ABSTRACT
Studies using dopaminergic and serotonergic agonists or antagonists implicate involvement of these systems in various aspects of early maternal behavior and postpartum aggression towards an intruder in rats, both of which are associated with the presence of oxytocin in specific brain regions. It is unclear however, if or how long-term uptake inhibition of either neurotransmitter system alone or in combination, affects oxytocin system dynamics or maternal behavior/aggression. Pregnant women frequently take drugs (antidepressants, cocaine) that induce long-term reuptake inhibition of dopamine and/or serotonin, thus it is important to understand these effects on behavior and biochemistry. Rat dams were treated throughout gestation with amfonelic acid, fluoxetine, or a combination of both, to investigate effects of reuptake inhibition of dopamine and serotonin systems respectively, on maternal behavior, aggression and oxytocin. The more appetitive aspects of maternal behavior (nesting, licking, touching) and activity were increased by the low dose of amfonelic acid, high dose of fluoxetine, or the high dose combination more than other treatments. Aggression was decreased by amfonelic acid and somewhat increased by fluoxetine. Dopamine uptake inhibition appears to have a strong effect on hippocampal oxytocin levels, while receptor dynamics may be more strongly affected by serotonin uptake inhibition.
Subject(s)
Aggression/drug effects , Dopamine Uptake Inhibitors/pharmacology , Maternal Behavior/drug effects , Oxytocin/metabolism , Selective Serotonin Reuptake Inhibitors/pharmacology , Animals , Behavior, Animal/drug effects , Brain/drug effects , Brain/metabolism , Dose-Response Relationship, Drug , Drug Synergism , Female , Fluoxetine/pharmacology , Male , Nalidixic Acid/analogs & derivatives , Naphthyridines/pharmacology , Postpartum Period , Pregnancy , Rats , Rats, Sprague-DawleyABSTRACT
The special circumstances of patients in mental health facilities often make questions concerning patient autonomy, freedom of choice, and consent to treatment even more complex than they are in other contexts. Individual facilities need to identify the ethical issues they are likely to encounter and create policies that address them effectively. The advent of managed care has created unprecedented access problems for mental healthcare providers. In many cases patients must be proven dangerous to themselves or others before they can be admitted for emergency care; because it is difficult to prove this, many persons go without needed treatment. The high costs of care and prejudices against persons with mental illness also create ethical problems. The necessity of performing clinical evaluations raises important ethical issues as well. Care givers evaluating someone at the request of a school, employer, or court should be sensitive to the possible consequences of their evaluation. They should also restrict their diagnoses to their area of competency and inform clients of the purpose of the evaluation, its possible consequences, and the limits of its confidentiality. Mental health professionals must also respect patients' rights to informed consent and understand the issues of voluntary or involuntary admissions. In addition, care givers should be aware of the various issues created by the need to occasionally control patients' behavior. Finally, for mental healthcare facilities, it is essential to establish an ethics committee to address these issues.
Subject(s)
Ethics, Institutional , Mental Health Services/legislation & jurisprudence , Mentally Ill Persons , Patient Advocacy/legislation & jurisprudence , Patient Rights , Behavior Control , Disclosure , Ethics Committees, Clinical , Health Services Accessibility/legislation & jurisprudence , Humans , Informed Consent/legislation & jurisprudence , Patient Access to Records , Patient Selection , Personal Autonomy , Professional Staff Committees , Psychotherapy/legislation & jurisprudence , Treatment Refusal , United StatesSubject(s)
Ethics, Institutional , Ethics , Governing Board/standards , Policy Making , Leadership , Social Values , United StatesABSTRACT
Views on Catholic health care administration vary. It is a "necessary evil" or a true proclamation of Jesus' healing ministry? Scripture confirms that administration is a ministry. Administrators participate in the Church's healing mission as they participate in the Catholic health care organization's ministry to the sick. Five aspects characterize the administrator's ministry: Ministry to individuals. Administrators have many opportunities daily to show hospitality and concern for the many persons with whom they come in contact. Ministry to committees. At meetings, administrators can teach others about the organization's mission and philosophy and explore issues involving values and ethics. Ministry to the organization. In all administrative activities--even mundane tasks--the administrator can incorporate the values of justice, respect for persons, and compassion. Ministry to community, city, and state. The administrator, in word and action, can call civic and governmental organizations to growth in justice and equity and can be a catalyst to effect ecumenism among the local churches. Ministry with the sponsoring religious institute. Acting on behalf of the sponsor, administrators must make certain that they act with compassion and love and that their decisions are consistent with the institute's mission and philosophy. By excelling in the ministry of hospitality, the administrator can witness to the Gospel and further the healing ministry in the Church.
