THIS MONTH'S ISSUE
Parse personalistic recreational temporal priority of conduct disorder with a lateralisation index of the stressor of awakening and graded activity in Languedoc-Roussillon, measure survival statistics with Icelandic antidepressants, then study compulsory admissions, violence exposure and overt discrimination. This is not a particularly memorable or instructive sentence but it contains what I regard as some of the essential words from all 14 papers in this month's issue. I am sure readers could do considerably better. Enclosed between Leon Eisenberg's smashing defence of social psychiatry (pp. ) — a fitting tribute to Julian Leff for his contribution to the subject — and the subtlety of stigma (the patronising attitudes of family and friends were a new angle for me; pp. ) we have a juicy sandwich for readers to get their teeth into. Do look carefully at Fig. 2 of the Simonoff et al (pp. ) article — it replaces yards of text — and try to puzzle out the reason for the resilience of Kenyan adolescents to traumatic experiences (pp. ), then go back to Leon Eisenberg. It could give you a little of the same buzz as liquid ecstasy (see pp. ) but will certainly not lead to withdrawal delirium.
USEFUL NEOLOGISMS
I was trying to persuade one of my patients to come into hospital and was getting desperate. In such situations I often use one of the weakest of arguments, the ‘in your best interests’ one. Whatever persuasive merits it had with patients in the past, it certainly does not work today and after I had used it twice I received a dusty response. ‘Stop parentorising me!’ he admonished, waving an arm with an accusatory finger vaguely pointing in my direction. I persisted, lamely; ‘I am not patronising you. It's just that I've known you for 10 years and at this point there is no alternative to hospital.’ This was getting even worse; the TINA argument is even less effective than the ‘in your best interests’ one. ‘Stop parentorising me!’ he said again. At this point I snapped. I might not be able to teach him logic but I could certainly teach him lexicology. ‘The word is “patronising”, not “parentorising”; there is no such word as “parentorising”.’ ‘Oh yes there is. “Patronising” is behaving like a father, “matronising” is behaving like a mother, and “parentorising” is behaving like a parent, all in the manner of what you regard as “patronising”. So stop parentorising me.’ I have read somewhere in this context, ‘collapse of stout party’. Now I know what it means.
IN CASE YOU MISSED IT...ETHICS
The world of ethics is being riven by a debate between researchers and ethicists over the new rules of consent developed since the Helsinki Convention of 2000. Consent is relatively easy to justify for individual treatments but becomes very difficult for complex health service interventions. For many of these the notion of informed consent is a pipe dream, particularly for populations with learning disabilities or experiencing an acute psychotic episode. Cassell & Young, in the Journal of Medical Ethics (2002, vol. 28, pp. 313–317) argue that the notion of individual consent is misguided. ‘Existing ethical guidelines do not help us decide how to seek consent in these cases, and have allowed managerial experimentation to remain largely unchecked. Inappropriate requirements for individual consent can institutionalise health inequalities and reduce access to services for vulnerable groups. This undermines the fundamental purpose of the National Health Service (NHS), and ignores our rights and duties as its members’. The battle is still in its early stages and interested readers are pointed to the Journal of Medical Ethics as it hosts this debate. Meanwhile, managerial experimentation goes on unchecked.
CHOICE OF VENUE
I was surprised to find at a recent meeting of the College for Honorary Fellows how many choose to read their Journal in the bath. Before we rush out a new version with a waterproof cover it would be useful to know whether other settings are equally attractive. This may be useful in delivering a riposte to those who claim that paper journals are now obsolete.
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