The ethics of treating the "untreatable".
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Biomedical subjects
Publications and source records attributed to R C Christensen.
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The authors consider the ethical issues involved in a case in which an elderly man suffering from recurrent, treatment-resistant depression expressed a wish to forgo life-sustaining treatment should it become necessary. The patient had no immediate life-threatening medical conditions but was in danger of becoming malnourished and dehydrated. The authors conclude that unrelieved suffering resulting from depression, when combined with repeated treatment failures, may justify refusal of life-sustaining treatment in very rare cases.
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Medical jargon is commonly used by health-care professionals. The use of such jargon is sometimes criticized as insensitive or callous. Rather than generalize, we identify four basic types of medical jargon and discuss their relevant moral distinctions. Our characterizations of jargon include medical acronyms, euphemisms, and initiatory and derogatory language. Physicians should be aware of the ways in which they use medical slang. Jargon can serve useful purposes but its moral status is often dependent on the function it serves and the context in which it is used. Jargon that is clearly derogatory can reflect negatively on the moral character of the medical profession and should be avoided when possible.
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Guidelines are suggested for baccalaureate health physics program content based on the schema used in a prior publication. The Guidelines assume a program with a primary emphasis on generalized health physics and presuppose an institutional breadth coursework requirement. Methods of strengthening areas of current general weakness are proposed, and one version of a coursework model is presented. Comments to the author and the Manpower and Professional Education Committee of the Health Physics Society are welcomed.
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Guidelines for the content of master's degree programs in general and reactor health physics are presented, with the level of presentation for each topic identified as "descriptive," "standard coverage" or "theoretical/specialized coverage." Assumptions about program type and prerequisite course work are specified.
Monthly listings of the Health Physics Society Placement Center from 8/77 to 6/82 were tabulated and analyzed for the temporal and regional trends in various areas of health physics. Almost half of listing employers advertised only a single position in 5 yr. Civilian nuclear power and its associated industrial support accounted for approximately half of the total positions available. Total annual employer and position listings increased sharply several months after the Three Mile Island incident. Activity has remained elevated since that time, and appears to have reached a plateau within the past year. A wide variety of professional positions were advertised in each region of the U.S. Recent data on numbers of graduating health physicists, plus a reasonable estimate of the number of new positions made available in recent years, imply current regional shortages of adequately trained personnel, particularly in the Far West, Rocky Mountain and South Central regions, but possibly also nationwide.
A salary questionnaire was distributed to health physicists in July 1980 as part of the July 1980 Health Physics Society Newsletter and as a handout at the 1980 Health Physics Society Annual Meeting in Seattle. 752 responses were obtained over a span of 3 months. Mean annual salary was correlated with a series of variables including experience (time in the field), academic background, employer type, region, sex and licensure status. The data supported the following conclusions: (a) Mean annual salary for the health physics personnel responding to the survey was $29,400. (b) Individuals in the southeast and southcentral states had below-average salaries, whereas individuals in the northeast and Rocky Mountain states had above-average salaries. The difference between these extreme annual means was often in the range of 5000-$8000, and should exert considerable impact on recruiting success. (c) Industrial and consulting positions carry higher-than-average salaries, whereas academic and governmental positions tend to be somewhat below average. (d) Women in health physics are a small but growing minority which tends to have lower-than-average salaries. (e) Recent demand for trained health physicists seems to have caused starting salaries to rise somewhat more rapidly than continuing salaries, in general.
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The lymphocyte transformation assay was used to monitor the cellular immune response of rabbits sensitized to cytomegalovirus (CMV). Peripheral blood lymphocytes from animals inoculated with purified virus were specifically stimulated by crude or twice-banded CMV. Blood cells from rabbits immunized to herpes simplex virus type 1 (HSV-1) responded to that antigen but not to CMV. Viable or heated CMV preparations stimulated unwashed blood cells as efficiently as washed cells. Furthermore, preincubation of stimulating antigen with anti-CMV serum did not prevent lymphocyte activation. Lymphoid cells readily stimulated by virus antigen were not stimulated by cells transformed by CMV or HSV-1.
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