento y análisis de una selección de artículos publicados en revistas académicas de medicina, se analizan los sentidos que profesionales de la salud asignaron a las mismas antes de la producción de fallos judiciales y normativas nacionales que reconocen la identidad de género como un derecho humano. El análisis realizado permite identificar las particularidades que asumían dichas iniciativas de corporización en el período de estudio, así como las formas en las que el campo médico argentino les imprimió sentidos morales, técnicos y profesionales.

Abstract This article deals with the discourses produced by the Argentine medical field relating to body transformation initiatives on the part of transvestites and transsexuals in Argentina from 1971-1982. Based on the compilation and analysis of a set of articles published in academic medical journals, it examines the meanings that health professionals assigned to these initiatives prior to the legal rulings and national legislation that recognized gender identity as a human right. This analysis helps identify the particular features of those body transformation initiatives during the period studied, as well as the ways in which the medical field in Argentina attached moral, technical and professional meanings to them.

La ética y la medicina social: la perspectiva de Michel Foucault / Ethics and social medicine: Michel Foucault's perspective

Resumen La preocupación de Michel Foucault por la medicina, su historia y su impacto en la sociedad, es una constante en su obra. El objetivo de este trabajo es contrastar el contenido de las conferencias que Foucault impartió en Río de Janeiro, en octubre de 1974, con los materiales preparatorios de las mismas que forman parte de los fondos adquiridos por la Biblioteca Nacional de Francia. Una de las cuestiones clave en dichas conferencias es la relación entre la ética y la medicina social contemporánea. Esa cuestión, analizada desde el punto de vista de Foucault, constituye el trasfondo e interés último del presente trabajo.

Abstract Michel Foucault's preoccupation with medicine, its history and its impact on society, is a constant in his work. The goal of this study is to contrast the content of the lectures Foucault gave in Rio de Janeiro, in October 1974, with the preparatory notes for them which are part of the archival holdings acquired by the National Library of France. One of the key questions in those lectures is the relationship between ethics and contemporary social medicine. This question, analyzed from Foucault's point of view, constitutes the background and ultimate interest of this article.

Ética do cuidado e política: contribuições do legado de Maria de Lourdes Pintasilgo / Ethics of care and politics: contributions from the legacy of Maria de Lourdes Pintasilgo

RESUMO A proposta deste texto tem a função de trazer contribuições da ética do cuidado para práticas da Atenção Básica em Saúde a partir do legado de Maria de Lourdes Pintasilgo (1930- 2004), Primeira Ministra de Portugal, de julho de 1979 a janeiro de 1980. Por meio do registro narrativo, trazem-se aspectos da trajetória de vida dessa política por meio do testemunho de uma importante parceira de luta, acrescido de aportes teórico-documentais, os quais fazem parte do acervo da Fundação Cuidar o Futuro, a qual buscava a melhoria sustentada da qualidade de vida e defesa de direitos básicos. A parlamentar teve expressiva participação política em Fóruns Europeus e das Organizações das Nações Unidas propondo ações que combatessem a desigualdade social e a opressão das mulheres. Inspirada na ética feminista, compreendia o cuidado como a pedra de toque de suas ações. Valorizava as experiências singulares das pessoas e comunidades como principal parâmetro de fortalecimento da participação social e efetividade dos direitos humanos. Por fim, expressava uma forma de fazer política em que o compromisso ético e o respeito consigo mesma, com o outro e com o meio ambiente balizavam seu modo de estar no mundo.

ABSTRACT The purpose of this text is to bring contributions from the ethics of care to the practices of Primary Health Care based on the legacy of Maria de Lourdes Pintasilgo (1930-2004), Prime Minister of Portugal, from July 1979 to January 1980. Through the use of narrative record, aspects of the life trajectory of the politician are brought through the testimony of an important partner in fights, as well as theoretical and documentary contributions, which are part of the Caring for the Future Foundation's collection, which sought sustained improvement of quality of life and the defense of basic rights. The parliamentarian had significant political participation in European and the United Nations Organizations Forums proposing actions that would combat social inequality and the oppression of women. Inspired by feminist ethics, she understood care as the cornerstone of her actions. She valued the unique experiences of people and communities as the main parameter for strengthening social participation and the effectiveness of human rights. Finally, she expressed a way of doing politics in which ethical commitment and respect for oneself, others, and the environment marked her way of being in the world.

The Study on the Lives and Health Conditions of Internees in Santo Thomas Camp of Philippines - Based on McAnlis's The War in Manila (1941-1945).

When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929). However, it was an unsanitary environment in a dense space, so it could not prevent endemic diseases such as dysentery and dengue fever. With the expansion of the war in Japan, prisoners in the Shanghai and Philippine prisons were not provided with medicines, cures and food for healing diseases. In May 1944, the Japanese military ordered the prisoners to reduce their ration. The war starting in September 1944, internees received 1000 kcal of food per day, and since January 1945, they received less than 800 kcal of food. This was the lowest level of food rationing in Japan's civilian prison camps. They suffered beriberi from malnutrition, and other endemic diseases. An averaged 24 kg was lost by adult men due to food shortages, and 10 percent of the 390 deaths were directly attributable to starvation. The doctors demanded food increases. The Japanese Military forced the prisoner to worship the emperor and doctors not to record malnourishment as the cause of death. During the period, the prisoners suffered from psychosomatic symptoms such as headache, diarrhea, acute inflammation, excessive smoking, and alcoholism also occurred. Thus, the San Thomas camp had many difficulties in terms of nutrition, hygiene and medical care. The Japanese military had unethical and careless medical practices in the absence of medicines. Dr. McAnlis and missionary doctors handled a lot of patients focusing mainly on examination, emergency treatment and provided the medical services needed by Philippines and foreigners as well as prisoners. Through out the war in the Great East Asia, the prisoners of Santo Thomas camp died of disease and starvation due to inhumane Japanese Policy. Appropriate dietary prescriptions and nutritional supplements are areas of medical care that treat patients' malnutrition and disease. It is also necessary to continue research because it is a responsibility related to the professionalism and ethics of medical professionals to urge them to observe the Geneva Convention.

