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PubMed1993

On being a whistleblower: the Needleman case.

We believe that members of the scientific community have a primary obligation to promote integrity in research and that this obligation includes a duty to report observations that suggest misconduct to agencies that are empowered to examine and evaluate such evidence. Consonant with this responsibility, we became whistleblowers in the case of Herbert Needleman. His 1979 study (Needleman et al., 1979), on the effects of low-level lead exposure on children, is widely cited and highly influential in the formulation of public policy on lead. The opportunity we had to examine subject selection and data analyses from this study was prematurely halted by efforts to prevent disclosure of our observations. Nevertheless, what we saw left us with serious concerns. We hope that the events here summarized will contribute to revisions of process by which allegations of scientific misconduct are handled and that such revisions will result in less damage to scientists who speak out.

Biomedical Research↗
PubMed1994

Process and detection in fraud and deceit.

There has been considerable interest recently in scientific misconduct. Although much has been written and discussed about specific cases, very little, if any, research has been carried out on the process of fraud. An understanding of this aspect can contribute much to methods of detection and lead to recommendations for preventing misconduct and for implementation of appropriate sanctions where fraud has been detected and proved. In this article I initiate a study of the process of fraud using a series of case studies. Hypotheses are generated by methods pioneered by Peirce and most recently developed and thoroughly discussed by Glaser and Strauss under the name of grounded theory. Some illustrations of what can be learned from such studies are included.

Biomedical Research↗
PubMed1996

The personal is the organizational in the ethics of hospital social workers.

Understanding the social context of clinical ethics is vital for making ethical discourse central in professional practice and for preventing harm. In this paper, we present findings about clinical ethics from in-depth interviews and consultation with 7 members of a hospital social work department. Workers gave different accounts of ethical dilemmas and resources for ethical decision making than did their managers, whereas workers and managers agreed on core-guiding ethical principles and on ideal situations for ethical discourse. We discuss the research team's initial interpretations, the relevance of the extant ethics literature to organizational structures and dynamics, and alternative perspectives on clinical ethics.

Administrative Personnel↗
PubMed1997

Nonsexual relationships between psychotherapists and their former clients: obligations of psychologists.

This article examines the issue of nonsexual relationships between psychologists and their former therapy clients. What little research is available concerning nonsexual relationships with former clients suggests that psychologists have clear reservations about some of these relationships, especially personal ones and intentional social interactions. Relationships immediately following termination are seen as particularly suspect. Drawing on the literature dealing with multiple relationships in general, and sexual relationships with former clients in particular, a number of arguments are made outlining why psychologists should avoid significant nonsexual relationships with former clients for at least some period of time following termination.

Attitude↗
PubMed1997

Dubious and bogus credentials in mental health practice.

Within an ethics framework, this article explores mental health practitioners' use of credentials that lack acceptable accreditation or authority. Increased competition among mental health care providers has elevated the importance of credentials for marketing professional services. Practitioners worried about economic survival, along with certain personality characteristics (e.g., sheer ego), are tempted to rely on credentials that lack proof of quality, thereby potentially jeopardizing professionalism. Specific assertions and recommendations are set forth in the interest of safeguarding consumers and promoting professionalism.

Counseling↗
PubMed2003

Relational discrepancy theory: the implications of self discrepancy theory for dyadic relationships and for the emergence of social structure.

Relationship formation and maintenance is guided by more than similarity between partners' actual selves. Expanding the domain of self-discrepancy theory (SDT; Higgins, 1987), we propose that a type of discrepancy previously not considered-discrepancies between self-aspects of relational partners-is central to relationship cognition, including perceptions of intimacy and trust, and to the emergence of roles within relationships. Our argument relates both to unconstrained environments, where individuals freely choose partners, and constrained environments (e.g., workplaces) with relationships imposed. We argue that SDT's prediction of emotional consequences from discrepancies permits a motivational account of why individuals might form and maintain relationships in terms of hierarchies and roles

Humans↗
PubMedDate not supplied

Socialization of student nurses into the qualified nurse role.

The journey that a new student nurse makes is a long one during which the traveller undergoes many changes. This article considers the way the student is socialized into the role of qualified nurse. In so doing it explores the part played by the nurse teacher in that process of change.

Humans↗
PubMed2005

Domestic violence: a tragedy behind the doors.

OBJECTIVE: To explore the prevalence, type, frequency and causes of domestic marital violence among Turkish women in a socio-economically developed metropolitan setting. METHODS: A cross-sectional study was performed in 2003. All married women, aged 18 years and over, who were visiting any of the 50 primary health care units for different purposes were asked to participate in the study. Of 1427 asked, 1010 gave consent and completed face-to-face interviews. Multiple correspondence analysis, and logistic regression were used for statistical analyses. RESULTS: Domestic violence was statistically significantly associated with educational level. Illiterate women reported marital abuse 2.6 times more than university or more educated women. No statistically significant relationship was observed between domestic marital violence and women's age or occupation, marital duration or family income. The most frequently reported type of violence was physical, followed by psychological. Among women reporting domestic violence, those with the lowest educational level and income were experiencing all types of domestic violence frequently. CONCLUSION: Placing more importance on educating girls could be a key component of preventing domestic violence.

Adult↗
PubMed2002

Health-related interactions and the self in marriage.

This study investigated the association between self processes and married partners' (N = 59 couples) perspectives of their health-related social interactions. Findings revealed that wives' self processes were associated with their social behavior from the perspective of each partner. The wives' self processes differentially predicted wives' and husbands' perspectives of their interactions, however. These findings demonstrate that wives' future expectations for the health of their husband, as well as for their role in maintaining his future health, motivate their current social behavior to promote the positive health lifestyle behaviors of their husband.

