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Richard Martinez

Publications and source records attributed to Richard Martinez.

9 recordsLinked to original sources
PubMed2006

Cross-cultural boundary dilemmas: a graded-risk assessment approach.

Behavioral health professionals are constantly faced with the dilemma of how to define boundaries in their relationships with clients. When working with groups from diverse cultures, defining boundaries becomes even more complex. This article urges a flexible approach, using the graded-risk model (Martinez, 2000) and a list of cultural factors for clinicians to consider. Possible benefits of reaching out to clients in concrete ways, as well as risks, are emphasized. Clients' notions of appropriate boundaries must be considered in the decision-making process. Case examples from a refugee mental health clinic are used to elucidate a flexible approach to boundary decisions.

Adult↗
PubMed2006

Commentary: the higher standards of aspirational ethics.

In response to a case presented by Dr. David Menkes, the authors argue for a standard of forensic practice that aspires to more than minimal requirements of ethics and law. Professional ethics for forensic experts require acknowledgment of both the duties and ideals of the profession if they are to meet societal expectations, honor the intent of legal procedure, and overcome jaundiced views of the "hired gun." Common values of transparency, truth-telling, and respect for moral relationships in professional work are suggested for analysis of this case, as are respect for the profession and its historical narrative. In fact, a robust professional ethic that requires broader consideration of personal, professional, and community values finds renewed expression in this ethical analysis.

Ethics, Professional↗
PubMed2005

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.

Attitude of Health Personnel↗
PubMed2003

Effects of one year of recombinant human growth hormone (GH) therapy on cardiac mass and function in children with classical GH deficiency.

Cardiac mass and function were evaluated in 10 children with classical GH deficiency. Echocardiograms were performed at baseline, 3, 6, and 12 months after initiation of recombinant human (rh) GH therapy (0.3 mg/kg.wk). Before treatment, left ventricular (LV) mass indexed to body surface area (BSA) was low or low normal (<50 g/m(2)) in five children compared with reference control data. Height SD score (-3.2 +/- 0.9 vs. -1.8 +/- 1.3 yr; P < 0.01), growth velocity SD score (-2.7 +/- 1.6 vs. 5.8 +/- 3.1; P < 0.01), LV mass (36 +/- 9 vs. 60 +/- 30 g; P < 0.02), LV mass/BSA (51 +/- 12 vs. 72 +/- 11 g/m(2); P < 0.01), LV mass/height (36 +/- 9 vs. 54 +/- 15 g/m; P < 0.02), and LV mass/m(2.7) (36 +/- 12 vs. 45 +/- 8; P < 0.05) increased significantly with rhGH therapy. Pretreatment LV mass/BSA correlated inversely with fold increase in LV mass/BSA over the year (r = -0.83; P < 0.01). Load-dependent indices of diastolic performance were normal at baseline and did not change with rhGH therapy. Percentage increase of mean velocity of circumferential shortening, an index of systolic function, correlated with fold increase in LV mass/BSA (r = 0.88; P < 0.02) over the year of rhGH administration. LV mass can be lower than predicted for body size in some children with severe GH deficiency but is responsive to rhGH replacement. LV mass/BSA increases into the normal range during the first year of rhGH therapy. The rate of increase of LV mass is greater than the increase in BSA during rhGH treatment, suggesting that GH could also be a trophic factor for the heart.

Blood Pressure↗
PubMed2002

The nature of illness experience: a course on boundaries.

With the Accreditation Council for Graduate Medical Education's designation of "professionalism" as one of six core competencies in residency medical education, some educators of residents and medical students believe that the concept of professional role is too restrictive and narrow for grappling with the complex dynamics of professional-patient relationships. The ethical quandaries of abortion and physician assisted suicide illustrate how individual personal values cannot be ignored in the dynamic relationship between health care professional and patient. This article describes a medical school course where students are paired with "patient mentors." Within the dynamic and intimate relationship that unfolds over several months, students explore the "experience of boundaries," and are invited to use this experience to consider their evolving professional identity.

Education, Medical↗