A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

Alvin Goldman develops the concept of “core voter knowledge” to capture the kind of knowledge that voters need to have in order that democracy function successfully. As democracy is supposed to promote the people's goals, core voter knowledge must, according to Goldman, first and foremost answer the question which electoral candidate would successfully perform in achieving that voter's ends. In our paper we challenge this concept of core voter knowledge from different angles. We analyse the dimensions of political trustworthiness and (...) their relevance for the voter; we contrast two alternative orientations that the voter might take—an “outcome-orientation” and a “process-orientation”; and we discuss how an expressive account of voting behaviour would shift the focus in regard to the content of voter knowledge. Finally, we discuss some varieties of epistemic trust and their relevance for the availability, acquisition and dissemination of voter knowledge in a democracy. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Driven from Home: Protecting the Rights of Forced Migrants Edited by David Hollenbach, SJ, and: Kinship across Borders: A Christian Ethic of Immigration by Kristen HeyerRené M. Micallef SJDriven from Home: Protecting the Rights of Forced Migrants EDITED BY DAVID HOLLENBACH, SJ Washington DC: Georgetown University Press, 2010. 296 pp. $20.46Kinship across Borders: A Christian Ethic of Immigration KRISTEN HEYER Washington DC: Georgetown University Press, 2012. 210 pp. (...) $29.23Although based on a conference held at Boston College in November 2008, Driven from Home is no less timely today, given the context of current debates on immigration in the United States, the European Union, Australia, and the Middle East. David Hollenbach’s introduction explains how the book brings together Christian (mostly Catholic) theologians, human rights activists, humanitarian practitioners, and legal scholars to help us focus on a class of persons referred to as “forced migrants” or “persons needing protection.” These individuals are neither classical “convention refugees” (according to international law definitions) nor are they simply “migrant workers” (in the classical sense) since their basic human rights to security and subsistence cannot [End Page 230] be adequately guaranteed in their home country or region. They do not emigrate merely in search of a higher standard of living; rather, forced migrants enter and settle in foreign lands seeking some sort of “protection” similar to that afforded to “conventional” refugees. More concretely, the book focuses on persons on the move—individuals fleeing violence and the extreme poverty rampant in regions devastated by ecological degradation and natural disasters.Extending the logic of the 1952 Refugee Convention and adapting it to the realities of today, one can argue convincingly that the international community has a duty to protect such persons when their states of origin are structurally unable or unwilling to afford protection (as argued in Susan Martin’s essay). However, paternalistic approaches that diminish rather than augment the agency of local governments and migrants are to be avoided (as maintained in M. Brinton Lykes’ essay). The book helps us reflect on what can be done to guarantee the basic rights of forced migrants not only at the level of international law and institutions but also through domestic and regional policymaking spurred and inspired by both Christian and secular global-humanitarian values. Such values are eminently compatible when applied to this particular issue (see Silvano Tomasi’s contribution). Agbonkhianmeghe Orobator’s essay—which offers insightful reflections (albeit rather general ones) from Christian ethics, ecclesiology, and biblical theology—likewise points to the need for a truly interdisciplinary approach to the issue. The other authors help the book achieve precisely this. Theological ethics finds its own distinctive place and voice in dialogue with a range of perspectives: legal and political sciences and case studies (Frank Brennan, Daniel Kanstroom); philosophical approaches (Arash Abizadeh); and sociological research on particular migrant populations (M. Brinton Lykes, Maryanne Loughry). The book includes essays that integrate case studies, technical reflections, useful summaries of theological principles and doctrines (J. Bryan Hehir, Mary M. DeLorey, and Tomasi), and philosophical stances (Abizadeh, Thomas G. Weiss), and present practical and legal proposals (see Martin’s essay). A stimulating read for scholars and for the general public, the volume provides good training material for faith-based activists and practitioners.The argumentation strategy in many of the essays in Driven from Home is to appeal to the reader’s sense of solidarity with the needy or suffering neighbor. It promotes the virtues of hospitable citizenship and hospitable disciple-ship while carefully trying to convince national and international policymakers to reinforce and expand the international protection regime. Emboldened by the 2005 “Responsibility to Protect” breakthrough at the United Nations, the authors seek to remain acceptable to a wide audience in an atmosphere of resurgent nationalism, nativism, and protectionism. The authors generally avoid harsh critiques of Westphalian models of sovereignty and do not dwell [End Page 231] on the Catholic doctrines of the universal destination of created goods and the (circumscribed) right to immigrate (and not only to emigrate). Rather, they seek to introduce a new protection niche without fundamentally challenging the prevailing ideology of sovereignty, gently proposing new legal instruments as though they... (shrink)

A brief, systematic exposition of the positions of seven classical thinkers on the subject of the logical and/or methodological unity of human knowledge. McRae writes methodically and accurately on a difficult subject.--R. G. M.

