Epistemological controversies in the analytic field elucidated by the theological realm

This article proposes to address certain epistemological controversies in psychoanalysis by elucidating them through the religious field. The theological field serves the author as the repressed, which indicates the latent stakes that continue to do work at the heart of these debates. The goal is to show how debates that take place on the epistemological level bring into confrontation different anthropological concepts and discursive traditions that have their roots in religious discourses. The principal hypothesis of the author is that the dissident theories of psychoanalysis can be understood as a return to a pre‐monotheistic theological conception or to an idolatrous practice that aims, primarily, to undo castration. This hypothesis will be used to elucidate the debates with two authors: Adler and Rank. The author shows how these theorists, by leaving analytical ground, connect their theories to pre‐monotheistic conceptions and highlight conceptual tools that are characteristic to them.     

Pacemaker deactivation: withdrawal of support or active ending of life?

In spite of ethical analyses assimilating the palliative deactivation of pacemakers to commonly accepted withdrawings of life-sustaining therapy, many clinicians remain ethically uncomfortable with pacemaker deactivation at the end of life. Various reasons have been posited for this discomfort. Some cardiologists have suggested that reluctance to deactivate pacemakers may stem from a sense that the pacemaker has become part of the patient??s ??self.?? The authors suggest that Daniel Sulmasy is correct to contend that any such identification of the pacemaker is misguided. The authors argue that clinicians uncomfortable with pacemaker deactivation are nevertheless correct to see it as incompatible with the traditional medical ethics of withdrawal of support. Traditional medical ethics is presently taken by many to sanction pacemaker deactivation when such deactivation honors the patient??s right to refuse treatment. The authors suggest that the right to refuse treatment applies to treatments involving ongoing physician agency. This right cannot underwrite patient demands that physicians reverse the effects of treatments previously administered, in which ongoing physician agency is no longer implicated. The permanently indwelling pacemaker is best seen as such a treatment. As such, its deactivation in the pacemaker-dependent patient is best seen not as withdrawal of support but as active ending of life. That being the case, clinicians adhering to the usual ethical analysis of withdrawal of support are correct to be uncomfortable with pacemaker deactivation at the end of life.     

Discerning the spirit(s) in the natural world: Toward a typology of “spirit” in the religion and science conversation

Recent developments in Christian theological thinking on the doctrine of the Holy Spirit (pneumatology) have raised questions about the relationship between “spirit” and science. Cursory review of the religion and science literature, however, yields a wide array of uses and understandings of the concept of spirit. Current attempts to assess the relationship of pneumatology to science require an inventory or basic classification scheme of the various notions of spirit that have been in circulation over the past generation. This essay presents a preliminary typology of such uses in order to enable scholars and researchers to chart courses for future research in this area.     

Death, organ transplantation and medical practice

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to "strong irreversibility" (death beyond the reach of resuscitative efforts to restore life) as a necessary criterion that patients must meet before physicians can declare them to be dead. Sam Shemie, who defends our current practice of NHBD, holds that in fact physicians consider patients to be dead or not according to physician intention to resuscitate or not. We suggest that criteria for a concept are not necessarily truth conditions for assertions involving the concept. Hence, non-heart beating donors may be declared dead without meeting the criterion of strong irreversibility even though strong irreversibility is implied by the concept of death. Our perception that a concept applies in a given case is determined not by the concept itself but by our necessary skill and judgment when using it. In the case of deciding that a patient is dead, such judgment is learned by physicians as they learn the practice of medicine and may vary according to circumstances. Current practice of NHBD can therefore be defended without abandoning death as an empirical concept, as Shemie appears to do. We conclude that the dead donor rule continues to be viable and ought to be retained so as to guarantee what the public most cares about as regards organ donation: that physicians can be trusted to make determinations of eligibility for organ donation in the interests of patients and not for other purposes such as increasing the availability of organs.     

Psychotropic medication from an object relations theory perspective: an analysis of vignettes from group psychotherapy

In this article we explore the content and dynamics of patients' verbalizations within a "living with medications" group. Patients' perceptions of their psychotropic medications are interpreted and classified within the framework of object relations theory. One's perception of the role of medication in one's life can serve as a gateway to one's inner world and the way that he or she perceives authority figures, peers, and oneself. We suggest that working through patients' relationships with their medications can help them to achieve better integration of internal object relations. Discussing patients' views about medications should therefore be seen as an important part of psychotherapy with many individuals. Such a discussion may enhance and improve efficacy of both psychotherapy and pharmacotherapy. It is of particular importance in group therapy, within milieu environments and with individuals reluctant to explicitly discuss interpersonal matters. Vignettes from the group sessions illustrate the way in which discussing medication advances group process.     

Intellectual ability and aggressive behavior in nonclinical-nonforensic males

The purpose of this study was to test the relationship between IQ and physical aggression in a nonclinical-nonforensic male sample in a laboratory setting. Thirty males completed an abbreviated version of the Wechsler Adult Intelligence Scale—Revised. Aggression was measured using a modified version of the Taylor reaction-time (RT) aggression paradigm in which subjects competed on a RT task and both received and delivered shocks to a fictitious opponent in provoking and nonprovoking conditions. Provocation conditions (High and Low) were defined by the intensity of shocks the subjects received. Results demonstrated strong inverse correlations between IQ and aggressive behavior under both High and Low Provocation conditions.     

Spatial versus tree representations of proximity data

In this paper we investigated two of the most common representations of proximities, two-dimensional euclidean planes and additive trees. Our purpose was to develop guidelines for comparing these representations, and to discover properties that could help diagnose which representation is more appropriate for a given set of data. In a simulation study, artificial data generated either by a plane or by a tree were scaled using procedures for fitting either a plane (KYST) or a tree (ADDTREE). As expected, the appropriate model fit the data better than the inappropriate model for all noise levels. Furthermore, the two models were roughly comparable: for all noise levels, KYST accounted for plane data about as well as ADDTREE accounted for tree data. Two properties of the data proved useful in distinguishing between the models: the skewness of the distribution of distances, and the proportion of elongated triangles, which measures departures from the ultrametric inequality, Applications of KYST and ADDTREE to some twenty sets of real data, collected by other investigators, showed that most of these data could be classified clearly as favoring either a tree or a two-dimensional representation.A portable PASCAL program implementing the Sattath and Tversky [1977] ADDTREE algorithm is available from J. Corter, Department of Psychology, Stanford University, Stanford, California 94305.