Relational suffering and the moral authority of love and care

Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering’s tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood as well as the academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant’s lived experience. But what if this is not the best question? What if instead of asking “can this infant suffer?” the discourse is broadened to ask “is there suffering here?” This latter question demands attention to patients’ subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients’ experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context.

     

Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

Applied Research in Quality of Life - This study identified associations between perceived neighborhood stress and adolescents’ perceptions of life satisfaction. African American adolescents...     

Student volunteer social support and infant intervention: A case study

The emphases in infant mental health have been in the three areas of supporting the mother-infant dyad through education, psychotherapy to help parents resolve emotional conflicts that interfere with the parent-infant interaction, and support during the acute crisis that follows an abnormal birth. The case described herein involves a child with a genetic defect born to competent parents, a chronic stressful situation that does not fit these categories. It became apparent in the first few months after the birth that both the child and parents were in need of some help in coping with the situation. An intervention was designed to help provide both the necessary stimulation for the baby and the needed emotional support for the family, while it acknowledged their skill and competencies as parents. This was done through the help of college student volunteers, who assisted the mother in the home. Developmental data recorded at birth, 7 months, 12 months, and 39 months indicate that the child is severely multiply handicapped. Interview data with the parents at those times document their personal and family difficulties, the eventual resolution as a family in dealing with this problem, and the importance of the volunteer help during that process.     

Fear and aggression in the rat

The effect of fear on two types of aggression in rats was investigated by adding a cat stimulus to a colony in which the dominant male was attacking an intruder (offensive aggression), or, to a tube test situation in which defensive biting was measured before and during tail shock. The cat completely abolished offense in the colony; when the cat was presented and removed before a strange rat was placed in the colony, attack on the intruder was also reduced. In contrast, defensive biting was unchanged or even slightly potentiated by the presence of the cat, demonstrating a separation of the effects of fear on offensive and defensive aggression.     

Virtual reality and the new psychophysics

Virtual reality (VR) promises methodological rigour with the extra benefit of allowing us to study the context-dependent behaviour of individuals in their natural environment. Pan and Hamilton (2018, Br. J. Psychol.) provide a useful overview of methodological recommendations for using VR. Here, we highlight some other aspects of the use of VR. Our first argument is that VR can be useful by virtue of its differences from the normal perceptual environment. That is, by virtue of its relative non-realism and poverty of its perceptual elements, it can actually offer increased clarity with respect to the features of interest for the researcher. Our second argument is that VR exerts its measurable influence more by eliciting an acceptance of the virtual world (i.e., ‘suspension of disbelief’) rather than by eliciting a true belief of the realism of the VR environment. We conclude by providing a novel suggestion for combining neuroimaging methods with embodied VR that relies on the suspension of disbelief.     

The epistemological objection to modal primitivism

Modal primitivists hold that some modal truths are primitively true. They thus seem to face a special epistemological problem: how can primitive modal truths be known? The epistemological objection has not been adequately developed in the literature. I undertake to develop the objection, and then to argue that the best formulation of the epistemological objection targets all realists about modality, rather than the primitivist alone. Furthermore, the moves available to reductionists in response to the objection are also available to primitivists. I conclude by suggesting that extant theories of the epistemology of modality are not sensitive to the question of primitivism versus reductionism.