Epistemological and ontological issues in counseling: Implications of social systems theory

Philosophical issues related to theoretical and methodological developments in counseling are addressed, especially related to epistemology (theory of knowledge) and ontology (theory of reality). Social systems theory is described as an epistemologically and ontologically significant challenger to psychological theory, which has traditionally predominated as a foundation for counseling approaches. Recent developments from cognitive biology are used to demonstrate how systems theory may be metatheoretical to the psychological point of view, accounting for all that psychological theory can account for, and more.     

Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.     

Beyond medical ethics: New directions for philosophy and medicine

A unique relationship exists between physicians and philosophers — one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the social cultural and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary.     

Oh death,where is thy sting? Reflections on dealing with dying patients

This paper examines the reactions of physicians and other health-professionals when they become involved in decisions about the death of their patients. The way people understand the condition of death has a profound influence on attitudes towards death and dying issues. Four traditional views of death are explored. The problem that physicians have in helping patients die (be it by hastening death through pain control, assisting patients in suicide or by more active means) is analyzed. Physicians, in dealing with such patients, must be mindful of their own, and their patients beliefs as well as mindful of the community in which such dying takes place. They must try to reconcile these often divergent views but can neither paternalistically deny patients their rational will, hide themselves behind an appeal to the law or go against their own deeply held moral views. When such views cannot be reconciled, compassionate transfer to a more compatible physician may be necessary.     

Paranoid character and the intolerance of indifference.

This paper suggests that aspects of paranoid character are structured around fantasies of magical and concrete connectedness to objects; these fantasies serve to avoid the terrors of object inconstancy. The authors describe how these fantasies are expressed in the psychoanalytic situation and explore their relation to common paranoid phenomena. The paranoid person must maintain these fantasies of connectedness at all cost or risk experiencing unbearable indifference between self and object. Paradoxically, the sacrifice of self and object boundaries inherent in these fantasies makes object constancy even more difficult to achieve because of the secondary defensive use of anger mobilized to protect the boundaries of the self.     

Line bisecting as a predictor of personal optimism and desirability of risky behaviors.

Our goal was to test whether current hemisphere predominance is a predictor of scores on standardized measures of personal optimism and preference for risk. In two between-subject experiments, current hemisphere predominance was measured by the direction and extent of line bisecting errors. Pearson correlations and median splits of the line bisecting errors showed significantly greater personal optimism and preference for risk with left hemisphere predominance. These results support previous research in which manipulation of hemisphere predominance produced similar effects on personal optimism in normal individuals and on risk taking in lesioned and normal samples. We conclude that the association of optimism and risk with left hemisphere predominance can be observed in resting as well as in manipulated situations.     

The association between teacher attitudes, behavioral intentions, and smoking and the prevalence of smoking among seventh-grade students.

Seventh-grade students and teachers from twenty-three middle and junior high schools were surveyed to determine the association between teacher attitudes, behavioral intentions, and smoking behavior and the prevalence of student smoking. Teacher attitudes toward smoking policies were found to be strongly related to the current smoking behavior of the teacher but not consistently related to student smoking. In addition, teacher likelihood of intervening showed a modest association with teacher smoking status, with current smokers generally indicating being the least likely to intervene for student possession or use of cigarettes. Teacher intentions to intervene were strongly associated with the prevalence of smoking among boys but not girls.