bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decisionally Impaired Persons in Research: Refining the Proposed Refinements
Authors: DeRenzo Evan G. 
Published: June 2007

The ethics of involving persons with cognitive impairments and/or mental illness in research continues to gain academic and public attention. Concerns about the ability of such persons to provide ethically and legally valid consent and about the appropriateness of their research involvement in certain categories of studies have resulted in publication of guidelines, position papers, standards, and court decisions. These analyses address not only when and from whom informed consent may be obtained but also under what conditions it is ethically permissible to involve persons in research who are too decisionally impaired to provide their own consent.It is an advance in research ethics that there is heightened appreciation of the need for greater protections for, and possibly research participation limitations on, persons unable to give their own consent. In our zeal to protect potentially vulnerable subjects, however, we must craft new protections carefully. Prudence is required in shaping and implementing any new protections.
Introduction: Legal and Regulatory Issues in Pain Management
Authors: Johnson Sandra H. 
Published: June 2007

The capacity to treat pain has never been greater; but, as you will read in the articles that follow, the problem of undertreated and neglected pain in the United States persists. Deep-seated perceptions and practices undergird this strong and well-documented pattern of neglect. Among the reasons frequently noted for the inadequacy of treatment for pain, however, is that the legal system actually penalizes effective interventions to relieve pain while it leaves neglect of pain unthreatened. It is the mission of the American Society of Law, Medicine & Ethics (ASLME) to explore areas, such as this one, where developments in medicine directly encounter the law and, in turn, create ethical issues for clinicians, regulators, patients, and lawyers.This special issue of the Journal of Law, Medicine & Ethics is part of a multi-year project in which ASLME, with the wonderful support of the Mayday Fund, has worked to address legal and regulatory barriers to effective pain relief.
In Search of a New Ethic for Treating Patients with Chronic Pain: What Can Medical Boards Do?
Authors: Martino Ann M. 
Published: June 2007

A decade ago, conventional wisdom in the medical establishment was that physicians treating chronic pain with opioid analgesics were at a substantial risk of being sanctioned for overprescribing by state medical regulatory boards. Dozens of articles written since have alluded to this risk as an obstacle to effective pain re1ief. In the early 1990s, a number of high profile cases in which physicians were disciplined by regulatory boards for overprescribing to patients with chronic pain were reported in the press. Although the board actions in many of these cases were eventually overturned by state judiciaries, the publicity heightened practitioners’. sensitivity to the regulatory risks associated with prescribing opioids.A review of the available data on state medical board actions nationwide for the period from 1990 to 1996 reveals that the perception of regulatory risk far exceeds the reality. Indeed, relatively few (less than 5 percent) of the disciplinary actions taken for overprescribing by state medical boards in any given year directly concern the treatment of chronic pain—malignant or nonmalignant—in patients.
The Emerging Technology and Application of Preimplantation Genetic Diagnosis
Authors: Tasca Richard J. , McClure Michael E. 
Published: June 2007

Efforts to improve the means to diagnose and treat human genetic diseases have a long history in biomedical research and medicine. Now, preimplantation genetic diagnosis (PGD) provides a new way to prevent the transmission of certain types of human genetic diseases to the next generation. It is an alternative to elective termination of pregnancies.PGD is used to test for genetic diseases that are due to defective single genes or abnormal chromosomes within days of fertilization and prior to the establishment of pregnancy. The procedure essentially begins with the biopsy of one or more cells of a cleavage stage or blastocyst stage preimplantation human embryo that has been produced by in vitro fertilization (IVF). In certain cases, PGD can be done on polar bodies—discarded by-products of egg formation containing excess chromosomes—of unfertilized eggs. Then, the cell(s), or a polar body, is placed into a tube for single gene analysis (DNA analysis by polymerase chain reaction (PCR)), or for chromosome analysis by spreading the nucleus of the cell on a microscope slide (fluorescence in situ hybridization (FISH)).
The Moral Underpinning of the Proxy-Provider Relationship: Issues of Trust and Distrust
Authors: Collopy Bart J. 
Published: June 2007

Despite clear legislative and judicial support, a well established ethical consensus, and increased efforts at information dissemination and education, proxy decision making for incapacitated patients continues to produce moral muddle and poor resolutions in end-of-life care.In her analysis of the proxy-doctor relationship, Nancy Dubler spells out the institutionalized patterns that keep the promise of proxy directives so often unrealized. Facing medically complex care of an incapacitated patient, health care teams are apt to view the proxy as a potentially indecisive or unrealistically demanding decision-maker, less a stand-in for the patient than an interloper whose improper, misguided, or self-interested decisions will work against the patient's best interests. So perceived, proxies are routinely relegated to the edges of care planning discussions, left relatively uninformed and unconsulted, and then suddenly thrust center stage to face decisions they find overwhelming. Confronting such decisions, proxies need support and compassion. What they often find is isolation and distrust, a web of professional and institutional practices that trammel their efforts to understand and execute their role.
Extubating Mrs. K: Psychological Aspects of Surrogate Decision Making
Authors: Powell Tia 
Published: June 2007

