Arguing ‘for’ the Patient: Informed Consent and Strategic Maneuvering in Doctor–Patient Interaction

As a way to advance integration between traditional readings of the medical encounter and argumentation theory, this article conceptualizes the doctor–patient interaction as a form of info-suasive dialogue. Firstly, the article explores the relevance of argumentation in the medical encounter in connection with the process of informed consent. Secondly, it discloses the risks inherent to a lack of reconciliation of the dialectical and rhetorical components in the delivery of the doctor’s advice, as especially resulting from the less than ideal conditions of the internal states of the doctor and the patient, and the lack of symmetry in their status.     

酒依赖与酒文化

在医疗过程中,无法取得患者的同意时,通常由他人代其做出同意。但是,代为同意人在代为做出同意时,必须以患者本人的最佳利益为原则。在判断患者的最佳利益时,可以借鉴英国《心智能力法2005》的规定,通过对诸因素的评估,来综合决定何谓患者的最佳利益。我国在制订和修改代为同意的相关规定时,应该考虑如何借鉴英国的规定,制订符合我国国情的代为同意制度。     

美国的患儿同意及借鉴意义

准确地评定患儿的同意能力,保障患儿的同意权得以有效行使,有利于尊重患儿的人格尊严,促进患儿身心健康。从患儿同意能力和同意权的角度出发,简要回顾了美国患儿同意产生的背景,介绍了美国患儿同意的现状,并对其进行了一定的分析和评价,希望对促进我国患儿同意的发展起到一定的借鉴作用。     

临床医疗中知情同意的实践与思考

尊重患者的知情同意权是患者和社会对医方所提出的要求,也是医方应尽的法律和伦理义务。医方应充分尊重患者的自主性,积极、有效地履行注意和告知义务,以切实保障患者知情同意权的实现。它不仅体现了医疗工作对人及其权利的尊重,也会对提高医疗质量、改善医患关系起到极其重要的作用。     

Issues Involving Informed Consent for Research Participants with Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants.     

The relation between scores on the Buss–Perry Aggression Questionnaire and aggressive acts,impulsiveness, competitiveness,dominance, and sexual jealousy

This paper examines the relation of the four subscales (physical, verbal, anger and hostility) of the Buss–Perry Aggression Questionnaire (BPAQ) to act‐based aggression questionnaires (involving same‐sex or partners as opponents, and direct or indirect aggression) and evolutionarily based predictors of aggression, using an online student sample. All aggression measures were moderately correlated with one another. The BPAQ physical and verbal scales were most closely related to act‐based measures of direct aggression to a same‐sex other and the hostility scale to indirect aggression to a same‐sex other. The evolutionary variables were less closely related to the BPAQ than were the act‐based measures. Dominance and sexual jealousy were predictors of BPAQ physical, verbal and anger, and impulsiveness was a significant predictor of anger. Aggr. Behav. 32:1–10, 2006. © 2006 Wiley‐Liss, Inc.     

Sexual prejudice and anger network activation: mediating role of negative affect

The present study sought to establish whether increases in negative affect following exposure to homosexuality mediate the relation between sexual prejudice and anger network activation. Participants were 159 heterosexual men who completed measures of sexual prejudice and state negative affect. Participants were randomly assigned to view a short video depicting either a male–male or male–female sexual interaction and, following the video, again reported state negative affect. Anger network activation was then assessed via response latencies from a lexical decision task that required participants to identify emotion or emotionally neutral words from non‐words. Results indicated that the pattern of covariation between sexual prejudice and anger facilitation was significantly more positive when participants viewed male–male erotica relative to male–female erotica. Increases in negative affect, particularly anxiety/fear, were found to mediate this association. These findings suggest that increases in negative affect following exposure to homosexuality may be the emotional trigger for biases in the processing of anger‐related information and represent the cognitive underpinnings of sexually prejudiced aggression toward gay men. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

What Do Women Want? A New View of Women’s Sexual Problems

Recent attempts to medicalize women’s sexual “dysfunction” are critiqued and a “New View” of women’s sexual problems is introduced. The author argues for a female-centered perspective on women’s sexual desires and problems, based on a review of the literature on women’s sexuality and her observations of young women’s sexual experiences from 25 years of teaching Human Sexuality to undergraduate women. The review suggests that a pill or a patch cannot adequately address the sexual problems commonly experienced by US women.     

The Effectiveness of Therapy with Couples Reporting a History of Childhood Sexual Abuse: An Exploratory Study

The purpose of this pilot study was to explore the impact of childhood sexual abuse (CSA) on couples therapy. Participants were couples seeking therapy who were screened for CSA prior to therapy. Groups were compared using self-report and therapist-rated measures of individual and relational distress. Results indicate that although therapists report significant differences between CSA couples and couples not reporting abuse at the onset of therapy, those differences do not translate into significant differences in the perceived effectiveness of therapy as measured by change scores on therapist rated levels of distress, questions regarding the effectiveness of therapy, dropout, and length of treatment.