Limiting the role of the family in discontinuation of life sustaining treatment

In matters of discontinuation of life-sustaining treatment, traditional role of the family to speak on behalf of the incompetent patient is questionable. We explore the reasons why physicians perceive patient autonomy to be transferrable to family members. Principle of patient autonomy may not suffice when futile treatment is demanded and may serve to erode the ethical integrity of medical profession. An enhanced role for bioethics committees is proposed when physicians propose to discontinue life-sustaining treatment against the wishes of the patient or their families.     

Qualitative Study of Suicidality and Help-Seeking Behaviors in African American Adolescents

This qualitative study explores adolescents’ perceptions of help-seeking behaviors in the context of a hypothetical suicide crisis. Cauce and colleague’s (2002, Journal of Consulting and Clinical Psychology, 70, 44–55) model was used to examine help-seeking behaviors in 3 domains: problem recognition, decision to seek help, and selection of helpers. Forty-two church-going African American adolescents participated in 1 of 6 focus groups that discussed ways to help a hypothetically suicidal student in a vignette. Findings suggest that although the majority of youth had been exposed to a suicidal peer (76%), they were unsure of the seriousness of suicide as a problem in the African American community. The findings suggest that youth were less comfortable with formal interventions in school, religious institutions or traditional mental health settings. However, youth were open to community-based programs that could be located in school, church or community settings if helpers were: young adults, empathic listeners, non-judgmental, maintained confidentiality, and viewed as “natural helpers”. Implications for developing church-based suicide interventions are discussed. This study was supported by a K-01 Career Development Award from NIMH     

The Self and the Other: Liberalism and Gandhi

This paper makes an attempt to philosophically re-construct what I have termed as a fundamental paradox at the heart of deontological liberalism. It is argued that liberalism attempts to create the possibilities of rational consensus and of bringing people together socially and politically by developing methodologies which overcome the divisive nature of essentially parochial substantive conceptions of the good. Such methodologies relying on the supposed universally valid dictates of reason and notions of procedural rationality proceed by disengaging men from the divisive particularities of their plural value contexts. That disengagement is sought to be achieved by conceptualizing the individual as self sufficient in her moral and epistemic being thereby conceptually isolating individual man from the other. The liberal effort to create rational consensus which can bring people together then gets off the ground by isolating the individual from the other. This I have termed as the paradox of the self and the other or alternatively the paradox of social atomism and universalism. As a possible philosophical alternative this paper makes an attempt to re-construct Gandhi’s conceptualization of the relationship between swaraj as self rule and Satyagraha as non-violent resistance. This Gandhian connection, it is argued, has the potential to transform the moral psychology of our response to the other, thereby posing a challenge to the modern, predominantly liberal, conceptualization of such a response.     

Comparison of Engagement with Ethics Between an Engineering and a Business Program

Increasing university students’ engagement with ethics is becoming a prominent call to action for higher education institutions, particularly professional schools like business and engineering. This paper provides an examination of student attitudes regarding ethics and their perceptions of ethics coverage in the curriculum at one institution. A particular focus is the comparison between results in the business college, which has incorporated ethics in the curriculum and has been involved in ethics education for a longer period, with the engineering college, which is in the nascent stages of developing ethics education in its courses. Results show that student attitudes and perceptions are related to the curriculum. In addition, results indicate that it might be useful for engineering faculty to use business faculty as resources in the development of their ethics curricula.     

