bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avoiding Family Feuds: Responding to Surrogate Demands for Life-Sustaining Interventions
Authors: Alpers Ann , Lo Bernard 
Published: June 2007

The laws and ethical guidelines governing decision making for incompetent patients evolved from controversies in which family members refused life-sustaining interventions. These cases led to a consensus that advance directives to limit interventions should be respected and that a surrogate designated by the patient or specified by statute could refuse interventions, even when other relatives disagreed. Surrogate decision-making statutes and ethical principles about respect for delegated autonomy promote an active role for family members or other surrogates in medical decisions for incompetent patients. Inviting surrogates to participate actively in medical decisions recognizes the importance of the patient's personal community and assures that decisions will reflect the patient's own preferences and values.The standard approach to decisions for incompetent adults gives advance directives priority over a surrogate's substituted judgment, which in turn has priority over assessments of the patient's best interest. A patient may express advance directives by appointing a proxy, stating specific preferences, or articulating general values. We use case examples to illustrate the limitations of all three types of advance directives.
Guidelines for IRB Review of International Collaborative Medical Research: A Proposal
Authors: White Mary Terrell 
Published: June 2007

The increase in the scope of international collaborative medical research involving human subjects is raising the problem of whether and how to maintain Western ethical standards when research is conducted in countries with very different social and ethical values. Existing international ethical guidelines for research largely reflect Western concepts of human rights, focusing on the bioethical principles of respect for persons, beneficence, and justice. However, in countries and societies where these values are understood differently or are not expressed in local cultures and institutions, it may be impossible or of no practical value to insert them into the research setting.In the United States, individual informed consent is considered ethically imperative for research involving human subjects. However, this imperative may be difficult to instill in societies that define persons by their relations to others, and important decisions are commonly made by heads of households or group leaders rather than by individuals. The baseline economic and health care conditions in foreign communities may also create ethical conflicts.
Non-Heart-Beating Organ Donation: A Defense of the Required Determination of Death
Authors: DuBois James M. 
Published: June 2007

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, it is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved.Many people now consider such cases of non-heart-beating organ donation to be ethically permissible. However, widespread disagreement persists as tohowsuch practices are to be justified and whether such practices are compatible with the Uniform Declaration of Death Act (UDDA). In this paper, I argue that non-heart-beating organ donation can be ethically justified, that in the justified cases the patients are in fact dead, and that the early declarations of death required for such donation do comply with the UDDA.
Ethical and Legal Aspects of Sperm Retrieval after Death or Persistent Vegetative State
Authors: Strong Carson 
Published: June 2007

Several methods have been reported for extracting sperm from a man after he dies or enters a persistent vegetative state (PVS). Although such sperm retrieval could be performed for nonprocreative purposes, such as research, in this paper I focus on cases involving procreative intent. Since 1980, more than ninety cases have occurred in which family members requested sperm retrieval from patients who died or were irreversibly unconscious, with the intent that a wife, girlfriend, or other woman would be inseminated. Recently, the first report of pregnancy and birth following postmortem sperm retrieval appeared in the media.In these cases, death or PVS typically is caused by anoxic injuries, trauma, or rapidly progressing infections.
The Role of Law in Health Services Delivery: Diabetes and State-Mandated Benefits
Authors: Hartsfield DeKeely , Vinicor Frank 
Published: June 2007

Diabetes is a chronic and systemic disease that has reached epidemic proportions. An estimated 17 million Americans have diabetes (5.9 million of which are undiagnosed), and an additional 16 million individuals are considered to have pre-diabetes. Studies have shown that timely screening and referral are necessary to maintain healthy blood glucose levels and slow the progression of diabetes-related complications. Furthermore, lifestyle changes (i.e., altered diet and physical activity) can prevent or delay the onset of Type 2 diabetes for high-risk individuals.The Division of Diabetes Translation at the Centers for Disease Control and Prevention undertook an analysis of diabetes-related legislation across the nation. More specifically, state laws, rules and regulations mandating health insurance coverage for diabetes-related supplies and services were examined according to Sample Purchasing Specifications for Services Related to Diabetes—an evidence-based model of standards of care for persons with diabetes.
When Public Health Meets the Judiciary
Authors: Murphy Michael J. , Murphy Anne M. , Conner Maureen E. , Chezem Linda 
Published: June 2007

