Justice and care: The implications of the Kohlberg-Gilligan debate for medical ethics

Carol Gilligan has identified two orientations to moral understanding; the dominant ‘justice orientation’ and the under-valued ‘care orientation’. Based on her discernment of a ‘voice of care’, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others.     

Counseling: A conversion experience

In this article, the experience of conversion, which is usually delegated to the realm of spiritual studies, is applied to the counseling experience. It is posited that a person who goes through a successful counseling process will experience a turning around, will cease leading life in a dysfunctional way, and will move forward in a manner by which the person experiences life in a new perspective. This new perspective brings the person wholeness and balance.     

Perception and its neuronal mechanisms

A classic view of the relation between sensorineural activity and perception has assumed that the former is somehow transformed into the latter at some locus in the brain. This notion conflicts with the modern view that the activity of the nervous system is restricted to transmitting and processing information. It is suggested that the conflict may be resolved by considering perception as reflective activity rather than passive reception. This cognitive process entails information about the perceiving self and the general context and not merely the stimulus input. Some aspects of perception can be related to neuronal mechanisms and even to neuronal activity at specific loci. How is this done? By identifying the characteristics of the perceptual process and finding a necessary and sufficient neuronal mechanism that receives information about the stimulus input and can perform the implied computation. Examples are taken from the study of visual development in human infants.     

Specific language impairment in children: A cross-linguistic study

A common profile in English-speaking specifically language-impaired children is a moderate deficit across a broad range of linguistic features and a more marked, selective impairment in using bound morphemes and components of the verb system. To gain a clearer understanding of the nature of these more serious problems, we examined the speech of monolingual Italian-speaking as well as English-speaking children with specific language impairment. The evidence suggested that phonological factors contributed significantly to these children's extraordinary problems with particular linguistic features. Contrary to expectations, other marked deficits seemed more related to the opacity of the rules involved and homonymity with other morphemes than to problems with formal grammatical devices in general or components of the verb system in particular.     

The differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children

The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.