In 1943, a distinguished child psychiatrist at Johns Hopkins University, Leo Kanner, published what would become a landmark article: a description of 11 children who suffered from a distinct disorder he called ‘infantile autism’. While initially quite obscure, in the early 1950s Kanner’s report garnered much attention, as clinicians and researchers interpreted these case studies as exemplifying the ill-effects of maternal deprivation, a new theory that rapidly gained currency in the United States. Sensory deprivation experiments, performed in the mid-1950s, further (...) complicated the picture, as experts debated whether maternal deprivation was unique or simply a form of environmental stimulation. As experts strove to make sense of this new disorder, they relied on concepts of maternal and sensory deprivation, both to promote their own theories and to critique or refute those of their colleagues. This interplay between the two theories also informed new forms of intervention, including ‘rage reduction therapy’, which served as a precursor for controversial forms of therapy today termed as the ‘attachment therapies’. This article sheds light on a little-known aspect of the history of autism, and examines the far-reaching effect popular etiological theories have in shaping debates over emerging medical concerns. (shrink)

This article examines the current state of end-of-life care in internal medicine wards in Israel, through an analysis of medical practice and the existing legal framework. The authors demonstrate the processes that lead chronically ill, elderly patients to perceive death as an unexpected phenomenon that is to be avoided at all costs. This perception stems, among other things, from the lack of public debate on questions relating to the end of life and the dominant cultural expectation that physicians provide curative (...) interventions. This results in a dearth of palliative care for the elderly along with a growing number of medical interventions that are of questionable value. The authors propose an alternative approach that highlights individual well-being and that demonstrates the potential areas of intervention by which death can be transformed into an expected and acceptable occurrence for the old and infirm. This approach allows patients to avoid unnecessary interventions and to reduce the burden of responsibility on family members and physicians, who are currently being called on to make end-of-life choices under exigent circumstances. We present these dilemmas by focusing on typical cases of incompetent elderly patients when there is no clear documentation of their wishes regarding treatment, and when their families do not have a coherent perception of what they may have wanted or of the care that would be most appropriate for them. We conclude with a call to action that highlights the need for greater awareness—through public discourse and private discussions—of end-of-life medical choices before the onset of ill-health and incompetence. (shrink)

In the 1950s, the term ‘deprivation’ entered American psychiatric discourse. This article examines how the concept of deprivation permeated the field of mental retardation, and became an accepted theory of etiology. It focuses on sensory deprivation and cultural deprivation, and analyzes the interventions developed, based on these theories. It argues that the controversial theory of cultural deprivation derived its scientific legitimization from the theory of sensory deprivation, and was a highly politicized concept that took part in the nature—nurture debate.