(2003). Ethical and Professional Demands for Forensic Mental Health Professionals in the Post-Atkins Era. Ethics & Behavior: Vol. 13, No. 1, pp. 3-9.

Hastings Center Report, Volume 51, Issue 5, Page 51-53, September‐October 2021.

A psychiatric advance directive (PAD) is a communication tool that promotes patients’ autonomy and gives capacitated adults who live with serious mental illnesses the ability to record their preferences for care and designate a proxy decision maker before a healthcare crisis. Despite a high degree of interest by patients and previous studies that recommend that clinicians facilitate the completion of PADs, the rate of implementation of PADs remains low. Research indicates that many clinicians lack the necessary experience to facilitate the (...) completion of PADs and to use them, and, as a consequence, do not effectively engage patients about PADs. This study developed practical recommendations for clinicians to improve their ability to communicate and facilitate PADs. We (1) thematically analyze definitions of PADs published in 118 articles across disciplines, and (2) present our recommendations for enhanced communication in clinical practice that emphasize patient-centeredness, usefulness, and clarity, aligned with evidence-based practices that put patients’ autonomy and understanding first. While there is no one-sizefits- all script to engage patients in complex conversations, our recommended strategies include an emphasis on patients’ autonomy, the adaptation of word choices, the use of metaphor not simile, and checking for patients’ understanding as effective methods of clinical communication. (shrink)

As in science, so in bioethics: if prohibiting conflicts of interest is not feasible, rigorous requirements for disclosure can at least manage them.

Carol Gilligan has identified two orientations to moral understanding; the dominant justice orientation and the under-valued care orientation. Based on her discernment of a voice of care, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the (...) liberal ideal. My analysis of justice -oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others. (shrink)

Edmund Pellegrino has argued that the dramatic changes in American health care call for critical reflection on the traditional norms governing the therapeutic relationship. This paper offers such reflection on the obligation to do no harm. Drawing on work by Beauchamp and Childress and Pellegrino and Thomasma, I argue that the libertarian model of medical ethics offered by Engelhardt cannot adequately sustain an obligation to do no harm. Because the obligation to do no harm is not based simply on a (...) negative duty of nonmaleficence but also on a positive duty of beneficence, I argue that it is best understood to derive from the fiduciary nature of the healing relationship. (shrink)

The productive use of English past tense morphology in school-aged children (N= 74; 3 years, 8 months to 13 years, 5 months) is explored using on elicited production task. Errors represented 20% of the responses overall. Virtually all of the children demonstrated productivity with regular (e.g., good) and irregular patterns (zero-marking, e.g., sit + sit; vowel-change, e.g., ride -+ rid). Overall frequency of errors decreased with age, yet the tendency for certain types of irregularizations increased in the older groups. Analyses (...) across items indicated that all error types were predicted by combinations of item frequency, phonological chamcteristics of stems and past tense forms, and aspects of phonological past tense “neighborhoods.” Contrary to “hybrid” or dual-mechanism models incorporating a phonologically-insensitive default mechanism (e.g., Prasada & Pinker, 1993), these results suggest that children’s productivity with regular and irregular patterns is consistent with a phonologically-based constraint satisfaction system similar to that implemented in connectionist models (Daugherty & Seidenberg, 1992; Plunkett 81 Marchman, 1991,1993). (shrink)

The purpose of this research report is twofold: First, we analyze a complex of attitudes about rape myths, adversarial sexual beliefs, and gender-role conservatism; and second, we evaluate the impact of rape-education intervention strategies on American college students' attitudes. Using the Solomon four-group design, we randomly assigned 14 classes of Sociology 101 students to three different treatment conditions: a live rape-education workshop, a video of the workshop, and a control group. We found significant gender differences in students' attitudes on all (...) the scales, with women being more knowledgeable about rape, less likely to blame the victim, and less accepting of adversarial sexual beliefs and gender-role conservatism. Most important, we found that within the limits of the study, rape-education intervention works in changing some attitudes about rape for both men and women students. We examine the impact of the different educational strategies and explore curricular implications, including the need to teach about rape within a feminist context. (shrink)

In this paper, I examine the notion of accountability and its historical evolution in health care. Using medical mistakes and adverse patient outcomes as my focus, I examine the interests served by particular models of accountability and argue for a model of collective fiduciary responsibility in U.S. health care today.

: The terms "appropriate" and "necessary" are crucial determinants in decisions regarding the use and reimbursement of medical treatments. This paper encourages greater awareness of the political, economic, and normative assumptions that give meaning to these concepts.

In the wake of the Supreme Court Decision, Dobbs v. Jackson Women’s Health Organization, Minkoff, Vullikanti, and Marshall (2024) argue that the unraveling of the constitutional right to abortion t...

