Physicians' values and physician-value neutrality

For years articles have decried the lack of empathy in physicians' relationships with patients. In addition to being empathetic, physicians are called upon to assume the posture of value neutrality, i.e., not imposing one's values when dealing with patients. Empathy is clearly an expression of deeply held values; even the language used to define it is value-laden. Physicians are consistently called upon to exhibit traits which are expressions of their underlying values. However, if proponents of value-neutrality are to be taken literally one must not impose any of one's values on one's patients. But then one wonders how empathy could ever be expressed; further, it is hard to imagine what a truly value neutral physician would be like. It is time we recognize that any relationship between two persons requires the expression of values from both parties. These values help shape that relationship and define its further history. Physicians are not excluded from this process just because they consider themselves professionals. Divulging personal values to patients is both more honest and more in keeping with the concepts of justice, beneficence, non maleficence, and autonomy than to feign value-neutrality. A presentation of some type statement of values is timely and would give patients an idea of where a physician stands on a myriad of issues. Rather than being value-neutral, value non-neutrality seems a more right and reasonable posture for physicians to assume.     

Dual diagnosis: Clinical issues in the treatment of substance abuse,and affective,personality, and psychotic disorders

Co-morbidity of alcohol and substance with the spectrum of other psychiatric diagnoses is examined with specific emphasis on diagnostic indicators for anxiety and mood disorders. Diagnostic issues for the chemically dependent person are examined with the context of borderline personality disorder, schizophrenia and other psychiatric disorders. Clinical research related to the dually-diagnosed patient is explored     

Characteristics and consequences of help-giving practices in contrasting human services programs

Relationships between human services program models and help-giving practices, and between both program models and help-giving practices and help-seeker control appraisals were examined in a study of 107 low socioeconomic background families. Three kinds of human services agencies were included in the study, each of which differed in terms of their implicit and explicit assumptions about the families they served and the roles professionals and families played as part of helping relationships. Results support the hypotheses that (a) a program philosophy that was family centered would be associated with more empowering help-giving practices compared to more professionally centered philosophies and (b) a family-centered program philosophy and empowering help-giving practices would be related to an enhanced sense of personal control over needed supports and resources from a target help-giver.     

Why a feminist approach to bioethics?

Many have asked how and why feminist theory makes a distinctive contribution to bioethics. In this essay, I outline two ways in which feminist reflection can enrich bioethical studies. First, feminist theory may expose certain themes of androcentric reasoning that can affect, in sometimes crude but often subtle ways, the substantive analysis of topics in bioethics; second, it can unearth the gendered nature of certain basic philosohical concepts that form the working tools of ethical theory.