Sex, immorality, and mental disorders.

Although the definition of a mental disorder has remained essentially the same from Diagnostic and Statistical Manual of Mental Disorder, Third Edition, Revised (DSM-III-R) through DSM-IV to DSM-IV-TR, the account of the paraphilias has changed continually. Although the definition in all the DSMs explicitly rules out deviant sexual behavior as sufficient for labeling someone as having a mental disorder, deviant sexual behavior counts as sufficient for all the paraphilias in DSM-III-R. In DSM-IV, the account of all the paraphilias is made consistent with the definition. In DSM-IV-TR, mere deviant sexual behavior is not sufficient for being classified as having a paraphilia, but immoral deviant sexual behavior is. Thus, in DSM-IV-TR, only those paraphilias that involve immoral deviant sexual behavior are inconsistent with the definition, but deviant sexual behavior by itself does not count as a mental disorder.

Core curriculum: research ethics for radiology residents.

RATIONALE AND OBJECTIVES: Scholarly activity, which may include research, is now a required element of resident training. In addition, residents are required to participate in a systems-based practice or quality improvement project. Residency programs are expected to provide training for these endeavors but may lack the necessary resources. This work is intended to provide a core curriculum in research ethics for radiology residents to help fulfill that need. MATERIALS AND METHODS: The material was developed through discussion and collaboration of the authors, review of pertinent literature, and consultation with experts in the field. RESULTS: This work includes a brief introduction to the topic, followed by cases designed to highlight the issues inherent in informed consent, privacy, the disclosure of results, authorship, study subjects, and health services research. CONCLUSION: Radiology residents are expected to learn about the design, performance, reporting, and critical evaluation of research. All of these elements can potentially raise ethical issues. Understanding the underlying ethical issues is critical for the future of radiology research.

Computer implants and death.

Although a patient whose whole brain has ceased to function may have his heart, lungs, and other organs continue to function if they are connected to the appropriate machines, the patient is still dead and the machines can be disconnected. In the future, nanotechnology, or other technology, may allow putting implants in the brainstem that can keep a patient's heart, lungs and other organs functioning, even though the whole natural brain has ceased to function. It would be useful to consider how this technology might affect the criterion of death before it is actually available.

A brief reply to Carson Strong.

Carson Strong's reply to my response to his article demonstrates what happens when there is unacknowledged disagreement about the facts of a case or about the meaning of the terms used to describe those facts. I hope that our dialogue will help reduce this disagreement.

Making the morally relevant features explicit: a response to Carson Strong.

Carson Strong criticizes the application of my moral theory to bioethics cases. Some of his criticisms are due to my failure to make explicit that both the irrationality or rationality of a decision and the irrationality or rationality of the ranking of evils are part of morally relevant feature 3. Other criticisms are the result of his not using the two-step procedure in a sufficiently rigorous way. His claim that I come up with a wrong answer depends upon his incorrectly regarding a weakly justified violation as one that all impartial rational persons would agree was permitted, rather than as one about which rational persons disagree.

The relevance of moral theory to pediatric neurology.

Although you should never abandon your well-considered moral judgments because of their conflict with a moral theory, you should also usually not hold that your well-considered moral judgments are the only correct moral judgments. Common morality does not provide unique correct answers to every moral question, it only sets limits to the range of morally acceptable answers. In serious discussions of controversial cases or policies, almost all of the answers will be morally acceptable. The recognition that there are sometimes several conflicting morally acceptable answers allows for a friendly and fruitful discussion with no one sacrificing their moral integrity.