The conflict between courts and medicine is best shown in the mental health cases requiring judgment of whether a person should be confined, and whether they should be medicated or left free to decide for themselves. In such cases, deprivation of liberty for noncriminal offenders is at question, but if they are released, they may be exposed to injury or injure others. “Clear and convincing” evidence is hard to prove in such cases.The TOPOFF 2 terrorism preparedness exercise was two years in planning, but the courts were involved only seven days before the exercise (because quarantine issues were added to that exercise only two weeks beforehand). Judge Murphy was put in charge of the Circuit Court building and was asked to stop all court proceedings to stop people from going into a building that might have been contaminated.
Applying the Regulatory Powers of Public Health
Authors: Monson Angela Z. , Pauls Jake , Leverett Michelle 
Published: June 2007

The advent of sales over the Internet has led to interesting developments in sales tax policy as states attempt to monitor, control, and collect revenue from illusive Internet tobacco vendors. Tobacco sales have been successfully monitored and regulated, to some extent, in convenience stores, grocery stores, and smoke shops, and in most cases sales taxes are collected. The Internet, however, is extremely difficult to regulate. States could use their regulatory powers to ban the sale of products such as tobacco and alcohol over the Internet, but enforcement would be nearly impossible.The issue of enforcement of Internet sales is extremely difficult. Keeping the products out of the wrong hands, under aged children for example, is difficult. Also, it is difficult in terms of tax policy.
New Developments in Public Health Case Law
Authors: Thiel Karen Smith 
Published: June 2007

In recent years, public health law has seen some important court decisions. Those are presented below.In Pelman v. McDonaldS Corporation, the court dismissed a complaint filed by three children who claimed that McDonald’s practices in making and selling its products were deceptive. This deception, the children alleged, caused them to consume McDonald’s products with great frequency and become obese, thereby injuring their health. The plaintiffs pled five causes of action against McDonald’s, alleging that McDonald’s: 1) failed to adequately disclose the ingredients and health effects of its products and described their food as nutritious without disclosing detrimental health effects; 2) engaged in marketing techniques geared toward inducing children to consume their products; 3) acted negligently in selling foods high in fat, cholesterol, salt, and sugar when studies show that foods containing these ingredients cause obesity and detrimental health effects; 4) failed to warn consumers of the quantity and qualities of levels of fat, cholesterol, salt, and sugar in its products or of the detrimental health effects of such foods; and 5) acted negligently in marketing foods that were physically and psychologically addictive.
Understanding Contemporary Millenarian Violence
Authors: Walliss John 
Published: June 2007

AbstractThe last quarter of the twentieth century witnessed several incidents of collective violence involving millenarian/apocalyptic New Religious Movements. This article reviews the academic literature that has emerged over the last few decades on millenarian violence, focusing on the key recurring characteristics and dynamics that have been highlighted by commentators as playing a significant role in both predisposing millenarian groups to volatility/violence, and also in precipitating these incidents of collective violence.
Crossing Boundaries, Crossing Scales: The Evolution of Environment and Resource Co‐Management
Authors: Plummer Ryan , Armitage Derek 
Published: June 2007

AbstractAs an approach to mediating human–environment interactions, the co‐management of natural resources influences a diverse array of geographic endeavors. This article chronicles the development of the concept from its historical roots to the more recent past, where it has gained prominence as a tenable solution in situations of competing property claims and as a model of environmental governance. In surveying more that 15 years of experience with co‐management, we draw attention to several points of contention or debate, including concerns about power‐sharing and representation in co‐management arrangements, and the imprecise use of the term. Despite these tensions, the concept of co‐management continues to evolve and is attracting increasing attention. In probing the frontier of this subject, we highlight theoretical developments, evaluative challenges, cultural and ethical sensitivities, and the need to embrace uncertainty and complexity through adaptation and learning. Concluding reflections recognize the multifaceted nature of co‐management, potential benefits, and importance to geographers.
Possession Anxiety: The Other Side of the Castration Complex
Authors: Sabbadini Andrea 
Published: June 2007

ABSTRACT Castration anxiety ‐ which is related to the expectation of the loss of a precious object ‐ is only one aspect of the castration complex. Attention is here drawn to its other side, so far neglected in psychoanalytic theory, which I propose to term‘possession anxiety’. Possession anxiety relates to the presence of an ambivalently charged object, which can take its power from the person possessing it. The person will then fear losing control over the object. Possession anxiety is a normal phenomenon, though it is most evident in sexual perversions and anorexia nervosa. It is symbolically represented by the phallus and is associated to the genital stage of psychosexual development.I briefly examine this concept from the viewpoint of its temporal connotations and in its psychotherapeutic significance for the understanding of the transference. I use as illustration fragments from child observation and from my clinical work with analytic patients.
From Envy to Therapeutic Empathy
Authors: Mester Roberto 
Published: June 2007

