Catholic pastoral care as a response to the HIV/AIDS pandemic in Southern Africa

Recent estimates suggest that more than 10% of Southern Africa is HIV+. This article is based on a research study of sixty four pastoral care projects focussing on the HIV/AIDS pandemic in Southern Africa. The projects, which fall under the auspices of the Southern African Catholic Bishops' Conference AIDS office, focus on both education for HIV prevention and the pastoral care of people living with HIV/AIDS (PLWHA). The article recounts the results achieved by these projects over the last two years, discussing their strengths and weaknesses, and proposes some recommendations for further action. The author discusses the pastoral and theological dimensions of these pastoral services indicating the importance of socio-cultural mediation in pastoral responses.     

The so-called duty to warn: The psychotherapeutic duty to protect third parties from patients' violent acts

This article discusses the much-misunderstood Tarasoff decision that requires psychotherapists to protect third parties from patients' violent acts. Through a normative approach, the paper analyzes four important issues: what to do when potential victims are unknown; what to do about the fact that the patients' potential for violence may be incorrectly perceived; the value of warning potential victims; and, the problem of discharging potentially violent patients from the hospital. The author proposes that the courts adopt a more flexible substantial departure test in most cases that involve psychiatric negligence.     

The duty to believe according to the evidence

‘Evidentialism’ is the conventional name (given mainly by its opponents) for the view that there is a moral duty to proportion one’s beliefs to evidence, proof or other epistemic justifications for belief. This essay defends evidentialism against objections based on the alleged involuntariness of belief, on the claim that evidentialism assumes a doubtful epistemology, that epistemically unsupported beliefs can be beneficial, that there are significant classes of exceptions to the evidentialist principle, and other shabby evasions and alibis (as I take them to be) for disregarding the duty to believe according to the evidence. Evidentialism is also supported by arguments based on both self-regarding and other-regarding considerations.     

The normative and conceptual foundations of a clinical duty to protect

The continuing controversy surrounding the Tarasoff inspired duty to protect as developed by the courts and legislatures has not adequately weighed the jurisprudential foundations of such an obligation. The authors argue that the duty's misguided thrust of social control grounded in character and status seriously violates broad principles of political morality underlying the law of social control. They conceptualize an alternative--a clinical duty to protect--that coheres with these underlying values and the limits of professional abilities. They contend that any extra-clinical intervention on the part of the psychotherapist entails a role transformation requiring independent justification.     

The impact of stigma on behavioral health care utilization among active duty service members

This study assessed the relationship between the stigma of seeking psychological help and use of outpatient behavioral health services over a 2-year period among active duty military service members initially referred for neuropsychological evaluation secondary to their histories of mild traumatic brain injury. Although research has examined how stigma predicts proxies for help-seeking (i.e., attitudes towards/intentions to use services), very little research has looked at actual behavior, and studies that do have largely focused on previous use. In this study, we examined the relationship between participants’ stigma and subsequent behavioral health use. Our results indicated that whereas greater self-stigma (i.e., negative self-judgments for seeking psychological help) was associated with attending fewer behavioral health care sessions, public stigma (i.e., perceptions of public attitudes towards people who seek psychological help) was not associated with service use. These findings support the need for addressing the self-stigma associated with seeking behavioral health care.     

Health care and human rights: against the split duty gambit

There are various grounds on which one may wish to distinguish a right to health care from a right to health. In this article, I review some old grounds before introducing some new grounds. But my central task is to argue that separating a right to health care from a right to health has objectionable consequences. I offer two main objections. The domestic objection is that separating the two rights prevents the state from fulfilling its duty to maximise the health it provides each citizen from its fixed health budget. The international objection is that separating a human right to health care fails the moral requirement that, for any given moral human right, the substance to which any two right-holders are entitled be of an equal standard.     

The prediction of violent behavior and the duty to protect third parties

A considerable theoretical, empirical, and clinical literature has accumulated on the prediction of dangerous and violent behavior. Despite the pleas of mental health professionals that the prediction of violent behavior is not clinically feasible, courts upholding a therapist's duty to protect third parties have created a legal duty to do so. The first generation of research studies of the clinical prediction of violent behavior focused on long-term predictions in offender populations, of little direct relevance to the setting of outpatient therapy with nonoffenders. More recent clinical research has centered on predictions of imminent violence in noncriminal populations, particularly in the process of involuntary hospitalization, but this reveals relatively low levels of predictive accuracy. Methodologic and ethical factors also limit the generalizability of such work. Given the likelihood that significant numbers of false positive predictions will result, especially in the low base rate population of outpatient treatment, it is suggested that therapists attempt to minimize the antitherapeutic influence of any breach of confidentiality.     

医生的宗旨是救死扶伤

科学的问题来不得半点虚假科学是在人类文明发展中产生的能够解决已知问题和做出可检验的预测的真善美的代表,是推动生产力发展的动力,同时又不断经受着实践的考验     

The psychotherapist's duty to act reasonably to prevent suicide: A proposal to allow rational suicide

It is proposed that society should re-examine its assumptions about suicide. Rational suicide is viewed as an extension of the right to die. After a review of the legal liability of the psychotherapist and psychiatric facility for both inpatient and outpatient suicide, the author presents an analysis of philosophical, ethical, and psychoanalytic arguments for allowing rational suicide. It is argued that emotional pain should be given more legitimacy as a reason for suicide. The decision to live or to die is argued to best rest with the individual.     

The biopsychosocial-spiritual health of active duty women

ABSTRACT

Women have been an active part of the military since the beginning of American history, holding various roles in the military for centuries. The purpose of this review is to explore the literature pertaining to the biopsychosocial and spiritual health of active duty women. These comparisons help to highlight factors that are most unique to women who are serving in our active duty armed forces. The current review revealed that while active duty women and men report similar levels of resiliency, and women may be no more susceptible to the negative effects of combat than men, there is evidence that active duty women experience higher levels of posttraumatic stress due to physical and sexual trauma in the military aside from combat exposure. Findings suggest that further research is needed to better understand the unique challenges of women in the military in order to create service delivery models that support the BPSS health of women in order to maintain mission readiness and retain women in the military.