The wizard behind the curtain: programmers as providers

It is almost universally accepted that traditional provider-patient relationships should be governed, at least in part, by the ethical principles set forth by Beauchamp and Childress (Beauchamp and Childress, Principles of biomedical ethics, 1979). These principles include autonomy, beneficence, non-maleficence and justice (Beauchamp and Childress, Principles of biomedical ethics, 1979). Recently, however, the nature of medial practice has changed. The pervasive presence of computer technology in medicine raises interesting ethical questions. In this paper we argue that some software designers should be considered health care providers and thus be subject the ethical principles incumbent upon “traditional” providers. We argue that these ethical responsibilities should be applied explicitly rather than as a passive, implicit, set of guidelines.     

The impact of resilience on role stressors and burnout in elementary and secondary teachers

The role of a teacher is becoming increasingly complex, and it is more important than ever that teachers develop resilience to overcome stress and burnout. A conceptual framework to explain the ability of resilience to decrease role stress and burnout was developed and tested. Participants included 415 teachers (174 elementary, 241 secondary) who taught in three adjacent school districts in the Midwest of the United States. Data were collected through a cross-sectional survey that included measures of resilience, role stressors, and burnout. Structural equation modeling was used to test the conceptual framework, and invariance analysis examined the equivalence of relationships across elementary and secondary teacher groups. Results generally supported the conceptual framework, and commonly experienced pathways were found to be invariant across groups. This study emphasizes the importance of resilience in helping to reduce perceived teacher stress and feelings of burnout.     

The range of autonomy: Informed consent in medicine

Theoretical Medicine and Bioethics - On the basis of the characterization of autonomy set out by Beauchamp and Childress in Principles of Biomedical Ethics, we first explore some of the parameters...     

Coping with Social Stress: Implications for Psychopathology in Young Adolescent Girls

This study investigated the impact of social stress on symptoms of psychopathology at the entry into adolescence (111 girls, Mage = 11.84, SD = 0.77). We examined whether peer stress and pubertal timing were associated with internalizing distress and aggression, and whether responses to stress and cortisol reactivity mediated or moderated these associations. Cortisol samples were collected from saliva samples during in-home visits, and the YSR was used to assess psychopathology. Interestingly, pubertal timing demonstrated a trend association with cortisol. Responses to stress mediated the association between social stress and symptoms of internalizing distress and aggression. Specifically, early maturers and girls with higher levels of peer stress exhibited more problematic responses to stress, in turn demonstrating higher levels of internalizing distress and aggression. Significant moderation effects also emerged. For example, early maturers who experienced higher levels of emotional/cognitive numbing in response to peer stress were at greater risk for aggression. Findings identify coping strategies that may be used in evidence-based programming to help girls transition more successfully into adolescence will be discussed.

When Danny said no! Refusal of treatment by a patient of questionable competence

The patient we call Danny was a mildly mentally retarded male in his mid-thirties who adamantly refused kidney dialysis when it was offered as the only therapeutic option for his progressive kidney failure. It was uncertain how fully Danny understood the implications of his refusal. To complicate the case still further, several “advocates” emerged to speak on Danny's behalf — each with a somewhat different interpretation of the situation and different sets of value presuppositions and ethical principles to apply to the choice. We chronicle the development of this situation through a series of scenes; and in each scene we also attempt to clarify the ethical and medico-legal issues involved at that point. Danny was finally permitted to make this decision for himself — though more by default than by an agreement by all parties to honor his autonomy. Our hope is that this presentation will lead to further discussion and clarification of these important issues.     

Integrating the dynamics of personality and close relationship processes: methodological and data analytic implications

A common theme that has emerged from classic and contemporary theoretical work in both the fields of personality and relationship science is a focus on process. Current process-focused theories bearing on personality invoke a view of the individual in ongoing action and interaction with the environment, reflecting a flow of experience rather than a static depiction. To understand the processes by which personality interacts with the social environment (particularly dyads), investigations must capture individuals interacting in multiple interpersonal situations, which likely necessitates complex study designs and corresponding data analytic strategies. Using an illustrative simulated data set, we focus on diary methods and corresponding individual and dyadic multilevel models to capture person-situation interaction within the context of processes in daily close relationship life. Finally, we consider future directions that conceptualize personality and close relationship processes from a dynamical systems theoretical and methodological perspective.     

Medusa’s Gaze Reflected: A Darwinian Dilemma for Anti-Realist Theories of Value

Street has argued that the meta-ethical realist is faced with a dilemma. Either evolutionary forces have had a distorting influenced on our ability to track moral properties or evolutionary forces influenced our beliefs in the direction of tracking moral properties. Street argues that if the realist accepts the first horn of the dilemma, the realist must accept implausible skepticism regarding moral beliefs. If the realist accepts the second horn of the dilemma, the realist owes an explanation of the fitness producing nature of moral beliefs. As Street establishes the dialectic, the anti-realist’s explanation is better. I will argue that Street’s first horn is question begging then I will grasp the second horn of the dilemma and argue that only the realist can explain the role of moral beliefs in our evolutionary history. My argument will take the form of a dilemma. For our evaluative judgments to be fitness conducive, they must be responsive to the right sort of external world properties. The non-reductive realist can provide such a set of properties. On the first horn of the dilemma, the anti-realist cannot. The realist, unlike the anti-realist, can explain why our evaluative judgments are fitness conducive. The realist has won the explanatory battle. On the second horn of the dilemma, the anti-realist can provide a set of non-normative external world properties that our evaluative attitudes are responsive to. In doing so, the anti-realist has provided the heretofore-missing component of the reductive realist’s project. Again, the realist has won.     

Models of Development: Understanding Risk in Adolescence

In this paper, we review developmental models for understanding adolescence as they might be applied to emerging sexuality and the challenges and risks that may be associated with different sexual orientations and identities. Models have been identified as: cumulative events or simultaneous change, accentuation, or trajectory models. Inclusion of risk and protective factors and considering the extent of balance between these elements of an adolescent's life is also discussed in terms of predicting mental health outcomes. These models have been particularly useful in the study of the development of psychopathology and clearly relate to the broader issue of understanding suicide risk during adolescence.