Moral atrophy in the welfare state

The welfare state is often accused of being counterproductive: as the scope of public responsibility expands, private morality (especially altruism and benevolence) atrophies. This essay surveys psychological findings for evidence, which turns out to be broadly consistent with either of two models of moral development, each bearing distinct policy implications. The model of morally keeping in practice that is implicit in the term moral atrophy suggests the need for frequent opportunities to exercise moral skills, which would seem inconsistent with the welfare state. Alternatively, the model of moral character-building favoured by both philosophers and ordinary discourse would require only occasional reminders of one's moral principles. On this model, benevolence could usefully supplement the welfare state.     

Measuring School-Related Stressors in Adolescents

Some 1620 high school students responded to 68 items that measure adolescent stressors. Thirty-five of the items were based on J. P. Kohn and G. H. Frazer's Academic Stress Scale [1(1986) An Academic Stress Scale: Identification and Rated Importance of Academic Stressors, Psychological Reports, Vol. 59, pp. 415–426] developed in the United States, while the remaining 33 items were developed from P. Strutynski's [(1985) A Survey of Queensland Year 10, 11 and 12 Student Attitudes to Schools and Schooling, State Planning Committee, International Youth Year, Brisbane] lists of the most frequently named problems of 2336 Australian high school students. Confirmatory Factor Analysis was used to test and develop a measurement model developed from an extensive review of previous scales. The High School Stressors Scale emerged from the analytic process and measures nine school-related stressors. For researchers focusing on school-related problems and stressors among adolescents, the HSSS promises to be a very useful instrument. It has sound construct and predictive validity and adequate reliability, as demonstrated by the goodness-of-fit indices the squared multiple correlations.     

Book reviews

Ash Amin and John Tomaney (eds), Behind the Myth of European Union: Prospects for Cohesion (Routledge, London, 1995), 334 pp., ISBN 0–415–13078–6 (pb)

Stephen Gundle and Simon Parker (eds), The New Italian Republic: Front the Fall of the Berlin Wall to Berlusconi (Routledge, London, 1996), 334 pp., ISBN 0–415–12161–2 (hb), 0–415–12162 (pb)

Donald Sassoon, One Hundred Years of Socialism: The West European Left in the Twentieth Century (I. B. Tauris, London, 1996), 965 pp., ISBN 1–85043–879‐X

Geoff Mulgan, Connexity: How to Live in a Connected World (Chatto & Windus, London, 1997), 280 pp., ISBN 0–7011–6396–8     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.