changing values

There's more to say about changing values. One set of values I've written and spoken about quite a lot in my efforts to corrupt the innocent minds of medical students goes by the name of family values. There's a great deal to say about these, and some of it has important implications for health - which is my reason for haranguing medical students. That's because values influence behaviour, and behaviour may be directly related to health in many subtle and unsubtle ways. When I was a child, divorce was very uncommon and carried a stigma. Coming from a home broken by a nasty divorce, I knew all about the stigma! I felt marked out as different from other kids because of it, and that compounded the sense of guilt I've written about in my memoirs (something I had done was the reason my parents split up; it was, perhaps still is, a common psychological response of young children to the breakup of their parents' marriage; and because of that needless, inappropriate feeling of guilt, the breakup leads to considerable insecurity of the affected child. No wonder I was a mixed up kid! But I digress). Divorce was rare 70-75 years ago when I was a small boy, so single parent mother-led families were rare too. Mine was the only one I knew of. Of course a decade earlier there had been many single parent mother-led families because the fathers had been killed in the mass slaughter of the Great War of 1914-1918. Kids in those families had been the object of sympathy and compassion, but not so in the late 1920s and early 1930s. Children with no father were usually illegitimate and that was a cause for even greater contempt and derision than being the child of divorced parents; but the two were sometimes confused, and maybe some of the vituperative remarks hurled at me by other kids at school arose from that confusion. The situation was made worse by the fact that I was bright, got the highest marks in tests, grounds for jealousy and hostility. But that was then. Now how different things are! Single parenthood by choice is common now, and there is no associated stigma. Unmarried young people live together now too, and that was unheard of the the 1930s. Another rare and shameful event then was abortion. Even a natural miscarriage, which may happen to between 1 in 5 and 1 in 10 early pregnancies, was hushed up and never spoken of in polite society. Termination of pregnancy by choice is commonplace now too, and legal as well. Next in this catalogue of changing values about the family is same-sex partnerships, even same-sex marriages, which are even legal, or at any rate recognized in law for such purposes as pensions and inheritance in many jurisdictions. Homosexuality carried an even greater stigma than divorce in my childhood and early adult life (some of my medical school classmates still had that implacably hostile attitude towards homosexual people, called them queers, fags, other pejorative labels, many of these unprintable, even as recently as our 50th anniversary reunion in 1999. I had a school friend who confessed to me he felt much more attracted to other boys and to one boy in particular (not me) than to girls. He was someone I liked and respected so maybe that was why I had a tolerant, accepting attitude to gays, dating from when I was about 15. Most decent and civilized people in our society now have an accepting tolerant attitude. So there's another value that has changed quite dramatically in my lifetime. Other values have changed too, including some that have major implications for health. The most obvious is the change in attitudes towards tobacco smoking. Offering a cigarette when introduced to strangers was an almost universal custom until about the middle to late 1960s, and it was customary to light cigarettes without asking if anybody minded. And we smoked everywhere, in public transport, in cinemas, restaurants. That's as socially unacceptable now as spitting on the living room carpet. We used to think it was noble and self-sacrificing to drive friends home to distant suburbs at the end of a party, no matter how much we had had to drink before getting behind the steering-wheel of the car. Those social customs are unacceptable now, with lives saved as a result.