Dignity,Disability, and Lifespan

In the Paraplegia Case, we must choose either to preserve the life of a paraplegic for 10 years or that of someone in full health for the same duration. Non‐consequentialists reject a benefit‐maximising view, which holds that since the person in full health will have a higher quality of life, we ought to save him straightaway. In the Unequal Lifespan Case, we face a choice between saving one person for 5 years in full health and another for 25 years in full health. Frances Kamm has recently unfurled an Equal Respect Argument in an effort to support the position that while we ought to give each person a 50% chance of being saved in the Paraplegia Case, we are morally permitted to save straightaway the person who would live longer in the Unequal Lifespan case. The article tries to show that a Kant‐inspired account of the dignity of persons is far more successful than Kamm's argument in supporting this position. The Kant‐inspired account owes this success to its conceiving of respect for persons not primarily as respect for their pursuit of what is of value for them, but rather as respect for the value in them.     

Primal Alternatives to Talk Therapy: The Batak “Tondi” of North Sumatra

Although talk therapy has tended to rely on exogenous or outside the person resources, many primal alternatives to talk therapy have emphasized the importance of endogenous or inside the person sources of empowerment. The Toba Batak of North Sumatra provide an internalized means of mediating mental health through a religious-based notion of the tondi, or source of power, inside the person as the source of mental-physical health and illness. The rituals necessary for maintaining health are discussed with the rationale supporting those rituals. Applications of these historical beliefs among contemporary university students are also discussed.     

The impact of perspective in visualizing health‐related behaviors: first‐person perspective increases motivation to adopt health‐related behaviors

Two experiments investigated the effects of perspective and visualization on motivation to engage in health‐related behaviors. Participants visualized themselves donating blood (Experiment 1) or quitting smoking (Experiment 2) from either the first‐person (own) or third‐person (observer's) perspective. Subsequently, motivation to engage in the visualized behavior was assessed. Contrary to previous findings showing the benefits of taking a third‐person perspective on behaviors not related to health, visualizing using the first‐person perspective had greater effects on motivation than visualizing using the third‐person perspective. Indeed, visualizing using the third‐person perspective was no more effective than not visualizing anything (Experiment 2). The theoretical implications and potential applications of these findings are discussed.     

Big Picture,Bad Outcomes: When Visual Perspectives Harm Health Goal Pursuit

People often fail to achieve health goals, which compromises their well‐being. Prior research suggests that seeing events through an observer's eyes (i.e., adopting a third‐person perspective) should facilitate goal pursuit. However, we find that third‐person perspectives discourage goal‐consistent intentions and behavior for health goals when goal centrality is low (i.e., the goal is peripheral to one's self‐concept). In Experiment 1, people who adopted a third‐person perspective chose more sugary foods if they considered a healthy eating goal to be more peripheral to the self. Experiment 2 examines why a third‐person perspective can hinder goal pursuit; it encourages a breakdown in implemental thinking which, in turn, increases negative self‐conscious emotions. While high goal centrality buffers people from negative effects on goal intentions, low centrality does not. Experiment 3 demonstrates that this effect is robust when goal centrality is manipulated. We recommend that consumers pursuing health goals (and individuals who support them) exercise caution when employing perspective‐based strategies, as they may backfire for people at greatest risk of goal abandonment.     

Visualizing actions from a third‐person perspective: effects on health behavior and the moderating role of behavior difficulty

Visualizing behavior from a third‐person (vs. first‐person) perspective can produce stronger motivation to enact the behavior. However, the effects of perspective on health behaviors have been mixed. Hypothesizing that the difficulty of the visualized behavior might moderate the effect of perspective, two experiments manipulated the difficulty of the visualized behaviors (fruit/vegetable consumption; exercise) plus perspective and subsequently measured motivation (Experiments 1 and 2) and behavior (Experiment 2). In both experiments, the third‐person perspective produced stronger motivation to perform the easier, but not the more difficult, behavior. This effect extended to behavior in Experiment 2. Under certain conditions, encouraging people to visualize behavior from a third‐person perspective could represent a useful and cost‐effective means of promoting health behavior change.     

Conditional health threats: health beliefs, decisions, and behaviors among adults.

We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed.     

Influence of character strengths on mental health stigma

We examined traits of open-mindedness, kindness, hope, and social intelligence in the context of mental health stigma. Stigma – a process that objectifies and dehumanizes a person who has mental illness – diminishes people’s ability to control their behavior as coping with stigma requires self-regulation. Exploring mental health stigma through the lens of character strengths allows for understanding individual differences and kinds of characteristics that help decrease the ramifications associated with stigma of mental health. Several tasks explored the effects of character strengths on implicit and explicit mental health stigma: implicit association task, measures of willingness to interact with those with a mental health disorder, and a social distance task of self, friend, and person with a disorder. Character strengths of social intelligence and kindness were indicative of less stigma of mental health. More open-minded individuals tended to not hold individuals diagnosed with a mental health disorder personally responsible for acquiring that disorder.     