Mrs. K is a thirty-one-year-old Russian-speaking mother of two, who was brought in by ambulance after attempting suicide by jumping in front of train. Probable depression x months. Stressor: lost custody battle over older child. Current status: deep coma, ventilator-dependent, and prognosis grim. Next of kin is estranged husband; he demands participation in medical decision making. Legal proxy is patient's boyfriend; forcibly removed from the intensive care unit (ICU) for agitated behavior and alcohol intoxication.I magine the difficulty for the ICU staff as it tries to patch together the broken body of Mrs. K, described above. If, as appears likely, the physicians’ efforts begin to fail, who will speak for this patient, who can no longer speak for herself, and determine the appropriate goals and limits of intensive medical care?
Compassionate Release from New York State Prisons: Why are So Few Getting Out?
Authors: Beck John A. 
Published: June 2007

It is inevitable that some inmates in large state prison systems will suffer from terminal conditions and die while incarcerated. But how those inmates experience that event is primarily controlled by correctional policies and by the prison medical and correctional staff assigned to their care. Compassion for inmates who are dying cannot be legislated or mandated, but humane and compassionate care for the dying can be facilitated or thwarted by legislative and correctional policies, and by the manner in which correctional personnel interpret those policies.Death in New York State prisons is a frequent event, occurring at a rate substantially higher than that in most other states. With a prison population that has risen to 70,000 inmates and with the nation’s highest rate of human immunodeficiency virus (HIV) infection, more than 2,817 inmates died in New York prisons during the period 1990-1998. In April 1992, in the face of an ever-increasing death rate in its prisons, the New York State legislature passed the Medical Parole Law, a measure designed to permit dying inmates to be released on parole prior to their normal release eligibility date.
Suicide in Adult Correctional Facilities: Key Ingredients to Prevention and Overcoming the Obstacles
Authors: Hayes Lindsay M. 
Published: June 2007

Despite increased general awareness of suicide in U.S. adult correctional facilities as well as the availability of research and correctional standards that advocate increased attention and services to potentially suicidal inmates, prevention efforts within correctional facilities remain piecemeal and inmate suicide continues to be a serious public health problem. A robotic state of mind excuse, that inmate suicide is not preventable, impedes prevention efforts. In the following discussion, the key ingredients to comprehensive suicide prevention programming are offered to dispel these obstacles.Suicide is a leading cause of death in jails across the United States, with well over 400 inmates taking their lives each year. In some urban jail facilities, deaths related to acquired immune deficiency syndrome (AIDS) slightly outnumber deaths by suicide. The rate of suicide in county jails is estimated to be approximately nine times greater than that of the general population. Overall, most jail suicide victims are young white males who have been arrested for nonviolent offenses and were intoxicated when arrested.
Death and Dying in Prison in Australia: National Overview, 1980–1998
Authors: Dalton Vicki 
Published: June 2007

This paper discusses the role of the Australian Institute of Criminology (AIC) in monitoring inmate deaths in custody on a national basis. It also provides a descriptive overview of Australian Indigenous and non-Indigenous inmate deaths in custody during the eighteen-year period between 1980 and 1998.In October 1987, the Royal Commission into Aboriginal Deaths in Custody (RCIADIC) commenced investigating the deaths of Australia's Indigenous people in custody throughout Australia between January 1, 1980 and May 31, 1989. RCIADIC's task was to examine the circumstances of the deaths; the actions taken by authorities; and the underlying causes of Indigenous deaths in custody, including social, cultural, and legal factors. The investigation found that the major factor contributing to the high number of Indigenous deaths in custody was the disproportionately higher rates at which Indigenous people come into contact with the criminal justice system. RCIADIC concluded that the most significant reason for this contact was the severely disadvantaged social, economic, and cultural position of many Indigenous people.
Commentary: Mal-Intentioned Illiteracy, Willful Ignorance, and Fetal Protection Laws: Is There a Lexicologist in the House?
Authors: Marshall Mary Faith 
Published: June 2007

