Research as therapy, therapy as research: Ethical dilemmas in new-paradigm research

Ethical dilemmas are raised by changes in research paradigms which encourage the development of a relationship between researcher and participant. In such contexts it becomes increasingly difficult to tell the difference between a therapeutic relationship and a research interview. The rapid development of research within the therapeutic world of counselling and clinical psychology poses further ethical issues relating to the use of clients as participants in research studies. It is concluded that there must be an increased awareness of these issues and a need to accept responsibility for relationships with both participants and clients.     

Ethics, public policy, and human fetal tissue transplantation research.

This article focuses on the deliberations of the National Institutes of Health Human Fetal Tissue Transplantation Research Panel in 1988. It explores various arguments for and against the use of fetal tissue for transplantation research, following elective abortion, and for and against the use of federal funds for such research. After examining the relevance of various positions on the moral status of the fetus and the morality of abortion, the article critically examines charges that such research, especially with federal funds, would involve complicity in the moral evil of abortion, would legitimate abortion practices, and would provide incentives for abortions. Finally, it considers whether the donation model is appropriate for the transfer of human fetal tissue and whether the woman who chooses to have an abortion is the apppropriate donor of the tissue.     

Integrative approaches to couple therapy: implications for clinical practice and research

Although meta-analyses affirm that various treatments for couple distress produce statistically and clinically significant outcomes, research findings also indicate that a large percentage of couples fail to benefit or subsequently deteriorate following current therapies. Based on these findings, we advocate potential advantages of integrative approaches to couple therapy. We distinguish among assimilative, transtheoretical, and pluralistic approaches to integration and describe exemplars of each. Integrative approaches to couple therapy are compared to distillatory or common factors approaches emphasizing common elements of treatment components, therapist characteristics, and client or relationship attributes. We argue that clinical practice of integrative approaches to couple therapy requires conceptual and clinical decision-making skills transcending those of any one theoretical modality and emphasizing the selection, sequencing, and pacing of diverse interventions in a coherent manner. We conclude with implications of integrative couple-based treatments for future research.     

Ethical dilemas for nurses and their emotional implications

Some of the ethical and emotional problems that are presented to nurses are described. Nurses dealing with them are often the same age as medical students who are just starting their training and on qualifying as doctors will be less experienced in dealing with various life-and-death dilemmas than the nurses looking after their patients. It is contended that despite the fact that almost everyone at some time in their lives is going to depend upon a nurse, the subject of nursing and its dilemmas has been largely neglected, particularly by psychoanalytic/psychotherapy training organisations. Training is described which it is hoped would remedy some of the deficiencies of current nurse-training and encourage personal development and growth. It is also suggested that the training of medical students should include a period of nurse experience and training. The power which can be invested in the nurse is also described, along with the corrupting effect this can have on the nurse/patient relationship.     

Transplantation of fetal brain tissue

Fetal brain tissue transplanted to the brain of an adult mammalian host is known to develop within this environment. The grafted tissue also forms connections with the host brain and can produce recovery from behavioral deficits associated with destruction of parts of the host brain. The ability of grafts of fetal brain tissue to both develop in and form electrophysiologically viable connections with brains previously exposed to neurotoxins is discussed in this review. Restoration of neurotoxin-induced behavioral dysfunction by fetal brain grafts is also discussed. Finally, several uses for neural transplantation in neurotoxicological research are suggested. These uses include restoration of behavioral function, identification of the particular structures responsible for observed behavioral deficits, from among several structures damaged by an environmental neurotoxin, and identification of mechanisms underlying neurotoxicity.     

Ethical implications in screening for ethics violations

The process of admittance to membership in a psychological organization is an opportune time to take into consideration any questionable behavior in the professional background of a prospective member. Membership application forms of the American Psychological Association (APA) and 58 affiliated organizations are reviewed to determine the kinds of questions that are asked about ethical misconduct. The nature of the inquiry differs considerably from one association to another, with a preponderance of organizations avoiding any direct questions about professional ethics. Discussion is focused on how these different screening strategies impact on the applicant and the organization. There is a demonstrated need for appropriately formulated queries. A case is made for resolving current inconsistencies among associations by adhering to a unified procedure in the ethical screening of psychologist applicants.     

Ethical issues and approaches in stem cell research: from international insights to a proposal

In recent years and months, human stem cell research has dominated many scientists' interests, the media, public debate, and social policy. This paper aims to consider, first, the major scientific data on stem cell research that are available. Second, I reflect on them by examining how they shaped policies in Europe and the United States. I also point to current changes in policy-making concerning the creation of ad hoc committees to address this novel issue and how, in a few instances, different ethical positions are part of the documents produced. In other words, diverse approaches are not solved but kept in tension. Finally, I suggest that the current state of research on human stem cell will benefit from an ethics of risk.