Parental blaming and acquisition of guilt: A developmental task of childhood

Incidents involving the authors' twin 10-year-old daughters illustrate that guilt is well established in normal children of 10. The incidents suggest how the expectation of parental blaming triggers guilt and shame. Guilt and shame are compared. While they may coexist in the 10-year-old, guilt clearly is assuming a dominant position. Mental health professionals have emphasized the psychopathology of guilt and many forget that it is essential for normal socialization in that the guilty person feels a need to repair damage allegedly done. Guilt presumes that at least a primitive mutuality has been established in the person; and mutuality is the hallmark of human maturity. Terms are defined here with some variation from their usage by mental health experts: shame, guilt, blame, and counterblame.     

Psychological health and change in closeness in platonic and romantic relationships

The authors investigated (a) whether increased closeness and decreased closeness of a relationship are associated with better and poorer psychological health, respectively; and (b) whether poorer psychological health is related to perceiving oneself or to perceiving the other person as primarily responsible for decreased closeness. A sample of English undergraduate students (52 female, 52 male; 16-23 years of age) completed M. Rosenberg's (1965) Self-Esteem Scale, D. P. Goldberg's (1972) 12-item General Health Questionnaire, and a 6-item scale developed for this study to measure change in closeness and to identify the initiator(s) of the change. Decreased closeness was related to poorer psychological health in male participants' platonic relationships and in female participants' romantic relationships. Poorer psychological health was associated with (a) perceiving the other person as responsible for decreased closeness in male participants' platonic relationships and (b) perceiving both parties as mutually responsible for decreased closeness in female participants' romantic relationships.     

性别选择与法律之回应——法理视野中的变性手术

变性人的出现对社会秩序及法律制度提出了挑战。自然人生而具有的人作为社会主体定在的自由和健康权利,为变性人享有性别选择的权利提供了法理支撑。在权利确认后,很有必要在变性手术的对象、施行者及程序上作出规范的应对,而变性人术后的社会角色及权利保护也应该得到法律的适时回应,以实现法的秩序、公正等价值。     

论生命健康权在医疗活动中的支配转移

现有法学理论认为,生命健康权是一种具有绝对性和支配性的民事权利,通常不得以任何形式让与他人,即不得买卖、转移、赠与或继承。自然人只能对自己的生命健康权实现有限制的支配。医疗实践证明,生命健康权存在支配转移的实际情况,生命健康权的支配转移是对现有法学理论的补充和完善。     

Psychological Health and Change in Closeness in Platonic and Romantic Relationships

Abstract

The authors investigated (a) whether increased closeness and decreased closeness of a relationship are associated with better and poorer psychological health, respectively; and (b) whether poorer psychological health is related to perceiving oneself or to perceiving the other person as primarily responsible for decreased closeness. A sample of English undergraduate students (52 female, 52 male; 16–23 years of age) completed M. Rosenberg's (1965) Self-Esteem Scale, D. P. Goldberg's (1972) 12-item General Health Questionnaire, and a 6-item scale developed for this study to measure change in closeness and to identify the initiator(s) of the change. Decreased closeness was related to poorer psychological health in male participants' platonic relationships and in female participants' romantic relationships. Poorer psychological health was associated with (a) perceiving the other person as responsible for decreased closeness in male participants' platonic relationships and (b) perceiving both parties as mutually responsible for decreased closeness in female participants' romantic relationships.     

A five‐year evaluation of the effectiveness of person‐centred counselling in routine clinical practice in primary care

Counselling is the recommended treatment for individuals with mild to moderate mental health problems of recent onset. In this evaluation of a primary care counselling service offering person‐centred counselling, the Core Outcome Measure (CORE‐OM) was administered at referral and at the beginning and end of therapy. A pre‐post therapy effect size for 697 individuals over a 5 year period was 1.2. This compares with a waitlist (between referral and pre therapy) effect size of 0.24 for 382 individuals over a three year period. The results indicate that person‐centred counselling is effective for clients with common mental health problems, such as anxiety and depression. Effectiveness is not limited to individuals with mild to moderate symptoms of recent onset, but extends to people with moderate to severe symptoms of longer duration.     

The acceptability of prophylactic mastectomy among lay people and health professionals: A pilot study

IntroductionWomen with certain genetic mutations have a risk of up to 85% of developing breast cancer. Bilateral prophylactic mastectomy is the most effective way to reduce risk of cancer.ObjectiveThis pilot study focuses on the acceptability of prophylactic breast surgery and examines, in a series of concrete cases, the cognitive processes by which health professionals and lay people make their judgments. This research also aims to identify the factors involved in these judgments. An additional objective is to determine whether there are groups with different patterns of responses.MethodWe recruited two samples in France, one comprising 90 lay people and the other 30 health professionals (n = 120) and asked them how acceptable it would be for a woman at a high risk of breast cancer to undergo a prophylactic surgery (mastectomy), in each of the 64 scenarios presented to them. The scenarios were all combinations of two levels of age, of marital status, of parenting status, of body appearance investment, of reconstructive surgery and also two levels of the person suggesting oncogenetic diagnosis.ResultsWe found that lay people and health professionals structured the factors in the scenarios in nearly the same way. They assigned importance to three factors: the most important one was reconstructive surgery, and then the age of the woman. The least important factor was the person who requested the genetic test. Furthermore, the age of the participants, and knowing a person who had cancer impacted the degree of acceptability assigned by participants. Being a lay person or a health professional did not have a direct impact on acceptability but influenced the integration of factors. In addition, cluster analysis showed that only a small group was opposed to mastectomy.ConclusionThis pilot study demonstrated that three factors have to be considered when judging the acceptability of prophylactic mastectomy and showed a common cognitive foundation for future discussion, at the levels of both clinical care and health policy, of the conditions under which prophylactic surgery might be acceptable.     

