Practice Precedes Theory: Doing Bioethics “Naturally” Is There an Ethicist in the House?: On the Cutting Edge of Bioethics

Jonathan Moreno argues that a pragmatic approach is the best approach for bioethicists and health care practitioners to use when confronted with difficult ethical problems. There is no one formula to which to appeal in determining which course of action is right or wrong when making decisions about hastening or prolonging life, for example. Instead the best decision that can be expected under the circumstances emerges as the result of a slow process of consensus building, negotiation, and compromise. Decision makers' interpretive and reflective skills need to be strengthened to achieve this type of ethical decision.     

Predictive factors of manual dexterity and cognitive performance at 17 years: a 10-year longitudinal study in a rural area of France

Studies of predictive factors of manual dexterity in adolescents and young adults are lacking. The present longitudinal study reports the relationship between cognitive and behavioural assessments at age 7 years and the schooling, cognitive performance, and manual dexterity at age 17 years. The participants were 65 schoolchildren, 30 boys and 35 girls, from a rural area in France. Assessment at age 7 years included the McCarthy scales and questionnaires measuring the behavior of the child, completed by the mother, the teacher, and the assessing psychologist. Assessment at age 17 years included schooling situation (whether they were in high school or not), cognitive testing (WAIS-R, Trail Making, Verbal Fluency, Cancel H, Stroop, Memory Assessment Scales), and manual dexterity testing (dynamometer, Finger Tapping, Santa Ana Test, Purdue Pegboard). After controlling for effects of parental education and IQ, a negative teachers' rating of children's behaviour and abilities in first-grade (7 years) was correlated with early cessation of schooling, but also, unexpectedly, with higher scores for manual dexterity at 17 years. Manual dexterity was not related to cognitive performance at 17 years. It is suggested that the relationship between manual and cognitive performance varies during development. Although manual exploratory behaviour is an important correlate of early cognitive development, manual dexterity is probably not related to later academic performance.     

Gender and culture differences in touching behavior

The authors used gender and culture to examine the theory that touching behavior is an expression of dominance. Participants were 120 men and women from Italy, the Czech Republic, and the United States. The authors examined both hand touches and nonhand touches. For hand touches, there was a significant gender-by-culture interaction in that Czech men as a group touched more than any of the other groups. For nonhand touches, Czech and Italian women and Italian men as groups touched significantly more than any of the other groups. Taken in cultural context, these results seem to support the dominance theory for touches with the hand but not for nonhand touches. The authors discussed implications and future directions.     

Stammering and therapy views of people who stammer

This study used a postal questionnaire to seek the views of adults who stammer concerning the effect of stammering on their lives, the speech and language therapy and other remedies they have tried, and their hopes for speech and language therapy in the future. The 332 returned questionnaires indicated that stammering had the greatest adverse effect on school life and occupation. Speech and language therapy had been helpful to many, but the nature of the benefits and specific therapies used were not cited in many responses. An emergent theme in unhelpful therapy was the dissatisfaction that arises when individual needs are not met. In the future, people want help in controlling stammering and in developing coping strategies. The desire for timely and effective therapy for children, ongoing help and for group or intensive work has implications for service organization and therapist's skills. The survey highlights the need for therapists and clients to negotiate therapy aims and procedures that are clearly defined, appropriate to individual needs, achievable, and, if possible, recorded and measured. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to list (1) the areas most and least affected by stammering, (2) the therapy approaches respondents had found helpful, and (3) other remedies that tried to help stammering.     

Love's labor in the health care system: working toward gender equity

In this commentary on Eva Feder Kittay's Love's Labor: Essays on Women, Equality, and Dependency, I focus on Kittay's dependency theory. I apply this theory to an analysis of women's inadequate access to high-quality, cost-effective healthcare. I conclude that while quandaries remain unresolved, including getting men to do their share of dependency work, Kittay's book is an important and original contribution to feminist healthcare ethics and the development of a normative feminist ethic of care.     

Bilateral language: Is the left hemisphere still dominant?

A 13-year-old left-handed boy with a left fronto-parietal vascular malformation evidenced bilateral symmetrical language representation at intracarotid amytal testing. Surgical resection of the parietal motor and frontal premotor area (sparing classical perisylvian language regions) for seizure control resulted in an acute aphasia. Language deficits were still apparent 3 months and to a lesser degree 1 year after surgery. This suggests that when language is bilateral and symmetrical, the left hemisphere may still be dominant or both hemispheres may be necessary to sustain full language competence. Explanations for atypical language localization within the left hemisphere are also discussed.