OBJECTIVES: To assess lifestyle factors including physical activity, smoking, alcohol consumption, and dietary habits in men and women with exceptional longevity. DESIGN: Retrospective cohort study. SETTING: A cohort of community-dwelling Ashkenazi Jewish individuals with exceptional longevity defined as survival and living independently at age 95 and older.
The success of science and medical technology has led to medical brinkmanship, pushing aggressive treatment as far as it can go. But medicine lacks the precision necessary for such brinkmanship to succeed, and the resulting cycle of expectation and disappointment in technology has, in part, led to an increasing acceptance of euthanasia and assisted suicide, linked closely with advocacy for patient autonomy. At the opposite extreme lies medical vitalism, which refers to attempts to preserve the patient's life in and of itself without any significant hope for recovery.
HIV appeared in Ireland following an opiate epidemic in the early 1980s. Initially, however, the gay community mounted the only response to the spread of the virus while the implementation of early actions by the government was hampered by the constructions of the disease within Irish society. This paper considers the influence of the religious hierarchy in both the development of AIDS policy and in the shaping of public perceptions of the disease and those affected.
In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs.
Physicians' religious attributes are unknown, and may affect patient care. The Women Physicians' Health Study (WPHS) is a random sample (n = 4501 respondents, 59% response rate) of US women physicians aged 30-70; the first large, national study of US women physicians. In this study US women physicians were less likely to be Christian than were other Americans (61.2% of women physicians versus 85.1% of the general population), but were more likely to be Jewish (13.2% vs 2.0%), Buddhist (1.4% vs 0.3%), Hindu (3.9% vs 0.4%), or atheist/agnostic (5.9% vs 0.6%).
In November 1998 biologists announced that they had discovered a way to isolate and preserve human stem cells. Since stem cells are capable of developing into any kind of human tissue or organ, this was a great scientific coup. Researchers envision using the cells to replace damaged organs and to restore tissue destroyed by, for example, Parkinson's disease, diabetes, or even Alzheimer's. But, since stem cells are taken from aborted embryonic and fetal tissue or "leftover" in vitro embryos, their use raises large ethical issues.
The principle of double effect is widely used to permit the administration of narcotics and sedatives with the intent to palliate dying patients, even though the administration of these drugs may cause hastening of death. In recent medical literature, this principle's validity has been severely criticized, causing health care providers to fear providing good palliative care. Most of the criticisms levelled at the principle of double effect arise from misconceptions about its purpose and origins.
The prospective payment system will require agencies to become more creative and network with community resources. This article describes a health needs assessment survey that provided the foundation for a parish nurse ministry. The survey revealed that parish nurses could complement home health nurses by filling some of the gaps in healthcare not provided by third-party payers.
The Journal of the American Academy of Psychiatry and the Law
Many young Americans, married and marriageable, are turning to more traditional or fundamentalist religions. Religiosity and ultra-strict morality often leads to attitudes that alter decision-making in marriage, divorce, and the disposition of the children of divorce. Judgmental pastoral counseling may affect these decisions even more. This paper discusses these issues, emphasizing the need for forensic psychiatrists involved in the custody arena to be aware of the religious, spiritual, irreligious, or even anti-religious feelings of the battling partners.
In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data.