Does parochial cooperation exist in childhood and adolescence? A meta-analysis

Although previous meta-analytic evidence supports the existence of parochialism in cooperation among adults, the extent to which children and adolescents are more willing to incur a personal cost to benefit ingroups, compared to outgroups, is not yet clear. We provide the first meta-analysis on the existence and magnitude of parochialism in cooperation among pre-adults. Based on 20 experimental economics studies (k = 69, N = 5268, age = 3–19, 12 countries, published 2008–2019), a multilevel meta-analytic model revealed a small overall effect size indicating that children and adolescents were more cooperative towards ingroups (d = 0.22, 95% CI [0.07, 0.38]). A series of single-moderator analyses tested for the following conditions: participant age and sex; game type ([mini-]dictator game, prisoner's dilemma, public goods dilemma, trust game, ultimatum game); outcome interdependence; membership manipulation (between- vs. within-subjects); group type (natural vs. experimental); reward type (monetary vs. non-monetary); and country of the participant. Parochial cooperation did not vary with participants' age. Parochialism was larger in non-interdependent (dictator-type) compared to interdependent (bargaining and social dilemma) games. There were no moderating effects of group type, membership manipulation or reward type. To provide more data on how parochialism develops, primary studies should report age ranges more precisely and use more restricted age groups.     

Suicide and African American teenagers: risk factors and coping mechanisms

In this study we investigated whether locus of control, hopelessness, and depression were primary risk factors for suicide ideation and attempts in African American youth, and whether congruency between locus of control and religious coping style reduced suicide risk. The sample consisted of 176 African American high school students (115 females; 61 males). Multiple and logistic regression were used to determine relationships among study variables. Depression was found to mediate the relationship between hopelessness and suicidal behaviors. External locus of control led to greater risk for hopelessness and depression, with a trend in the predicted direction for suicide attempts. Religious coping style alone was not always associated with reduction of risk of suicidal behaviors, yet some evidence suggests that congruency between locus of control and religious coping style reduces risk. Results provide additional support for suicide interventions to target depressive symptoms. Results also highlight the importance of examining the role of culturally salient variables such as fatalism and religious coping style when developing intervention programs for suicide.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

Freedom and the Dynamics of the Self and the ‘Other’; Re-constructing the Debate Between Tagore and Gandhi

Tagore and Gandhi shared a relationship across 26 years. They argued about many things including the means for the attainment of swaraj/freedom. In terms of this central concern with the nature of freedom they came fairly close to an issue that has perhaps dominated the (European) Enlightenment. For the Enlightenment has sought to clarify what is meant by individual freedom and attempted to secure such freedom to the individual. This article argues that the Tagore-Gandhi debate can perhaps be reconstructed around the issue of freedom and the collective. Gandhi was able to employ the idea of collective action with conceptual and practical ease. He seemed to have felt no tension between individual freedom and the notion of the collective of which an individual becomes a part in his/her attempt to deal with the contending ‘other’ and secure his /her freedom/swaraj. To understand Tagore’s opposition to the Gandhian idea of swaraj this article draws a philosophical parallel between Tagore and Kant on individual freedom as primarily the freedom to reason. Tagore’s argument seemed to have centered on the insight that the location of the individual in a collective hypostatized self in order to protect his or her freedom from ‘others’ reaffirms the self other divide. The insider-outsider exclusionary dynamics that are generated not only consolidate such distinctions as external to (and outside of) the collective self, but they also initiate internal dynamics that create the ‘silenced insider.’     

Provision of spiritual and pastoral care facilities in a high-security hospital and their increased use by those of Muslim compared to Christian faith

The relationship between religion and psychiatry remains controversial amongst British psychiatrists. We looked at the provision of spiritual and pastoral care facilities in a high-security hospital and the role of faith chaplains with particular reference to the Muslim minority group. There was a significantly higher uptake of pastoral care services amongst those of Muslim faith compared to Church of England and Roman Catholic Christians. Possible reasons for this are discussed. Resources allocated for the Muslim faith group were limited and heavily dependent on the availability of the Muslim faith chaplain. Our study highlighted the need for clearly defined standards for the provision of spiritual and pastoral care within high-secure psychiatric hospitals, and by implication other NHS psychiatric settings, a re-examination of the role of the faith chaplain in relation to the clinical team, and raised questions about the equitable allocation of resources between various faith groups within the hospital.