Aged↗
PubMed2006

Gender please, without the gender police: rethinking pain in archetypal narratives of butch, transgender, and FTM masculinity.

Why is it that many of the often-cited narratives about butch, FTM, and/or transgender masculinity happen to be fictions that highlight suffering as a de facto rite of passage for the butch, FTM, or transgendered protagonist? This essay attempts to answer that question, first by outlining the "coherentist assumptions" of lesbian feminism and the forms of gender-policing that cast butch, FTM, and transgendered subjectivities as "false consciousness." It then analyzes the practice of anchoring butch, FTM, and/or transgender identity claims in pain-filled narratives such as "The Well of Loneliness," "Stone Butch Blues," and "Boys Don't Cry." While these narratives do important cultural work-exposing the violence heaped upon butches, FTMs, and transgendered guys-it may be time to imagine alternative narratives that are less invested in suffering as a barometer of masculine authenticity.

Female↗
PubMed2000

Among friends? An examination of friendship and the self-serving bias.

Do friends bound each other's self-enhancement tendencies? Do friends display the self-serving bias (SSB; i.e. taking individual credit for success but blaming a partner for failure)? Dyads consisting of either friends or strangers engaged in an interdependent-outcomes creativity test, received bogus success or failure feedback at the dyadic level, and made responsibility attributions for the joint test performance. Strangers displayed the SSB. Friends, in contrast, refrained from the SSB: they shared responsibility for both successful and unsuccessful test outcomes. Friendship does place boundaries on self-enhancement.

Adolescent↗
PubMed2000

Attitude-behaviour relations: the role of in-group norms and mode of behavioural decision-making.

Two experiments provided support for the central hypothesis--derived from social identity/self-categorization theories--that attitudes would be most likely to predict behaviour when they were supported by a congruent in-group norm. In the first experiment, norm congruency and mode of behavioural decision-making (spontaneous or deliberative) were orthogonally manipulated in a between-subjects study of career choice in psychology. Participants exposed to an attitudinally congruent in-group norm towards their preferred career choice were more likely to display attitude-behaviour consistency than those exposed to an attitudinally inconsistent group norm, an effect that was evident under both spontaneous and deliberative decision-making conditions. Using a mock jury paradigm, Expt 2 replicated and extended the first experiment by including a manipulation of in-group salience. As predicted, participants exposed to an incongruent norm displayed greater attitude-behaviour inconsistency than those exposed to a congruent norm. Contrary to predictions, this effect did not vary as a function of group salience, nor did the effects of group norms for high and low salience participants vary as a function of mode of behavioural decision-making. However, there was evidence that perceived identification with the group moderated the influence of norms on attitude-behaviour consistency.

Adult↗
PubMed2000

Power lines: Derrida, discursive psychology and the management of accusations of teacher bullying.

This study connects broad issues of classroom control and the disciplining of pupils by teachers with a detailed examination of the way teachers deal with an implied accusation that they have been bullying. The analysis of interviews develops with reference to discursive psychology and Derrida's development of deconstruction. Billig's (1992) insights into ways that participants' accounts can neutralize threats to established social arrangements are employed in relating detailed analytic points to the broader power relations between teacher and pupil. Interviews were conducted with Scottish secondary school teachers, and subjected to close textual analysis. This resulted in the development of three themes: (1) Subjectivity Construction, in which the functional role of the construction of mental entities is examined; (2) Normalizing Techniques, identifying strategies whereby intimidation can be constructed as normal; and (3) Figuration, examining the utility of figurative language--metaphors, maxims, and so on. These themes display the subtlety and complexity of teachers' strategies for distancing themselves from being held accountable for reported intimidation. To conclude, three broader features of the study are discussed: the contribution to discursive psychology that Derrida's deconstructive philosophy can make; the respecification of psychology and subjectivity as participants' resources for action; and the contribution that this type of detailed study can make to issues of power and social critique.

Adolescent↗
PubMed1995

Clinical violence intervention: lessons from battered women.

Attempts to address violence intervention and prevention in clinical practice are hampered by the difficulty of creating definitions and categories that accurately reflect community experience. Current medical and legal paradigms, for instance, do not integrate gendered experience into definitional understanding of domestic violence and, consequently, risk the development of systems of care that poorly address women's needs. A model of women's experience of domestic violence and key elements of clinical intervention are presented. Health and public health agencies need to actively integrate an understanding of gender relations in violence intervention and prevention.

Domestic Violence↗
PubMed2000

Trust in managed care organizations.

Two basic criticisms of managed care are that it erodes patient trust in physicians and subjects physicians to incentives and pressures that compromise the physician's fiduciary obligation to the patient. In this article, I first distinguish between status trust and merit trust, and then argue (1) that the value of status trust in physicians is probably over-rated and certainly underdocumented; (2) that erosion of status trust may not be detrimental if accompanied by an increase in well-founded merit trust; and (3) that under conditions of managed care the physician's commitment to traditional medical ethics cannot serve as an adequate basis for merit trust. Next, drawing on an analogy between managed care organzations and politics, I argue that (4) the most appropriate basis for merit trust in managed care is a conception of organizational legitimacy that includes procedural justice, empowerment of constructive criticism within the organization, and organizational accommodation of the noninstrumental commitment to patient well-being that is distinctive of medical professionalism. I then explore the conditions necessary for robust competition for merit trust among managed care organizations and indicate the kinds of public policies needed to facilitate such competition. Finally, I show how the account of organization-based merit trust can accommodate the special fiduciary obligation of medical professionals, without indulging in the delusion that it is the physician's fiduciary obligation always to provide all care that is expected to be of any net benefit to the patient.

Cost-Benefit Analysis↗