Persons and humans: refashioning ourselves in a better image and likeness

Abstract. This article argues that there are neither moral considerations that in principle forbid the development or use of recom-binant DNA technology, nor grounds to hold that its application is likely to cause more harm than good. A defensible moral position would enjoin a prudent assessment of consequences, rather than an absolute prohibition. The technology may remain controversial because it presupposes the difference between being a person, an entity who can evaluate and manipulate its own biological structure, and human-ness as a biological structure likely to be the subject of engineering over the long-range future.     

THE CRISIS OF VIRTUE: ARMING FOR THE CULTURAL WARS AND PELLEGRINO AT THE LIMES

Theoretical Medicine and Bioethics -     

Holiness, virtue, and social justice: contrasting understandings of the moral life.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice.     

Internalizing and externalizing characteristics of sexually and/or physically abused children

This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children’s Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.     

Event-related brain potentials elicited by rhyming and non-rhyming pictures differentiate subgroups of reading disabled adolescents

Event-related brain potentials were recorded while disabled adolescent subjects read and judged whether two sequentially presented pictures had names that rhymed. Subjects with relatively good phonetic skills displayed an N400 priming effect, i.e., a significant reduction in the amplitude of the negative peak, occurring approximately 400 msec post-stimulus, for pictures with names that rhymed with preceding pictures as compared with pictures that had names that did not rhyme with the prime. No such effect was evident for subjects with relatively poor phonetic skills. This lack of an N400 priming effect provides evidence for a reduction in neural capacity and/or activation during phonological processing in the subjects with poor phonological skills. Demonstrating the N400 priming effect to be stronger in one group of reading disabled subjects, compared to another, supports the position that specific subtypes of reading disability exist. In addition to the stronger N400 priming effect, the phonetically stronger group also exhibited an enhanced negativity, from 700 to 1,000 msec after target stimulus onset, compared to phonetically inferior subjects. This finding replicates earlier work and possibly reflects a higher level of confidence in the group with better phonetic skills.     

Ethical issues in diagnosis

The ways in which ethical issues arise in making clinical judgments are briefly discussed. By showing the topography of the role of value judgments in medical diagnostics it is suggested why clinical medicine remains inextricably a value-infected science.