Supreme Emergencies Without the Bad Guys

This paper discusses the application of the supreme emergency doctrine from just-war theory to non-antagonistic threats. Two versions of the doctrine are considered: Michael Walzer’s communitarian version and Brian Orend’s prudential one. I investigate first whether the doctrines are applicable to non-antagonistic threats, and second whether they are defensible. I argue that a version of Walzer’s doctrine seems to be applicable to non-antagonistic threats, but that it is very doubtful whether the doctrine is defensible. I also argue that Orend’s version of the doctrine is applicable to non-antagonistic threats, but that his account is not defensible, regardless of whether the threats are antagonistic or not.

Short-Term Psychiatric Treatment

With the increasing prevalence of short-term psychiatric hospitalization, brought about in part by reduced inpatient insurance coverage, decisions must be made concerning both the nature of treatment and who will provide services. The impracticality of traditional rehabilitative services in these settings has serious implications for the future role of occupational therapists in psychiatric health care. It is proposed that necessary modifications to treatment approaches must and can be made without abandoning fundamental theories of practice. Recommendations are made to upgrade the current level of practice via improved communication of information concerning short-term methodologies, to develop long-range plans to strengthen professionalism, and to make greater use of community-based alternatives for the delivery of services no longer practical in short-term treatment settings.     

Social Comparison and Bystander Intervention in Emergencies

In a 2 × 2 experimental design, male subjects were exposed to a "lady in distress" in the presence of a confederate who was either similar or dissimilar to the subject and who reacted to the situation with either passive unconcern or with apparent alarm. Consistent with a social comparison interpretation, the confederate's reactions markedly influenced whether subjects intervened. While degree of similarity was unrelated to probability of occurrence of an intervention response, it exerted a strong effect on intervention response latency. It is proposed that social comparison processes not only may influence an observer's interpretation of a situation, but may also contribute to situational ambiguity and affect the observer's degree of confidence in the validity of his interpretation of the situation. Any of these factors may, in turn, determine whether and how quickly an intervention response occurs.     

Moral Tragedies, Supreme Emergencies and National-Defence

abstract Assume that some group, A, is under a serious threat from some other group, B. The only way group A can defend itself is by using lethal force against group B, but the standard conditions for using force in self‐defence are not met. Ought group A to avoid the use of force even if this means yielding to an aggressive, evil power? Most people would resist this conclusion, yet given the violation of essential conditions for self‐defence, this resistance is hard to justify. The aim of this paper is to point to an interesting yet unnoticed move made by some philosophers to find a way out of this problem, a move which relies on construing the situation at hand as a tragic dilemma. I show the attractiveness of this solution and argue that in the end it fails.     

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

Community Mental Health in Emergencies and Mass Disasters

Summary

Mass disasters are widespread and intensive, affecting individuals, families, communities, society, and culture. Mental health services must play a crucial role in order to meet non-routine challenges that put basic professional issues to the test both in theory and in practice. In the Tel Aviv Model, responsible planning is based on a broad system of mediators and activities during normal times, supplemented by intervention personnel and techniques set in motion during emergencies. This operation is coordinated with municipal and governmental support systems, which must be aware of the importance of comprehensive and flexible emergency systems for treating the population.     

Psychiatric malpractice in the military

Available data indicates that the incidence of malpractice in military psychiatry, involving both civilian and active duty beneficiaries, is the lowest of all specialties and may be lower than in the civilian sector. Recovery for malpractice damages by means of claim versus suit is restricted to civilian patients; active duty service members recover through a special disability system. The federal government provides military psychiatrists with considerable protection from personal financial loss when involved in malpractice, but there may be limits to that protection. There have been recent efforts to criminally prosecute military physicians in some instances. A registry review of military psychiatry malpractice cases from 1978 to 1987provides a profile of the malpractice situation and suggests areas of practice that need vigilance. The Department of Defense has established a broad-based, comprehensive program of quality assurance and risk management in the interest of maximizing the benefit of medical care and minimizing substandard practice.     

Psychiatric hospitalization after deliberate self-poisoning

The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for: age 25 or older, homelessness, unemployment, previous self-harm, psychiatric inpatient treatment within 12 months, earlier psychiatric inpatient treatment, suicidal ideation or plan, mood or psychotic disorders, and lower clinician experience; and lower risk for being married/defacto, and after hours presentation. Recommendation for psychiatric hospitalization was based on complex decision making. These findings have implications for clinical practice guidelines, service costs, and service organization.     

Psychiatric labeling and social perception

The present study explores the effects of three types of psychiatric labeling on attribution of causality and impression formation. It was found that observers tended to be more person-oriented in their attributions when explaining an accident of a person being labeled formerly mentally ill and formerly psychiatrically hospitalized, as compared to a non-psychiatric control label. However, no such tendency towards person-orientation in causal attribution was found for a problems-of-living label. These effects were found to be independent of variation in amount of neutral context information about the person being labeled. The effect of labeling on impression formation was found to be inconclusive, and reasons for this are discussed. Context information was found to affect impression formation in that the person was evaluated more positively. No sex differences in attribution of causality and impression formation was found.     

突发公共卫生事件中志愿者行动的伦理支持

在突发公共卫生事件下,志愿者行动有着天然的伦理支持。从伦理的外在维度来说,政策支持、组织力量和伦理精神为志愿者提供了强有力的行动保障。从内在维度来说,疫情环境下的志愿者行动是其自身的伦理使然。伦理观是行动论的先导,志愿者自身的道义伦理观、效果伦理观和美德伦理观是志愿者行动的道德保障和精神表达。疫情时代志愿队伍的发展需要伦理价值观的引导,才能为突发公共卫生事件中的志愿者行为指引方向,进而为社会秩序的维护提供道德支持。