The author contends that overworking residents cannot be ethically justified. There is evidence that overwork is detrimental both to the resident and to the patient. In addition, thu argument that working long hours is essential to maintain medicine's status as a profession is analyzed. The claim cannot be supported by definitions of professionalism. Although Flexner's definition does specify altruism as an essential component, it does not justify long working hours for residents. Altruism is obligatory in some limited cases, but only (...) when it is required to fulfill some contractual obligation. Keywords: professionalism, altruism, residency, medical education CiteULike Connotea Del.icio.us What's this? (shrink)

The author discusses conceptual problems in psychiatry, illustrated by a debate over inclusion of a new disorder, masochistic personality disorder, in DSM-III-R, the manual of psychiatric diagnoses. While the DSM committee has attempted to avoid assumptions about theory and values in an attempt to be scientific, this has proved impossible, as theory is an integral part of scientific observation and values are a prerequisite for any judgment. The foundation for psychiatry cannot be theory – it can only be patient need. (...) Keywords: psychiatry, diagnosis, disease, illness, mental illness, women CiteULike Connotea Del.icio.us What's this? (shrink)