WHY BIOETHICS NEEDS THE PHILOSOPHY OF MEDICINE: SOME IMPLICATIONS OF REFLECTION ON CONCEPTS OF HEALTH AND DISEASE

Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the “science” of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of medical history, I shall show that it does capture an essential part of modern medical ideology. However, it is also a self-contradictory notion. By making explicit the value desiderata of medical nosologies, a reconfiguration of the relation between medicine, bioethics, and the philosophy of medicine is initiated. This, in turn, will involve a recovery of the caring dimensions of medicine, and thus a more humane practice.     

行为与脑的关系及其与机体其它属性间的相互作用的研究──心理学研究展望

“二十一世纪的心理学”的论题是当今许多科学家感兴趣的．这种预测是一种想象与现实相结合的尝试。审视过去和现在．心理学未来的雏形的基础可能是行为与脑的关系及其与生命其它属性之间的相互作用。     

Ethnic differences in psychiatric disorders among adolescent substance abusers in treatment

The present study describes the diagnostic profile of over 800 adolescents admitted to residential therapeutic community programs for treatment of drug abuse and related problems. The relationship between race/ethnicity and psychiatric disturbance is examined, and the association among these factors to outcome is investigated. Over 90% of the sample had a DSM-III-R nonsubstance diagnosis. There were significant differences among the race/ethnic groups on attention deficit-hyperactivity and the disruptive behavior and affective disorders. In general, African-American adolescents yielded the lowest rates of disturbance across all categories of disorders. There was no relationship among race/ethnicity, psychiatric disturbance, and 1-year posttreatment outcomes.     

Judged Person Dangerousness as Weighted Averaging 1

This article reports two experiments requiring subjective evaluative judgments of the potential dangerousness of hypothetical persons. The research operationally fits the paradigm for the study of personality impression formation, and seeks to illuminate the processes by which two offenses combine to evoke a net judgment of dangerousness. The theoretical framework and philosophy adopted is Anderson's information integration and functional measurement theory. In Study 1, all paired combinations of 10 distinctive crimes were each presented as having been committed by the same person on two separate occasions. Subjects judged overall offender dangerousness. In Study 2, judgments of dangerousness were made when the time purportedly elapsing between two crimes was systematically varied over several ranges of up to 41 years. Three key findings emerged. First, judgments of dangerousness result from an averaging process. This result yields paradoxical implications having considerable pragmatic significance. Second, judgments of dangerousness following two sequential criminal acts (one of high and one of low seriousness) are consistently higher when the high seriousness one is the second crime. Third, with certain qualifications discussed in the text, a serious earlier crime appears to elicit an approximately constant magnitude of judged present dangerousness no matter how long ago it was perpetrated. This result implies that subjects infer considerable permanence of criminal predilection to those who have committed a serious crime in the past.     

A PRELIMINARY COMPARISON OF REINFORCER ASSESSMENT METHODS FOR CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

We evaluated the relative treatment utility of a verbal forced-choice questionnaire, child nomination, and direct observation for identifying the most potent reinforcers for children with attention deficit hyperactivity disorder. Results demonstrated that all three methods were more likely to disagree than to agree, that a forced-choice format may enhance verbal reinforcer assessment, and that further development and evaluation of verbal reinforcer-assessment methods are needed.     

Are All Hostility Scales Alike? Factor Structure and Covariation Among Measures of Hostility1

Few studies have examined the correlational and structural relationships between measures of hostility that may predict coronary heart disease. Using data from a population-based study (N= 2,682), we examined the factor structure among the five subscales from Siegel's (1986) Multi-dimensional Anger Inventory, the three subscales from Spielberger et al.'s (1985) anger expression scales, a Cook-Medley (Cook & Madley, 1954) hostility subscale that measures cynicism, and items measuring hostility from four scales that assess Type A behavior. Eight separate factors were identified: hostile anger expression, perceived control over the expression of one's anger, frequency of anger, ease of anger provocation, brooding, hostile outlook, cynicism, and sullenness. These results suggest that the structure of hostility measures is more complex than previous factor analyses have suggested. Our findings point to the dangers in assuming that a factor structure can be generalized beyond the data on which it is based to provide theoretical statements about psychological structure. The new scales appear to be valid because they correlate with demographic variables and indicators of social support in the expected directions.     

Comparing Students From Substance Abusing and Dysfunctional Families: Implications for Counseling

This research compared family role dysfunction, college adjustment, chemical dependence, and family functioning among a sample of 245 college students from three groups: homes in which significant alcohol or other chemical abuse or dependence dysfunction existed; dysfunctional homes in which substance abuse was not a significant problem; and nonabusing, nondysfunctional homes. The results suggest that chemical abuse or dependence in families is associated with slowed adult role assimilation and increased risk for alcohol and other drug abuse among children.     

Parallel short forms of the family of origin scale: Evidence of their reliability and validity

Two parallel short forms of the Family of Origin Scale were developed from data provided by 69 women and 63 men who completed the full Family of Origin Scale along with a variety of measures of family-of-origin characteristics. Data on the reliability and validity of the short forms are provided and discussed. The results indicate that both short forms are strongly and significantly correlated with each other and with the full-scale version of the FOS and that they share its reliability and validity characteristics to a very high degree.