Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

Child's play: The political imaginary of international relations and contemporary popular children's films

Many scholars in International Relations (IR) have drawn from popular films to examine various problématiques that have informed the discipline's main theorisations. As Cynthia Weber remarks, popular films are powerful because they engage in the very ‘serious political work’ of mythologising the ‘truths’ and ‘realities’ which provide the foundation for many of IR's main theoretical envisionings of our world. To date, however, children's films have received very little attention. For the purpose of this paper, three have been isolated: Toy Story (1995), A Bug's Life (1998) and Rescue Heroes: The Movie (2003). Children's films, it can be argued, help to craft and restore certain perspectives for each new generation of young minds during the crucial years when the world is being textualised for the first time. The objective of this paper, therefore, is to read these films as working towards producing and sustaining the power/knowledge that seeks to defend contemporary forms of world order while concurrently extending and disseminating the rule of these forms of world order through the medium of children's popular cinema.     

ASSESSING NEIGHBORHOOD AND SOCIAL PSYCHOLOGICAL INFLUENCES ON CHILDHOOD VIOLENCE IN AN AFRICAN‐AMERICAN SAMPLE*

The present study examines the extent to which neighborhood and social psychological influences predict childhood violence among 867 African‐American youth. The results showed that neighborhood affluence was the only neighborhood‐level variable to exert a significant influence on childhood violence. Furthermore, childhood violence was significantly related to social psychological influences, such as adopting a street code, associating with violent peers, parental use of violence, and quality parenting. Overall, the findings suggested that simply living in a violent neighborhood does not produce violent children, but that family, peer, and individual characteristics play a large role in predicting violence in childhood.     

Should Abused Women's Reports of Partner Substance Abuse Be Accepted as Valid?

Current research suggests that a husband's substance abuse is correlated with severity of physical abuse and the woman's decision to leave a violent situation. Often, only the battered woman's report of abuse is available. This study compares women's reports of their partners' substance use/abuse with their partners' report using a brief measure of polydrug and alcohol abuse, the Substance Abuse Subtle Screening Inventory (SASSI) and the Conflict Tactics Scale (CTS). Data were analyzed for 25 recovery couples and 25 nonrecovery couples. The correlations for all 50 couples between the male's reported use and the female's report of her partner's use on the SASSI and the CTS were significant on all but one of the CTS scales. They ranged on SASSI from .73 to .33 and from .31 to .06 on the CTS. This suggests that the SASSI and possibly the CTS could be used as valuable tools for assessing women's reports of their partner's substance use/abuse.     

Inmates: Who occupies our jails?

The purpose of this investigation was to identify inmate personal and demographic data that may be used to further define or profile persons with a greater likelihood of being at risk for serving a jail sentence. This study was explorative. The survey administration was similar in format to that conducted by the U.S. Department of Justice. Chaplains were used as survey proctors. Pilot studies were conducted to determine the suitability of survey content. Surveys consisted of 172 items. Subjects included four hundred inmates: males comprised 88.75 percent of the sample, Caucasians 58.25 percent, Blacks 37 percent, Hispanics 3.25 percent and other 1.5 percent of the sample. Respondents ranged in age from 15 to 64 years with an average age of 30.3 years. Less than two percent of the contacted inmates refused participation in the survey. Results are presented for demographic data, select legal/criminal data, select drug and alcohol use data, employment data, health, parent/family data, education data, social data, and “other”.     

Relationships between psychosocial development and personality disorder symptomatology in late adolescents

The present study investigated the extent to which psychosocial development through the first five stages of Erik Erikson's theory of personality development is associated with Diagnostic and Statistical Manual (third edition, revised; DSM-III-R) Axis II personality disorder symptomatology in a late adolescent sample of undergraduate students. The Inventory of Psychosocial Development (IPD) and the Personality Diagnostic Questionnaire—Revised (PDQ-R) were administered to a mixed-sex sample of 106 undergraduate students. The results of this research were that IPD scores assessing negative resolutions of the first five Eriksonian developmental stages consistently predicted scores on the PDQ-R composite scale and the PDQ-R impairment/distress index—both measures of overall personality disorder symptomatology. The IPD subscales varied substantially in the extent to which they predicted scores on the 13 PDQ-R subscales that assess symptoms of specific DSM-III-R personality disorders—ranging from the trust vs. mistrust subscale, which predicted scores on 12 of the 13 PDQ-R subscales, to the initiative vs. guilt subscale, which predicted scores on only 6 of the 13 PDQ-R subscales. Implications of these findings for our understanding of the relationship between psychosocial development and psychopathology are discussed in the context of previous research in this area, and suggestions for future research are offered.Received Ph.D. from Temple University. Research interests include personality disorders, depression, and life events.     

CONTRACTORS' EXPERIENCE OF COMPULSORY COMPETITIVE TENDERING: A CASE STUDY OF CONTRACT CLEANERS IN THE NHS

Compulsory competitive tendering (CCT) has been an important instrument of Conservative government economic policy since 1979. Its effectiveness in generating cost-effective services depends on competition to supply the service in question.
The NHS domestic market is large and, prior to the introduction of CCT, promised to be profitable for contractors. Many contract cleaners with office cleaning experience entered. In the event the costs of entry were heavy, and the profit margins of established firms were reduced. When contracts have been awarded to firms, they tended to be to those with a track record. Many firms therefore withdrew; and the few that remained have profit margins in the NHS little different from those found elsewhere. Of more than by firms with a serious interest in entry, probably no more than a handful can have come out of the experience in net profit in the first seven years.
The experience of CCT in the market for NHS domestic services has shown that a degree of competition in the market can be achieved, arguably because of the presence of direct service organizations. Competition for this market, on the other hand, can be limited by the high costs of entry.