Confidentiality in the military

This article presents and analyzes options military physicians face regarding whether or not to respect gay servicepersons' confidentiality. This situation is considered to be generic to others that involve similar conflicts. Dilemmas arising before and after the emergence of HIV-related diseases are discussed. Recommendations regarding psychiatrists' ethical obligations when conducting forensic exams are compared with military physicians' obligations to respect servicepersons' confidentiality. It is suggested that military psychiatrists should violate servicepersons' confidentiality under some circumstances, but generally should warn them in advance that they will do so. Possible exceptions exist when warning servicepersons would increase the likelihood that justice would be violated or substantial harm would occur.     

Bilingual enhancements have no socioeconomic boundaries

To understand how socioeconomic status (SES) and bilingualism simultaneously operate on cognitive and sensory function, we examined executive control, language skills, and neural processing of sound in adolescents who differed in language experience (i.e. English monolingual or Spanish‐English bilingual) and level of maternal education (a proxy for SES). We hypothesized that experience communicating in two languages provides an enriched linguistic environment that can bolster neural precision in subcortical auditory processing which, in turn, enhances cognitive and linguistic function, regardless of the adolescent's socioeconomic standing. Consistent with this, we report that adolescent bilinguals of both low and high SES demonstrate more stable neural responses, stronger phonemic decoding skills, and heightened executive control, relative to their monolingual peers. These results support the argument that bilingualism can bolster cognitive and neural function in low‐SES children and suggest that strengthened neural response consistency provides a biological mechanism through which these enhancements occur.     

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.     

Exploitation in biomedical research

This essay analyzesexploitation in biomedical research in terms ofthree basic elements: harm, disrespect, orinjustice. There are also degrees ofexploitation, ranging from highly exploitationto minimally exploitation. Althoughexploitation is prima facie wrongful,some exploitative research studies are morallyjustified, all things considered. The reasonan exploitative study can still be ethical isthat other moral considerations, such as theautonomy of the research subject or the socialbenefits of research, may sometimes justifystudies that are minimally exploitative. Calling a research project exploitative doesnot end the debate about the merits of thestudy but invites one to ask additionalquestions about how the study is exploitative,and whether the study is justifiablenevertheless.     

Rethinking the military paradigm

The article begins with an overview of the historic moment of ‘the end of the Cold War’, and of the paradoxically deepening moral, social, and environmental problems posed by the military system. It demonstrates that historical and contemporary analyses of defence and war have dogmatically presupposed the military paradigm, and have therefore failed to recognize the self‐reproducing structure of covert premisses and inferences upon which it rests. In laying bare this underlying system of unreason, the analysis demonstrates that the military paradigm's ultimately self‐contradictory concepts of ‘security’ and ‘defence’ repose on unstated interests of social and political rule. Proposing new distinctions between pathological and life‐enabling forms of war, and between guilty and innocent combatants, the argument develops alternative, non‐military principles of war to guide rational and moral agency     

Thinking theologically about reproductive and genetic enhancements: the challenge.

Current philosophical and legal bioethical reflections on reprogenetics provides little more than a rationalization of the interests of science. There are two reasons for this. First, bioethicists attempt to address ethical issues in a "language of precision" that characterizes science, and this works against analogical and narratological modes of discourse that have traditionally provided guidance for understanding human nature and purpose. Second, the current ethical and legal debate is framed by a public/private distinction that banishes robust norms to the private realm, and leaves a minimalist public discourse of harm avoidance that is insuffucient for regulating the science. In this essay, I argue that Mark Hanson's account of anxiety provides a valuable starting point for addressing deficiencies in the current philosophical and legal debate, and it highlights the need for a theological discourse on genetic enhancements. Through an assessment of Joel Shuman's criticism of the public/private distinction, I show how the needed theological discourse should be situated in the context of robust communities, and how such a communitarian inter-ethic is compatible with a variant of liberalism. Finally, I critically assess James Keenan's account of virtue and perfection, in order to outline what a sufficient discourse on reproductive and genetic enhancements requires.     

