Why Bioethics Should Be Concerned With Medically Unexplained Symptoms

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs.     

Future Directions for the Zygon Center

Abstract. A brief comparison of the Zygon Center for Religion and Science and the Center for Theology and the Natural Sciences is given. The work and emphases of the two Centers overlap but also differ in significant ways. Without neglecting the physical sciences or the Christian tradition, ZCRS would do well to continue to give high priority to the biological sciences and the dialogue with the major world religions.     

Demarcating depression

How to draw the line between depression‐as‐disorder and non‐pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach. On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right.     

Fanon via Lacan,or: Decolonization by Psychoanalytic Means … ?

ABSTRACT

Lacanian psychoanalysis is often considered antithetical to Frantz Fanon's decolonizing political project. This paper argues, by contrast, that by exploring hitherto under-explored aspects of the Fanon-Lacan relation we are able to re-articulate many of Fanon's most crucial political insights. The paper adopts three routes of enquiry. Firstly, it investigates Fanon's earliest citations of Lacan, noting how Fanon utilizes Lacan's ideas of historically-situated forms of madness, (mis)recognition, paranoia and psychic causality. Secondly, it highlights a series of conceptual affinities that exist between the work of the two theorists including idea of sociogeny, the importance of symbolic (or social) structure, the notion of fantasy and of a social (or transindividual) unconscious. Thirdly, it provides an instructive example of how Fanon's theorizations of colonial oppression might be supplemented by means of Lacanian social theory especially in respect of how the colonized are positioned as "non-subjects" relative to the master-signifier of whiteness.     

Children's and adults' understanding of the impact of nutrition on biological and psychological processes

Four studies examined children's and adults' beliefs about the impact of nutrition on growth and mood states. In Studies 1 and 2, 271 participants (preschoolers through adults) judged the impact of healthy and unhealthy nutrition on height and weight. In Studies 3 and 4, 267 participants judged the impact of healthy and unhealthy nutrition on positive and negative mood states. The results suggest that young children demonstrate a co‐existence of an ontologically distinct theory of biology as well as a theory of cross‐domain interaction when reasoning about the impact of food on biological and psychological processes.     

Frantz Fanon in the Time of Mad Studies

Abstract

Amidst renewed interest in the psychiatric writings of Frantz Fanon, this article reads his work against the background of contemporary mental health advocacy and scholarship. Epitomized in the emergent field of Mad Studies, whose origins lie in anti-psychiatry and psychiatric user/survivor movements, this body of scholarship espouses a discourse of madness as identity and culture. While Fanon continues to be disassociated from or (occasionally) associated with anti-psychiatry, this article elaborates elements in his work that animate such ambiguity. It proposes that Fanon and Mad studies be put in a relation of mutual critique.     

Family systems psychiatry in an acute in‐patient setting: the implementation and sustainability 5 years after its introduction

From 2003 to 2008 a multicentre research project, systems therapy methods in acute psychiatry (SYMPA), attempted to establish structured in‐patient treatment based on systemic interventions in German non‐university psychiatric hospitals. Utilising multi‐professional family systems training for team members in six in‐patient wards, its main goal was to improve the involvement of familial and non‐familial important others. This follow‐up study explores the sustainability of family systems psychiatry by evaluating the frequency of the utilisation of four core systemic interventions; elements of a systemic organizational culture in psychiatry; and institutional barriers to this new approach. The degree of implementation was high to moderate, depending on the intervention. More intense communication developed among staff of different professions and the status of nursing staff improved. Organizational barriers to implementation included the ambiguous role of junior doctors in teams, continuously understaffed wards and frequent over‐occupancy.     

Caregiving stress and adjustment problems of Kenyan orphans raised by grandmothers

The present study compared levels of caregiving stress among 115 biological mothers and 134 grandmothers raising their orphaned grandchildren. The associations between parenting stress and adjustment difficulties exhibited by children raised by these two groups of caregivers were also assessed. Full‐time caregiving grandmothers reported elevated levels of stress more than did the biological mothers. A significant negative association was found between child maladjustment and caregiving stress. Caregivers' experienced stress was linked to advanced age and extensive, new adoptive roles now occupied by grandmothers. There was no evidence suggesting that these orphaned children were less well adjusted when compared to children still living with their own birth parents. Copyright © 2005 John Wiley & Sons, Ltd.     

生物-心理-社会医学模式与控烟及吸烟相关性疾病的防控

大量流行病学研究证实，吸烟是导致肺癌的首要危险因素。因此，控烟才是解决问题的根本途径。本文简述了吸烟的主要危害及目前我国吸烟的现状，在此基础上提出需要在生物-心理-社会医学模式的理论框架下全面考虑控烟及吸烟相关疾病的预防和管理。