This book is the first in a series of planned volumes focused on preserving the character of the development of bioethics in particular cultural contexts. As the first of these volumes, Leo Pessini, Christian de Paul de Barchifontaine, and Fernando Lolas Stepke's work has succeeded well. It has brought together accounts by sch- ars who were crucial to the emergence of bioethics in the Ibero-American cultural domain. This trail-blazing work in the history of bioethics will be of enduring s- nificance. I am deeply in their debt for having shouldered this far from easy task. Bioethics is the product of very particular socio-historical developments. Most prominent among them have been (1) the secularization of the dominant culture of North America, Western Europe, and now Central and South America as well, (2) a deflation of the status and authority of physicians as moral authorities able to guide their own profession, and (3) the salience of a post-traditional animus that gives c- tral place to persons as isolated atomic sources of moral authority. Bioethics initially took shape in North America as a post-Christian, post-professional, post-traditional social movement. This bioethics sought to establish a moral discourse for the public forum, a moral practice able to give practical guidance in hospitals and other insti- tions, and a body of undergirding and justifying theoretical reflections.

This book is the first in a series of planned volumes focused on preserving the character of the development of bioethics in particular cultural contexts. As the first of these volumes, Leo Pessini, Christian de Paul de Barchifontaine, and Fernando Lolas Stepke's work has succeeded well. It has brought together accounts by sch- ars who were crucial to the emergence of bioethics in the Ibero-American cultural domain. This trail-blazing work in the history of bioethics will be of enduring s- nificance. I am deeply in their debt for having shouldered this far from easy task. Bioethics is the product of very particular socio-historical developments. Most prominent among them have been (1) the secularization of the dominant culture of North America, Western Europe, and now Central and South America as well, (2) a deflation of the status and authority of physicians as moral authorities able to guide their own profession, and (3) the salience of a post-traditional animus that gives c- tral place to persons as isolated atomic sources of moral authority. Bioethics initially took shape in North America as a post-Christian, post-professional, post-traditional social movement. This bioethics sought to establish a moral discourse for the public forum, a moral practice able to give practical guidance in hospitals and other insti- tions, and a body of undergirding and justifying theoretical reflections.

Why a new book on stress when so many are already available? There is widespread awareness of the impact of scientific research in this field, both theoretical and practical. Scores of articles and books have been published. What is especially exciting about the range of theories and ideas presented in this book is that they derive from a variety of different intellectual traditions and scientific disciplines. The book is not an attempt to replace more extensive or basic treatments of this subject. Rather, it seeks to present the authors viewpoints together with data and methodological applications based on their personal experience in a straightforward manner. A number of the articles were commissioned some time ago, when Horst Mayer decided to publish the papers presented at a symposium which he organized in Heidelberg under the auspices of the German College of Psychosomatic Medicine. Others emerged from later contacts with authors in different parts of the world. The result is a rather heterogeneous collection of "perspectives" on stress which, it is hoped, will stimulate readers to arrive at their own conclusions through its very diversity. When it was decided that Femando Lolas would join this endeavor at the end of 1984, it became clear that the material had lost none of its appeal.

The psychological states of patients with diabetes mellitus were compared with those of patients suffering from other chronic diseases and people with no diagnosed chronic diseases. These states were assessed by applying content analysis scales to transcripts of their descriptions of their current experiences. Analyses of the diabetics' scale scores re vealed a pattern characterized by much anxiety, depression, anger expressed both direct ly and indirectly, together with feelings of helplessness. The sources of anxiety which proved to be of most importance to them were fears of death and bodily mutilation, as weIl as guilt and shame. They experienced little sense of sharing with most people around them, although they showed considerable enjoyment of dose relationships with family and friends. This pattern of psychological states did not vary with the sex of the patients or whether they were interviewed in a hospital or at horne nor with recency of onset or multiplicity of health problems. It was similar to the pattern of patients with other chronic diseases but differed significantly from that of the healthy group. Acknowledgment The authors wish to acknowledge the contribution ofCarol Preston to the collection and analysis of these data which were made available, inpart, by patients of the Wollongong Hospital and members of the Illawarra Branch of the Diabetic Association of N ew South Wales. References 1. Strong JA, Baird JD (1971) Diseases ofthe endocrine system. In: Davidson S, McLeod J (eds) The principles and practice of medicine."