In this issue of the American Journal of Bioethics, manuscripts focus on the obligations of clinicians and researchers in pragmatic clinical trials (Garland, Morain, and Sugarman 2023; Morain and L...

Femicide is an ongoing public health and human rights crisis of global proportions. Currently, however, there is a relative vacuum of ethics theory and discussion about femicide amongst the health professions. This article draws from three illustrative case examples along the continuum of femicide to explore contemporary ethical concerns relevant to addressing gender-based violence and death through clinical medicine and public health. Using an epistemic justice framework, we analyze the relative invisibility of femicide in public health discourse today, and renew (...) a conversation about ethical issues inherent to health interventions and policy-making around femicide. (shrink)

_Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach_ offers a new, short term psychotherapeutic approach to working dynamically with children who suffer from irritability, oppositional defiance and disruptiveness. _RFP-C_ enables clinicians to help by addressing and detailing how the child’s externalizing behaviors have meaning which they can convey to the child. Using clinical examples throughout, Hoffman, Rice and Prout demonstrate that in many dysregulated children, _RFP-C_ can: Achieve symptomatic improvement and developmental maturation as a result of (...) gains in the ability to tolerate and metabolize painful emotions, by addressing the crucial underlying emotional component. Diminish the child’s use of aggression as the main coping device by allowing painful emotions to be mastered more effectively. Help to systematically address avoidance mechanisms, talking to the child about how their disruptive behavior helps them avoid painful emotions. Facilitate development of an awareness that painful emotions do not have to be so vigorously warded off, allowing the child to reach this implicit awareness within the relationship with the clinician, which can then be expanded to life situations at home and at school. This handbook is the first to provide a manualized, short-term dynamic approach to the externalizing behaviors of childhood, offering organizing framework and detailed descriptions of the processes involved in _RFP-C_. Supplying clinicians with a systematic individual psychotherapy as an alternative or complement to PMT, CBT and psychotropic medication, it also shifts focus away from simply helping parents manage their children’s misbehaviors. Significantly, the approach shows that clinical work with these children is compatible with understanding the children’s brain functioning, and posits that contemporary affect-oriented conceptualizations of defense mechanisms are theoretically similar to the neuroscience construct of implicit emotion regulation, promoting an interface between psychodynamics and contemporary academic psychiatry and psychology. Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach is a comprehensive tool capable of application at all levels of professional training, offering a new approach for psychoanalysts, child and adolescent counselors, psychotherapists and mental health clinicians in fields including social work, psychology and psychiatry. (shrink)

In response to its current crisis, scholars call for the revitalisation of democracy through democratic innovations. While they make ample use of life metaphors describing democracy as a living organism, no comprehensive understanding of ‘life’ has been established within democratic theory. The Black Lives Matter (BLM) movement articulates the urgency of refocusing on life and its meaning through radical democratic practice. This article employs a grounded theory approach, enriched with participatory methods, to develop a radical democratic concept of life in (...) conversation with BLM. It conceptualises life as the existence of a perspective that constantly transforms through its fundamental interconnectedness. Building on this concept, the article outlines four principles of a living democracy that go beyond the revitalisation discourse. A living democracy (1) safeguards the existence of all humans and nonhumans, (2) nurtures a diversity of perspectives, (3) fosters social and planetary connectivity, and (4) enables self- and collective transformation. (shrink)

Successful formulation and implementation of end-of-life care requires ongoing communication with the patient. When patients, for reasons of general medical or psychiatric illness, fail to verbally communicate, providers must be receptive to messages conveyed through alternate avenues of communication. We present the narrative of a man with schizophrenia who wished to forgo hemodialysis as a study in the ethical importance of attention to nonverbal communication. A multilayered understanding of the patient, as may be provided by both behavioral and motivational models, (...) can inform the provider’s ability to receive, process, and represent communicated content to the patient or his or her surrogate decision-maker. (shrink)

Volume 20, Issue 5, June 2020, Page 26-28.

It is widely believed that gender role attitudes are more traditional in the southern United States than elsewhere in the nation. We examine this notion, using eight gender-related questions from the NORC General Social Survey data. Responses to these questions suggest that Southerners tend to hold more conservative opinions on questions about women in politics and employed women. On questions of whether employed women can be good mothers, however, Southern and non-Southern opinions are very similar. An examination of how Southerners (...) and non-Southerners answered the gender questions over time shows that attitudes in both regions have become more egalitarian. (shrink)

This article examines the ethical basis for government involvement in health care. It first provides the case for individual autonomy, focusing on the justifications–particularly ethical ones–for allowing individuals to make their own choices in health care, and to control more of their own resources in doing so. Next, it provides the opposite case–for abridging individual autonomy, and in particular, for redistributing resources from those who are well off to those who are not. The overriding reason for favouring the latter case, (...) which trumps the notion of individual autonomy, is to ensure that individuals who are at a disadvantage have an equal probability of attaining good health. (shrink)