Palliative sedation: clinical context and ethical questions

Practitioners of palliative medicine frequently encounter patients suffering distress caused by uncontrolled pain or other symptoms. To relieve such distress, palliative medicine clinicians often use measures that result in sedation of the patient. Often such sedation is experienced as a loss by patients and their family members, but sometimes such sedation is sought as the desired outcome. Peace is wanted. Comfort is needed. Sedation appears to bring both. Yet to be sedated is to be cut off existentially from human experience, to be made incapable of engaging self-consciously in any human action. To that extent, it seems that to lose consciousness is to lose something of real value. In this paper, I describe how sedation and the question of intentionally bringing about sedation arise in the care of patients with advanced illness, and I propose heuristics to guide physicians, including Christian physicians, who seek to relieve suffering without contradicting their profession to heal.     

Vicarious Peer Victimization and Adolescent Violence: Unpacking the Effects of Social Learning,General Strain,and Peer Group Selection

This study examines how the victimization of a close friend, or vicarious peer victimization, affects adolescent violence. Competing processes linking vicarious peer victimization and violence are empirically evaluated including social learning theory, general stain theory, and peer group selection models. The analyses use peer-network data from three waves of the National Longitudinal Study of Adolescent Health (Add Health). Regression models demonstrate that the association between vicarious peer victimization and violence is attributed primarily to peer-group selection and social learning mechanisms. These findings indicate that victimization affects not only the immediate victims of violence, but permeates throughout adolescent social networks.     

Religion and Disparities: Considering the Influences of Islam on the Health of American Muslims

Both theory and data suggest that religions shape the way individuals interpret and seek help for their illnesses. Yet, health disparities research has rarely examined the influence of a shared religion on the health of individuals from distinct minority communities. In this paper, we focus on Islam and American Muslims to outline the ways in which a shared religion may impact the health of a racially, ethnically, and socioeconomically diverse minority community. We use Kleinman’s “cultural construction of clinical reality” as a theoretical framework to interpret the extant literature on American Muslim health. We then propose a research agenda that would extend current disparities research to include measures of religiosity, particularly among populations that share a minority religious affiliation. The research we propose would provide a fuller understanding of the relationships between religion and health among Muslim Americans and other minority communities and would thereby undergird efforts to reduce unwarranted health disparities.     

Religion and United States Physicians’ Opinions and Self-Predicted Practices Concerning Artificial Nutrition and Hydration

This study surveyed 1,156 practicing US physicians to examine the relationship between physicians’ religious characteristics and their approaches to artificial nutrition and hydration (ANH). Forty percent of physicians believed that unless a patient is imminently dying, the patient should always receive nutrition and fluids; 75 % believed that it is ethically permissible for doctors to withdraw ANH. The least religious physicians were less likely to oppose withholding or withdrawing ANH. Compared to non-evangelical Protestant physicians, Jews and Muslims were significantly more likely to oppose withholding ANH, and Muslims were significantly more likely to oppose withdrawing ANH.     

No evidence of racial discrimination in criminal justice processing: Results from the National Longitudinal Study of Adolescent Health

One of the most consistent findings in the criminological literature is that African American males are arrested, convicted, and incarcerated at rates that far exceed those of any other racial or ethnic group. This racial disparity is frequently interpreted as evidence that the criminal justice system is racist and biased against African American males. Much of the existing literature purportedly supporting this interpretation, however, fails to estimate properly specified statistical models that control for a range of individual-level factors. The current study was designed to address this shortcoming by analyzing a sample of African American and White males drawn from the National Longitudinal Study of Adolescent Health (Add Health). Analysis of these data revealed that African American males are significantly more likely to be arrested and incarcerated when compared to White males. This racial disparity, however, was completely accounted for after including covariates for self-reported lifetime violence and IQ. Implications of this study are discussed and avenues for future research are offered.     

Psychometric Properties of the Anticipatory Social Behaviours Questionnaire

Relative to other components of Clark and Wells’ (1995) model, anticipatory processing has been understudied, despite research that suggests that anticipatory processing may maintain social anxiety through mechanisms such as increased anxiety, negative memory biases, and other negative consequences. Anticipatory processing has only been examined as a unitary process, with no efforts examining the underlying structure of this process. The purpose of the current study was to examine the factor structure of the Anticipatory Social Behaviours Questionnaire (ASBQ, Hinrichsen and Clark Journal of Behavior Therapy and Experimental Psychiatry, 34, 205–218, 2003) and identify relationships between the measure’s factors and other constructs of social anxiety. Study 1 (N?=?861) used exploratory factor analysis and concluded that a two-factor model (Avoidance and Preparation) was the best conceptualization of anticipatory processing. Study 2 confirmed the two factor model in a separate sample (N?=?485) and demonstrated the superiority of the two-factor model over a unitary model. Results of Study 3 suggested that, with a sample of high-socially-anxious undergraduates (N?=?59), the Avoidance factor was more maladaptive than the Preparation factor. Results are discussed in the context of the anticipatory processing literature and future directions are proposed.     

The Behavioral Genetics of Religiousness

Behavioral geneticists have sought to characterize the genetic and environmental contributions to individual differences in religiousness. Behavioral genetic methodology is described and twin and adoption studies of religiousness are reviewed. It is concluded that familial resemblance for religiousness is due largely to shared environmental factors in childhood and adolescence, but to genetic factors in adulthood. Additional evidence shows that there is a genetic correlation between religiousness and antisocial and altruistic behavior. Claims for the discovery of a “God gene” are premature and unlikely, as any genetic influence is likely to represent the aggregate effect of many genetic factors.