Recently, two prescription drugs have become salient to breast cancer prevention. With the advent of these drugs, referred to as “chemoprevention,” a mandate has emerged to classify certain women as high risk for breast cancer to determine a group of legitimate users of the drugs. This article examines the development and standardization of the model used to create such a group of high-risk women. The author argues that while the model remains uncertain and controversial, it has become the standard tool (...) for the many jobs associated with legitimizing chemoprevention use in the United States. It has become the assumed standard—shaping practices, identities, and definitions—through its organizational embeddedness in the multiple practices and public images of chemoprevention despite its uncertainty and widespread critique. (shrink)

Delusions play a fundamental role in the history of psychology, philosophy and culture, dividing not only the mad from the sane but reason from unreason. Yet the very nature and extent of delusions are poorly understood. What are delusions? How do they differ from everyday errors or mistaken beliefs? Are they scientific categories? In this superb, panoramic investigation of delusion Jennifer Radden explores these questions and more, unravelling a fascinating story that ranges from Descartes’s demon to famous first-hand accounts (...) of delusion, such as Daniel Schreber’s Memoirs of My Nervous Illness. Radden places delusion in both a clinical and cultural context and explores a fascinating range of themes: delusions as both individually and collectively held, including the phenomenon of folies á deux ; spiritual and religious delusions, in particular what distinguishes normal religious belief from delusions with religious themes; how we assess those suffering from delusion from a moral standpoint; and how we are to interpret violent actions when they are the result of delusional thinking. As well as more common delusions, such as those of grandeur, she also discusses some of the most interesting and perplexing forms of clinical delusion, such as Cotard and Capgras. (shrink)

Spanning 24 centuries, this anthology collects over thirty selections of important Western writing about melancholy and its related conditions by philosophers, doctors, religious and literary figures, and modern psychologists. Truly interdisciplinary, it is the first such anthology. As it traces Western attitudes, it reveals a conversation across centuries and continents as the authors interpret, respond, and build on each other's work. Editor Jennifer Radden provides an extensive, in-depth introduction that draws links and parallels between the selections, and reveals the (...) ambiguous relationship between these historical accounts of melancholy and today's psychiatric views on depression. This important new collection is also beautifully illustrated with depictions of melancholy from Western fine art. (shrink)

Background: In the ever-changing and complex healthcare environment, nurses encounter challenging situations that may involve a clash between their personal and professional values resulting in a profound impact on their practice. Nevertheless, there is a dearth of literature on how nurses develop their personal–professional values. Aim: The aim of this study was to understand how nurses develop their foundational values as the base for their value system. Research design: A constructivist grounded theory methodology was employed to collect multiple data sets, (...) including face-to-face focus group and individual interviews, along with anecdote and reflective stories. Participants and research context: Fifty-four nurses working across various nursing settings in Indonesia were recruited to participate. Ethical considerations: Ethics approval was obtained from the Monash University Human Ethics Committee, project approval number 1553. Findings: Foundational values acquisition was achieved through family upbringing, professional nurse education and organisational/institutional values reinforcement. These values are framed through three reference points: religious lens, humanity perspective and professionalism. This framing results in a unique combination of personal–professional values that comprise nurses’ values system. Values are transferred to other nurses either in a formal or informal way as part of one’s professional responsibility and customary social interaction via telling and sharing in person or through social media. Discussion: Values and ethics are inherently interweaved during nursing practice. Ethical and moral values are part of professional training, but other values are often buried in a hidden curriculum, and attained and activated through interactions during nurses’ training. Conclusion: Developing a value system is a complex undertaking that involves basic social processes of attaining, enacting and socialising values. These processes encompass several intertwined entities such as the sources of values, the pool of foundational values, value perspectives and framings, initial value structures, and methods of value transference. (shrink)

In Moody Minds Distempered philosopher Jennifer Radden assembles several decades of her research on melancholy and depression. The chapters are ordered into three categories: those about intellectual and medical history of melancholy and depression; those that emphasize aspects of the moral, psychological and medical features of these concepts; and finally, those that explore the sad and apprehensive mood states long associated with melancholy and depressive subjectivity. A newly written introduction maps the conceptual landscape, and draws out the analytic and (...) thematic interconnections between the chapters. Radden emphasizes and develops several new themes: the implications, theoretical phenomenological and moral, of recognizing melancholy and depressive states as mood states; questions of method, as they affect how we understand and characterize claims about melancholy and depression; and the persistence and force of cultural tropes linking such states to brilliance, creativity, and sagacity. Insights from literature and the history of medicine, psychology, and psychiatry are woven together with those from the more recent disciplines of feminist theory and cultural studies. This is interdisciplinary writing at its best-part analytic philosophy, and part history of ideas. (shrink)

