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.     

On the waves: a new kind of surf in Rio de Janeiro

Surfmen are thus called young daredevils who climb to the roof of suburban trains in Rio de Janeiro, Brazil and vie with each other in agility and prowess, some of them often falling on the railway tracks and being killed. The practice started as a need to hang on anything outside the crowded train and became a sport of sorts. Even though repressed by the railway authorities and punished by fines and imprisonment, the practice has been going on since the eighties and developed into a competition with rules, code of honour, grading of achievement. It became a means of improving self-esteem as well as securing leadership and social prestige by people who otherwise carry on lives devoid of any charm or ludic stimulus. A substitute behavior, it results from processes of cultural elaboration at work in the youth culture of our cities.     

“Comorbidity” of behavioral, emotional, and cognitive problems in adolescence

The purpose of this study was to examine in a sample of 11,516 secondary school students the extent to which different behavioral, emotional and cognitive problems (a) reflected one or more underlying common factors; (b) actually cooccurred; and (c) were single problems. Principal Component Analyses were performed and percentagewise techniques were used. PCA demonstrated that one or more general syndromes could not by far account for all of the variance of the variables. The results suggest the existence of adolescent subgroups with divergent comorbidity patterns: those who primarily report one single symptom; those who report concurrent symptoms either exclusively in the category of behavioral problems or exclusively in the category of emotional and cognitive problems; and those who report concurrent symptoms in both categories. This distinction between different subgroups has important theoretical, diagnostic, and treatment implications.     

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.