Honour and subsistence: invention, credit and surgery in the nineteenth century.

The origins of contemporary exclusion of surgical methods from patenting lie in the complexities of managing credit claims in operative surgery, recognized in the nineteenth century. While surgical methods were not deemed patentable, surgeons were nevertheless embedded within patent culture. In an atmosphere of heightened awareness about the importance of 'inventors', how surgeons should be recognized and rewarded for their inventions was an important question. I examine an episode during the 1840s which seemed to concretize the inapplicability of patents to surgical practice, before looking at alternatives to patenting, used by surgeons to gain social and financial credit for inventions.

Joseph Constantine Carpue and the Bicentennial of the Birth of Modern Plastic Surgery.

September 2014 marked the bicentennial of the birth of modern plastic surgery. It was then that Carpue began a prospective observational study of nasal reconstruction that culminated in his 1816 monograph, which caused an explosion of interest in reconstructive surgery throughout Europe. In conducting his study, Carpue demonstrated ethical standards and the power of planning a procedure. His methods to document his results accurately would remain unsurpassed until photography was adopted at the end of the 19th century. Carpue took an apocryphal story of surgery performed in India more than twenty years earlier and transformed it into the beginning of modern plastic surgery. He succeeded in a number of unrecognized tasks that are themselves landmarks not only in plastic surgical history, but surgical history: devising the first prospective observational study, using exclusion criteria, maintaining appropriate patient confidentiality, setting a standard for preoperative disclosure and ethical approval over a century before these measures were codified, having independent documentation of his preoperative and postoperative findings, devising a method to objectively monitor and document the forehead flap, and describing the potential value of tissue expansion. He shared his experience by publishing his results and by lecturing in Europe. His contemporaries recognized him for his contributions and he was honored by election to the Royal Society. Carpue launched the modern era of plastic surgery in an ethical, logical, and objective manner. While plastic surgery has changed in the last two centuries, the principles that Carpue followed remain valid.

From skid row to Main Street: the Bowery series and the transformation of prostate cancer, 1951-1966.

Between 1951 and 1966, more than twelve hundred homeless, alcoholic men from New York's skid row were subjected to invasive medical procedures, including open perineal biopsy of the prostate gland. If positive for cancer, men typically underwent prostatectomy, surgical castration, and estrogen treatments. The Bowery series was meant to answer important questions about prostate cancer's diagnosis, natural history, prevention, and treatment. While the Bowery series had little ultimate impact on practice, in part due to ethical problems, its means and goals were prescient. In the ensuing decades, technological tinkering catalyzed the transformation of prostate cancer attitudes and interventions in directions that the Bowery series' promoters had anticipated. These largely forgotten set of practices are a window into how we have come to believe that the screen and radical treatment paradigm in prostate cancer is efficacious and the underlying logic of the twentieth-century American quest to control cancer and our fears of cancer.

Aspectos bioéticos en el tratamiento de la retinopatía diabética / Bioethical aspects of the treatment of diabetic retinopathy

La medicina es una práctica tan antigua como la humanidad, que se ha ido modificando y enriqueciendo con la revolución científico-técnica, pero siempre sigue los mismo principios y normas éticas que establecen una relación médico- paciente basada en el respeto, la confianza y el precepto hipocrático de no hacer daño. En el quehacer del ejercicio de la medicina, la mayoría de los procedimientos diagnósticos, terapéuticos y profilácticos involucran riesgos, esto se aplica especialmente a la investigación biomédica y a todos aquellos novedosos medios diagnósticos y tratamientos que pueden ocasionar cierto perjuicio al aplicarlo. La retinopatía diabética constituye una de las principales causas de ceguera en pacientes en edad laboral. La búsqueda de alternativas de tratamiento para esta enfermedad debe evaluar siempre los riesgos y beneficios.

Medicine is such an old practice as the mankind. It has been modified and enriched with the scientific and technical revolution advances, but it always follows the same principles and ethical standards that set the physician-patient relationship based on respect, confidence and the Hippocratic precept of doing no harm. In the medical practice, most of the diagnostic, therapeutic and prophylactic procedures involve risks. This is especially true for the biomedical research and mainly for all those novel diagnostic and therapeutic methods which can cause some damage when applied. Diabetic retinopathy is one of the main causes of blindness in working-age patients. Searching alternative treatments for this illness should always evaluate the risks and the advantages.

History and evolution of surgical ethics: John Gregory to the twenty-first century.

As surgery grew to become a respected medical profession in the eighteenth century, medical ethics emerged as a response to the growing need to protect patients and maintain the public's trust in physicians. The early influences of John Gregory and Thomas Percival were instrumental in the formulation of patient-centered medical ethics. In the late nineteenth century, the modern surgical advances of anesthesia and antisepsis created the need for a discipline of ethics specific to surgery in order to confront new and evolving ethical issues. One of the founding initiatives of the American College of Surgeons in 1913 was to eliminate unethical practices such as fee-splitting and itinerant surgery. As surgery continued to advance in the era of solid organ transplantation and minimally invasive surgery in the latter half of the twentieth century, surgical innovation and conflict of interest have emerged as important ethical issues moving forward into the twenty-first century. Surgical ethics has evolved into a distinct branch of medical ethics, and the core of surgical ethics is the surgeon-patient relationship and the surgeon's responsibility to advance and protect the well-being of the patient.