Conscientious objection and person-centered care

Person-centered care offers a promising way to manage clinicians’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role expectations. In this milieu of blurred boundaries, person-centered care offers a constructive way to accommodate conscientious objection by clinicians. The constitutionally social nature of clinicians commits and enables them, through care mechanisms such as self-care, to optimize the quality of health care and protect the welfare of patients. To advance these conditions, it is recommended that the medical profession develop a person-centered culture of care, along with clinician virtues and skills for person-centered communication.     

Can Cognitive‐Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico

This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive‐behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre‐ to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1‐year follow‐up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT‐alone showed an increase. The implication of these findings is discussed.     

Improving organizational newcomers’ creative job performance through creative process engagement: The moderating role of a synergy diversity climate

Despite the mounting research demonstrating that employee seniority positively relates to creative job performance, we predict that a synergy diversity climate eliminates the employee seniority–creative job performance relationship by unleashing the creative potential of organizational newcomers. Drawing upon the integration-and-learning perspective for managing diversity, Study 1 finds that a synergy diversity climate moderates the relationship between employee seniority and supervisor-rated creative job performance lending support to our hypothesis. Study 2 provides an extension by showing how creative process engagement mediates this moderating effect on self-rated creative performance. Finally, Study 3 replicates and extends Study 2 by demonstrating the mediating role of creative process engagement but utilizing supervisor-rated creative job performance, while again showing synergy diversity climate to be an important boundary condition. In sum, we find that synergy diversity climate, as opposed to fairness and discrimination diversity climate, interacts with employee seniority by facilitating greater creative process engagement for newcomers subsequently impacting creative job performance. We discuss theoretical and practical implications for how the individual-level creative job performance effects may represent a microfoundation to creative team dynamics that confer a sustainable competitive advantage.     

The history,origin, and meaning of Nietzsche’s slave revolt in morality

Abstract

While it is uncontroversial that the slave revolt in morality consists in a denial of the nobles as objects of value, Nietzsche’s account in the Genealogy’s first essay invites ambiguities concerning its origin, ressentiment’s relationship to value creation, and its meaning. In this paper, I address these ambiguities by analyzing the morality of good and evil as an historical artifact of Judeo-Christian tradition, and I argue for a two-stage, non-strategic interpretation of the slave revolt, according to which Judaism and Christianity each made essential and different contributions. The inversion of values began with the Jewish prophets, who claimed the poor were holy and ‘good’ and the rich ‘evil’ (BGE 195), and it was sustained throughout the Second Temple period by the Jewish priests in relation to a ‘priestly-noble’ (GM I 7) conception of the virtuous person as holy and pure. Christ, through his espousal of egalitarianism (A 27), negated the pathos of distance essential to noble values, thus beginning the second phase of the slave revolt where goodness became associated with a distinctly slavish conception of virtue.