THE ‘OTHER 23 HOURS’: SPECIAL PROBLEMS OF PSYCHOTHERAPY IN A ‘SPECIAL’ HOSPITAL

In this paper, I describe and discuss the complexities of being a therapist in a maximum security forensic psychiatric hospital, working with patients who have committed acts of serious violence, and who also suffer from severe mental illness and personality disorders. I suggest that profound disturbances in the patient's inner world get played out in triangular disputes between the patient, the therapist and other professionals working in the hospital. I also describe how real events in the life of the institution impact on the therapeutic process, and the importance for the therapist of reflection on the ‘other 23 hours’ that the patient lives outside of therapy. Finally, I raise some ethical dilemmas that arise for therapists working in such settings, where the stated therapeutic aim is not only treatment but also the containment and prevention of future violence.     

Polish students’ attitudes towards sexuality

The following article contains an analysis of medicine and pedagogy students’ attitudes towards sexuality. These attitudes were studied with the use of a scale of author’s own construction. The scale was used to determine: (1) the nature of respondents’ attitudes towards individual aspects of sexuality including several criteria: quality of life, health, acceptability, and morality; and (2) respondents’ preferences of normative regulations of sexual behaviours. It was found that the respondents accept love as relatively the most important aspect for the quality of life, and sex education (seen as a moral aspect). Students also give positive scores to physical aspects of sexuality, yet the scores are lower. Natural contraception in all its aspects is evaluated positively, whereas artificial contraception is evaluated ambiguously, similarly to masturbation and homosexuality. The fundamental norm in regulating sexual behaviour is the welfare of other human beings, the least important are the teachings of the Church.     

世界主要发达国家医学的学术体系发展比较及启示

“新医科”的建设对于加强中国医学学术体系提出了新的要求。研究确立了包含学术训练、学术研究、学术评价的医学学术体系分析框架,检索和梳理了美、英、日、德、法五个国家医学的学术体系建设的历史沿革、显著特征以及发展趋势。发达国家具有教研一体的协同培养机制、严格的教育质量监管体系、多元筹资机制和注重应用的多维评价体系。建议我国医学教育促进学科交叉融合、注重应用为导向的科研经费分配与监管、重视医教产研合作的考核体系,以完善我国医学的学术体系建设。

     

The mentor and the trainee in academic clinical medicine

Medicine is a scientific discipline, but it is sometimes difficult to separate what is scientific and what is a clinical, practical activity. Man is the object, but he is always the subject of medical research and therefore these two elements become closely bound together by a thread of moral interdependencies. Every mentor of a young academic and all institutions dealing with the teaching of and research into medicine must understand multidimensional, multifaceted, and multilevel aspects of their activity and give them due regard in the educational process. The educational mission of an academic institution and of the teacher working there may be summed up in one phrase: Teach thinking! At the same time, the task of a school and the individual mentor is to teach the student to distinguish personal freedom from a lack of the feeling of responsibility. The medieval principle “Universitas magistrorum et scholarium”, and thus the corporation, the community of teachers and students, has not lost any of its relevance and value today. The situation is, in its far-reaching consequences, tragic in which the “insufficiently tutored teach”. Both physician and teacher, and especially physician-teacher, are not only professions, but also callings. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.     

用达尔文医学的观点看待近视眼的发生和治疗

从近视眼的进化史来看,伴随人类生活方式的改变,眼睛对近距离信息摄取的需求膨胀是近视眼形成的终因.在漫长的人类历史中,近视眼获得的每一种益处,都伴随着相应的代价.而达尔文医学关于生物进化的不完美性决定了近视眼的进化适应和代价将长期共存.因此,从治疗模式来看,应该摒弃达尔文医学固有的消极性而考虑生物的整体性和生态性.近视眼的中医和基因治疗正是避免了达尔文医学治疗模式的理论消极性,而且融入了其有关生物进化、遗传与环境统一的部分理念,可能成为近视眼治疗的候选策略.     

Creating a sustainable global society— the evolutionary path

Many indicators suggest that modern society is presently in a period of transition. The older order is showing obvious signs of decline, and elements of a new order appear to be forming. Growing numbers of people are coming to recognize that the worsening global dilemmas are best viewed as symptoms of an underlying disorder involving some of the most deeply underlying assumptions of modern society. The ultimate resolution of these dilemmas will come about, not through politically implemented “solutions,” but through our further evolution to a fundamentally different, “trans‐modern” society. The key challenge to individuals and organizations is to understand the necessary evolutionary change well enough to contribute toward its taking place with a minimum of attendant social disruption and human misery.     

Chapter 8: “Always Green and Full of Sap”: Facilitating Wholeness in Aging

SUMMARY

Wholeness in aging is difficult to define, especially in the face of physical disability or catastrophic illness. How one meets the challenges of aging depends upon numerous physical, emotional, and spiritual factors. Rehabilitation may play an important role in restoring wholeness to those with physical disabilities. Likewise, a physical fitness program may lessen some of the effects of aging, helping the older person maintain a higher quality of life. The lived theologies of the older patients and their caregivers also interact, providing an important ground of connection in rediscovery of wholeness as well. Ultimately, our most important role as healthcare providers is to help our older patients regain and maintain this multidimensional wholeness even in times of physical challenge.