Past and Present: Illness Diagnosis

There has always existed a relationship between moral beliefs and medicinal procedures. One example can be seen in denominational hospitals where doctors do not perform controversial procedures, such as abortion, because it is against their religious beliefs. But there has existed a problem within this relationship for decades. Some groups of people feel that creating a diagnosis to define a group of symptoms is acceptable. Because its “symptoms” defy their moral values, calling a behavior or act a disease helps to justify the symptoms. Medical diseases seem like the easiest way to define such negative behaviors because of the negative connotation associated with calling something a “disease.” This occurrence can be seen in both past and contemporary articles.

Tristham Engelhardt Jr. wrote an article titled “The Disease of Masturbation: Values and the Concept of Disease.” Engelhardt is a Professor in the Department of Medicine and Community Medicine, and a member of the Center for Ethics, Medicine, and Public Issues at the Baylor College of Medicine in Houston, Texas. It was originally written in 1974 for the Bulletin of the History of Medicine. In his article he explores a specific behavior that was once thought of an actual disease, but later research suggested that the disease “acted as a schema for organizing various signs and symptoms which we would now gather under different nosological categories.” This behavior of masturbation was looked upon with so much scrutiny that “masturbation in the 18th and especially in the 19th century was widely believed to produce a spectrum of serious signs and symptoms and was held to be a dangerous disease entity.” Furthermore, psychologist Dr. C George Boeree wrote an article in 2003 on sexuality in which he stated the following:

Beginning in the 1930's, a Harvard entomologist name Alfred Kinsey started to systematically collect data on sexual practices. He found, for example, that 90% of the men he interviewed had masturbated, that 85% had engaged in premarital intercourse, and that 60% had engaged in oral sex. This of course shocked a conservative American public, who had (like their Victorian predecessors) been in heavy denial about this sort of thing!

There is countless evidence similar to Boeree’s article that confirms early American mindsets and the general disapproval of expressing human sexuality. Because values play such a large role in the medical field, according to Engelhardt, it was easy to justify the behavior of masturbation by diagnosing it a disease.

On the other hand, a recent article written by the National Abortion Foundation (NAF) in 2010 titled “Post-Abortion Syndrome” addresses the very existence of this abortion syndrome. Summarizing various experiments and research on the presence of this syndrome in women that had abortions, the article concludes that there is no medical evidence to validate the existence of a “post-abortion syndrome.” Where did this diagnosis even originate from? The article explains the term was first coined by an Anti-abortion psychologist that attempted to put a medical diagnosis on the symptoms that women who had abortions felt afterwards in an attempt to prevent women from further receiving abortions. The stress that can come from having an abortion was associated to be similar like the stress felt by soldiers after war, also known as post-traumatic stress syndrome. But research showed that “severe negative reactions after abortions are rare” and can be as stressful as normal life occurrences.

These two articles are taken from two different time periods, but they are similar in several ways. Both discuss how an “immoral” private behavior or act was determined to be some sort of illness or disease at one point in history. Both the acts of masturbation and abortion are currently still controversial issues that are being debated about regularly. In both cases, the claims that masturbation and abortion are illnesses were made before any scientific evidence existed to disprove it, which made it easier for such a diagnosis to become accepted and popular. It is true that both masturbation and abortion may require medical intervention at one point because if done frequently it could be dangerous to the individual; but, this does not mean it is necessary to condemn them as illnesses. Anything done in excess can be detrimental to a person but not everything is deemed an illness or disease. Moreover, both articles entail how when research was finally conducted, the illnesses associated with those behaviors could not be validated. Further evaluation of these “illnesses” suggested peoples’ morals were the major factor for such diagnoses to come about.

Furthermore, beyond the obvious similarities between the two articles, the important issue behind the similarities is that differing moral values create ambiguity and misleading perceptions on medical procedures and/or conditions. According to NAF, “anti-choice counselors tend to direct anger towards the abortion provider by claiming that women are misinformed about the psychological trauma that abortion inflicts.” Also, women are afraid to get this syndrome if they were to receive an abortion even though according to Wikipedia "post-abortion syndrome has not found widespread acceptance outside the pro-life community; the American Psychological Association and the American Psychiatric Association do not recognize PAS as an actual diagnosis or condition, and it is not included in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR or in the ICD-10 list of psychiatric conditions.” Unfortunately, abortion is currently a hot topic in politics; thus, this “syndrome” will continue to be controversial and remain in existence in society.

To end, it is not such a negative thing to incorporate moral values into the medical field. After all, doctors and other health professionals make ethical decisions on a daily basis: whether or not to refer patients to medically controversial treatments or doctors in denominational hospitals choosing not to perform procedures that conflict with their religious beliefs. But when it comes to intruding on and condemning ones’ private behaviors with no scientific evidence proving these behaviors are harmful, there needs to be a limit on health professionals’ personal beliefs and the role they play in the individuals’ private lives. Eventually I think with time that enough research and political lobbying will allow for most people to abandon the use of the term “post-abortion syndrome” just like masturbation is no longer considered a disease by most people. But it is dangerous for disproven medical conditions to come into existence to satisfy those that disagree with the so-called symptoms and behaviors of that condition. This creates ambiguity for patients that are worried they might get such a condition from their “immoral” behavior when, in reality, it is no more harmful than everyday behaviors.

Works Cited
• “Abortion and Mental Health.” Wikipedia. Wikimedia Foundation, 29 Nov 2011. Web. 23 Nov 2011.
• Engelhardt, Tristram. "The Disease of Masturbation: Values and the Concept of Disease." Sickness and Health in America. N. page. Print.
• Pappas, Stephanie. “America & Abortion: Will Controversy Ever Die?” LiveScience. Tech Media Network, 10 Nov 2011. Web. 12 Nov. 2011.
• “Post-abortion Syndrome.” National Abortion Federation. Prochoice.org. 2010. Web. 14 Nov. 2011. http://www.prochoice.org/about_abortion/myths/post_abortion_syndrome.html
• Boeree, C. George. “Sexuality.” Webspace.ship.edu. N.p., 2009. Web. 21 Nov 2011.