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171.
Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. 相似文献
172.
Simon O'loughlin 《Journal of constructivist psychology》2013,26(2):143-147
Seven couples referred to a clinical psychologist for marital therapy or psychosexual counseling were asked to complete a variety of repertory grid ratings and a marital satisfaction questionnaire. Links between understanding, similarity, perceived similarity, and marital satisfaction were examined; sex differences were also considered. In this small sample, understanding, similarity, and marital satisfaction were not found to be related. The men did tend to be better than the women at predicting their respective partner's grid. These findings are discussed in relation to previous research on marital satisfaction within the personal construct literature. 相似文献
173.
In five experiments, we investigated the detection of symmetry (i.e., translation plus reflection) or repetition (i.e., translation alone) between two vertical jagged contours. The complexity of the two contours was manipulated, as was their figure-ground assignment; the two contours either belonged to a common object "inside" them, to two separate objects "outside" them, or to two separate objects each to the right of one contour. Replicating Baylis and Driver (1994), symmetry judgements were unaffected by contour complexity when made within a single shape, implying a parallel process operating efficiently across contour discontinuities. However, all the other conditions yielded substantially slower judgements as complexity increased, suggesting either effortful point-by-point comparisons, or a highly inefficient parallel process. In agreement with Baylis and Driver (1995a), symmetry perception was harder when figure-ground assignment turned convexities along one contour into concavities along the other contour; and likewise for repetition detection. However, even when convex parts matched between the two contours, judgements were still affected by complexity unless they belonged to a common object. This supports Baylis and Driver's (1993) proposal that effortless comparisons for the layout of multiple convex parts can only be made within single perceptual objects. 相似文献
174.
This article reports three experiments that investigated the relationship between working memory capacity and syllogistic and five-term series spatial inference. A series of complex and simple verbal and spatial working memory measures were employed. Correlational analyses showed that verbal and spatial working memory span tasks consistently predicted syllogistic and spatial reasoning performance. A confirmatory factor analysis showed that three factors best accounted for the data—a verbal, a spatial, and a general factor. Syllogistic reasoning performance loaded all three factors, whilst spatial reasoning loaded only the general factor. The implications of these findings are discussed in the context of reasoning theories and contemporary accounts of the structure of working memory. 相似文献
175.
Stephen E. Newstead Peter Bradon Simon J. Handley Ian Dennis Jonathan St. B. T. Evans 《Thinking & reasoning》2013,19(1):62-90
The aim of the present research was to develop a difficulty model for logical reasoning problems involving complex ordered arrays used in the Graduate Record Examination. The approach used involved breaking down the problems into their basic cognitive elements such as the complexity of the rules used, the number of mental models required to represent the problem, and question type. Weightings for these different elements were derived from two experimental studies and from the reasoning literature. Based on these weights, difficulty models were developed which were then tested against new data. The models had excellent predictive validity and showed the relative influence of rule based factors and factors relating to the number of underlying models. Different difficulty models were needed for different question types, suggesting that people used a variety of approaches and, at a wider level, that both mental models and mental rules may be used in reasoning. 相似文献
176.
Simon Hope 《Res Publica》2013,19(1):37-52
It is sometimes held that modern institutionally-focussed conceptions of social justice are lacking in one essential respect: they ignore the importance of civic friendship or solidarity. It is also, typically simultaneously, held that Aristotle’s thought provides a fertile ground for elucidating an account of civic friendship. I argue, first, that Aristotle is no help on this score: he has no conception of distinctively civic friendship. I then go on to argue that the Kantian distinction between perfect and imperfect duties is more useful than talk of civic friendship in capturing the non-institutional demands of social justice. 相似文献
177.
Simon Heyland 《欧洲心理治疗、咨询与健康杂志》2013,15(3):345-347
This article seeks to explore how John Rolland's Family Systems Illness Model can be utilized by counselling psychologists working with individuals or families experiencing medical problems. Based on systemic theory the model provides a psychosocial typology of illness and examines how the demands of an illness over time can provide a number of hurdles to be overcome by the client and his/her family. Specific examples and techniques are described to illustrate how the application of the model can be used to guide the interventions employed in a counselling session. the model applies a biopsychosocial approach to health care, and the applicability of this within a British NHS healthcare setting is discussed with the conclusion that such an approach may be in its infancy in this country. Limitations and ideas for expansion of the model from chronic physical illness into spheres of mental health are discussed. 相似文献
178.
Simon Dein 《Mental health, religion & culture》2013,16(3):195-202
Can social causes directly effect physiological processes? In many parts of the world, there are reports that those who have broken a ritual prohibition or hold that they are victims of sorcery give up and die, a phenomenon labelled by anthropologists as voodoo death. The mechanisms for this remain controversial. The features include: lethargy, lack of motivation, extreme guilt, social withdrawal, reduced appetite and thirst, and ultimately death. Although a belief in the power of sorcery is rare among indigenous white British people, it is not uncommon among ethnic minorities and may be diagnosed as a delusion. The author reports two cases from his own clinical experience in a Western setting that raise the question as to whether the phenomenon is similar to depression and what can be done about it. In one case, the victim made a rapid recovery once the curse was removed. Is death really an individual or a social phenomenon? 相似文献
179.
Michael Band Simon Dein Kate Miriam Loewenthal 《Mental health, religion & culture》2013,16(10):1031-1047
The relationship between religion and mental health has been the subject of extensive research, particularly in recent years. The issues of coping and suicidality have also been widely studied. Significantly, however, how religious people cope with harsh life situations is an area which has been overlooked. The present study based on 18 semi-structured interviews, analyses have members of the Religious Zionist community in Israel cope with harsh life situations. Although the study confirms the conclusions of previous research – in general religion creates a buffer to suicide – the results showed a relatively low impact of religiosity on coping: in general these religious interviewees found it difficult to access their religiosity during harsh life situations. The paper suggests a range of explanations, for example the complexity of personal and collective identities which characterise this group, or – more significantly – the possibilty that religious coping is not actually absent but is only available in a second, later stage of coping. 相似文献
180.
Understandings of auditory verbal hallucinations (also referred to as “hearing voices”), and help for people distressed by them, are dominated by a biomedical framework. Yet, many people who have sought help for the distress and/or impairment caused by hearing voices express dissatisfaction with treatment solely within this framework, highlighting the need for a more rounded, biopsychosocial-spiritual approach. This paper examines the neglected role of a fundamental part of human experience, love, in the experience of hearing voices. First, we argue a lack of love is likely to play a causal role in voice-hearing experiences. Second, we demonstrate that a lack of love is central to the distress and dysfunction often caused by hearing voices. Finally, we show that love plays a core role in recovery. Given this centrality of love, we argue that an interdisciplinary approach to hearing voices involving the mind sciences and theology/religion may be fruitful. The relevance of this for psychotherapeutic interventions for people who hear voices is discussed. 相似文献