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The limits of conscientious objection to abortion in the developing world.

The South African Choice on Termination of Pregnancy Act 92 of 1996 gives women the right to voluntary abortion on request. The reality factor, however, is that five years later there are still more 'technically illegal' abortions than legal ones. Amongst other factors, one of the main obstacles to access to this constitutionally enshrined human right is the right to conscientious objection/refusal. Although the right to conscientious objection is also a basic human right, the case of refusal to provide abortion services on conscientious objection grounds should not be seen as absolute and inalienable, at least in the developing world. In the developed world, where referral to another service provider is for the most part accessible, a conscientious objector to abortion does not really put the abortion seeker's life at risk. The same cannot be said in developing countries even when abortion is decriminalised. This is because referral procedures are fraught with major obstacles. Therefore, it is argued that the right to conscientious objection to abortion should be limited by the circumstances in which the request for abortion arises.

Abortion, Illegal↗

A longitudinal study of the relationships between conscientiousness and the social-environmental factors and substance-use behaviors that influence health.

The present study tested the relationships among conscientiousness-related traits, social-environmental factors that affect health, and substance-use behaviors across a 30-year period from age 21 to age 52 in the Mills Longitudinal study of women (N=99). Results showed that the trait of social responsibility (a facet of conscientiousness) assessed at age 21 predicted family, work, and substance use outcomes at midlife (age 43 and age 52). In turn, marital quality, duration of marriage, divorce, participating in paid work, status level of work, and marijuana consumption were associated with changes in social responsibility. The implications for personality, health, and personality development are discussed.

Adult↗

Health within the experience of breast cancer.

The purpose of this descriptive research was to explicate the concept of health within illness by describing women's experiences with breast cancer. The study is based on Newman's view of illness as expanding consciousness. Twenty women, ages 38-60, with previously diagnosed (within 4-18 months) breast cancer, were asked to describe their experience with breast cancer through two open-ended interviews. Data collection and analyses were based on a qualitative research methodology which incorporates aspects of existential phenomenology and phenomenological nursology with a focus on person-environment interaction patterning. Through thematic analyses and patterning of the person-environment analyses based on the North American Nursing Diagnosis Association Taxonomy I dimensions, themes consistent with health as expanding consciousness emerged.

Adult↗

Responsibility and autonomous nursing practice.

In this paper, the consequences were there greater autonomy in nursing practice, are considered. Autonomous practice implies accountability which entails both personal and professional responsibility: a personal responsibility to endorse ethical conduct consistent with professional practice; and a professional responsibility to exercise discretionary powers to the ultimate benefit of the patient. In this context, discretionary responsibility implies: recognizing a patient's wants may not be consistent with a patient's needs; abstaining from collusion with noncompliant patients; supporting the patient's right to refuse treatment only after full psychological exploration; understanding the psychological ramifications of informed consent from a practitioner and recipient point of view; maintaining appropriate personal and professional boundaries; and fostering collegiate relationships with the medical fraternity grounded on egalitarian principles. The author provides a philosophical and psychological analysis of responsibility in an effort to achieve a deeper understanding of the relationship this has with the concepts of 'freedom' and 'accountability'.

Choice Behavior↗

Newly isolated Friend cell lines are blocked at the same stage of erythroid differentiation as established clones.

Friend erythroleukemia cells, a widely used in vitro model of murine erythropoiesis, express prior to induction, a state of erythroid differentiation similar to that of the early erythroblast in vivo. To investigate whether this uniform and stable epigenetic state was the result of a selection in long-term culture for the corresponding cell type, 29 new cell lines were isolated from the hemopoietic organs of DBA/2 mice infected with Friend virus and were analyzed without delay for the expression of several erythroid traits. All the lines examined displayed levels of expression of the markers indistinguishable from those displayed by established Friend cell clones. Thus, newly isolated Friend cell lines appear to be blocked at essentially the same stage of erythroid differentiation as established clones. This indicates that the expression of several characteristic erythroid markers is remarkably stable in vitro and does not result from long-term selection. In contrast, the capacity of these cells to respond to chemical inducers varies considerably from clone to clone and with time in culture.

Animals↗

Spontaneous, in vitro, malignant transformation of a basophil/mast cell line.

