Beyond medical ethics: New directions for philosophy and medicine

A unique relationship exists between physicians and philosophers — one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the social cultural and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary.     

Oh death,where is thy sting? Reflections on dealing with dying patients

This paper examines the reactions of physicians and other health-professionals when they become involved in decisions about the death of their patients. The way people understand the condition of death has a profound influence on attitudes towards death and dying issues. Four traditional views of death are explored. The problem that physicians have in helping patients die (be it by hastening death through pain control, assisting patients in suicide or by more active means) is analyzed. Physicians, in dealing with such patients, must be mindful of their own, and their patients beliefs as well as mindful of the community in which such dying takes place. They must try to reconcile these often divergent views but can neither paternalistically deny patients their rational will, hide themselves behind an appeal to the law or go against their own deeply held moral views. When such views cannot be reconciled, compassionate transfer to a more compatible physician may be necessary.     

Ethical dilemmas in pharmacy practice

The purpose of this study was to document the responses of pharmacy students and pharmacists to various ethical dilemmas. The responses of the first professional year students, third professional year students and pharmacists were evaluated and compared. In most instances, responses indicated a high priority for patient/client welfare. Pharmacists and students reportedly act with regard to the dignity of life, individual freedom, and an inner sense of right.     

Failure of acute and chronic administration of Δ9-tetrahydrocannabinol to affect the repeated acquisition of serial position responses in pigeons

Pigeons were trained to acquire a new four-response position sequence each day by pecking three response keys in a predetermined order. The key color varied after each correct response prior to food delivery. Acute administration of Γ⁹-tetrahydrocannabinol (Δ⁹-THC) up to a dose that completely eliminated responding, had no effect on total acquisition errors, or on within session patterns of error elimination. Chronic administration of Δ⁹-THC (3–10 mg/kg/day), either before or after the session for 4–7 weeks, also did not affect these error measures, although rates of responding were markedly suppressed and at times no responding occurred Discontinuation of Δ⁹-THC administration for periods of 4–6 weeks also was without effect on errors. These experiments suggest that neither acute nor chronic Δ⁹-THC produce specific effects on the repeated acquisition of serial position responses in pigeons.     

A rapid and sensitive method for measuring the conditional emotional response II: On-the-baseline excitatory conditioning and extinction

The present study outlines a rapid and sensitive on-the-baseline conditional emotional response (CER) procedure. Using rats as the experimental subject, the method detects delay conditioning, incubation, extinction and spontaneous recovery. In addition, the method detects conditional responding using electric shock ranging from 0.23 to 0.50 mA as the unconditional stimulus. Because of its speed and sensitivity, the method shelters the subject from unnecessary long-term deprivation and pain.     

Differences in school behavior and achievement between children from intact, reconstituted, and single-parent families.

Differences in school behavior and achievement between students from intact, reconstituted, and single-parent families were analyzed. Students from intact two-parent families had fewer absences and tardies, higher grade point averages, and fewer negative and more positive teacher behavioral ratings than did those from reconstituted and single-parent families.     

Sources of stress and coping responses of high school students.

A series of focus group interviews was used to identify major sources of stress and coping responses of Grade 10 students. Relationships with parents and family, work, and lack of money were found to be important sources of stress. Major coping responses included substance use and diversionary activities. Differences between academic streams (tracks) in sources of stress and coping responses were examined.     

Malevolent object representations in borderline personality disorder and major depression.

To study malevolent representations, earliest memories were reliably coded on scales of affect tone. Ss were diagnosed with borderline personality disorder: 31 without and 30 with concurrent major depression. Nonborderline comparison subjects had either major depressive disorder (n = 26) or no psychiatric diagnosis (n = 30). Borderline subjects were discriminated from comparison subjects by their more malevolent representations; they more frequently produced memories involving deliberate injury; and they portrayed potential helpers as less helpful. Results suggest the diagnostic significance of malevolent representations, which need to be explained by any theory of borderline personality disorder.     

Forms of memory failure in schizophrenia.

Effortful and automatic memory task performances were examined in 36 schizophrenic patients and 18 normal control Ss. Tasks included free recall, recognition, and frequency estimation. Patients demonstrated impairment in recall, in recognition, in semantic encoding, and in frequency estimation. Deficits were observed across tasks despite differences in attentional demands. The results suggest a basic compromise of memory function, which is consistent with recent neuroimaging evidence of structural or physiological abnormalities in frontal and temporal lobe structures in schizophrenia.     

Illness, Family Theory, and Family Therapy: I.Conceptual Issues

This article examines and clarifies controversies about the concept of illness in the field of family therapy. We contend that illness, as traditionally understood in all cultures, is a relational, transactional concept that is highly congruent with core principles of present-day family theories. Family therapists need not buy into a biotechnical, reductionistic reframing of illness as disease. Rather, it is more appropriate to conceptualize and work with illness as a narrative placed in a biopsychosocial context. Such a narrative includes how shared responsibility for coping and for finding solutions can take place, without becoming involved in disputes about causal models.