Reflective Capacity: An Antidote to Structural Racism Cultivated Through Mental Health Consultation

Effecting a paradigm shift from “reproductive health” to “reproductive justice” within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient–provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.     

Reconceiving the field: Infant mental health,intersectionality, and reproductive justice

The field of infant mental health is conventionally comprised of professional discourses including developmental science, psychology, and psychiatry, among others, and involves spheres of practice as wide-ranging as pediatrics, maternal/child health, early intervention, early care and education, and child welfare. The World Association of Infant Mental Health [WAIMH] put out its position paper on the rights of infants in 2014 (amended in March 2016) in recognition of the human rights implications of professional understanding of infants’ unique, yet universal, developmental capacities and needs. This article links the policy issues outlined in the WAIMH position paper with critical issues in the field of reproductive justice, extending the reach of WAIMH's call to action on behalf of infants’ rights, and pointing the way toward potent alliances among interconnected movements. Connecting the dots among economic injustice, race-based health disparities, and gender inequities, the article demonstrates that it is not possible to safeguard infant mental health unless we make reproductive justice a reality.     

A Woman's Choice? — On Women, Assisted Reproduction and Social Coercion

This paper critically discusses an argument that is sometimes pressed into service in the ethical debate about the use of assisted reproduction. The argument runs roughly as follows: we should prevent women from using assisted reproduction techniques, because women who want to use the technology have been socially coerced into desiring children--and indeed have thereby been harmed by the patriarchal society in which they live. I call this the argument from coercion. Having clarified this argument, I conclude that although it addresses important issues, it is highly problematic for the following reasons. First, if women are being coerced to desire to use AR, we should eradicate the coercive elements in pro-natalist ideology, not access to AR. Second, the argument seems to have the absurd implication that we should prevent all women, whether fertile or not, to try to have children. Third, it seems probable that women's welfare will be greater if we let well informed and decision-competent women decide for themselves whether they want to use AR.     

Who wants privacy protection,and what do they want?

As privacy controversies have become more salient since the early 1980s, one response by policy makers has been to try to encourage consumers to demand privacy protection, by expecting goods and services to be designed with privacy‐enhancing technologies (PETs) embedded in them. But what scope is there for this? Conventional approaches to understanding consumer demand for privacy protection have not been very helpful in providing robust accounts of when consumers will want which kinds of protection. This paper offers a neo‐Durkheimian institutionalist theoretical account of the roots of consumer preferences for privacy and services with PETs in particular, which yields testable hypotheses for future research. It grounds preferences in risk perceptions, shows how distinct styles of risk perceptions are the result of distinct types of situation in social organisation, and derives typical demand curves for each of these types, before exploring the extent of mobility of preferences predicted by the theory, which in turn provides the basis for understanding the scope for persuading consumers to demand privacy‐respecting services of different types. Rooted in the sociology of knowledge and in anthropological approaches, the argument represents a challenge to psychometric, naïve empiricist and postmodernist accounts, and it offers a distinct research agenda. Copyright © 2002 Henry Stewart Publications Ltd.     

人类干细胞研究的伦理学争论

关于干细胞研究的伦理学争论越来越成为热门话题。2000年8月23日,美国卫生研究所颁布了涉及人类多能胚胎干细胞研究的指南。指南允许联邦政府资助的研究者进行干细胞研究,但是按照布什总统2001年8月9日的决定,政府只资助有限制的干细胞研究。而在英国、法国、日本、澳洲、以及其他国家,干细胞研究不仅在私人的实验室里而且也在政府的实验室里进行着。无论如何,人类干细胞研究应该按照一定规范谨慎进行。     

Assisted Suicide,Suffering and the Meaning of a Life

The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would relieve suffering without causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others.     

Some promising dimensions for behavioral community technology

In recent years, the search for effective and replicable approaches to planned change in communities has escalated. Applied behavior analysts have participated in these efforts to remedy existing community problems and to increase the capacities of community residents to meet their goals. Examples of behavioral technologies for community settings are described and their advantages are noted. Criteria for more contextually appropriate community technologies are suggested and strategies for developing behavioral methods according to these criteria are described. This paper outlines some promising dimensions for behavioral community technology and discusses several possible limitations to a behavioral approach to addressing societal problems.     

The experience of counselling for UK egg providers

Objective

The aim of this study was to address current gaps in knowledge regarding the appropriateness and quality of counselling provided to egg donors in the UK.

Methods

The present study used a cross-sectional, qualitative design. Semi-structured interviews were carried out with 29 UK egg donors to explore their experiences of egg donation and the counselling received.

Results

Of the 29 participants, 24 had received counselling. The remaining five did not receive counselling because they were either not accepted as a donor (n = 4) or were offered, but chose not to take up the session (n = 1). The findings are presented in relation to five themes: feeling supported via counselling; feeling well-informed; welcoming an individualised approach; the counselling setting; and thinking about the future.

Conclusion

Egg donors in this study had varying experiences of counselling offered to them as part of the egg donation process in the UK.

Implications

The findings indicate that there are some aspects of counselling in the UK that could be improved, including the routine offering of counselling throughout the egg donation process and the tailoring of counselling to meet egg donors' individual needs.     

The Rights of Man: Libertarian Concern for Men's,But Not Women's,Reproductive Autonomy

Libertarianism enshrines individual autonomy as its central political principle, but it has been criticized for applying this principle selectively. Reproductive decisions can stress the concept of individual autonomy by placing into conflict the claimed rights of each biological parent to choose. Two studies (N₁ = 296; N₂ = 580) show that among U.S. participants, libertarianism is associated with opposition to women's reproductive autonomy and support for men's. Libertarianism was associated with opposition to abortion rights and support for men's right both to prevent women from having abortions (male veto) and to withdraw financial support for a child when women refuse to terminate the pregnancy (financial abortion). Adjusting for the association between libertarianism and conservatism, only the relationship with opposition to abortion rights was rendered nonsignificant. Mediation analyses suggest that hostile sexism may account for libertarians' selective support for men's and not women's reproductive autonomy.     

Insights into the effectiveness of messaging promoting intentions to use connected vehicle technology

Connected vehicles offer considerable promise for reducing congestion, pollution, and crashes. Nonetheless, less than a third of road users are aware of the potential for connected vehicles to transform transport systems. This study examined the effectiveness of messaging aimed to increase the public’s knowledge of connected vehicle technologies using a short, animated video and its effects as assessed via a survey. Participants were assigned to either a control group, who were not exposed to the messaging, or an intervention group, who were exposed to the messaging, within a pre-post design. Participants (in the intervention group) answered questions about their knowledge of and experience with connected vehicle technologies prior to seeing the messaging and again following being exposed to such messaging together with their intentions to use these technologies in the future. As a theoretically informed investigation, the Theory of Planned Behaviour (TPB) constructs of attitudes, subjective norms, and perceived behavioural control were also measured. The results showed that the messaging increased knowledge about and intention to use connected vehicle technologies. Furthermore, changes in how the TPB constructs predicted intentions were found between the control and intervention groups which may help to explain how the messaging influenced participants’ intentions to use such technology in the future.