The paper is concerned with explaining some of the principal theoretical developments in elementary particle physics and discussing the associated methodological problems both in respect of heuristics and appraisal. Particular reference is made to relativistic quantum field theory, renormalization, Feynman diagram techniques, the analytic S-matrix and the Chew — Frautschi bootstrap.

Although rationing of scarce health-care resources is inevitable in clinical practice, there is still limited and scattered information about how physicians perceive and execute this bedside rationing (BSR) and how it can be performed in an ethically fair way. This review gives a systematic overview on physicians’ perspectives on influences, strategies, and consequences of health-care rationing. Relevant references as identified by systematically screening major electronic databases and manuscript references were synthesized by thematic analysis. Retrieved studies focused on themes that fell (...) under three major headings: (i) conditions and influences of BSR, (ii) strategies of BSR, and (iii) consequences of BSR. The range of themes indicates that physicians’ rationing behavior is highly variable, strongly influenced by context-related factors, and consists mainly of implicit rationing strategies. Torn between patient advocacy and the obligation to contain costs, physicians experience various role conflicts. The development of explicit rationing strategies seems necessary to avoid arbitrary BSR and allow a fair allocation of health-care resources. (shrink)

OBJECTIVES: To measure the preference regarding disclosure of a serious diagnosis, and its determinants, of the Lebanese public. DESIGN AND SETTING: Non-random sample survey of 400 persons interviewed in health care facilities in Beirut in 1995. RESULTS: Forty-two per cent of respondents generally preferred truth not to be disclosed directly to patients. Preference for disclosure was associated with younger age, better education and tendency to rapport-building with physicians. There were no meaningful associations between place of residence (urban/rural), level of religious (...) practice, or religious affiliation, and preference for disclosure. CONCLUSIONS: Under one plausible interpretation, this survey suggests that the expectation for concealment will decrease as the advantage of knowledge in better coping with disease is understood by an increasingly better educated public, and that the Lebanese public will increasingly come to expect direct and full disclosure of serious diagnoses. (shrink)

Anecdotal reports obtained from three individuals with prosopagnosia, all of whom have participated in an investigation, capture the essence of their impairment. This article focuses on the contrast between two prominent forms of prosopagnosia, one of which results from an acquired brain insult in an otherwise premorbidly normal individual and a second which appears to be lifelong and occurs in the absence of any obvious brain damage, at least as evident on conventional brain imaging. It reviews two central issues: the (...) first concerns the similarities and differences in the psychological representations of faces in acquired prosopagnosia and congenital prosopagnosia, and the second concerns the nature of the underlying neural representations of faces in these two populations. Some well-established overlapping behavioral characteristics are identified. (shrink)

When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new ef orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate i ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should clinical (...) innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so. (shrink)

Background: Publications and discussions of survey research in empirical bioethics have steadily increased over the past two decades. However, findings often differ among studies with similar research questions. As a consequence, ethical reasoning that considers only parts of the existing literature and does not apply systematic reviews tends to be biased. To date, we lack a systematic review (SR) methodology that takes into account the specific conceptual and practical challenges of empirical bioethics. Methods: The steps of systematically reviewing empirical findings (...) in bioethics are presented and critically discussed. In particular, (a) the limitations of traditional SR methodologies in the field of empirical bioethics are critically discussed, and (b) conceptual and practical recommendations for SRs in empirical bioethics that are (c) based on the authors’ review experiences in healthcare ethics are presented. Results: A 7-step approach for SRs of empirical bioethics is proposed: (1) careful definition of review question; (2) selection of relevant databases; (3) application of ancillary search strategies; (4) development of search algorithms; (5) relevance assessment of the retrieved references; (6) quality assessment of included studies; and (7) data analysis and presentation. Conceptual and practical challenges arise because of various peculiarities in reviewing empirical bioethics literature and can lead to biased results if they are not taken into account. Conclusions: If suitably adapted to the peculiarities of the field, SRs of empirical bioethics provide transparent information for ethical reasoning and decision-making that is less biased than single studies. (shrink)

