Commentary: toward a unified theory of personal and professional ethics

In response to Dr. Ezra Griffith's essay, we support the view that forensic practice cannot be cleanly divided from its ethics foundation in medical and general psychiatric practice. Personal and professional values cannot be separated in formulating a unified theory of ethics for professionalism in forensic practice. We support Dr. Griffith's narrative perspective and offer a delineation of how narratives may be considered in forensic work. We would like readers to focus on both the duties and the moral ideals that ultimately define professional ethics. By honoring personal and professional narratives together, forensic professionals can advocate and reshape a system that devalues non-dominant cultures. They can also recognize more easily the influences that affect their forensic work. This kind of forensic practice, informed by narrative ethics while respecting fundamental principles, can be an essential part of what we aspire to as forensic professionals. As we argued in an earlier work, a robust professionalism for forensic psychiatry cannot ignore our physician background or our diverse personal histories. Dr. Griffith's essay contributes forcefully to the development of such a view.     

Commentary: A new chapter for forensic ethics

In response to a new ethics framework for forensic publishing, this commentary invites speculation on how the framework will develop to incorporate the theories of its authors. Although medical ethics may now be an established cornerstone for forensic practice, it is in the more novel theories of cultural narrative, compassion, and robust professionalism that this new ethic will find its full expression. The commentary argues that it is only through approaches that integrate such multiple perspectives that publishing will join professionalism in protecting the ethics values that remain vulnerable in forensic practice.     

Gender, sex, and professional ethics in child and adolescent psychiatry

Ethics in child and adolescent psychiatry can be understood as a collective effort to reconcile three potentially conflicting sets of duties toward the minor patient, the parents of the minor patient, and the community. Therapists have a primary duty to the medical needs and the emerging autonomy of the minor patient and must take into account the anticipated needs of the adult that the child will become. Therapists also have a duty to respect the authority of parents in medical decision-making and to respect the community's interest in preventing harm to children. Conflicts arise when parental demands or refusals are inconsistent with ethically weighty interests of the child and when a community mandates professional actions that serve families badly. Examples of these are examined.     

Psychiatry, molecular genetics and ethics: the new discoveries and the new issues

Recent developments in molecular genetics are examined with particular reference to psychiatry. The new technologies available have allowed significant advances in the understanding of certain illnesses such as familial Alzheimer's disease and Huntington's chorea, and will provide powerful tools to explore many other important psychiatric illnesses. The area of genetic counselling is already characterized by complex ethical issues. We can expect that as the new technologies provide the prospect of positive germ line genetic engineering, these ethical issues will become more complex. It is important that psychiatrists prepare themselves for these future developments and take an active role in leading the debate.     

Neurology Journal Club: a new subsection

The term "journal club" traditionally refers to a gathering of physicians for the critical review of current medical literature and discussion regarding the clinical application of the results. Since the formation of the first documented journal club over 130 years ago, the organization and purpose of this academic tool has gone through many changes. Despite the advent of "virtual" online journal clubs, most academic departments still employ a physical meeting between trainees and the faculty. The Neurology? Journal Club is a new subsection of the Resident & Fellow Section with the goal of enhancing the traditional journal club experience by publishing examples of structured critical appraisals of medical literature. The Journal Club critiques, written by neurology residents and fellows with faculty supervision, will examine each article for key features of hypothesis and design, methods, results, and interpretation.     

Professional ethics: Thinking again for the new millennium

The associations between sexual compatibility and sexual and relationship satisfaction were examined in a sample of 133 college-age heterosexual couples. Hierarchical regression analyses were conducted to assess the relationship between two types of sexual compatibility (actual sexual compatibility and perceived sexual compatibility) and sexual and relationship satisfaction. Age, length of relationship, and satisfaction were included as covariates in the hierarchical regression analyses. Couple difference scores from four subscales of the Sexual Excitation/Sexual Inhibition Inventory used to measure actual sexual compatibility, and women's and men's Hurlbert's Index of Sexual Compatibility scores measuring perceived sexual compatibility were included as predictors of sexual satisfaction and relationship satisfaction in the analyses. The strongest predictor of sexual satisfaction, after accounting for relationship satisfaction, was perceived sexual compatibility. Similarly, the strongest predictor of relationship satisfaction, after accounting for sexual satisfaction, was perceived sexual compatibility. The final models predicting sexual satisfaction accounted for 66% of the variance in the women's model and 75% of the variance in the men's model. The final models predicting relationship satisfaction accounted for 20% of the variance in the women's model and 27% of the variance in the men's model. Perception of sexual compatibility may be more important to couple satisfaction than actual sexual compatibility of specific sexual acts.     

A story to create: stroke survivors' broken narratives

In this commentary, I explore the impact on stroke survivors of the disclosure or the lack of disclosure by attending medical personnel of the limits of knowledge of Western medicine. Examining the effect of internal narratives on attention and engagement, this commentary presents the view that survivors' internal narratives are significantly influenced by the statements of attending medical personnel. Their willingness to disclose the limits of medical knowledge can alter the outcome of recovery and the creative adaptation of a survivor's life post stroke.     

Journal of NeuroVirology: A new exanded scope

Editorial

Journal of NeuroVirology: A new exanded scope     

Patient rights, professional ethics, and situational dilemmas in mental health services.

Patient rights, professional ethics and situational dilemmas in mental health services are discussed in terms of their interrelationships, with a major focus on voluntary clients and community-based services. Vignettes are provided under the headings of: I. The rights to respect, dignity, and non-discrimination; II. The rights to appropriate treatment, to consent and to refuse; III. The rights to least restrictive, least intrusive intervention; IV. The rights to confidentiality of personal information, to consent to or refuse release of records, and the right to peruse personal records. The author stresses that the rights and responsibilities of various parties must be balanced to arrive at the best decisions.