Jewish medical ethics in the care of the cancer patient

The care of the patient with cancer requires the development not only of a medical plan, but an ethical plan as well. This plan should integrate the physician's and the patient's perceptions of medical and ethical propriety. Jewish biomedical ethical principles are based on the teaching of the Old Testament and its various interpretations. In this paper, I discuss how these principles can be used to help guide the physician caring for the patient with cancer. Other ethical systems could be applied in a similar fashion.     

An indigenous community mental health service on the Tohono O'odham (Papago) Indian reservation: Seventeen years later

The status of a fully indigenous mental health program serviced and controlled by the Tohono O'odham (Papago) Indian tribe is reviewed from the perspective of its 17-year history. The program functions in large measure in a crisis intervention model, with suicidal or acutely disturbed cases being most frequent. However, a whole range of disorders and ages are seen. Traditional Medicine Men and Women are often used as consultants, as are some professionals. In recent years child sex abuse and abuse of drugs among youth are prominent problems. The program experienced problems of obtaining services off reservations for patients in need, and in establishing credibility of the Indian Mental Health workers with the outside service providers.     

A reanalysis of the influence of a "friendly visitor" program

A paper in the American Journal of Community Psychology (AJCP), by Reinke, Holmes, and myself, reported the results of a study of the influence of a friendly visitor program on the cognitive functioning and morale of elderly individuals. The program was reported to have had a significant multivariate effect on a combination of cognitive and morale measures and significant univariate effects on memory, self-perceived health, and activity director's ratings. Being intrigued by the memory finding, I conducted a follow-up study to further investigate the effect of a visitation program on cognitive functioning. In this second study the dependent measures included all of the cognitive variables included in the original study as well as some additional memory variables. The visitation program in the follow-up study had no effect on any of these measures. As a result of my failure to obtain a significant memory effect such as that reported in Reinke et al. (1981), I reanalyzed the data from the original study. In my reanalysis, the only significant effect was a borderline univariate effect for self-perceived health; the multivariate effect did not approach significance. On the basis of my inability to produce the results reported in Reinke et al. when I reanalyzed the original data, I must conclude that the friendly visitor program did not have the effects attributed to it in the original report.     

The precaution adoption process

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.