We should not investigate facts by the light of arguments, but arguments by the light of facts.Myson of Chen, one of the Seven Sages ca. 600 B.C.To settle scores as well as problems, to shake things up, to make people think about what they said and wrote, to be provocative without being unjust ...Kingsley AmisIn their critique of Wisconsin's revised child protection Statute, Kenneth De Ville and Loretta Kopelman argue rightly that “words matter.” Word mongering infects most political dialogue and is nowhere more virulent than in the American abortion debate. Dichotomies such as “ unborn child” and “fetus,” expectant mother” and “pregnant woman,” “anti-choice’’ and “pro-choice,” “pregnancy termination” and “murder” symbolize the polarity of the abortion argument and the importance of language as a powerful conceptual weapon. The debate over reproductive rights is a war often fought on a linguistic battlefield. There, combatants forgo rules of engagement. Mal-intentioned illiteracy, ranging from the puerile to the vituperative, is always strategic.
Bajakajian: New Hope for Escaping Excessive Fines under the Civil False Claims Act
Authors: Ballengee Melissa 
Published: June 2007

Ever since the U.S. Attorney General named health care fraud as the government's second highest priority after violent crime, the government has cracked down on health care fraud and abuse. Some of this crackdown has been needed. The General Accounting Office (GAO) estimates that as much as 10 percent of all government expenditures on health care are being siphoned out of the system because of fraud or abuse.The extreme measures taken to curb health care abuse have raised eyebrows, however. The American Medical Association and the American Hospital Association both have been vocal in their disapproval, describing the current enforcement initiative as “absolutely out of control.” The associations even went so far as to file suit to enjoin the government's actions.
Public Health Preparedness and the Law in Communities of Color
Authors: Randall Vernellia R. , Safford Glen , Williams Walter W. 
Published: June 2007

Public health preparedness must use a comprehensive approach that includes both communities and public health systems. There are three basic questions that should be asked when evaluating public health preparedness in communities of color: 1) Is the community basically healthy?; 2) Does the community have access, to necessary information, resources and services?; and 3) Are the information, resources and services available and provided to the community in a nondiscriminatory manner?Racial-based health disparities is a well documented fact for many communities of color. Individuals from these communities tend to have more morbidity and higher mortality. This health disparity is race based and not just a function of social class. Similarly, access to basic goods and health care is racialized and class based.
Particle Verbs and Argument Structure
Authors: McIntyre Andrew 
Published: June 2007

AbstractThe article describes the data and literature pertaining to the argument‐structural behaviour of verb–particle combinations in Germanic languages. This topic is of interest for theories of complex verb formation and of verbal and prepositional argument structure. While serving as an introductory text for readers unfamiliar with particle verbs, the article should also interest particle specialists because it highlights problems with existing theories and provides a broader taxonomy of the argument‐structural effects of particles and their interactions with other arguments than has hitherto been offered.
How Linguistics Has Influenced Schools in England1
Authors: Hudson Richard 
Published: June 2007

AbstractThe article reviews a number of changes in English schools that can be attributed to the influence of linguistics. The most obvious one is the introduction of a course on the English language, which occupies about a third of the last 2 years of secondary school (A‐level English language) and which has proved extremely popular with pupils. Other changes are due to two influential ideas: language awareness (the subject ‘language’ unites English and foreign‐language classes and pupils should learn about its general characteristics) and knowledge about language (pupils should learn explicitly about language structure). These two ideas have had a major impact on recent changes in the teaching of both first‐language English and foreign languages, both of which have emerged from a ‘grammarless’ period; the teaching of grammar (and other aspects of language structure) is now required by official documents, although it is not always easy for teachers who themselves know little grammar.
Myths and Modes of Motherhood
Authors: Raphael‐Lef Joan 
Published: June 2007

ABSTRACT: It is postulated that some metapsychological concepts, once popularized, acquire the reified status of a Myth which may outlive its usefulness and/or validity and yd remain influential beyond its time.Ten psychoanalytical ‘myths’ relating to femininity, mothers and motherhood are to examined in the tight of historical, social and theoretical developments:1. The myth of the castrated mother2. ‘Anatomy is destiny’3, Female passivity and masochism4. Baby = penis5. Femininity is unfulfilled before motherhood6. Maternal instinct7. There is a right way to mother8. Asocial, antisocial or sociable infant?9. Mother‐baby symmetry of needs10. Mothering the exclusive, full‐time commitment of the biological mother.Two contrasting modes of mothering are formulated, each illustrating different elements of these myths.The conclusion is that a theoretical framework describing or prescribing femininity and/or motherhood a single, static entity, inevitably obscures the complex Variations between women and mother, in their personal and historical development over time, Adherenre to outdated myths prejudices our psychotherapeutic work with female patience.
Surviving Trauma ‐ Dilemmas in the Psychotherapy of Traumatised Children
Authors: Lanyado Monica 
Published: June 2007