Comments on G. Marcus' criticisms (see record 1996-24670-001) of K. Plunkett's and V. Marcham's (see record 1994-35650-001) connectionist account of the acquisition of the English past tense (verb morphology). The original model is reviewed. Graphing, overregularization, and other criticisms are addressed (PsycINFO Database Record (c) 2000 APA, all rights reserved).

This paper presents the behavioral interview model that we developed to formalize our hiring practices when we, most recently, needed to hire a new clinical ethicist to join our staff at the Center for Ethics at Washington Hospital Center.

Hastings Center Report, Volume 52, Issue S1, Page S3-S11, March‐April 2022.

This paper presents the behavioral interview model that we developed to formalize our hiring practices when we, most recently, needed to hire a new clinical ethicist to join our staff at the Center for Ethics at Washington Hospital Center.

Certain characteristics of childhood immaturity (e.g., infantile facial features) may have been favored by natural selection to evoke positive feelings in adults. We propose that some aspects of cognitive immaturity might also endear young children to adults. In two studies, adults rated expressions of mature and immature thinking attributed to children. Immature thinking in which children expressed a supernatural explanation elicited positive affect reactions, whereas other forms of immature thinking, which made no attribution to supernatural causation, were responded to negatively. (...) This pattern was found for parents and others, males and females, American and Spanish college students, and for target children 3 to 9 years of age. We suggest that persistence of supernatural thinking in adulthood causes people to view the expressions of such thinking in children in a positive manner, fostering nurturance of young children who display them. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

In May 2011, the clinical ethics group of the Center for Ethics at Washington Hospital Center launched a 40-hour, three and one-half day Clinical Ethics Immersion Course. Created to address gaps in training in the practice of clinical ethics, the course is for those who now practice clinical ethics and for those who teach bioethics but who do not, or who rarely, have the opportunity to be in a clinical setting. “Immersion” refers to a high-intensity clinical ethics experience in a (...) busy, urban, acute care hospital. During the Immersion Course, participants join clinical ethicists on working rounds in intensive care units and trauma service. Participants engage in a videotaped role-play conversation with an actor. Each simulated session reflects a practical, realistic clinical ethics case consultation scenario. Participants also review patients’ charts, and have small group discussions on selected clinical ethics topics. As ethics consultation requests come into the center, Immersion Course participants accompany clinical ethicists on consultations.Specific to this pilot, because participants’ evaluations and course faculty impressions were positive, the Center for Ethics will conduct the course twice each year. We look forward to improving the pilot and establishing the Immersion Course as one step towards addressing the gap in training opportunities in clinical ethics. (shrink)