Jennifer Trusted's new book argues that metaphysical beliefs are essential for scientific inquiry. The theories, presuppositions and beliefs that neither science nor everyday experience can justify are the realm of metaphysics, literally `beyond physics'. These basic beliefs form a framework for our activities and can be discovered in science, common sense and religion. By examining the history of science from the eleventh century to the present, this book shows how religious and mystical beliefs, as well as philosophical speculation have (...) had a considerable role in motivating scientists and inspiring scientific inquiry. _Physics and Metaphysics_ presupposes no technical knowledge of either philosophy or science. It is an ideal introduction to science and the important forces that have shaped its history and ideas. (shrink)

Melanie presented at twenty weeks of gestation to an obstetrics clinic in a critical access hospital in rural Vermont. She was excited to undergo routine fetal ultrasonography, but her obstetrician gave her grave news: the ultrasound revealed hypoplastic left heart syndrome, a devastating congenital heart defect. Initially, Melanie agreed in general to pursue surgical care for her fetus—a three‐stage process that has somewhat uncertain results and could only be done in tertiary care facilities far from her home in Vermont. A (...) week later, while the maternal fetal medicine and pediatric cardiology units made arrangements with colleagues in Boston, Melanie began having second thoughts. An ethics meeting was called to discuss conflicting clinician reactions to Melanie's dilemma. Most of the clinicians were stunned that the patient would change her mind. What advice should the ethics consultant offer the team about caring for Melanie? (shrink)

We outline some ways in which motor neglect (the underutilization of a limb despite adequate strength) and hysterical paralysis (failure to move a limb despite no relevant structural damage or disease) may throw light on the pathophysiology of catatonia. We also comment on the manifold inadequacies of distinguishing too firmly between symptoms of “neurologic origin” and of “psychiatric origin.”.

Video‐recording healthcare interactions provides important opportunities for research and service improvement. However, this method brings about tensions, especially when recording sensitive topics. Subsequent reflection may compel the researcher to engage in ethical and moral deliberations. This paper presents experiences from a South African genetic counselling study which made use of video‐recordings to understand communicative processes in routine practice. Video‐recording as a research method, as well as contextual and process considerations are discussed, such as researching one's own field, issues of trust (...) and anonymity, the challenge of providing true informed consent and capturing details which may cause psychological harm. Several recommendations for research practice in diverse healthcare settings are made. This includes the value of reflective pieces, the importance of retrospective consent, disclosure of the limitations to anonymity, as well as the collective responsibility of those involved to produce ethical research. These recommendations have value for genetic counselling and other healthcare fields. (shrink)

Issues-driven shareholder activism suggests that specific issue characteristics brought by shareholders, a group to which firms are obligated to respond, interact in a way that affects the materiality of the issue in the eyes of the modern corporation. Relevant issue characteristics include: issue type, social significance, and issue life cycle stage.

Hom and colleagues (2016) argue in favor of allowing religious exemptions to congenital critical heart disease (CCHD) newborn screening, but the logic of their position is at odds with the moral ju...

In this essay Robert Rhoads, Jennifer Berdan, and Brit Toven-Lindsey examine some of the key literature related to the open courseware (OCW) movement (including the emergence and expansion of massive open online courses, or MOOCs), focusing particular attention on the movement's democratic potential. The discussion is organized around three central problems, all relating in some manner or form to issues of power: the problem of epistemology, the problem of pedagogy, and the problem of hegemony. More specifically, the authors raise (...) issues related to the narrow notion of knowledge typically conveyed in the OCW movement, a limited understanding of what constitutes empowering pedagogy, and the lack of treatment of inequities associated with the production of courseware materials. The authors go on to argue that the lack of critical analysis of the OCW movement is tied to its relative alignment with educational reforms driven by neoliberal ideology and that such alignment serves to limit the movement's democratic possibilities. (shrink)

Jennifer Anna Gosetti-Ferencei demonstrates that the exotic, as reflected in major works of German literature and in the philosophy and art that inspires it,..

When does an interaction between a mental health clinician and a patient cross the line from a reasonable offer of care to coercion? In a classic account of coercion in psychiatry, Szmukler and App...

Through examination of a case study of Liberian refugee participation in the Truth and Reconciliation Commission of Liberia, this article highlights concerns about the lack of opportunity for refugee participation in peacebuilding generally. The experience of the authors working with refugees in the Buduburam Settlement near Accra, Ghana, demonstrates the overwhelming desire of refugees to participate in the processes that directly impact their lives, as well as the future of their home and host countries. The article concludes with the suggestion (...) that the Liberian Truth and Reconciliation Commission’s work with refugees can serve as a model of how refugee participation can be enhanced in similar processes in the future. (shrink)

These are the words Achilles speaks to Hektor, whom he has just struck with a fatal blow. He reminds the son of Priam how, after stripping Patroklos’ fallen body, Hektor made off with the fallen man's armour, which is Achilles’ own.

