Repressive authenticity in the quest for legitimacy: Surveillance and the contested illness lawsuit

When seeking compensation for workplace injury, workers predictably face examination over the legitimacy of their condition from employers and medical and legal professionals. When the alleged injury is a contested environmental illness, the suspicion aroused and the scrutiny faced by workers is much more acute. In this paper, I analyse the medico-legal experiences of eight chemically sensitive claimants in Australia to reveal the nature and extent of the surveillance they are subjected to in their quest to prove the legitimacy of their disease. Four forms of surveillance are identified: medical scrutiny; legal surveillance, insurer investigation, and self-regulation. Advancing the Foucauldian concept of self-surveillance, I demonstrate that this latter form of regulation has the most deleterious impact on the claimants. The result of this scrutiny is a 'repressive authenticity' (Wolfe, 1999), where the chemically sensitive are expected to adhere to a particular normative ideal of sickness, which becomes therapeutically counterproductive.     

中药饮片鉴别真伪的意义及相关方法

中药饮片是指按中医药理论对中药材进行加工炮制,可以直接应用于临床的中药。中药饮片的鉴别真伪是保证临床药物安全有效,保证人民健康安全的重要保证。常见的中药饮片掺假方法有掺杂泥沙、石块,非药用部位混入药用部分,伪造等;中药饮片的常用鉴别方法有经验鉴别、显微鉴别、浸出物鉴定法、来源鉴定、理化鉴定、生物鉴定等。中药饮片鉴别真伪的知识是一项重要的理论技术,掌握基本的中药鉴别方法和技能可确保临床用药安全有效。     

The ethics of self-change: becoming oneself by way of antidepressants or psychotherapy?

This paper explores the differences between bringing about self-change by way of antidepressants versus psychotherapy from an ethical point of view, taking its starting point in the concept of authenticity. Given that the new antidepressants (SSRIs) are able not only to cure psychiatric disorders but also to bring about changes in the basic temperament structure of the person—changes in self-feeling—does it matter if one brings about such changes of the self by way of antidepressants or by way of psychotherapy? Are antidepressants a less good alternative than psychotherapy because antidepressants are in some way less authentic than psychotherapy? And, if so, what does this mean exactly? In this paper I try to show that the self-change brought about by way of antidepressants challenges basic assumptions of authentic self-change that are deeply ingrained in our Western culture: that changes in self should be brought about by laborious ‘self-work’ in which one explores the deep layers of the self (the unconscious) and comes to realise who one really is and should become. To become oneself has been held to presuppose such a journey. While the assumed importance of self-work appears to be badly founded on closer inspection, the notions of exploring and knowing oneself appear to be more promising in fleshing out an ethical distinction between psychopharmacological and psychotherapeutic practice with the help of the concept of authenticity. Psychotherapy, to a much greater extent than psychopharmacological interventions, involves the whole profile of the self in its attempts to effect a change, not only in the temperament but also in the character of the person in question, and this is important from an ethical point of view. In the article, the concepts of self-change, authenticity, temperament and character are presented and used in order to understand and flesh out the relevant ethical differences between the practice of psychotherapy and the use of antidepressants. Looping, collective effects of psychopharmacological self-change in a cultural context are also considered in this context.     

Psychopharmacological Enhancement

Many drugs have therapeutic off-label uses for which they were not originally designed. Some drugs designed to treat neuropsychiatric and other disorders may enhance certain normal cognitive and affective functions. Because the long-term effects of cognitive and affective enhancement are not known and may be harmful, a precautionary principle limiting its use seems warranted. As an expression of autonomy, though, competent individuals should be permitted to take cognition- and mood-enhancing agents. But they need to be aware of the risks in chronic use of these agents and to take responsibility for their effects. A reasonable middle ground between these positions is to warn those who choose to enhance that doing so entails risks.     

An immunoassay for distinguishing between crustacean tailmeat and white fish

An immunoassay has been developed which facilitates discrimination between white fish, such as coley, and crustacean tailmeat, such as scampi. Preliminary studies with this non‐competitive indirect ELISA clearly demonstrate the feasibility of using immunochemical tests for detecting adulteration of high value crustacean tailmeat products with lower value white fish.     

Rituals of verification: the role of simulation in developing and evaluating empathic communication

The use of simulation and standardized patients in medical education is firmly established. In this "point-counterpoint" format we debate not their important function but the extent to which they are used to establish "evidence" for trainees' empathic communication skills beyond their surface manifestations. We also question such issues as the power dynamics implicit in simulation when patients are not really worried or dependent but rather students who are under the evaluative surveillance gaze, often relying on formulaic and superficial behaviors associated with good communication. We offer educative experiences in narrative domains as opportunities to develop the habits of thinking and authentic feeling often absent in evaluative-based simulations.     

土茯苓与“黑果菝葜”、“肖菝葜”的真伪鉴别

目的探讨土茯苓饮片的真伪鉴别方法。方法利用土茯苓与其混淆品＂黑果菝葜＂、＂肖菝葜＂的性状和显微特征等方面的不同加以鉴别。结果土茯苓真伪品之间差别明显。结论利用性状、显微特征及理化试验方面的差异,能有效地鉴别土茯苓的真伪。     

儿童家长免疫回忆真实性调查

目的 评估不同文化程度、不同居住环境的不同家长对儿童免疫接种状况回忆的真实程度。方法 采用横断面调查方法,在河南省18个市各随机选择2个县、1个区,分别调查分析1～2岁的常驻儿童和流动儿童家长免疫回忆的真实性。结果 全省儿童基础免疫四苗全程接种率为89.7％,其中流动儿童为77.9％。儿童家长回忆孩子接种过疫苗的真实性高达96％以上;接种过疫苗的儿童,其家长能明确回忆其接种过该疫苗的比例不超过50％;家长文化程度为中学及以上的免疫回忆真实性高于文盲及小学者;儿童母亲的免疫回忆真实性高于父亲;在家长免疫回忆为不详的儿童中,有高达97％以上的儿童均接种过相关疫苗。结论 儿童家长对已接种过疫苗的肯定回答具有很高的可信性;文化程度较高的儿童母亲,对儿童的免疫回忆具有更高的可信性;免疫史回忆不详的儿童不能作为未免疫者。     

《中药鉴定技术》实践教学增加真伪鉴别的改革初探

为了培养中药等相关专业毕业生对中药真伪的鉴别能力,课题组成员经过在教学工作中的摸索,提出了在原有的以性状鉴别为主的实践教学模式上增加真伪鉴别的实训环节,并已在教学中逐步实施,并阐述了课题组成员对增加真伪鉴别实践教学的一些观念及操作应用.