Rehabilitating Self-Sacrifice: Care Ethics and the Politics of Resistance

ABSTRACT

How should feminists view acts of self-sacrifice performed by women? According to a long-standing critique of care ethics such acts ought to be viewed with scepticism. Care ethics, it is claimed, celebrates acts of self-sacrifice on the part of carers and in doing so encourages women to choose caring for others over their own self-development. In doing so, care ethics frustrates attempts to liberate women from the oppression of patriarchy. Care ethicists have responded to this critique by noting limits on the level, form, or scope of self-sacrifice that work to restrict its role in their theories. While we do not here take issue with the initial feminist critiques of self-sacrifice, we suspect that the strategies offered by Care ethicists in response are importantly flawed. Specifically, these responses undervalue the positive roles that self-sacrifice can play in fighting patriarchal oppression. As a result, in attempting to restrict an oppressive norm, these responses risk foreclosing on valuable means of resistance. Our aim is to explore these positive roles for self-sacrifice and thereby rehabilitate its standing with feminists.     

抗战时期四川公共卫生事业发展的契机

四川地处中国西南,居祖国内陆,多山地丘陵,交通不便,较为闭塞。全面抗战初期,四川政治、经济、文化相对落后,卫生条件也较为简陋,在全国医疗卫生水平排名中处于较低地位。而在国民政府迁都重庆后,四川成为抗战领导组织的核心地区,占据重要的战略地位。战略地位的改变,带来了卫生资源的调整,医疗卫生需求的急剧增加和国内外卫生发展支持力量的帮助,给四川医疗卫生发展以难得的机遇。抗战时期四川公共卫生事业的发展对当时四川的社会稳定和抗战胜利提供了有力的保障,并奠定了战后四川医疗卫生事业大省的地位。     

反义寡核苷酸——新型抗菌药物的曙光

细菌耐药性是一个严重的医学问题,并由于数量增加的耐药菌对多种结构无关的药物产生耐药而又无新的抗生素可使用而加剧。反义寡核苷酸可特异性抑制或下调同源基因表达,从而能成为基因治疗的首选药物。多年的研究表明:反义寡核苷酸能够有效抑制细菌代谢的基础酶类及致病基因;但也存在着一些尚未完全解决的问题。建议以科学哲学的方法论和系统方法为指导,展开多学科联合的科学活动,推动新型抗菌药的研发,使基因治疗早日实现。     

妊娠合并结核临床诊治的决策

妊娠合并结核是一种对母婴健康危害极大的妊娠期疾病。在妊娠期结核病中,多数患者无明显症状,早期症状与妊娠期某些生理反应相似,加之妊娠与结核病的相互影响,x线、CT等重要的影像学检查受限,致使本病易被误诊或误治。某些抗结核药物对母婴的不良影响,使其治疗难以实施,由于结核病本身及治疗后可能对胎儿的影响,在临床上是否终止妊娠往往难以决策。本文就妊娠合并结核诊治过程中的相关问题进行综述,以期为临床诊治决策提供帮助。     

ACTION,AGENCY, AND EMPATHY: SCHAFER ON THE ANALYST'S DILEMMA

Throughout his career, a central feature of Roy Schafer's theorizing has been to highlight the role of activity and personal agency in every facet of human experience. This theme has remained at the forefront of Schafer's work, despite being embedded within different frames of reference. In this paper, the author highlights Schafer's focus on activity, notes some clinical problems to which it can give rise, and suggests the way that Schafer has attempted to deal with these difficulties.     

Robert Burns in the counsellor's chair: A socio-cultural analysis of the Burns myth

To illustrate how difficult endings are, this paper first cites an Italian therapist's experience of the use of time with university students in Naples and then associates to contrasting examples in the novel, art, music and the cinema. It uses a dialogue about ending in the film Brief Encounter as a possible paradigm for what is needed in brief therapy. It then refers to the work of James Mann on different experiences of time which underlie the resistance to brief work. How can brief therapy contain the paradox between finite and infinite time? Incorporating another model of therapeutic intervention with the use of Milton Erickson's attitude to time and the unconscious, the paper then moves on to a clinical example, where treatment consisted of an assessment and five sessions. Here the practice of not interpreting the transference is challenged, along with an exploration of the concept of transference to the organization and the use of pre-treatment ‘maternal reverie’ associations. Using the combination of informal trance-like states with a clear focus on the ‘here and now’, the process of the therapeutic relationship is then worked with in the case material.     

Therapist Awareness of Client Resistance in Cognitive-Behavioral Therapy for Generalized Anxiety Disorder

Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist–client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.     

Women's Sexual Aggression Against Men: Prevalence and Predictors

In this study, we investigated the prevalence of women's sexual aggression against men and examined predictors of sexual aggression in a sample of 248 women. Respondents reported their use of aggressive strategies (physical force, exploitation of a man's incapacitated state, and verbal pressure) to make a man engage in sexual touch, sexual intercourse, or oral sex against his will. Childhood abuse, gender role orientation, ambiguous communication of sexual intentions, level of sexual activity, and peer pressure were included as predictors of sexual aggression. Almost 1 in 10 respondents (9.3%) reported having used aggressive strategies to coerce a man into sexual activities. Exploitation of the man's incapacitated state was used most frequently (5.6%), followed by verbal pressure (3.2%) and physical force (2%). An additional 5.4% reported attempted acts of sexual aggression. Sexual abuse in childhood, ambiguous communication of sexual intentions, high levels of sexual activity, and peer pressure toward sexual activity were linked to an increased likelihood of sexual aggression. The findings are discussed in relation to the literature on men's sexual aggression.