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Biomedical subjects

C M Culver

Publications and source records attributed to C M Culver.

12 recordsLinked to original sources
PubMed1992

An analysis of interpersonal manipulation.

The term 'manipulation' is frequently employed but rarely discussed or defined in psychiatric circles. This paper reviews previous conceptual analyses of the term by philosophers and psychiatrists, and examines its use in ordinary discourse. A series of characteristics which comprise the conceptual core of the term when it is unambiguously applied in interpersonal settings are proposed. Manipulation is contrasted with other behavior control methods such as rational persuasion and coercion, with emphasis on the role played by deception and the communicative context in which the manipulative transaction occurs. It is argued that manipulative behavior is fundamentally intentional, and the usefulness of the concept of 'unconscious manipulation' is questioned. Though the proposal that Manipulative Personality Disorder be formally recognized as a new diagnostic category is rejected, it is urged that the concept of manipulation receive wider attention and discussion within the mental health community.

Attitude of Health Personnel↗
PubMed1992

Radiation safety considerations for post-iodine-131 thyroid cancer therapy.

The purpose of this study was to develop guidelines based on direct patient measurements as to when 131I-treated thyroid cancer patients may resume close personal contact after release from the hospital. External exposure rates were measured on 27 patients using a calibrated ionization survey meter. The patients' exposure rates were measured at the time of release from the hospital and 2-7 days post-hospital discharge. Measurements were taken at 1, 0.6 and 0.3 meters from the patient's upright body axis (stomach to thyroid). Vertical movement of the survey instrument was utilized to obtain the maximum reading each time. All patients had exposure rates less than 2 mR/hr at 1 meter at 2-4 days post-hospital discharge. Eight-eight percent (21/24) had exposure rates less than 2 mR/hr at 0.6 meter at 2-4 days post-hospital discharge. Guidelines can be prepared specifically for thyroid cancer therapy patients that are rational and consistent with existing radiologic health standards.

Adult↗
PubMed1991

Radiation safety considerations for post-iodine-131 hyperthyroid therapy.

The purpose of this study was to develop guidelines based on patient measurements as to when iodine-131- (131I) treated hyperthyroid patients may resume close personal contact. External exposure rates were measured on 59 patients using an ionization survey meter in the upright position. The initial measurement was recorded within 20 min post-dose administration at one meter. Exposure rates were measured 2-11 days post-dose administration at 1, 0.6, and 0.3 meters from the patient's thyroid. In the administered dose range of 3 to less than 12 mCi of 131I, all 40 patients measured less than or equal to 2.0 mR/hr at one meter on Day 0, and 25 patients (25/29) were less than or equal to 2.0 mR/hr at 0.6 meter on Days 2-4. Guidelines can be prepared based on the administered dose that are rational and in conformity with existing radiologic health standards.

Breast Feeding↗
PubMed1990

The inadequacy of incompetence.

Patients' competence to make medical decisions, analysts frequently hold, is the key concept for determining whether those decisions may be overruled. Competence, however, is neither a necessary nor a sufficient condition for concluding when it is morally admissible to supersede refusals of treatment. People may be able to reach kinds of decisions involving immediate medical consequences, but not ones entailing long-term outcomes. Open recognition of the limited but important exceptions to the principle of never overruling competent patients' refusal of care would better preserve their autonomy than unduly accepting the absoluteness of the principle.

Beneficence↗
PubMed1989

Moral theory and neurology.

This article presents an outline of a general moral theory and shows its relationship to the concepts of paternalism and that of valid consent and refusal. The authors then show how this theory and these concepts can be usefully applied to the moral problems that neurologists often face in determining how to act when they have distressing information for their patients. Finally, a procedure is provided for determining when it is morally justified to deceive patients by withholding information about their diagnoses, prognoses, or about their prospective treatments.

Comprehension↗
PubMed1986

Distinguishing between active and passive euthanasia.

The standard ways of distinguishing between active and passive euthanasia, act versus omission, and removal of ordinary versus removal of extraordinary care, do not have any clear moral significance. We have used particular aspects of the physician-patient relationship to make a morally significant distinction between active and passive euthanasia. Passive euthanasia is defined as the physician's abiding by the rational valid refusal of life-sustaining treatment of a patient or his surrogate decision-maker. Understanding passive euthanasia in this way makes it clear why, everything else being equal, there is no morally significant difference between discontinuing a treatment and not starting it, for example, taking a patient off a respirator versus not putting him on in the first place. It also makes clear why stopping the feeding and hydration of some patients is not merely morally permissible but is morally required. Patients may make a rational valid refusal of food and fluids just as they may of other kinds of life support, and what patients rationally refuse when competent holds its force when they become incompetent. By basing the distinction between active and passive euthanasia on the universally recognized moral force of a rational valid refusal, we have provided a clear foundation for the moral significance of this distinction. Our way of making the distinction preserves for patients the control over their lives that has sometimes been unjustifiably taken from them. It also eases the burden on doctors who no longer are forced to make use of ad hoc and confused distinctions in which they justifiably have little faith.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1977

Clinical signs in diffuse cerebral dysfunction.

Abnormal responses to 13 questions from a typical mental status examination and 32 signs of neurological dysfunction were correlated with increasing degrees of cognitive impairment as measured by the Halstead-Reitan Neuropsychological Battery. Thirteen of these factors were found to be useful predictors of diffuse cerebral dysfunction when combined into a brief screening examination for application at the bedside.

Adolescent↗
PubMed1977

On the safety of long-term treatment with lithium.

Thirteen patients with bipolar affective illness who had received lithium therapy for 1-5 years were tested retrospectively for evidence of cortical dysfunction. Data on patients younger than 55 show no abnormalities on the Halstead-Reitan Neuropsychological Battery and suggest that chronic lithium therapy is relatively safe. Significantly elevated Halstead Impairment indexes were observed among elderly patients, but these data are difficult to interpret.

Adolescent↗
PubMed1975

The nuchocephalic reflex.

The nuchocephalic reflex, previously undescribed, was investigated in a controlled study of 146 subjects ranging in age from 11 hours to 94 years. In 110 subjects over 16 years of age, the presence of the reflex was correlated directly with evidence of diffuse cerebral dysfunction as measured by a shortened form of the Wechsler Adult Intelligence Scale. Thirty-six children were studied from the newborn period to the age of 16 years. The reflex was found to be uninhibited in infants and to become inhibited by the age of 4 years. Among the adult subjects, the nuchocephalic reflex was found to be sensitive indicator of the status of higher cortical function. The presence or absence of the reflex appears to have somewhat different predictive value at different points in the adult age spectrum.

Adolescent↗