SummaryThe therapeutic process that was significant for the recovery of two traumatised children is described. Exploration of the meaning of the trauma for the children led me to believe that they had experienced it as their internal and external parents failing to protect them from disaster. In addition to this, they felt that their parents had further failed them by being unable to contain their children's distress after the event.The therapy developed in such a way that I found that I had to be in a state of mind which was like that of the devoted mother's reverie for her infant. This helped the children to feel totally contained again and, having re‐introjected this experience, they slowly started to recover and face the demands of growing up. Attention is drawn to the similarities of this therapeutic process to normal family development.Both children had extreme difficulty in talking about their traumatic experience, and could only communicate it to me by projection in the transference relationship. In view of their immaturity, verbalisation may not be as important or helpful for these children as containment of the non‐verbal communication.
CLINICAL COMMENTARY
Authors: Sidoli Mara 
Published: June 2007

ABSTRACT: My impression on reading this observation is that the mother does not hold the baby enough in her mind. She does not hold him in her arms either and generally conveys the impression of experiencing him as clinging and potentially dangerous. He seems to use his muscles to hold himself together and appears compliant and does not protest by crying in several instances where crying might have been appropriate. His skin rash and snuffling are in my view somatisations of his feeling unheld and distanced by mother. Note that mother associates her cold and bronchitis with the loss of her father. Jimmy seems to be somatising the loss of the breast.This mother and baby couple appear very often not to be in tune with each other. The only good and rewarding experience for Jimmy appears to be the bottle‐feeding although again mother interrupts before he has finished.
The Outcome of Maritally Focused Psychotherapy offered as a Possible Model for Marital Psychotherapy Outcome Studies
Authors: Balfour Frederick , Clulow Christopher , Dearnley Barbara 
Published: June 2007

Abstract. A model for describing and judging change in a couple relationship is set out, drawing on a follow‐up method established at the Tavistock Clinic for the assessment of change in individual patients. We present the follow‐up work done with the couple in the chronological order in which it occurred.Our aim is to show how a psychodynamic formulation of a relationship can be made by using the concept of the shared unconscious phantasy as a factor which describes and justifies treating separate individuals as part of a single system. We suggest that such a framework provides an economic method of formulating a base from which to assess change.
Handling Overdetermination in Short‐Term Dynamic Psychotherapy
Authors: Pierloot R. A. 
Published: June 2007

Abstract.In psychoanalytic conceptions the overdetermination of symptoms by preoedipal as well as oedipal conflicts has been stressed. This entails the necessity of analysing successively the unconscious contents with relation to the different stages of infantile development. This can be realized in a classic analysis, prolonged over a long period of time.In short‐term dynamic psychotherapy focusing on one crucial conflict is essential in limiting the length of the therapy. But what about other conflicts, co‐determining the disorder? A possible solution is offered by Malan, by introducing in a systematic way the separation‐individuation conflict in the endphase of the therapy.Another possibility for the problem of overdetermination consists of integrating some elements of other conflicts in the analysis of the focal conflict. This is justified by the idea that in childhood development the working up of later conflicts is impregnated with fixations in former stages. So the elaboration of the oedipal conflict is often coloured by elements of oral fixation. Also negative and positive oedipal desires are often mixed up. This creates the possibility that, although focusing on an oedipal conflict, some aspects of deeper conflict material are revealed. These ideas are illustrated by two case‐histories.
Shame and Envy
Authors: Berke Joseph H. 
Published: June 2007

Abstract.‘In this paper I have discussed the nature of shame and its relation to envy. Shame arises from a sudden unwelcome awareness about oneself, while envy is provoked by the painful perception of discrepancies between oneself and another. Both shame and envy aim to eliminate the subsequent tormenting inner tension by rageful, destructive attacks on the real or imagined causes of the torment. However, with shame it is the tension itself which most people recognise as shame, while with envy it is the angry discharge which follows. In fact the model is the same for both which leads to the conclusion that shameful tension is a variation of, as well as a contributor to, envy.
The Metaphor of Twinship in Personality Development
Authors: Fisher Susan 
Published: June 2007

Abstract.To develop one's own separate identity and sense of personal authority is a particularly difficult task within a twinship relationship. Twinship creates the additional obstacle of separating from a need‐satisfying sibling before progressing to the struggle for separation from mother. This paper examines these difficulties within the metaphor of twinship, linking them to the development of identical twins, object relationships and psychotherapeutic practice. Twinship is discussed as a schizoid phenomenon, with reference to reality, narcissism, relatedness, mirroring, dependency needs, boundaries and space.
An Integrative Approach to Couple Therapy: Altering the Treatment Modality to Resolve an Impasse
Authors: Cohn Barbara R. 
Published: June 2007

ABSTRACTIn this article the author demonstrates an integrative approach to couple therapy in order to resolve a treatment impasse. The systematic alternation of individual and couple sessions was introduced into an ongoing couple treatment. This change in treatment modality enabled necessary work on the self systems of members of the couple which in turn improved the couple relationship. The author uses an understanding of object relations, self psychology, and systems thinking both to explore the dynamics of the couple and to explain why the restructuring of the treatment was useful.