The Buddhist Spiritual Path: A Counselor's Reflection on Meditation,Spirituality, and the Nature of Life

The author describes her spiritual path from the perspective of a person who was raised in a Buddhist tradition and trained in a Western mental health profession. A foundation for the Buddhist concept of mental health is presented, and the relationship among counseling. Western developmental theory, and the development of a spiritual path is discussed. Strategies are presented for assisting clients with their search for spiritual development.     

The 2004 Indian Ocean Tsunami Catastrophe,its Survivors,Job and the Universal Features of Suffering: A Theoretical Study

The purpose of this theoretical article is to discuss the existential and universal feature of suffering—as illustrated by Job’s suffering in the Book of Job in the Bible and by the survivors of the 2004 Asian tsunami catastrophe—and to highlight its significance for health care. Further, the study is aiming at contributing to health professionals’ understanding of patients’ suffering. The sources are narratives, comprising Job’s book, TV interviews 1 year after the tsunami catastrophe and the survivors’ autobiographies. The methodological approach is a philosophical analysis. The existential, universal, ontological and epistemological aspects of suffering are carefully scrutinized to unveil the universal and existential versus culture-specific features of suffering. Based on the results, the authors’ recommendations are (1) a holistic concept of the patient and health care has to seriously consider suffering in all its complexity because when a person is in pain, it is not his/her body but the whole person as a unity of body, psyche and spirit that suffers and (2) suffering should be seen as the most central concept of health care, which should provide treatment for physical pain and all dimensions of suffering: physical, social, mental and spiritual aspects.     

Le consentement du patient aux actes de secours lors d’interventions extrahospitalières

The acquirement of a person's consent to the medical care that is proposed to a patient is an absolute basic principle in rescue health care. This is mandatory for first arrival rescuers ; especially since their actions are, in view of the French Emergency Medical Service call centers, considered as being a medical act. The basic principle of consent to first medical care hence imposes itself as a humanitarian act as well as preventing any potential litigation. Nevertheless there are numerous situations where the management of the consent of the person in need of non-medical assistance will present difficulties. It is the necessary to analyze how the rescue health care system can manage and limit the risks s linked to the different situations when treatment is refused by the person in need of such help ; and this so as to respect the individual's dignity whilst not abandoning the needed health care. A collaboration between rescue personnel and the call center coordinating medical doctor is then mandatory especially when no consent is obtained. This will enable the detection of hypotheses where the individual's lucidity is altered and implement proportionately required and helpful measures. It will also equally enable the transmission of efficient information to the patient, in relation to the matter of patient consent and to ensure that the patient is aware of the consequence of his or her decision and that this decision was fully expressed. It would hence be deemed useful that the referenced work frame and recommendations, pertaining to the emergency rescue of a person, established by the General Management of Public Safety and Crisis Management detail more in detail these difficult and delicate situations so as to ensure that rescue personnel can better anticipate them. To conclude were commend a formalization of procedures that could be implemented in situations where a patient that has full mental capacities refuses the proposed health care, and we give the advantages of such a procedure be discussed.     

Citizen Advocacy Observed: Tool or Tokenism?

Citizen advocacy, where a volunteer works in partnership with a vulnerable person, compliments self- and legal advocacy. In the context of mental health services, citizen advocacy is a tool for enabling and empowering people who use these services, and is founded on the recognition that mental health service users are frequently socially oppressed and disadvantaged. This article describes the development of a Citizen Advocacy service for people with mental health difficulties, and also the problems they brought to this service. The problems encountered in sustaining the service are noted and lessons are drawn for the future.     

Self-regulation,health, and behavior: A perceptual-cognitive approach

Abstract

Self-regulation systems are designed to adapt to threats via coping procedures that make efficient use of resources based upon valid representations of the environment. We discuss two components of the common-sense model of health threats: illness representations (e.g., content and organization) and coping procedures (e.g., classes of procedure and their attributes - outcome expectancies, time-lines, dose-efficacy beliefs, etc.). Characteristics of each of these domains, and the connection between the two, are critical to understanding human adaptation to problems of physical health. Rather than posing a barrier to factors outside the person that control behavior, an emphasis on subjective construal involves a view of the person as an active problem-solver embedded in a bidirectional system of sensitivity and responsiveness vis á vis the social, physical, and institutional environments in which health threats occur and through which intervention efforts may be directed.