老年人的调脂治疗

血脂异常是老年人心脑血管病的主要危险因素之一.循证医学充分证实,积极合理的调脂治疗能够显著降低老年人心脑血管病发生率和病死率.而老年人常并存肝肾功能减退等慢性疾病,在已使用多种药物基础上再服调脂药物,易于发生药物相互作用和不良反应.本文重点介绍老年人调脂治疗的必要性、合理性和安全性.     

Some new problems in biomedical regulation

The purpose of this paper is to present rather than resolve some new ethical problems which are likely to become the subject of public discussion in the near future. Some problems likely to be the subjects of extensive debate are: the foetal patient, 'home abortifacients' and abortifacient vaccines, the withdrawal of life-sustaining treatment, experimentation on 'spare' human embryos, the legalization of heroin abuse and the use of anencephalics and the persistently comatose as organ donors.     

Performance-enhancing technologies and moral responsibility in the military

New scientific advances have created previously unheard of possibilities for enhancing combatants' performance. Future war fighters may be smarter, stronger, and braver than ever before. If these technologies are safe, is there any reason to reject their use? In this article, I argue that the use of enhancements is constrained by the importance of maintaining the moral responsibility of military personnel. This is crucial for two reasons: the military's ethical commitments require military personnel to be morally responsible agents, and moral responsibility is necessary for integrity and the moral emotions of guilt and remorse, both of which are important for moral growth and psychological well-being. Enhancements that undermined combatants' moral responsibility would therefore undermine the military's moral standing and would harm combatants' well-being. A genuine commitment to maintaining the military's ethical standards and the well-being of combatants therefore requires a careful analysis of performance-enhancing technologies before they are implemented.     

Counteracting effect of threat on reward enhancements during working memory

Cognitive performance has been shown to be enhanced when performance-based rewards are at stake. On the other hand, task-irrelevant threat processing has been shown to have detrimental effects during several cognitive tasks. Crucially, the impact of reward and threat on cognition has been studied largely independently of one another. Hence, our understanding of how reward and threat simultaneously contribute to performance is incomplete. To fill in this gap, the present study investigated how reward and threat interact with one another during a cognitive task. We found that threat of shock counteracted the beneficial effect of reward during a working memory task. Furthermore, individual differences in self-reported reward-sensitivity and anxiety were linked to the extent to which reward and threat interacted during behaviour. Together, the current findings contribute to a limited but growing literature unravelling how positive and negative information processing jointly influence cognition.     

Regulating Compensatory Paternalism

Res Publica - Some recent arguments for paternalist government interventions have been based in empirical results in psychology and behavioral economics that would seem to show that adult human...     

Financializing epistemic norms in contemporary biomedical innovation

Synthese - The rapid, recent emergence of new medical knowledge models has engendered a dizzying number of new medical initiatives, programs and approaches. Fields such as evidence-based medicine...     

Urinary testing for drugs of abuse in the military

The military has tested urine for drugs of abuse since 1971.Testing followed the evidence of heroin use in Vietnam. The program was limited, by technical constraints, to a few drugs and in 1974by a decision that precluded the use of information gained by urinalysis in disciplinary actions. In 1980, testing expanded enormously due in part to the availability of immunoassays for cannabis metabolites. The period of 1981-1983was marked by deficiencies in military laboratories; faulty testing, inadequate personnel, and the inability to document challenged results. As many as 50,000 discharges were subject to review and revision. The 1983Einsel Commission, a toxicology panel, submitted recommendations that reformed the testing systems. This experience affects current nonmilitary testing programs. Many give the program credit for decreasing drug use and improving performance. The empirical proof of this is not obvious and the cost effectiveness of the program can still be criticized.     

Intergenerational occupational inheritance in the military: a reexamination

Recent problems the military services have experienced in retaining sufficient personnel to meet growing manpower requirements are unlikely to diminish in the 1980s. As a consequence, it is vital that military decision makers understand the factors that influence career commitments of service members. Based on a stratified probability sample of Air Force married enlisted personnel and officers, this study reexamines the relationship between the military service patterns of fathers and the career intentions of their sons who enlist in military service. It also expands upon past analysis to include the actual career decisions of military men as a dependent variable. In partial support of past research, the present investigation provides no support for an intergenerational linkage between military service patterns of fathers and the career intentions and decisions of their sons--either enlisted members or officers. Implications for future research are discussed.