ABSTRACT Envy and empathy are both object‐related manifestations. The therapist's experience of envy in the course of the therapeutic process is potentially a springboard to the empathic understanding of the patient's immediate psychological state. Fragments of psychotherapies illustrate: (1) the gradual transmutation of the therapist's internalised image of the patient through the progressive understanding of the therapist's own envy; (2) how the resolution of the therapist's envy opens the way to therapeutic empathy.Countertransferential envy may block the road to therapeutic empathy. The blockage in the cases discussed in this paper function mainly through the use of projection, projective identification and extensive denial. The activation of such mechanisms was rooted in: (1) fear of loneliness and abandonment; (2) anxiety about losing control of aggressive impulses; (3) narcissistic pain. The detection and elaboration by the therapist of his/her own envy removed the blockage to understanding and permitted the empathic analysis of the envied qualities of the patients.
Sexual Abuse in Schools
Authors: Gaitonde Alison 
Published: June 2007

SUMMARYThe frequency of both allegations and overt sexual abuse within schools could not be established because no records are kept apart from the Department of Education and Science who hold figures of prosecuted cases. In contrast, the daily press suggests sexual abuse in schools is frequent. Research of paedophiles indicates their preference for work in schools.Clinical cases are described illustrating different types of sexual relationship and group processes within a school following an allegation. The difficulty of establishing the truth is discussed. It is suggested that children may not be properly protected at present.
The Psychotic Adolescent in the Group
Authors: Kwiatkowski Richard M. 
Published: June 2007

ABSTRACT: The transition from troubled adolescent to working group member is rarely achieved with ease. The adolescent psychotherapy group with its tendency towards higher group anxiety levels and subsequent skilled defences, and its dependence on behavioural rather than verbal expression requires particular attention. When a psychotic psychopathology is then superimposed upon an already turbulent adolescent process the difficult task of integrating the adolescent into the therapeutic group is massively intensified.In this paper I shall address myself both to the Psychotic Adolescent in the context of the therapeutic community and more specifically in the psychotherapy group.
The Treatment of Acute Schizophrenic Patients in Private Practice
Authors: Karon Bertram P. 
Published: June 2007

ABSTRACTThere are more schizophrenic patients outside hospitals than in them. Acute schizophrenics are a varied group of patients who very frequently may be best treated in outpatient office practice. They need a therapist who is strong enough to be a protective object and an auxiliary ego and who will deal with the unconscious meaning of the hallucinatory and delusional experiences. Relatives may provide support and housing for patients who would otherwise be hospitalised. Relatives can tolerate a psychotic individual surprisingly well if they see this as a response to an emergency situation which will be necessary for only a month or two at most. The availability of the therapist to the patient by telephone also permits the patient to deal with experiences and situations that would otherwise overwhelm him and require hospitalisation, or end in suicide. How to deal with patients without medication or how optimally to use medication, if that is the therapist's or the patient's preference, is discussed. In the light of current evidence it is clear that prolonged and continuous medication is not neurologically in the patient's best interest.
The Rediscovery of the Lost Twin: An account of therapy for a child and his parents
Authors: Small Jacqueline , Greenway Muriel 
Published: June 2007

ABSTRACT. A tame‐year‐oldboy whose twin brother had died at birth presented will longstanding, severe psychosomatic symptoms previously resistant to treatment. A combination of milieu and an therapy for the child together with parent and family interviews proud asst in allowing suppressed grief to be acknowledged by parents and child, with consequential alleviation of his symptoms and resumption of normal development and social progress.
‘Therapy Contained Suicide’in the Inpatient Treatment of a Schizophrenic Adolescent ‐ Vicissitudes of Countertransference
Authors: Hazan Yoram 
Published: June 2007

ABSTRACTIn the treatment of an adolescent in a psychoanalytically‐oriented ward a unique schizophrenic experience emerged which allowed for an interaction with the therapist through which we were able to learn of therapists’inner experiences in reaction to the suicide of a patient. The dynamic process of the schizophrenic experience is presented as well a as comparison of the therapists’descriptions of the feelings after the death of a patient with the feelings that arose in this treatment. Through these presentations we shall attempt to understand better the emotional, no of such an encounter.
Infancy and Childhood: A Jungian Vertex
Authors: Sidoli Mara. 
Published: June 2007

