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[Freedom in disorders of the mind and spirit].

The much used and popular word "freedom" is being examined as to its significance and in that context the peculiar expression "freedom of will" is also brought into the discussion. In the course of this clarification, philosophy, jurisprudence, poetic-literary and our everyday language all had to lend a hand. In its application to psychic abnormal and sick persons one finds that in the endogenous psychoses, because of the profound change of existence, some patients experience the freedom of being for the very first time; this, however, can in the course of the illness turn into its opposite.

Bipolar Disorder

Medical research and human freedom.

This discussion of the nature of human freedom supports the common-sense view of conscious self-determination. The capacity for self-determination is expanded by knowledge and should be optimal among medical scientists, but many such have been passive when faced by increased restrictions on inquiry. Restrictions should be guided by medical ethics defined in major part by physicians and medical scientists. They are urged to protect their freedoms more actively.

Decision Making

Editorial: The right to know. On the freedom of medical information.

Information about health and disease has high social value and is, thus, subject to a variety of controls. These influence the freedom of investigators to generate it; of editors and publishers to transmit it; and of professionals and the public to have access to it. Unconstrained research may threaten the social order and evoke legal or political limit setting. Prominent in the present era are the possibilities of dangerous ethical and biological consequences of new knowledge or, perhaps more important, of procedures for obtaining it. Medical information is transmitted through both the mass media and professional journals. Access to both by potential authors is limited by institutionalized mechanisms of social control and the academic-research subculture. An emerging factor is the editor's possible ethical responsibility for material which he accepts for publication. Access to information is determined by what finally is published, as well as membership in informal communication networks. It is also influenced by dependence, due to cost, time limitation and information overload, on prepackaged material presented in texts, anthologies, busy clinician-oriented journals, or commercial, e.g., pharmaceutical firms. The possibility that governments will, in time, become the major distributors as well as generators of medical information raises new questions as to its eventual freedom and control.

Biomedical Research

A psychoanalytic model for human freedom and rationality.

The nature and scope of freedom and rationality in man are explored in light of the problems posed by a deterministic framework for understanding and explaining human though, feeling, and behavior. It is argued that the sort of explanation afforded by a psychodynamic theory is fully compatible with attributing freedom and rationality to persons. In particular, psychoanalytic theory is able to account for the existence of causal laws governing all aspects of human behavior, while providing a schema by which we can distinguish rational from irrational behavior, and free acts from those that are unfree.

Behavior

[Professional freedom and Act 101 of 1965].

Act 101 of 1965 replaced Act 13 of 1928 because the latter had become obsolete. Act 101 makes many new demands on and restricts certain privileges of the medical profession. New ideas, particularly if they restrict previous privileges, are resented. Also, new ideas do not necessarily denote progress. I am of the opinion that these curtailments are detrimental to public benefit. However, to provide positive suggestions to ease the situation is extremely difficult. All those concerned with public welfare should once again review public requirements. Ultimately, Act 101 prescribes for the whole population--is it then unreasonable to curtail medical professional freedom? Under the present circumstances this does not seem to be the case. However, sections of the Act may hamper doctors in the performance of their duties.

Ethics, Medical

Analogs of bradykinin with restricted conformational freedom.

Three analogs of bradykinin have been synthesized which bear an alpha-methyl group in the place of an alpha proton at position, 4, 5, or 8. Such analogs possess restricted conformational freedom and are of interest for three reasons. (1) They may provide information about the receptor-bound conformation of the peptide. (2) They may provide a route to antagonists of the native peptide. (3) They may be degraded slowly by proteolytic enzymes. None of the analogs described here antagonized the action of bradykinin, but one exhibited tissue specificity and decreased pulmonary inactivation in the rat.

Amino Acid Sequence

Society of the alone: Freedom, Privacy and Utilitarianism as dominant norms in the SRO.

The social world of the aged SRO tenant is described and analyzed. Charteristic features include an impoverishment of social roles and relationships which result in a "world of strangers". Dominant norms of SRO life which preclude the establishment of intimacy are examined; these include prescriptive norms of privacy, freedom, and utilitarianism

Aged

Period of freedom from relapse as an indication of cure in minimal change nephrotic syndrome in adults.

17 adult-onset nephrotic patients with minimal-change glomerular lesions experienced 39 relapses in all. The relationship between the remission period t (expressed in months) preceding each relapse and the rate of relapse (relapse rate) F (t) was proven to correspond closely to Weibull's distribution function as follows (chi 2 = 1.72, 0.5 less than p less than 0.75): In In (formula - see text) From the equation, the time when 99% of relapsing patients have relapsed is 39.3 months. This means that adult-relapsing nephrotic patients with minimal-change lesions will experience a relapse within 39.3 months of remission. They should be free from relapse and considered cured with a 99% reliability when remission has continued longer than 39.3 months, i.e. beyond the 'period of freedom from relapse'.

Adolescent

Freedom of inquiry and subjects' rights: historical perspective.

The author presents an historical overview of the various attitudes toward animal and human experimentation. He cites advocates (Bacon, Welch) and opponents (Johnson, Shaw) and traces the debate from the Graeco-Roman era, through the rise of the scientific establishment, to the present. Controversy over the fundamental rights of individual research subjects versus a future-oriented freedom of inquiry has been and continues to be a dilemma for clinicians and research scientists.

Animals

Subjects' rights, freedom of inquiry, and the future of research in the addictions.

Since the recent passage of regulations concerning subjects' rights and freedom on inquiry, opposition by the public and others to some areas of research in the addictions has prevented its implementation or continuation. Research investigators in the biomedical and behavioral sciences have been placed in the position of defending their work in an adversary climate. The author points out the importance of transmitting to the public, the scientific community, and legislators the investigators' concern that "subjects' rights" not be viewed only in a legalistic context, but also in the context of not harming the patient.

Advisory Committees

Dental auxiliaries, universities, and academic freedom.

The practicing dental profession lately has asked questions regarding the propriety of research programs designed to investigate the use of expanded duty dental auxiliaries. The dental schools see paraprofessional research as socially responsive. Dental societies recognize the usefulness of auxiliaries but feel their responsibilities should be limited. This paper examines the status of dental auxiliaries, universities, and academic freedom.

Allied Health Personnel

Development of a mandibular tracking device with six degrees of freedom using optoelectronic system.

The purpose of this study was to develop a prototype handy mandibular tracking device with six degrees of freedom using the optoelectronic kinematic data acquisition system and to evaluate its accuracy. The system consisted of the light-weight sensor part mounted on the mandibular incisor portion and two 2-D PSD cameras positioned in front of the patient. On the sensor part, three light emitting diodes (LEDs) were attached in triangular form. Displacements of the sensor part were detected by two cameras, transformed into electric signals, and sampled by A/D converter in a desktop computer. Since the overall accuracy of this system was about 0.03 mm in the displacement and 0.06 degrees in the rotation angles, this system was proven to be capable for the wide range of clinical application.

Humans