Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

Minimizing the number of observations: A generalization of the spearman-brown formula

A new method for determining the minimum number of observations per subject needed to achieve a specific generalizability coefficient is presented. This method, which consists of a branch-and-bound algorithm, allows for the employment of constraints specified by the investigator.     

School adjustment, school performance and peer relations among first-graders in a Swedish suburban area

A study of 95 first-graders in one school management area used teacher ratings of problems and sociometric ratings to assess school adjustment and peer relations; 14% of the children had difficulties in reading/writing, motor skill, concentration and psychosocial function. Behavioural problems did not generally coincide with poor scholastic performance, but a small group (6.3%) exhibited problems in both reading/writing, concentration, gross and fine motor skill and psychosocial functions. Sociometric results showed only moderate agreement with teacher ratings. Extremely popular boys had no teacher-rated problems, but children with teacher-rated problems did not to any high degree tend to be isolated. Poor gross motor skill did distinguish isolated boys from others, a relationship that was not evident among the girls. The need to study the validity of teacher ratings as well as the prognostic value of school adjustment in first grade was stressed.     

Influential observations in principal factor analysis

We propose a method for detecting influential observations in iterative principal factor analysis. For this purpose we derive the influence functionsI(x; LL ^T ) andI(x; ) for the common variance matrixT =LL ^T and the unique variance matrix , respectively, in the common factor decomposition =LL ^T + . A numerical example is given for illustration.The authors are grateful to Tomoyuki Tarumi and Atsuhiro Hayashi for their kind permission to use their software Seto/B for drawing Figures 1 and 2 and to anonymous reviewers for comments on the paper.     

Social anxiety and fear of bodily sensations in panic disorder and agoraphobia: A matched comparison

This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20 patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agoraphobics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensitivity to bodily sensations and interpersonal situations.This research was supported by Grant 560-268-009 of the Dutch Organization for Scientific Research.     

The Drinking Expectancy Questionnaire: A revised measure of alcohol-related beliefs

Alcohol-related expectancies have been recently proposed as potentially important determinants of drinking behavior. This study describes the development of a New Zealand measure of such beliefs, the Drinking Expectancy Questionnaire (DEQ). Items selected through interviews, literature review, and the modification of other relevant questionnaires were piloted on 333 drinkers in a community sample and 275 college students. Factor analyses of both samples revealed nine alcohol reinforcement domains relating to assertiveness, affective change, sexual enhancement, social enhancement, relaxation, cognitive impairment, dependence, carelessness, and aggression. The potential clinical and research possibilities using this revised expectancy measure are briefly discussed, along with the scale's strength and weaknesses.The financial assistance of the Alcoholic Liquor Advisory Council of New Zealand in conducting this study is gratefully acknowledged.     

HUMANITY IN THE WORLD OF LIFE

Abstract. The position and role of humanity in the world of life is examined in the light of the ontological structure of life itself. This problem is approached by considering the possible units of life representing various modes of life phenomena. I argue that the only meaningful unit of life without interposing some special external conditions is "global life" framed in a star-planet system. Any other possible unit of life exhibited by various kinds of individuals is conditional in the sense that it would leave out an essential part as "co-life." The relationship between human being and the global life should be understood in this general scheme of individual and global life. It is emphasized, however, that human being occupies a unique position in global life in the sense that humanity can promote either a cancerous situation or a healthy higher-order enhancement of the global life.