Biomedical subjects

Stephen A Green

Publications and source records attributed to Stephen A Green.

4 recordsLinked to original sources

PubMed2006

An ethical framework for psychiatry.

Psychiatry has not reached a consensus hitherto concerning an optimal theoretical framework for ethical decision-making and corresponding action. Various theories have been considered, but found wanting. Moreover, classic theories may contradict one another, contribute to confusion and immobilise the clinician. We have examined major theories commonly applied in bioethics, conferred with moral philosophers and psychiatrists and striven to apply more recent insights drawn from moral philosophy. We report that instead of pursuing a single theoretical framework, we should garner the strengths of compatible approaches in a synergistic way. We propose a particular complementarity of principlism--with its pragmatic focus on respect for autonomy, beneficence, non-maleficence and justice--and care ethics, a variant of virtue theory, which highlights character traits pertinent to caring for vulnerable psychiatric patients.

Adult↗

PubMed2005

Daily timed melatonin feedings mimic effects of short days on testis regression and cortisol in circulation in Siberian hamsters.

This study tested the efficacy of timed oral administration of melatonin as an alternative both to invasive methods (daily injections, timed infusions) and to untimed oral administration in Siberian hamsters (Phodopus sungorus), an important model for the study of photoperiodism. Hamsters readily consumed a small piece of melatonin-treated apple immediately when presented and circulating melatonin was rapidly elevated with a half-life of approximately 3.5 h. Melatonin-treated apple was fed to hamsters for 3 weeks at 2 h before lights off to extend the duration of the nighttime rise in endogenous melatonin. Melatonin treatment induced testicular regression and elevated serum cortisol, effects comparable to those in hamsters exposed to short days. These findings support the hypothesis that timed oral administration of melatonin can mimic the effects of short days and provide a method by which melatonin can be delivered without the potentially confounding effects of handling and injection stress.

Animals↗

PubMed2004

Will insured citizens give up benefit coverage to include the uninsured?

OBJECTIVE: To describe the willingness of insured citizens to trade off their own health benefits to cover the uninsured. DESIGN: Descriptive study of individual and group decisions and decision making using quantitative and qualitative methods. SETTING AND PARTICIPANTS: Twenty-nine groups of citizens (N = 282) residing throughout Minnesota. INTERVENTIONS: Groups participated in Choosing Healthplans All Together (CHAT), a simulation exercise in which participants choose whether and how extensively to cover health services in a hypothetical health plan constrained by limited resources. We describe individual and group decisions, and group dialogue concerning whether to allocate 2% of their premium to cover uninsured children in Minnesota, or 4% of their premium to cover uninsured children and adults. MEASUREMENTS AND MAIN RESULTS: While discussing coverage for the uninsured, groups presented arguments about personal responsibility, community benefit, caring for the vulnerable, social impact, and perceptions of personal risk. All groups chose to insure children; 22 of 29 groups also insured adults. More individuals chose to cover the uninsured at the end of the exercise, after group deliberation, than before (66% vs 54%; P < .001). Individual selections differed from group selections more often for the uninsured category than any other. Nevertheless, 89% of participants were willing to abide by the health plan developed by their group. CONCLUSION: In the context of tradeoffs with their own health insurance benefits, groups of Minnesotans presented value-based arguments about covering the uninsured. All 29 groups and two thirds of individuals chose to contribute a portion of their premium to insure all children and most groups chose also to insure uninsured adults.

Adult↗

PubMedDate not supplied

The ethical commitments of academic faculty in psychiatric education.

OBJECTIVE: This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. METHOD: The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. CONCLUSION: Specific recommendations are provided.

Attitude↗