Euthanasia,Senicide, and the Aging Society

ABSTRACT

The elderly, particularly the severely demented, are at the cutting edge of the debate over active euthanasia. Such debilitated persons fall below the standards of “personhood” as these have been defined by various moral philosophers. With the pressures of economic hard times, one might predict that the most impaired aged would be candidates for “direct termination.” However, this essay defends the thesis that the prohibition against mercy killing must be upheld despite such pressures. It draws on the wisdom of both Hippocrates and Abraham.     

Brief strategic therapy in first myocardial infarction patients with increased levels of stress: a randomized clinical trial

Background: Little is known about the impact of interventions targeting chronic stress levels on clinical outcomes among myocardial infarction (MI) patients with increased levels of stress. Objectives: To examine the impact of the addition of brief strategic therapy (BST) to usual care (UC) on clinical outcomes in first MI patients with increased levels of stress. Design: Eighty-one patients were randomly assigned to BST in conjunction with UC (medical treatment, risk factor information, and guidance on unhealthy behavior change) or to UC. Methods: The outcome measures were scores on the Perceived Stress Scale, reinfarction and cardiac mortality rates, and scores on the Health Survey. Measures were taken before, post-treatment, and at two follow-ups. Results: Patients subjected to BST showed reduced perceived stress at post-treatment and maintained decreased levels at follow-ups. At 1-year follow-up, they had a lower rate of non-fatal reinfarction, and at 2.5-year follow-up, they had a lower rate of fatal reinfarction. Their mental and physical health was improved at post-treatment and this was sustained at follow-ups. Conclusion: The addition of BST to UC favorably influences the disease course after MI in patients with increased levels of stress.     

Sexual Contact Between Psychologists and Patients

Summary

This article discusses sexualized dual relationships between psychologists and patients, including both sexual contacts while treatment is in progress and after its termination. The reported prevalences of sexual contact between psychologists and patients and between psychologists and former patients are discussed as well as practitioners attitudes towards these two types of relationships. The profiles of both psychologists and patients likely to be involved are outlined as are the clinical and professional consequences of these behaviours. Finally, the APA Ethics Code (2002) is examined to determine whether its inclusions in these areas are adequate and to shed more light on clinicians' continued roles and responsibilities even after treatments have concluded.     

Existential themes in the treatment of people at suicide risk. Understandings and practices of specialist healthcare professionals

ABSTRACT

This qualitative study focuses on the ways in which existential themes were understood and addressed in therapeutic relationships with patients who had attempted suicide. Health care professionals (HCP) from Norway specialist healthcare participated in focus groups. The interviews were transcribed and analysed by systematic text-condensation through a four-step procedure. We found that the HCPs emphasised the context-specific functions of their departments. They considered these conversations essential but demanding. They indicated existential themes of hope/hopelessness, loneliness, meaning, life/death, shame, religion and suicide. The HCPs’ understandings of themes deemed to be existential and how they should be addressed were primarily based on clinical experience. This appeared to exacerbate the pressure on their personal involvement, leading to the question of whether patients’ existential needs are tackled or instead disappear into a conversational vacuum. The study suggests that HCPs' professional competence of existential themes pertaining to patients at suicide risk needs to be strengthened.     

Dissociated deficits of visuo-spatial memory in near space and navigational space: Evidence from brain-damaged patients and healthy older participants

ABSTRACT

Defects confined to spatial memory can severely affect a variety of daily life activities, such as remembering the location of objects or navigating the environment, until now the skills involved have been mostly assessed with regard to the visual domain using traditional pencil and paper tests. Our aim was to test the efficacy of a recently developed psychometric instrument (Walking Corsi Test: WalCT) to assess the specific contribution of spatial memory to the complex task of retrieving route knowledge. The WalCT is a 3×2.5-m version of the well-known Corsi Block-tapping Test (CBT), in which patients are required to memorize (and replicate) a sequence of body displacements. We assessed the ability of left and right brain-damaged patients, as well as healthy young and senior controls, to perform both the CBT and the WalCT. Results showed differences related to age in the healthy individuals and specific functional dissociations in the brain-damaged patients. The double dissociations found in this study demonstrate the importance of having a task able to detect navigational disorders, because virtual reality tasks are often much too difficult for aged brain-damaged patients to perform.     

Listening to the Voices of Children in Early Schooling in the South African Context of HIV/AIDS

This study explored how children in early schooling interpreted their social reality to construct vulnerable childhoods in an HIV/AIDS context. Ten males and ten females between the ages of eight and nine years from low-income families in KwaZulu-Natal participated in the study. In order to raise the voices of the children, a listening framework was created through participatory techniques. Focus group interviews, drawings, story telling and projection techniques were used in the study. The study found that children actively interpreted their social reality through engaging with circumstances that surrounded their lives in an HIV/AIDS context. Child activism is important to HIV/AIDS education.     

HIV/AIDS Awareness of In—School Adolescents in Nigeria: Implications for Adolescence Sexuality

This study investigated HIV/AIDS awareness of in-school adolescents in Nigeria to determine their risk for contracting HIV/AIDS. A total of 892 purposively selected adolescents (mean age = 16. 5 years; SD = 5. 2; males = 492; females = 400) participated in the study. The participants responded to the HIV/AIDS Awareness Inventory (HAAI). The questions on the survey included the following aspects: meaning of HIV/AIDS; prevalence; mode of transmission; consequences and prevention. Differences in gender, age, school location and father's educational background in understanding HIV risk were examined. A group means comparison procedure revealed a significant difference in HIV awareness by gender, age, school location and father's educational background. Female adolescents, the older adolescents, those living in urban centres and those whose fathers are literate had higher HIV/AIDS awareness than their counterparts from rural areas. Nigerian adolescents need education regarding HIV/AIDS awareness.     

Les déterminants de la charge de travail perçue dans deux services d’urgence hospitaliers en France

This article gives an account of research carried out the workload of healthcare providers in hospital emergency wards, by focusing on several factors that are both related to the patients and to their activity. Based on 121 observations conducted in two hospitals, coupled with the NASA-TLX scale and an ad hoc questionnaire, this research indicates that the elements which contribute the most to perceived workload are the agitated behavior of patients and communication difficulties linked to handicap. However, variations in the number of tasks do not seem to have an influence on the workload perceived by health care providers which tends to highlight that the relations to patients contribute more to the perception of workload than the number of tasks. In the situation observed, the regulation of workload is made possible by the management of relational factors (physical demand, frustration and effort) which determine, in part, workload perception. In order to reduce or adapt this load, this article suggests basing interventions on the way to deal with difficult patients and not on the regulation of the number of tasks.     

重症医学科患者安全——一个需要关注的问题

随着重症医学的发展,重症医学科暴露的患者安全问题已逐步引起人们关注。重症医学科患者安全问题与医务人员职业倦怠、医患关系、团队合作、科室管理等因素密切相关,提高科室高效管理、加强团队建设、提高人文素养等措施是重要有效的解决办法。