Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

Elegiac Poetry: A Pastoral Resource with Complicated Grief

This essay argues that elegiac poetry, the poetry of mourning, may be a resource for pastoral care with complicated grief. It builds on Freuds distinction between mourning (normal grief) and melancholia (complicated grief), particularly as appropriated by French literary critic and psychoanalyst Julia Kristeva. It makes the case for elegy as a locus for externalizing a lost object which, in complicated grief, has been internalized as part of the bereaved persons self and which is not only grieved but also treated ambivalently if it is not hated. Drawing on the suffering God motif in Christian theologies of the cross, theological reflections supplement psychological arguments.     

From <Emphasis Type="Italic">Pintele Yid to Racenjude</Emphasis>: Chaim Zhitlovsky and racial conceptions of Jewishness

The Russian Jewish intellectual, Chaim Zhitlovsky (1865–1943), a leading architect of secular Jewish culture and thought, was a central figure in the progressive Jewish intelligentsia of the late nineteenth and early twentieth century. In an essay written in 1927, Yidn un Yiddishkayt (Jews and Jewishness), he sought to define the secular essence of what he calls Yiddishkayt. This essay is not the first in Zhitlovskys long publicistic career in which he searches for new, secular definitions of Jewish identity and culture. But this essay differs, since it is marked by Zhitlovskys use of contemporary social scientific notions of race and racial traits to conceptualize what he believes constitutes Jewishness in a non-religious context, along with his adoption of the mystical Jewish concept of the pintele yid, the theory of an innate Jewishness embodied by a Jewish spark. Zhitlovskys desire to craft a truly secular theory of Jewish identity led him ironically to accept models of Jewish identity at odds with his stated larger vision. In turning to contemporary racial theory, as well as long nurtured mystical models of Yiddishkayt, Zhitlovsky reveals the wide range of ideological discourses that led him to innovative and controversial notions of modern Jewish identity.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Australian lawyers' views on competency issues in older adults

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions.     

Perceptions of Ethical Behaviour among Business Faculty in Canada

Faculty members at Canadian business schools were surveyed regarding their ethical perceptions of behaviours related to undergraduate instruction. Fifty-five behavioural statements were listed and respondents were asked to rate the extent to which they felt each behaviour was ethical or unethical. The only item that respondents endorsed as unequivocally unethical (90% indicated it was definitely unethical) was Becoming sexually involved with an undergraduate in one of your classes. We also compared the results of our sample to those of an American sample. Overall, an interesting pattern of differences emerged between the responses obtained in Canada and the U.S. In general, the direction of the significant differences was such that Canadian professors viewed the behaviours in question as less ethical than did their American counterparts.     

Visual perspective taking for avatars in a Simon task

In modern digital applications, users often interact with virtual representations of themselves or others, called avatars. We examined how these avatars and their perspectives influence stimulus–response compatibility in a Simon task. Participants responded to light/dark blue stimuli with left/right key presses in the presence of a task-irrelevant avatar. Changes in stimulus–response compatibility were used to quantify changes in the mental representation of the task and perspective taking toward this avatar. Experiments 1 and 2 showed that perspective taking for an avatar occurred in orthogonal stimulus–response mappings, causing a compatibility effect from the avatar’s point of view. In the following two experiments we introduced a larger variety of angular disparities between the participant and avatar. In Experiment 3, the Simon effect with lateralized stimulus positions remained largely unaffected by the avatar, pointing toward an absence of perspective taking. In Experiment 4, after avatar hand movements were added in order to strengthen the participants’ sense of agency over the avatar, a spatial compatibility effect from the avatar’s perspective was observed again, and hints of the selective use of perspective taking on a trial-by-trial basis were found. Overall, the results indicate that users can incorporate the perspective of an avatar into their mental representation of a situation, even when this perspective is unnecessary to complete a task, but that certain contextual requirements have to be met.     

Aesthetic Truth and Pastoral Theology: A Proposal for a New Method of Reflection and Practice

Pastoral theology needs to clarify its identity as an autonomous theological discipline by developing its own knowledge base, body of research, and practice methods. It needs to broaden its scope to include not only a concern for personal issues, but also larger sociocultural and anthropological ones as well. Additionally, there is a pressing need for moving beyond the confines of traditional methods of correlation. This essay offers a new method for pastoral theological reflection and practice that is grounded in Hans-Georg Gadamer's understanding of aesthetic truth and hermeneutics. It offers a new way of conceptualizing the relationship of pastoral theology to such conversation partners as the Bible and theological tradition, the social sciences, and practical wisdom, demonstrating how these can contribute to the pastoral theological task.