Cheiron's origins: personal recollections and a photograph

When the Cheiron Society convened at the University of New Hampshire for its thirty-fifth annual meeting in June 2003, members were returning to the site where the proposal to establish a new scholarly organization to promote research in the history of the behavioral and social sciences originated in the summer of 1968. I was witness to Cheiron's birthing and have been closely involved in its evolution over the years, and so was asked to comment on the circumstances that produced what has become a vibrant source of stimulation and support for those of us interested in the field. (For other published accounts of the Institute and Cheiron's founding see Brozek, Watson, & Ross, 1969, 1970; Goodman, 1979, 1982; Watson, 1972, 1975; and Weyant, 1968.)     

The origins and evolution of bioethics: some personal reflections

Bioethics was officially baptized in 1972, but its birth took place a decade or so before that date. Since its birth, what is known today as bioethics has undergone a complex conceptual metamorphosis. This essay loosely divides that metamorphosis into three stages: an educational, an ethical, and a global stage. In the educational era, bioethics focused on a perceived "dehumanization" of medicine by the rising power of science and technology. Remedies were sought by introducing humanities, ethics, and human "values" into the medical curriculum. Ethics was one among the humanistic disciplines, but not the dominant one. In the second era, ethics assumed a dominant role as ever more complex dilemmas emerged from the rapid pace of biological research. As such dilemmas were applied to medical practice, the need for a more rigorous and more formal analysis of their moral status was clear. Philosophically-trained ethicists had an obvious role. They began to teach, write, and profoundly influence medical education and practice. In the third -- and present -- period, the breadth of problems has become so broad that ethicists must, themselves, draw on disciplines well beyond their expertise -- e.g., law, religion, anthropology, economics, political science, psychology, and the like. The era of bioethics as a global enterprise is upon us. The original hope for humanizing medicine has not been overtly successful; however, much has been accomplished of value to patients, the profession, and society. Medical morality has been transformed into a formal, systematic study of a whole range of issues of the greatest significance to humanity. Now the major challenge is one of identity, or inter-relationships and connections between the theoretical and the practical. Bioethics has outgrown its beginnings.     

Dementia. A personal legacy beyond words

This is the revised text of a lecture presented at the Joint Meeting of the Faculty of Old Age Psychiatry and the Special Interest Group in Spirituality and Psychiatry on 14 December 2005. The paper explores the interface of clinical, ethical, and spiritual dimensions in the promotion of communication in dementia. Themes are derived from personal anecdotal experience, principles of logotherapy, and ethical frameworks. It is argued that individuals with dementia remain at the centre of meaningful interaction through the period of illness and that it is incumbent upon formal carers to be aware of the lasting needs of the whole individual, and not to dismiss a spiritual approach. Finally, the paper introduces suggestions for the development of an integrated framework. Strategies and tools are being developed jointly by clinicians and spiritual advisors, and are aimed at preserving the dignity of the person with dementia, their right to be accepted at different stages of decline, in recognition of a meaning to their life and experience even beyond the point where normal language skills are irreparably lost.

In view of the possibility of finding meaning in suffering, life's meaning is an unconditional one, at least potentially. That unconditional meaning, however, is paralleled by the unconditional value of each and every person. It is that which warrants the indelible quality of the dignity of man. (Frankl, 2004 Frankl, V. 2004. Man's search for meaning, 5th, London: Random House.  [Google Scholar], p. 151, first published as Ein Psycholog erlebt das Konzentrationslager in 1946)     

Some reflections on the problem of advance directives, personhood, and personal identity

In this paper, I consider objections to advance directives based on the claim that there is a discontinuity of interests, and of personal identity, between the time a person executes an advance directive and the time when the patient has become severely demented. Focusing narrowly on refusals of life-sustaining treatment for severely demented patients, I argue that acceptance of the psychological view of personal identity does not entail that treatment refusals should be overriden. Although severely demented patients are morally considerable beings, and must be kept comfortable whilst alive, they no longer have an interest in receiving life-sustaining treatment.     

Stereotypes and retrieval-provoked illusory source recollections

When expectations and stereotypes are activated at retrieval, they spontaneously create distorted and illusory recollections that are consistent with these expectations. Participants studied doctor (physician)-related and lawyer-related statements that were presented by 2 different people. When informed, on a subsequent source memory test, (i.e., of who presented what) that one of the study sources was actually a doctor and the other source was a lawyer, there was a strong tendency to attribute the test items in a stereotype-consistent manner. In 3 experiments, participants frequently reported recollecting specific details, such as via "remember" judgments, to justify their stereotype-consistent but incorrect responses. These experiments rule out explanations involving either the misattribution of strong familiarity or differences in the bias to making remember responses as accounts for the illusory source attributions. Instead, the illusory recollections are consistent with the notion that recollective experience is manufactured from both the information in the memory trace and information in the retrieval environment, such as an individual's expectations, stereotypes, and general knowledge.     

Psychotherapy in France: the legacy and the future

This paper looks at the present situation of psychotherapy in France. In studying the historical background to the introduction of psychoanalysis in France since the 1920s, an assumption is made about the similar changes in paradigms brought about by the emergence of a new field, whether this be psychoanalysis or psychotherapy.     

Autobiographical memory in middle childhood: recollections of the recent and distant past

To address the question of whether memories from early childhood survive into later childhood, participants visited the laboratory at age 3 and again at 7, 8, or 9. At age 3, each talked with a parent about six events; at the later age each child talked with a researcher about four of these distant events as well as two more recent events. School-aged children recalled fewer than half of the distant events introduced. Further, the proportion of distant events recalled was negatively correlated with age. Those distant events that were recalled, however, were recounted in an accurate, detailed manner. Importantly, reports of distant events did not reflect the full extent of children's narrative ability. Reports of recent events were more coherent and included twice the detail. Implications for existing interpretations of autobiographical memory and childhood amnesia are discussed, and the need for further research employing innovative methods is emphasised.