A meta-analytic review of attitudes towards the sexuality of adults with intellectual disabilities as measured by the ASQ-ID and related variables: Is context the key?

BACKGROUND: The attitudes of others towards the sexuality of people with intellectual disabilities are one of the main perceived barriers to them expressing their sexuality. Research on what influences these attitudes yields heterogeneous results. METHOD: A systematic review of the literature and a meta-analysis were carried out. RESULTS: Eleven studies using the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) were included. Within the included studies, the country's socio-economic development and level of individualism were associated with attitudes towards the sexual rights, parenting and self-control of adults with intellectual disabilities. General population and staff samples held more favourable attitudes than family samples in terms of sexual rights and parenting. Age and gender did not yield significant results. CONCLUSIONS: Variables related to country context may underlie the differences observed between countries and therefore influence the population's general thinking and ideologies. Unexpectedly, no age differences were observed. Gender-related results may reflect rapprochement between genders in sexuality. These findings are relevant for researchers and practitioners, as they suggest the importance of considering contextual factors when developing effective interventions that aim to support adults with disabilities to live their sexuality.

Ethical considerations on the complicity of psychologists and scientists in torture.

INTRODUCTION: The long-standing debate on medical complicity in torture has overlooked the complicity of cognitive scientists-psychologists, psychiatrists and neuroscientists-in the practice of torture as a distinct phenomenon. In this paper, we identify the risk of the re-emergence of torture as a practice in the USA, and the complicity of cognitive scientists in these practices. METHODS: We review arguments for physician complicity in torture. We argue that these defences fail to defend the complicity of cognitive scientists. We address objections to our account, and then provide recommendations for professional associations in resisting complicity in torture. RESULTS: Arguments for cognitive scientist complicity in torture fail when those actions stem from the same reasons as physician complicity. Cognitive scientist involvement in the torture programme has, from the outset, been focused on the outcomes of interrogation rather than supportive care. Any possibility of a therapeutic relationship between cognitive therapists and detainees is fatally undermined by therapists' complicity with torture. CONCLUSION: Professional associations ought to strengthen their commitment to refraining from engaging in any aspect of torture. They should also move to protect whistle-blowers against torture programmes who are members of their association. If the political institutions that are supposed to prevent the practice of torture are not strengthened, cognitive scientists should take collective action to compel intelligence agencies to refrain from torture.

[Diaphyseal pseudarthrosis treatment algorithm]. / Algoritmo del tratamiento de la seudoartrosis diafisaria.

We present a therapeutic guide of diaphyseal pseudoarthrosis with the different degrees of difficulty faced by the orthopedic surgeon, mentioning the principles that must be followed to obtain optimal results.

Se presenta una guía terapéutica de la seudoartrosis diafisaria con los diferentes grados de dificultad a que se enfrenta el cirujano ortopédico, mencionando los principios que deben seguirse para obtener óptimos resultados.

Ethical and legal issues in the care of the impaired newborn.

The subject is approached from the standpoint of the debates and events of the "Baby Doe era," from 1982 to 1985. Historic episodes of mass infanticide and practices in other cultures, while often cited as warnings of moral peril, are difficult to apply to the problem of infant euthanasia. Key cases in American courts are reviewed, although no standard pattern of analysis is found to have emerged. The two streams of policy making at the national level, from the Department of Health and Human Services and the Congress, have effectively led back to underlying ethical dilemmas about the proper interpretation of the infant patient's best interests. The conclusion alludes to several issues that neonatal ethics has yet to confront.

"The only feasible means." The Pentagon's ambivalent relationship with the Nuremberg Code.

Convinced that armed conflict with the Soviet Union was all but inevitable, that such conflict would involve unconventional atomic, biological, and chemical warfare, and that research with human subjects was essential to respond to the threat, in the early 1950s the U.S. Department of Defense promulgated a policy governing human experimentation based on the Nuremberg Code. Yet the policymaking process focused on the abstract issue of whether human experiments should go forward at all, ignoring the reality of humans subjects research already under way and leaving unanswered ethical questions about how to conduct such research. Documents newly released to the Advisory Committee on Human Radiation Experiments tell the story of the Pentagon policy.

Who's to choose? Surrogate decisionmaking in New York State.

The problem of finding appropriate decisionmakers for incapacitated patients continues to beleaguer caregivers. In New York state, a specially appointed task force has recently examined this issue and made some novel recommendations.

Goodbye to all that. The end of moderate protectionism in human subjects research.

Federal policies on human subjects research have undergone a progressive transformation. In the early decades of the twentieth century, federal policies largely relied on the discretion of investigators to decide when and how to conduct research. This approach gradually gave way to policies that augmented investigator discretion with externally imposed protections. We may now be entering an era of even more stringent external protections. Whether the new policies effectively absolve investigators of personal responsibility for conducting ethical research, and whether it is wise to do so, remains to be seen.

Private genes and public ethics.

KIE: Moreno reports on recent activities in Washington, D.C., that could affect future genetic research. Concerned about the implications of genetic interventions in humans, 63 theologians and scientists released a statement on 8 June 1983 calling for a congressional moratorium on genetic research that could alter the human germline. An alternative to banning genetic experimentation would be the creation of a body to evaluate such research. Among the proposals under consideration are establishing a new President's Commission, setting up an ethics committee under the jurisdiction of the National Academy of Science's Institute of Medicine, or expanding the National Institutes of Health's Recombinant DNA Advisory Committee.^ieng

The limits of the ledger in public health promotion.

Recent efforts to support state regulation of risky behavior like cigarette smoking, alcohol consumption, driving without seatbelts and riding motorcycles without helmets have focused on economic justifications--the costs to society of the consequences of these activities. However, opponents have successfully argued that the economic burdens of regulation outweigh the social benefits. To reduce the toll on society of these behaviors, we need justification for regulation that asserts the moral primacy of health and the well-being of the community.

KIE: Recent public policy debates over seatbelt and motorcycle helmet laws and taxes on alcohol and tobacco are described and evaluated. Advocates of stronger state actions in these areas are faulted for framing their justifications almost solely in economic terms, leaving their opponents able to argue that the economic burdens of regulation outweigh the social benefits. It is concluded that the justification for such regulation must include an assertion of the moral primacy of health as a social good and of the well-being of the community as a legitimate concern of public policy.