Genetic screening technology: ethical issues in access to tests by employers and health insurance committees

Whereas the introduction of new technologies previously has raised the ethical question of who ought to have access to a new procedure or device, genetic testing technology raises the new ethical question of to whom access to a new technology ought to be limited. In this article we discuss the implications of employers and private health insurance companies having access to genetic testing technology. Although there may be legitimate business interests in allowing employers and insurers to conduct genetic screening, there are other valid societal interests in regulating or limiting the use of this technology by third parties. Public policy developed in the area of new genetic technology must reflect such interests.     

Treatment issues for survivors of physical and sexual abuse*

Many clients who participate in family therapy have experienced trauma such as physical and sexual abuse in their families of origin. Extensive literature suggests that abusive experiences can result in post-traumatic stress disorders, depression, anxiety, personality disorders, and other long-term effects. Without recognition of the effects that abuse can have on individuals, it is possible to misdiagnose clients or fail to provide them with adequate assistance. This study is an attempt to compare the symptomology of nonabused clients with physically and sexually abused clients using an empirically sound measure. The results demonstrate that the majority of clients who experienced physical and/or sexual abuse in their backgrounds scored in the clinical range on scales from the Millon Clinical Multiaxial Instrument (MCMI) (Millon, 1984). In contrast, clients who did not report abuse had significantly lower scores than the abused clients, and the majority of the nonabused clients scored in the nonclinical range on the scales of the MCMI. Treatment and theoretical implications surrounding the issues of abuse are discussed, and recommendations for marriage and family therapists are provided.     

Net worth and the economic diversity of the elderly

Using data from the 1984 panel of the Survey of Income and Program Participation (SIPP), this article examines characteristics of the older population disaggregated by net-worth quintiles. The authors argue that income is not a sufficient measure of economic status for current policy discussions on issues such as changing Medicare co-payments, increasing the taxation of social security benefits, or means-testing under Medicaid. Net worth is a better measure of economic status, particularly for the elderly, because it represents the net value of assets accumulated over the life course. Their results indicate that there is considerable diversity in the economic status of the older population, which is masked by aggregate statistics (such as means and medians) typically used to summarize the economic status of population groups. Stereotypical views of the elderly based on such aggregates result in misdirected policy formulation. In the future, policymakers will need to formulate policies and programs using information on the distributions of income and assets among the older populations rather than relying on statistical aggregates.     

The NTEE classification system: tests of reliability/validity in the field of higher education

An analysis of the field of higher education reveals a surprisingly large number of classification errors within the (US) National Taxonomy of Exempt Entities database. Of the nearly 4,000 non-profit entities coded within the universe of institutions of higher education, we estimate that approximately 60 per cent were incorrectly included (Type II errors). Institutions incorrectly excluded from the higher education universe (Type I errors) represent roughly 10 per cent of the institutions coded correctly. These errors result primarily from assigning codes on the basis of the names of organisations (for example, College Park Towers is classified as a college, when it is in fact a housing complex for senior citizens) and from trying too hard to assign codes in ambiguous situations. The consequences can be significant for the users of these data, and we recommend raising bright warning flags while simultaneously enlisting the help of the entire non-profit sector in improving the classification coding process.The authors are with The Andrew W. Mellon Foundation. In addition to our colleagues on the staff of the Foundation, we wish to thank Helmut Anheier, Ted Bozovich, Harvey Dale, Virginia Hodgkinson, Stephen Noga and Christopher Toppe for helpful suggestions.     

The minds of a medical director

This article is offered in a nod to all those readers who have been exposed to "whole brain" theory, either through the American College of Physician Executives or elsewhere. As managers struggle with balancing the "left brain" and "right brain" aspects of their work, the author says, they might consider exploiting a third area of activity, or inactivity--the "no brain." This center position can be especially effective in dealing with the high-technology aspects of delivering health care.     

Eye-contact as a chance product of individual looking: Implications for the intimacy model of argyle and dean

From time to time during social encounters, people look at one another in the region of the eyes, and sometimes their eyes meet to make eye-contact. According to Argyle and Dean (1965), eye-contact in dyadic encounters signals the intimacy of the interaction and is controlled largely by the competing approach and avoidance forces that motivate the pair. In the present paper, new analyses are reported of three published experiments that were designed originally to test aspects of the intimacy model and it is shown that the duration of eye-contact is no more than a chance product of how long the two subjects look individually. Looking and not eye-contact, it is argued, should be the basis for models of visual interaction, and the intimacy model is ill-founded conceptually; the role of emotion in gaze has been overstressed at the expense of the concept of information; and the most important aspect of vision is in any case not looking and eye-contact but visual access to the whole person. The more cueless the encounter—that is, the fewer the social cues from vision and all the other senses combined—the greater the psychological distance; and the greater the psychological distance, the more task-oriented and depersonalized the content of what people say and, in turn, the less spontaneous their style of speech and the less likely a debate to end in compromise.Research for this article was sponsored by the Social Science Research Council of Great Britain.     

Optimal Times to Contact Sample Households

Finding a suitable respondent at home is an essential and expensivecomponent of a household survey. This article reports on theresults of a study of the probabilities of finding someone aged14 or older at home and discusses the application of such datato survey design and budgeting.     

Welfare reform in the 1950s.

Contrary to the impression left by historians, neither welfare expansion nor welfare reform died in the 1950s. Even conservatives believed in the necessity of federal spending for welfare. Disagreements came over the proper ways to spend federal money. The Eisenhower administration propagated a rehabilitation approach in an attempt to use federal money to end individual, state, and local dependence on the federal government. The administration's 1954 social security and vocational rehabilitation laws reflected this approach. Bureaucrats in the Department of Health, Education, and Welfare, working with a Democratic Congress, managed to extend the 1954 laws into a major expansion of federal power, as the passage of disability insurance in 1956 demonstrated. Institutional continuity, not heroic individual effort, provided the dynamic for welfare reform in the 1950s.