Versions and extensions of intuitionistic and modal logic involving biHeyting and bimodal operators, the axiom of constant domains and Barcan's formula, are formulated as structured categories. Representation theorems for the resulting concepts are proved. Essentially stronger versions, requiring new methods of proof, of known completeness theorems are consequences. A new type of completeness result, with a topos theoretic character, is given for theories satisfying a condition considered by Lawvere . The completeness theorems are used to conclude results asserting that certain (...) logics are conservatively interpretable in others. (shrink)

In the UK, over 70% of AIDS, including new cases, is located in a few Districts in central London where the distribution of previously occurring and new cases is essentially confined to the original risk groups of homosexual/bisexual men, drug addicts of both sexes, and some of their sexual partners and consorts. But control policy is still based on the assumption that HIV has already spread from persons in these risk groups into the general population, and that it will spread (...) hereafter at an increased rate because of heterosexual transmission to cause a widespread epidemic of AIDS.The basis and implications of this policy were investigated in the South East region adjacent to London, Analysis of demographic and epidemiological data shows that, with one exception, there is very little extension of AIDS from affected Districts in London to the surrounding region or even to the suburban fringe. Where AIDS is prevalent, as in this exception, the distribution follows the same, original pattern which relates essentially to risks arising from life-styles. There is no significant association between the prevalence or spread of AIDS and conventional markers of deprivation, economic and social disadvantage.Allocations of personnel, services and expenditure, assessed from returns required under the AIDS Control Act of 1987 and official registration data, continue to follow the original policy assumptions. They are therefore unrelated to the numbers of existing and new cases, disproportionate and unrealistic. Claims that this widespread excess of effort is justified by the fact that AIDS has not spread to the general population are falsified by the continuation of cases almost exclusively in risk groups. There is nothing in the data required under the Act or in registrations in this main locus of AIDS in the UK to suggest any change in this or to justify continuation of current expenditure and redundant activities.There is no evidence in these data that ethnic variations in the resident populations of Districts are associated with variations in the prevalence of AIDS. However, the larger figures available in some of the national data do indicate a disproportionate increase in some minority ethnic groups. Further detail about risks factors in these groups are required and, meanwhile, effort and expenditure should be re-orientated toward treatment, contact tracing and other public health measures for more effective containment of the continuing spread of AIDS in all the high risk groups. (shrink)

In the UK, over 70% of AIDS, including new cases, is located in a few Districts in central London where the distribution of previously occurring and new cases is essentially confined to the original risk groups of homosexual/bisexual men, drug addicts of both sexes, and some of their sexual partners and consorts. But control policy is still based on the assumption that HIV has already spread from persons in these risk groups into the general population, and that it will spread (...) hereafter at an increased rate because of heterosexual transmission to cause a widespread epidemic of AIDS.The basis and implications of this policy were investigated in the South East region adjacent to London, Analysis of demographic and epidemiological data shows that, with one exception, there is very little extension of AIDS from affected Districts in London to the surrounding region or even to the suburban fringe. Where AIDS is prevalent, as in this exception, the distribution follows the same, original pattern which relates essentially to risks arising from life-styles. There is no significant association between the prevalence or spread of AIDS and conventional markers of deprivation, economic and social disadvantage.Allocations of personnel, services and expenditure, assessed from returns required under the AIDS Control Act of 1987 and official registration data, continue to follow the original policy assumptions. They are therefore unrelated to the numbers of existing and new cases, disproportionate and unrealistic. Claims that this widespread excess of effort is justified by the fact that AIDS has not spread to the general population are falsified by the continuation of cases almost exclusively in risk groups. There is nothing in the data required under the Act or in registrations in this main locus of AIDS in the UK to suggest any change in this or to justify continuation of current expenditure and redundant activities.There is no evidence in these data that ethnic variations in the resident populations of Districts are associated with variations in the prevalence of AIDS. However, the larger figures available in some of the national data do indicate a disproportionate increase in some minority ethnic groups. Further detail about risks factors in these groups are required and, meanwhile, effort and expenditure should be re-orientated toward treatment, contact tracing and other public health measures for more effective containment of the continuing spread of AIDS in all the high risk groups. (shrink)