It has recently become possible to grow basophil/mast cells in vitro for extended periods of time. Normally, these cultures remain fully dependent upon the presence of an adequate supply of growth factor(s) and the cells express several basophil/mast cell differentiated traits. We report here a case of spontaneous, in vitro, malignant transformation of such a basophil/mast cell line. The transformed cells no longer require the addition of growth factor(s) for continuous proliferation in vitro, and they have become highly tumorigenic in vivo. In contrast, when compared to their untransformed counterparts, they display the same set of differentiated traits, characteristic of immature basophil/mast cells. Thus, the data support the hypothesis that cell transformation results from a decreased sensitivity of precursor cells toward normal growth regulators but does not affect significantly the expression of differentiated functions.

Animals↗

Growth-factor-independent proliferation in vitro and tumorigenicity in vivo are associated in basophil/mast-cell lines and their somatic hybrids.

According to a current model, leukemic cells arise from normal hemopoietic progenitors as a result of two phenotypic changes: (1) a shift from a high to a low probability of completing differentiation, and (2) the loss of requirement for physiological growth regulators, such as multilineage hemopoietic growth factor (MHGF). In agreement with this model, we have recently reported that the spontaneous, in vitro, malignant transformation of a factor-dependent basophil/mast-cell line was coincidental with the appearance of MHGF-independent proliferation in vitro. We have now fused the MHGF-independent cells with their nontransformed counterparts. In the present study, 29 out of 32 hybrid clones analyzed exhibited an association between, on the one hand, the absence of MHGF requirement in vitro and high tumorigenicity in vivo and, on the other hand, MHGF-dependent proliferation in vitro and a reduced capacity to make tumors in vivo. These data support the idea that the tumorigenic behavior of the transformed cells in vivo and their lack of requirement for MHGF in vitro are directly related.

Animals↗

Does professional autonomy protect medical futility judgments?

Despite substantial controversy, the use of futility judgments in medicine is quite common, and has been backed by the implementation of hospital policies and professional guidelines on medical futility. The controversy arises when health care professionals (HCPs) consider a treatment futile which patients or families believe to be worthwhile: should HCPs be free to refuse treatments in such a case, or be required to provide them? Most physicians seem convinced that professional autonomy protects them from being forced to provide treatments they judge mentally futile, given the lack of patient benefit as well as the waste of medical resources involved. The argument from professional autonomy has been presented in a number of articles, but it has not been subjected to much critical scrutiny. In this paper I distinguish three versions of the argument: 1) that each physician should be free to exercise his or her own medical judgment; 2) that the medical profession as a whole may provide futility standards to govern the practice of its members; and 3) that the moral integrity of each physician serves as a limit to treatment demands. I maintain that none of these versions succeeds in overcoming the standard objection that futility determinations involve value judgments best left to the patients, their designated surrogates, or their families. Nor do resource considerations change this fact, since they should not influence the properly patient-centered judgment about futility.

Administrative Personnel↗

Effort on homework in grades 5-9: development, motivational antecedents, and the association with effort on classwork.

In 2 studies, an expectancy-value framework was applied to investigate effort expended on mathematics homework. In Study 1 (2,712 students in grades 5, 7, and 9; mean age=13.37 years), lower homework effort was found in higher grades. The effects of intrinsic value on homework effort were higher in the older cohorts, whereas the effects of the expectancy component were lower. In Study 2 (571 students in grades 8 and 9; mean age=14.72), an expanded expectancy-value framework was found to explain both homework and classwork variables. The means for effort and value were lower for homework than for classwork; these differences were partly moderated by students' conscientiousness. The implications of homework behavior and motivation for developmental research are highlighted.

Age Factors↗

The systematic application of ethical codes in the counseling of persons who are considering euthanasia.

As health psychology develops, psychologists and counseling professionals are becoming progressively more involved with patients who have chronic terminal illnesses such as AIDS, Alzheimer's disease, and cancer. Consequently, they will be consulted increasingly by patients, caregivers, and lawyers in cases where euthanasia is being considered. There are numerous ethical dilemmas that could arise when counseling persons who are contemplating euthanasia. Professionals must consider carefully issues such as informed consent, bodily autonomy, respect for a person's dignity, patient welfare, as well as responsibility to society. The national psychological, social work, and medical associations of North America have each adopted a code of ethics. These codes may be used by counseling professionals to assist in the resolution of ethical dilemmas that may arise as a result of working with persons considering euthanasia. This paper discusses the relevance of these codes to the counseling of terminally ill patients.

Amyotrophic Lateral Sclerosis↗

Am I bothered?

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Conscience↗