SUMMARY. In this paper I have tried to give an account of the way in when a Jungian approach to infancy and childhood has developed and is still evolving, beginning with Jung's early on childhood as a stage of adaptation to the demands made on the child by the external world, and his idea that the child is, as it were, still enclosed in the psychic atmosphere of his parents until the onset of adolescence when lie consciously begins m separate from them. Into, United States Frances Wicker was a contemporary of Jung who worked with children, but her ideas on the subject entered very little from Jung's own.It was Michael Fordham who, in the 19501 made a great contribution to the field of Jungian child analytical psychology by applying Jung's theories of the self, the archetype and individuation to infancy and childhood. He conceptualised a primal self, the totality of psychesoma in a germinal stage from the tarp start of intrauterine life, a steady state of integration from which the child's psyche and his physical growth will unfold through a dynamic process which he named deintegration‐reintegration processes. Applying the theory of archetypes to infancy means that a predisposition exists in the child to develop archaic ideas, feeling and phantasies without their being implanted in him and without his interesting then.Following Fordham, I proceed to discuss how the instinctual discharges in Infancy get modified by the experience of being mothered, and how the baby discovers background images which both fit and evoke his experience. I compare Fordham's definition of a‘primary integrated state’with concepts used by both Bion and Meltier to describe a similar primitive state of affairs then consider the function of the mother as the container of the baby's body and mind, as well as an orientating cents which enables the baby to build up his internal and external sense of space and time. From this point go on to consider the process o took separation individuation and quote an example from an infant observation of a baby girl who took along time to come to life.
How the Infant Develops a Sense of Time
Authors: Sabbadinil Andrea 
Published: June 2007

SUMMARY. The initial lack of differentiation between self and object, the predominance of the pleasure principle, of primary process functioning and of primitive narcissism are reflected in the infant's experience of time as a mono‐dimensional omnipresent, related to the timelessness of the Unconscious.With the gradual establishment of object relationships, object and self constancy, secondary process functioning and the reality principle, the child begins to experience time in a differentiated past/present/future perspective.I briefly illustrate the connection between disturbances in the development of the sense of identity, time awareness and object relationships, with material from the analysis of two adult patients: a borderline artist and a‘replacement child’.
Schizophrenia, Genetics and Analytical Psychology
Authors: Royston Robin 
Published: June 2007

ABSTRACT.A brief summary of genetic research into schizophrenia is followed by a résumé of Jung's ideas regarding the psychology of schizophrenia. The latter is then discussed in the light of recent biological findings followed by a discussion of the tendency to see psychological factors as causative. Finally, a model incorporating biological and psychological factors based on Jung's hypothesis is proposed.
The Origins of Transpersonal Psychology
Authors: Guest Hazel 
Published: June 2007

ABSTRACT.This paper discusses some of the concepts in the theory and practice of transpersonal psychology and the sources from which they have been derived. The basic concept of the ‘self as distinct from the‘ego’is characteristic of most Eastern philosophies. The use of imagery as a means of contacting unconscious material can be traced back through the esoteric practices of both West and East, its recent applications having been developed by Carl Jung and Roberto Assagioli. Abraham Maslow began modern research into transcendental altered states of consciousness with his research on peak‐experiences.
Exploratory Therapy in Two‐Plus‐One Sessions I ‐ Rationale for a Brief Psychotherapy Model
Authors: Barkham Michael 
Published: June 2007

ABSTRACT.This paper presents the rationale for a brief form of psychotherapy based on the Conversational Model of psychotherapy developed by R F Hobson. In the proposed model, termed Two‐Plus‐One Exploratory therapy, clients are seen for two sessions one week apart followed by a third session three months later. Issues pertaining to service delivery needs and client selection are discussed prior to presentation of (1) the clinical basis for the model, and (2) the research bases relating to number of treatment sessions, treatment span, and planned follow‐up. The implications of implementing the proposed model for both psychotherapy researchers and clinicians are discussed.
Exploratory Therapy in Two‐Plus‐One Sessions II ‐ A Single Case Study
Authors: Barkham Michael , Hobson Robert F. 
Published: June 2007

ABSTRACT.This paper presents a single case study employing a model of brief Exploratory therapy, termed two‐plus‐one therapy, in which a client, Doris, presenting with an intense fear of thunder, was seen for two sessions one week apart followed by third session three months later. The therapist was Dr Robert Hobson and the three sessions were videotaped. The paper presents five central components of the model: (1) focus on the client's affect; (2) identification of a focal issue; (3) personal meaning of dream content; (4) emphasis on the interpersonal process in the ‘here and now’; and (5) identification of a narrative point of origin. These components are presented with extensive use of verbatim transcripts of the sessions to illustrate these components together with the techniques used in this mode of brief therapy. The changes achieved, and not achieved, in the client's pathology are discussed.