Because of historical mistreatment of ethnic minorities by research and medical institutions, it is particularly important for researchers to be mindful of ethical issues that arise when conducting research with ethnic minority populations. In this article, we focus on the ethical issues related to the inclusion of ethnic minorities in clinical trials of psychosocial treatments. We highlight 2 factors, skepticism and mistrust by ethnic minorities about research and current inequities in the mental health care system, that researchers should consider when (...) developing psychosocial interventions studies that include ethnic minorities. (shrink)

The relative reinforcing value of food measures how hard someone will work for a high-energy-dense food when an alternative reward is concurrently available. Higher RRV for HED food has been linked to obesity, yet this association has not been examined in low-income preschool-age children. Further, the development of individual differences in the RRV of food in early childhood is poorly understood. This cross-sectional study tested the hypothesis that the RRV of HED to low-energy-dense food would be greater in children with (...) obesity compared to children without obesity in a sample of 130 low-income 3- to 5-year-olds enrolled in Head Start classrooms in Central Pennsylvania. In addition, we examined individual differences in the RRV of food by child characteristics and food security status. The RRV of food was measured on concurrent progressive-ratio schedules of reinforcement. RRV outcomes included the last schedule reached for cookies and fruit, the breakpoint for cookies in proportion to the total breakpoint for cookies and fruit combined, and response rates. Parents completed the 18-item food security module to assess household food security status and the Behavioral Activation System scale to assess reward sensitivity. Pearson’s correlations and mixed models assessed associations between continuous and discrete child characteristics with RRV outcomes, respectively. Two-way mixed effects interaction models examined age and sex as moderators of the association between RRV and Body Mass Index z-scores. Statistical significance was defined as p < 0.05. Children with obesity had a greater cookie Pmax [F = 4.95, p = 0.03], higher RRV cookie [F = 4.28, p = 0.04], and responded at a faster rate for cookies [F = 17.27, p < 0.001] compared to children without obesity. Children with higher cookie response rates had higher BMIZ ; and RRV cookie was positively associated with BMIZ for older children and boys, but not younger children or girls. The RRV of food did not differ by household food security status. Low-income children with obesity showed greater motivation to work for cookies than fruit compared to their peers without obesity. The RRV of HED food may be an important contributor to increased weight status in boys and future research is needed to better understand developmental trajectories of the RRV of food across childhood. (shrink)

The assessment of text quality is a transdisciplinary issue concerning the research areas of educational assessment, language technology, and classroom instruction. Text length has been found to strongly influence human judgment of text quality. The question of whether text length is a construct-relevant aspect of writing competence or a source of judgment bias has been discussed controversially. This paper used both a correlational and an experimental approach to investigate this question. Secondary analyses were performed on a large-scale dataset with highly (...) trained raters, showing an effect of text length beyond language proficiency. Furthermore, an experimental study found that pre-service teachers tended to undervalue text length when compared to professional ratings. The findings are discussed with respect to the role of training and context in writing assessment. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