In the 1960s, newborn screening programs tested for a single very rare but serious disorder. In recent years, thanks to the development of new screening technology, they have expanded into panels of tests; a federally sponsored expert group has recommended that states test for twenty-nine core disorders and twenty-five secondary disorders. By the standards used to decide whether to introduce new preventive health services into clinical use, the decision-making in newborn screening policy has been lax.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Songs of Degrees: Essays on Contemporary Poetry and PoeticsVirginia A. La CharitéSongs of Degrees: Essays on Contemporary Poetry and Poetics, by John Taggart; 254 pp. Tuscaloosa: University of Alabama Press, 1994, $29.95 paper.John Taggart is a highly respected American poet whose passion for objectivism permeates his critical reading as well as his own creative works. The volume Songs of Degrees: Essays on Contemporary Poetry and Poetics represents the (...) first time that his various critical articles have been collected into a single work. Of the eighteen essays, all but one were previously published in various journals between 1975 and 1989; the eighteenth is an essay or “A Preface” on one of his own collections of poetry, Peace on Earth. By addressing his own poetry, Taggart’s volume cleverly includes himself as poet in this study of what he considers valuable in a work of art. [End Page 398]Finding a poem to be a simple composition of words (principle) and an image suggested by that composition (process), Taggart adopts the title Songs of Degrees from Louis Zukofsy’s seven short poems published in 1956 as Some Time. A song is then a poetic form, a continuing complete statement which actualizes the separate entities (words) of its expression. However, and most importantly, a song does not begin as a visual report; rather, a song moves towards being visualized. Consequently, everything depends on technique and everything turns on its structure, as the mind coordinates the information received by the eye. Degrees, then, emerge as variations of consonance and dissonance or word-sound functions. To write down is to compose; to compose is to create. Hence, a song of degrees is both an actual object and a metaphor for that object.Under the poetic of objectivism, Taggart’s essays are primarily concerned with poets whose work is in accord with his own: George Oppen (three essays), Frank Sampori, William Bronk, Louis Zukofsy (three essays), Bruce Andrews, Susan Howe (two essays), Robert Duncan, Charles Olson, and Theodore Enslin. Taggart demonstrates here that he is a sensitive and intellectually alert reader. These essays on criticism are in actuality essays on Taggart’s concept of poetics. Implicit is Taggart’s bias as an objectivist poet who insists that poetry has a spiritual value in the visionary tradition of Robert Lowell and Robert Duncan and to an extent Wallace Stevens.But perhaps of even greater interest than Taggart’s superb readings of his poetic colleagues—and it can be justifiably argued that perhaps only Taggart can read these poets with the sympathetic eye that they deserve—is the inclusion of three essays on other arts: dance (Trina Collins), stained glass (Mark Rothko), and jazz (John Coltrane). By including these essays with those of literary criticism, Taggart expands the terms poetics and poetry to any text or object which is a moving line and complete at the same time. Form comes from language; language is then based on experience, not belief, and the resulting image is what is revealed and reflected, what is seen. A work (poem, song, text) is valuable because its visionary imagination captures the collective conscience to regain spiritual ascesis. The process of objectification is the metaphor or song, which emerges in degrees of interaction. The song has substance, it is tangible, and it has an objective existence of its own. To be critical is to objectify the composition or structure at hand. Critical is another term for technical, and indeed it is the technical aspect of writing poetry which Taggart so deftly elucidates in his volume of essays.For anyone interested in objectivist poetry, Taggart’s collection of essays is mandatory reading. His insights into this kind of cerebral poetry are invaluable, for he blends appreciation with analysis, information with inspiration, and logic with imagination. His own sensitivity to the struggle which is the poetic process brings a new consciousness to the poetics of poetry.Virginia A. La CharitéUniversity of KentuckyCopyright © 1995 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Downcast Eyes: The Denigration of Vision in Twentieth-Century French ThoughtVirginia A. La CharitéDowncast Eyes: The Denigration of Vision in Twentieth-Century French Thought, by Martin Jay; xi & 632 pp. Berkeley: University of California Press, 1993, $35.00.The book jacket flyleaf for Martin Jay’s Downcast Eyes proclaims in exuberant and laudatory terms that this study has a double agenda: one is to show that vision is by no means the (...) dominant sense in ordering Western culture and the other is to posit instead a “plurality of ‘scopic regimes, particularly in the climate of postmodernism. Indeed, antiocularcentrism provides the unifying thread of Jay’s work, which reviews the theory of vision from Plato to Bergson in the first three chapters and concentrates on “the culture of modernity” in chapters four through eight; the ninth chapter interestingly and curiously places Derrida and feminist criticism side by side under the aegis of “phallogocularcentrism” and presents Derrida and Irigaray if not as the high points of modernism, then at least as the center of the poststructuralist discourse, which argues for the elevation of the word over the eye and so offers downcast eyes as the new logo for what is now identified as postmodernism. Jay’s last chapter addresses postmodernism as a foreclosure on visual practice or the ocularcentric. The short seven-page conclusion attempts to place a positive note on the author’s admitted denigration of the notion of visuality in modern French intellectual thought and culture by calling for a plural or multiple—“polyscopic”—visual experience. Hence, Jay concludes that his notion of downcast eyes or disillusionment is “no solution” (p. 592) to the problem. Certainly, Broodthaer’s “L’Oeil” on the jacket cover does not present [End Page 162] downcast eyes but rather the very feminine alluring eye of a seductress. In this sense, the real message of Jay’s work is reader, beware! His provocative title and even more provocative subtitle initiate from the outset a critique of one of the long-held and cherished myths about the dominance and prominence of the visual sense in Western culture, especially in modern French thought. It is the unsettling of the comfortableness of this notion which Jay’s work successfully undertakes.The study is well-organized and lucidly written. It forcefully argues the author’s case. Unfortunately, there is no bibliography. The omission of a bibliography undercuts the project and casts scholarly suspicion on the entire venture. In all truth, the inclusion of a bibliography would dramatically call attention to serious lacunae in the scholarship. The French thinkers presented and analyzed, such as Bataille, Barthes, Sartre, Foucault, Derrida, Irigaray, and Lyotard, have been studied in depth—at times brilliantly—but Jay ignores this rich corpus of critical material. In particular, his treatment of important French poets such as Rimbaud, the surrealists, Ponge, and others is so skewed in order to reinforce his denigration of the dominant role of vision in twentieth-century French writing that the reader in the field of French studies questions the quality of the basic research undertaken for the project and the author’s skill at reading with understanding and sensitivity hermetic material in the original French. Once these questions are raised, the very nature of Jay’s study itself becomes suspect.As the reader progresses through the volume, it seems that most of Jay’s analyses of the primary texts are based on English translations and are in fact limited to those works available in translation. While this may not be the actual case, the lack of a bibliography reinforces such a suspicion and contributes to the steady erosion of the credibility of the study. Even worse, it poses a troubling if not invidious question: who is the audience for Downcast Eyes? Surely, the audience is not humanists who specialize in twentieth-century French studies. If the intended audience is one of scholars and their students in cultural history and the social sciences with little grounding in contemporary French intellectual thought as manifested in its literature and literary criticism, this audience needs to begin its reading with Jay’s conclusion which is a masterfully subtle denigration of his own work on... (shrink)