The social individual in clinical ethics

Except for several provocative final sentences, Sigrid Fry-Revere's "A Libertarian Critique of H. Tristram Engelhardt, Jr.'s The Foundations of Bioethics" is not a libertarian so much as it is a philosophical critique. Engelhardt's work has been widely reviewed, and its arguments have been discussed in Fry-Revere's article and elsewhere. Although it would be impractical in this context to undertake the development of a full-scale, philosophical alternative to libertarianism in bioethics, some recent work in philosophy and clinical ethics bears strongly on the challenge that Engelhardt's work represents. In this commentary I will focus on the implications of a certain alternative philosophy -- and by comparison the limitations of Engelhardt's libertarianism -- for one important aspect of clinical ethics: our understanding of the nature of individuality, with special reference to the situation of the patient. I write as an admiring critic of Engelhardt's work, from which I have learned and drawn inspiration....     

Significant events in a psychodynamic psychotherapy group for eating disorders

This qualitative pilot study was designed to identify and explain significant events for patients participating in a psychodynamic psychotherapy group for eating disorders. Specifically, seven members of a mixed (i.e., anorectic, bulimic, obese) eating disorders group recorded what they perceived as the three most significant events in group meetings for 14 weeks. In addition, group members were instructed to record why each event was significant. Manifest and latent content analyses of the data revealed that members found feedback and observing others the two most common types of significant events, and emotional experience, insight, and relationship the reasons these events had such impact. The implications of these results for working with the eating-disordered patient in group, as well as their implication for general group theory and practice, are discussed.An earlier vesion of this paper was presented at the 1991 meeting of the American Group Psychotherapy Association, New York. This paper was funded, in part, by a California State Faculty Support Grant and a Santa Barbara Cottage Hospital Research Grant awarded to the first author. The authors would like to thank Sean T. Casey, Sally Barton, Dr. Allison Wollitzer, Tom Knowlton, Craig Park, and Beth Buxton for their assistance in the preparation and execution of this study.     

Body image in eating disorders: the influence of exposure to virtual-reality environments

The aim of this article was to study the effect of virtual-reality exposure to situations that are emotionally significant for patients with eating disorders (ED) on the stability of body-image distortion and body-image dissatisfaction. A total of 85 ED patients and 108 non-ED students were randomly exposed to four experimental virtual environments: a kitchen with low-calorie food, a kitchen with high-calorie food, a restaurant with low-calorie food, and a restaurant with high-calorie food. In the interval between the presentation of each situation, body-image distortion and body-image dissatisfaction were assessed. Several 2?x?2?x?2 repeated measures analyses of variance (high-calorie vs. low-calorie food?x?presence vs. absence of people?x ED group vs. control group) showed that ED participants had significantly higher levels of body-image distortion and body dissatisfaction after eating high-calorie food than after eating low-calorie food, while control participants reported a similar body image in all situations. The results suggest that body-image distortion and body-image dissatisfaction show both trait and state features. On the one hand, ED patients show a general predisposition to overestimate their body size and to feel more dissatisfied with their body image than controls. On the other hand, these body-image disturbances fluctuate when participants are exposed to virtual situations that are emotionally relevant for them.     

Slouching Toward Policy: Lazy Bioethics and the Perils of Science Fiction

Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies.     

La androginia y el ajuste de pareja

RESUMEN

En este artículo se constrasta la hipótesis de que existe una relación entre las orientaciones de roles sexuales de los miembros de parejas heterosexuales y el ajuste de dichas parejas. Comenzando con la exposición del panorama actual de las investigaciones sobre el tema y tras concretar los objetivos de su estudio, los autores describen el método y resultados del mismo. Finalmente en las conclusiones destacan que se ha visto confirmada la existencia de una posible relación entre las distintas orientaciones hacia el rol sexual de los sujetos y el modo en que éstos estiman su relación de pareja, siendo los hombres femeninos y las mujeres andróginas quienes por lo general informaban de mayor felicidad. Respecto a los tipos de parejas y el ajuste de las mismas, los autores afirman que sus objetivos parecen haberse confirmado ampliamente, ya que las parejas más ajustadas eran aquéllas en donde tanto un miembro como el otro habían sido categorizados como andróginos, o en donde al menos uno presentaba un alto grado de características tanto masculinas como femeninas.