Sanitary Worker’s Death Unnerves Pakistan’s Health Care Ethics to the Core

Health care ethics is a sensitive domain, which if ignored, can lead to patient dissatisfaction, weakened doctor–patient interaction and episodes of violence. Little importance has been paid to medical ethics within undergraduate medical education in developing countries such as Pakistan. Three doctors in Pakistan are currently facing an official police complaint and arrest charges, following the death of a sanitary worker, who fell unconscious while cleaning a drain and was allegedly refused treatment as he was covered in sewage filth. The medical license of the doctors in question should be cancelled, if found guilty following a thorough investigation into the case. The ‘right to life’ has been universally assured by all moral, cultural and legal codes and no society can ever argue against the sacredness of a human life. It is quite clear that the aforesaid doctors’ actions are not only against the core principles of the physicians’ code, but also go against the doctrine of human rights. If serious efforts on an urgent basis are not made by the regulatory and governing bodies, one can definitely expect similar incidents for at least a few more decades before any noticeable change is seen.     

Whose Meaning? The Wax and Gold Tradition as a Philosophical Foundation for an Ethiopian Hermeneutic

This essay is an attempt to assess critically the wax and gold tradition as a philosophical foundation of Ethiopian hermeneutics. In the first part, I shall analyze the wax and gold tradition as a poetic and literary tradition. After exploring how this tradition has shaped social and political interaction in the second part, in the third part I will show the implications of the wax and gold tradition for hermeneutics. I shall then make a critical assessment of the wax and gold tradition as an interpretive philosophy before closing the essay with concluding remarks.     

Culture,salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application

Introduction

Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence construct including impoverished definitions of culture as religious, national or ethnic group and of congruence as validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct.

Results

The article distinguishes symbolic from phenomenological conceptions of culture, the latter expanded upon through two sources: Husserl’s phenomenological analysis of background intentionality and neuropsychological literature on salience. It is argued that culture is not limited to symbolic presuppositions and shapes subjects’ experiential dispositions. This conception is deployed to re-examine the meaning of (in)congruence. The main argument is that a significant, since foundational, deviation from culture is not from a value or belief but from culturally-instilled experiential dispositions, in what is salient to an individual in a particular context.

Conclusion

Applying the concept of cultural congruence must not be limited to assessing violations of the symbolic order and must consider alignment with or deviations from culturally-instilled experiential dispositions. By virtue of being foundational to a shared experience of the world, such dispositions are more accurate indicators of potential vulnerability. Notwithstanding problems of access and expertise, clinical practice should aim to accommodate this richer meaning of cultural congruence.

     

The genetic and environmental architecture to the stability of IQ: Results from two independent samples of kinship pairs

Existing research has revealed that IQ remains relatively stable over the life course, though questions remain about how stable IQ is and whether the stability of IQ varies across different developmental periods of the life course. Despite this stability, there are also questions surrounding the factors that might explain the stability of IQ. Against this backdrop, we conduct bivariate genetic models to estimate genetic, shared environmental, and nonshared environmental influences on the stability of IQ. To do so, we analyze kinship pairs drawn from two separate longitudinal samples: The National Collaborative Perinatal Project (CPP) and the National Longitudinal Study of Adolescent Health (Add Health). Across both samples, IQ was found to be relatively stable. Moreover, the genetic analyses revealed that between 66% and 83% of the stability in IQ was due to genetic factors and between 43% and 69% of the change in IQ was due to genetic factors. The remainder of the stability and change in IQ was the result of a combination of shared and nonshared environmental influences. Importantly, some substantive race differences emerged in respect to genetic and environmental influences on the stability of IQ. We conclude with a discussion of the limitations of the study and avenues for future research.     

Combat Exposure and Posttraumatic Stress Disorder Among Portuguese Special Operation Forces Deployed in Afghanistan

Several combat- and noncombat-related stressors have been reported in Afghanistan. There is now accumulating evidence that suggests that posttraumatic stress disorder (PTSD) is linked to combat experiences; however, little is known about how these exposures might affect elite combat troops. This research aims to evaluate the prevalence of combat and noncombat related stressors, as well as PTSD in Portuguese Special Forces deployed in Afghanistan. Overall, participants reported high levels of exposure to combat and adverse physical conditions but also high levels of within-unit comradeship. The analysis also exposed that 2.7% of the participants reported symptoms compatible with PTSD and 8.8% with compatible partial PTSD. When the authors conducted a binary logistic regression, only the higher levels of combat exposure explained the symptoms of PTSD.     

Caregiving Behavior Is Associated With Decreased Mortality Risk

ABSTRACT— Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals ( N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted decreased mortality for the caregiver, independently of behavioral and cognitive limitations of the care recipient (spouse), and of other demographic and health variables. These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care.     

High-Risk Palliative Care Patients’ Knowledge and Attitudes about Hereditary Cancer Testing and DNA Banking

Even at the end of life, testing cancer patients for inherited susceptibility may provide life-saving information to their relatives. Prior research suggests palliative care inpatients have suboptimal understanding of genetic importance, and testing may be underutilized in this clinical setting. These conclusions are based on limited research. This study aimed to estimate genetic testing prevalence among high-risk palliative care patients in a National Cancer Institute-designated comprehensive cancer center. We also aimed to understand these patients’ understanding of, and attitudes toward, hereditary cancer testing and DNA banking. Palliative care in-patients with cancer completed structured interviews, and their medical records were reviewed. Among patients at high risk for hereditary cancer, we assessed history of genetic testing/DNA banking; and related knowledge and attitudes. Among 24 high-risk patients, 14 (58.3%) said they/their relatives had genetic testing or they had been referred for a genetics consultation. Of the remaining 10 patients, seven (70%) said they would “probably” or “definitely” get tested. Patients who had not had testing were least concerned about the impact of future testing on their family relationships; two (20%) said they were “extremely concerned” about privacy related to genetic testing. Of patients without prior testing, five (50%) said they had heard or read “a fair amount” about genetic testing. No high-risk patients had banked DNA. Overall, 23 (95.8%) said they had heard or read “almost nothing” or “relatively little” about DNA banking. Written materials and clinician discussion were most preferred ways to learn about genetic testing and DNA banking. Overall, this study demonstrates underutilization of genetics services at the end of life continues to be problematic, despite high patient interest.