Professional Autonomy and the Normative Structure of Medical Practice

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine.     

Global Progress I: Empirical Evidence for ongoing Increase in Quality-of-life

This paper argues that both the relativist and the pessimist critiques of the idea of progress are inadequate. Progress is defined as increase in global quality of life (QOL). Such QOL is intrinsically subjective, but not relative. It can be reliably measured through life satisfaction-type questions. The World Database of Happiness provides extensive data on social, economic and psychological factors that correlate with overall QOL. They include wealth, health, security, knowledge, freedom and equality. Various statistical data suggest that all these QOL indicators have undergone significant improvements during the last half century, in most of the world. This gives strong support to the thesis that progress objectively occurs.     

Immigrant Sex: the Transport of Affection and Sensuality across Cultures

This paper outlines the ways in which an individual’s notions of sexuality are challenged by immigration. It describes four basic facets of sexuality and the ways in which each are rooted in culture. These include (1) the relative importance of sexuality in daily life; (2) potential or overt homosexuality; (3) marriage—whether based on arrangement or love; and (4) cross-cultural romantic and marital relationships. Immigration can stir up conflicts in each of these realms and lead to defensive retreat into familiar customs or a counterphasic plunge into new cultural avenues. Ideally, it would lead to a working-through of these conflicts and subsequent growth in the immigrant’s understanding of his or her sexual self.     

Explicit and implicit attitudes towards food and physical activity in childhood obesity

This study investigated differences in the explicit and implicit attitudes towards food and physical activities between children with obesity (n=38) and a matched control group (n=38). The implicit attitude was assessed using the Extrinsic Affective Simon Task (EAST; J. Exp. Psychol. (50) (2003) 77), a modified version of the Implicit Association Test (IAT; J. Personality Social Psychol. (74) (1999) 1464). It was expected that both groups would report a positive explicit attitude towards healthy food and intense physical activities, and a negative explicit attitude towards unhealthy food and sedentary activities. Of particular interest was the hypothesis that children with obesity would have a more positive implicit attitude towards unhealthy food and sedentary activities than the control group. Results revealed no differences between groups in the explicit attitude towards food and physical activity. Children and adolescents with obesity had a more pronounced positive implicit attitude towards food in general. The relevance of these findings in terms of prevention, treatment and further research is discussed.     

The importance of job autonomy, cognitive ability, and job-related skill for predicting role breadth and job performance

Role theory suggests and empirical research has found that there is considerable variation in how broadly individuals define their jobs. We investigated the theoretically meaningful yet infrequently studied relationships between incumbent job autonomy, cognitive ability, job-related skill, role breadth, and job performance. Using multiple data sources and multiple measurement occasions in a field setting, we found that job autonomy, cognitive ability, and job-related skill were positively related to role breadth, accounting for 23% of the variance in role breadth. In addition, role breadth was positively related to job performance and was found to mediate the relationship between job autonomy, cognitive ability, job-related skill, and job performance. These results add to our understanding of the factors that predict role breadth, as well as having implications for how job aspects and individual characteristics are translated into performance outcomes and the treatment of variability in incumbent reports of job tasks.     

The relationship between employee job change and job satisfaction: the honeymoon-hangover effect

Recent research suggests that the turnover process is not fully captured by the traditional sequential model relating job dissatisfaction to subsequent turnover. The present study contributes to this research by modeling within-individual job satisfaction as a function of job change patterns to determine if individual work attitudes change systematically with the temporal turnover process. Specifically, the authors hypothesized that low satisfaction would precede a voluntary job change, with an increase in job satisfaction immediately following a job change (the honeymoon effect), followed by a decline in job satisfaction (the hangover effect). Though this pattern is suggested in the literature, no prior research has integrated and tested this complete temporal model within individuals. Findings based on a sample of managers supported the proposed honeymoon-hangover effect.     

Teamwork in multiteam systems

The authors examined how networks of teams integrate their efforts to succeed collectively. They proposed that integration processes used to align efforts among multiple teams are important predictors of multiteam performance. The authors used a multiteam system (MTS) simulation to assess how both cross-team and within-team processes relate to MTS performance over multiple performance episodes that differed in terms of required interdependence levels. They found that cross-team processes predicted MTS performance beyond that accounted for by within-team processes. Further, cross-team processes were more important for MTS effectiveness when there were high cross-team interdependence demands as compared with situations in which teams could work more independently. Results are discussed in terms of extending theory and applications from teams to multiteam systems.