The relevance of Rawls' principle of justice for research on cognitively impaired patients

An ethical conflict arises when we must performresearch in the interest of future patients,but that this may occasionally injure theinterests of today's patients.In the case of cognitively impaired persons, thequestion arises whether it is compatible withhumane healthcare not only to treat, but alsoto use these patients for research purposes.Some bioethicists and theologians haveformulated a general duty of solidarity, alsopertaining to cognitively impaired persons, as ajustification for research on these persons. Ifone examines this thesis from the theory ofjustice according to John Rawls, it is revealedthat such a duty of solidarity cannotnecessarily be extrapolated from Rawls'conception of justice. This is at least true ofRawls' difference principle, because accordingto the difference principle only those measuresare justifiable which serve the interest of therespective least well off. Those measures whichwould engender additional injury for the leastwell off could not be balanced by any utilityaccording to Rawls.However, John Rawls' difference principleis subordinate to the first principle,which is that each person has an equalright to the most extensive basic libertycompatible with the same liberty for others.These primary goods are determined by thefreedom and integrity of the person.This integrity of decisionally impaired personswould be in danger if one would abstain fromresearch and thus forego the increase inknowledge related to their disease. Thus onecould conclude, at least from Rawls' firstprinciple, that society must take on a duty toguarantee the degrees of freedom forcognitively impaired persons and thus alsosupport the efforts for their healing.     

Pessimism

The problem of pessimism is the secular analogue to the evidential problem of evil facing traditional theism. The traditional theist must argue two things: that the evidence shows that this is on balance a good world and that it is the best possible world. Though the secular optimist who advocates any form of secular moral theory need not argue that the current and future world will likely be the best possible world, she nonetheless must argue that were there a clean solution to the problem of current and future suffering in which all sentient life could be instantly and painlessly eliminated, we would have reasons not to employ the clean solution because the future promises to bring on balance a good world in which the evil of human and animal suffering is outweighed by whatever is good in the world. Pessimism is the view that the evidence argues against secular optimism. It is argued here that it is anything but clear that secular optimism is warranted when viewed from an impersonal point of view. The problem is then evaluated from the personal point of view in which a form of personal optimism is defended even in the face of impersonal pessimism.     

Caring,Social Policy,and Homelessness

Care theory offers a way to overcome a weaknessof liberalism – its reluctance to intervene inthe private lives of adults. In caring for thehomeless, we must sometimes use a limited formof coercion, but our intervention is alwaysinteractive, and the process of finding asolution is one of negotiation between theneeds expressed by the homeless and the needswe infer for them.     

When religion may be an ethical issue

Though Americans are a religious people, there are times when religion or religious views may confound the ethical process. This article claims that religious values may be expressed as either principles or narratives, then seeks to establish a case for dealing with religious claims as principled narratives. Methods of evaluation are explored and then seven guidelines are offered for dealing with religion in ethics consultations.     

Attachment to the Missing Object: Infidelity and Obsessive Love

In an object relations study on infidelity and obsessive love, the author observes that in relationships marked by chronic, repetitive infidelity and obsession, the lover is enamored with that which they can not have and that the psychological development of such individuals may have been traumatized by early attachment disturbances in the primary dyad. Tenacious, unsatisfying love-attachments as seen in sexual addictions and obsessional love may result from the internalization of an absent or intermittent object relationship—a morbid attachment to the missing object of infancy. Such patients often demonstrate depressive/addictive traits and schizoid defenses and typically have difficulty forming an attachment bond with the analyst, perceiving the analyst as a dangerous, rejecting agent who will recapitulate the original trauma. In the clinical case of Gretchen, the author uses Winnicott's (1960) concept of holding to create a progressive therapeutic bond, as toxic resistant forces are gradually resolved.     

社会因素对剖宫产率的影响

近二三十年来,剖宫产率在世界范围内不断升高。究其原因,除了医学因素外,社会因素起着重要作用,从社会经济发展,社会科学文化水平、社会习俗观念、法律、医疗道德、国家计划生育政策、医学教育等多个角度分析了社会因素对剖宫产率的影响,并就如何发挥社会因素的积极作用,消除和避免其消极作用,使剖部率维持在合理的范围内进行了讨论。     

Immigrant Sex: the Transport of Affection and Sensuality across Cultures

This paper outlines the ways in which an individual’s notions of sexuality are challenged by immigration. It describes four basic facets of sexuality and the ways in which each are rooted in culture. These include (1) the relative importance of sexuality in daily life; (2) potential or overt homosexuality; (3) marriage—whether based on arrangement or love; and (4) cross-cultural romantic and marital relationships. Immigration can stir up conflicts in each of these realms and lead to defensive retreat into familiar customs or a counterphasic plunge into new cultural avenues. Ideally, it would lead to a working-through of these conflicts and subsequent growth in the immigrant’s understanding of his or her sexual self.     

Depression and Contributors to Vocational Satisfaction in Roman Catholic Secular Clergy

A nationally selected, random sample of Roman Catholic secular (i.e., diocesan) priests was examined using the Center for Epidemiological Studies-Depression scale and an instrument developed for this study to assess contributors to priests' vocational satisfaction. In addition, a self-report inventory gathered information regarding participants' demographics as well as four categories of predictor variables (i.e., overall level of vocational satisfaction, social support, spiritual activities, physical environment). The study yielded a response rate of 45%. Secular clergy reported rates of depression approximately seven times greater than are found in the general population, and also indicated that the recent sexual abuse scandal in the Roman Catholic church had negatively affected their mood. Priests' engagement in sacramental activities contributed greatly to their vocational satisfaction, and low levels of vocational satisfaction were found to be most predictive of depression. Factors comprising priests' vocational satisfaction were External Manifestations (e.g., preaching, teaching), Internal Manifestations (e.g., prayer life, affirmation of God's call), and Social Manifestations (e.g., relationships with parishioners, appreciation from others).     

Cross-Cultural Reactions to Academic Sexual Harassment: Effects of Individualist vs. Collectivist Culture and Gender of Participants

Male and female university students from the United States, Canada, Germany, the Netherlands, Ecuador, Pakistan, the Philippines, Taiwan, and Turkey read a standardized scenario in which a male professor was accused of sexually harassing a female graduate student. Respondents from individualist countries judged the professor to be guilty of sexual harassment more often than did those from collectivist countries. Women rendered significantly more guilty judgments and assigned more severe punishments to the accused professor than did men. Implications for the individualist–collectivist classification system and cross-cultural research are discussed.     

Interpersonal Dependency in Child Abuse Perpetrators and Victims: A Meta-Analytic Review

Meta-analysis of studies assessing interpersonal dependency in child abuse perpetrators (N of studies = 7) and victims (N of studies = 9) indicated that perpetrators have higher dependency levels than nonabusing controls (d = 0.43), and child abuse victims have higher dependency levels in early adulthood than people who were not abused as children (d = 0.47). An array of other personality traits and disorders showed comparable associations with abuse suggesting that in both populations increased dependency reflects a generalized increase in pathology and distress. Theoretical implications of these results are discussed, and suggestions for future research on dependency and abuse are offered.