Based on Davenport’s (1998) social audit, we examined six firms’ corporate social responsibility activities within the beer industry in an effort to identify and compare these firms’ industry social standing. The results have implications in our understanding and assessment of corporate citizenship practices both within and across business industry groups.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 357-359 [Access article in PDF] Learning From Disunity Jennifer Radden In describing his four cases, Lloyd Wells (2003) throws out a challenge. He asks his readers to recognize similarities between their own more ordinary self-identity and the discontinuous narrative and seeming absence of a steady authorial subject resulting from disorders such as depression, schizophrenia, and Multiple Personality Disorder (MPD). In light of (...) these cases, he implies, the unity of the self we have unreflectively assumed until now to be universal requires reconsideration. Psychopathology seems to force a sharpening, clarification, and closer conceptualization of our philosophical theories of self-identity.While acknowledging that philosophical categories and theories of narrative identity can help us to assess the ravages wrought by mental disorder, James Phillips (2003) is also respectful of the contribution of psychopathology to theorizing about identity: he ends his thoughtful discussion of Wells' cases by looking not at how philosophy can enlighten us about psychopathology but at how cases such as these can illuminate philosophical categories. Speculating on the tragic absence of narrative identity in schizophrenia and advanced Alzheimer's disease, Phillips concludes that, as he puts it, psychopathology "reconfigures the contours of our notion of narrative identity and requires a looser, minimized, nonsubstantial notion of the narrative self" and argues for a self that "transcends the limits and loss of narrative identity" (2003, 326).I also support the approach, shared by Wells and Phillips, that allows psychopathology to clarify and illuminate philosophical concepts and categories. Here, in a handful of footnotes to their insights, I want to point out ways that cases from psychopathology reveal distinguishable elements or aspects of self-identity often confused because, in the normal case, they form an unquestioned and apparently indissoluble unity. One of these is the difference between synchronic and diachronic subjective unity. Another is the difference between the elements of authorship and temporality in conceptions of narrative identity. And last is the difference between what I shall call constitutional identity and self-identity. Synchronic and Diachronic Identity The difference between synchronic and diachronic identity, elements so seamlessly blurred in more ordinary subjectivity, is nicely illustrated by Wells' cases. Mary's dissociative states leave her with interruptions in her diachronic identity: the memory of her experiences is fragmented and incoherent. Yet at any given moment, her synchronic unity is unimpaired. She recognizes and can describe the oneness of her experiences and their boundaries; she is aware which are her experiences and which are not. For all her scatteredness and dissociation, as Phillips puts it in describing Mary's case: "there is a strong and [End Page 357] articulate narrator... the fact remains that this I is there" (2003, 318).In contrast, the shy and self-conscious adolescent Edward seems to suffer not from diachronic but from synchronic disunity. (And if anything, as Melvin Woody [2003] points out, Edward's "narrative" seems to fuel the comparisons which so distress him about his uncomfortable and distressing subjective experiences.) Edward struggles to "delineate what's inside my mind and what's outside it... " When he thinks about what he sees as a firm boundary around the self in others which is not well demarcated in his own case, he remarks "... I completely lose any sense of myself" (p. 330).Thought insertion or "made" feelings in psychosis provide similar instances of such fracturing of their sufferer's synchronic identity (it is perhaps such experiences that Edward alludes to here; Wells' quotations are too sparse for us to tell). Just as Edward complains of losing any sense of himself, so other sufferers from these alarming conditions complain of losing a sense of the self's boundaries, of possession and mind control, and of being the unwelcome host to alien thoughts, feelings, and intentions.In normal experience diachronic and synchronic unity—my oneness across time and at a time—form a seamless whole. These cases, where one or the other is compromised, vividly remind us that these two forms of unity must be distinguished. Narrative Identity Phillips (2003) explicates an analysis of narrative identity which comprises entwined but distinguishable features: a narrating... (shrink)

We use the format of a hypothetical case study to review issues related to pharmaceutical product approval and physician prescribing practices. In this case, a new FDA-approved drug is recommended for a patient who subsequently experiences an adverse event that may or may not be related to the prescription. This case raises a number of ethical and legal considerations physicians routinely face when deciding whether to recommend such drugs for their patients. Despite the need for ongoing observation by the regulatory (...) apparatus, physicians should be cognizant of the limitations of the drug approval system and the post-approval prescription drug surveillance system. We discuss physicians’ ethical obligations when faced with a newly approved drug, including seeking out independent sources of learning, reporting adverse effects, and notifying patients about limitations in available knowledge about therapeutic recommendations. (shrink)

The individualization thesis has been widely applied to explain women’s increasing autonomy in romantic relationships and marital decisions across both Western and non-Western contexts. In China, individualization is believed to have enhanced women’s freedom in love and marriage, supported by the 1950 Marriage Law, which abolished arranged marriages and granted women equal legal status to men. However, Chinese women still face notable constraints in exercising full autonomy over their choice of partners and the timing of marriage. Parental involvement in matchmaking, (...) pressure from media discourses that stigmatize “leftover women”, and social expectations continue to define women’s happiness in relation to timely marriage and childbearing. Importantly, Confucian family and gender norms now appear to have a greater influence on women’s romantic choices than they did during the early reform era. With the “return” of Confucian marital values and increasing parental involvement in matchmaking, does the individualization thesis still sufficiently explain Chinese women’s marital freedom? By addressing the “nonlinear” aspect of second modernity, this article aims to deconstruct the concept of “traditions” within the marital sphere. It argues that traditions have re-emerged in an “evolved” form, blending both traditional and modern requirements within China’s unique context of individualization. The nonlinear nature of individualization offers a dynamic perspective for understanding the complex relationship between tradition and modernity in rapidly transforming societies like China. (shrink)

While an accurate assessment of risk is always important, it is especially so in pediatric research. Recognizing the pivotal nature of the minimal-risk standard, we set out to determine under what circumstances pediatric magnetic resonance imaging research does or does not meet this standard. We found that while the physical and psychological risks that attend the MRI procedure do not exceed minimal risk, the sedation and contrast enhancement that are sometimes associated with MRI research do, as both exceed the level (...) of risk encountered by typical, healthy children in their everyday experiences. (shrink)