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1Throwing Jello: a Primer on Helping Patients.

In this issue of The Journal of Clinical Ethics, a case from the Harvard Ethics Consortium discusses a patient named Lorraine who sometimes was so violent she drove careproviders from her room. Such situations are not uncommon, and the outcomes often are tragic. In this case, Lorraine eventually stopped treatment, suffered greatly, and died of infection from her decubitus ulcers. In situations like this, staff are often split: some side with the patient and others side against. The latter may come to feel contempt for the patient, and, if they do, the situation typically worsens. The patient can feel increasingly alone, and become more aggressive, maybe because isolation is the most painful of all feelings. Staff may then feel even more helpless and enraged, and the vicious cycle intensifies. This is apparently what happened with Lorraine. As Jennifer Repper-DeLisi and Susan M. Kilroy write in “ ‘We Need To Meet,’ ” the staff’s “natural responses” to the patient were “frustration, anger, and rejection.” Staff usually try to do the best they can, as in Lorraine’s case, but we may not help patients as much as we hope. In reality, it may not be possible to help them — for example, in this case it is unlikely that Lorraine could have done better. But there are exceptional approaches that can be used when conventional approaches don’t succeed. These approaches may help all patients, but, with patients like Lorraine, they may be lifesaving, so ethics consultants and other careproviders should at least know about them.

2006The Journal of Clinical Ethics（2006）引用：24

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2Why Are They Boxing Us in Like This?

Previous articleNext article No AccessAt the BedsideWhy Are They Boxing Us in Like This?Edmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences in Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 16, Number 2Summer 2005 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200516201 © 2005 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2005The Journal of Clinical Ethics（2005）引用：23

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3Shame, Slap Jack, and Families That Should Lie.

Next article No AccessAt the BedsideShame, Slap Jack, and Families That Should LieEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences in Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 16, Number 4Winter 2005 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200516401 Views: 1Total views on this site © 2005 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2005The Journal of Clinical Ethics（2005）引用：23

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4What Research Practices in China May Teach the U.S.

Next article FreeWhat Research Practices in China May Teach the U.S.Edmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 15, Number 1Spring 2004 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200415101 © 2004 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2004JOURNAL OF CLINICAL ETHICS（2004）引用：23

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5Some New Paradigms for Ethics Consultants.

Next article No AccessSome New Paradigms for Ethics ConsultantsEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 15, Number 3Fall 2004 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200415301 © 2004 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2004The Journal of Clinical Ethics（2004）引用：22

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6Criteria for Deceit.

Next article No AccessCriteria for DeceitEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 15, Number 2Summer 2004 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200415201 Citations: 1Citations are reported from Crossref © 2004 The University of Chicago. All rights reserved.PDF download Crossref reports the following articles citing this article: Mark F. Carr The Spectrum of Religion and Science in Clinical Encounters, The Journal of Clinical Ethics 19, no.44 (Dec 2022): 360–370.https://doi.org/10.1086/JCE200819409

2004JOURNAL OF CLINICAL ETHICS（2004）引用：24

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7Hope or Truth: Commentary on the Case of Mr. T.

Previous articleNext article No AccessHope or Truth: Commentary on the Case of Mr. TEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 3Fall 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314311 © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003JOURNAL OF CLINICAL ETHICS（2003）引用：24

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8Death-defying Empathy.

Next article No AccessDeath-Defying EmpathyEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 4Winter 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314401 Views: 1Total views on this site © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003The Journal of Clinical Ethics（2003）引用：23

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9Peter Singer and Beastiality

Previous articleNext article No AccessPeter Singer and BeastialityEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 4Winter 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314413 Views: 4Total views on this site © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003The Journal of Clinical Ethics（2003）引用：24

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10Treating Torture Victims and Enhancing Human Rights

Treating Torture Victims and Enhancing Human RightsEdmund Howe and James E. McCarrollEdmund HoweSearch for more papers by this author and James E. McCarrollSearch for more papers by this authorPublished Online:June 2005https://doi.org/10.1521/psyc.66.1.65.20287PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutThe Mobilization of Shame.Asch , S., Leake, B., and Gelberg, L. Does fear of immigration authorities defer patients from seeking care? Western Journal of Medicine (1994, October) 161:373–6. Medline, Google ScholarBrown , D. Program would bring life-sustaining drugs to poorest nations. Washington Post (2002, July 7): A13. Google ScholarDreger , A. D. Intersex in the Age of Ethics. University Publishing Group, 1999. Google ScholarFainaru , S. Court allows closed immigration hearings to continue. Washington Post (2002, June 29): A14. Google ScholarFeitlowitz , M. A Lexicon of Terror: Argentina and the Legacies of Torture. Oxford University Press, 1998. Google ScholarGreene , G. (from a letter to the editor of the London Daily Telegraph, November 6, 1964). In J. Amery, S. and S. P. Rosenfeld, trans., At the Mind's Limits: Contemplations by a Survivor on Auschwitz and Its Realities (p. 23). Schocken Books, 1980. Google ScholarGrieger , T., and Adams, B. Guantanamo Bay, Cuba 1996: Psychiatric services to Cuban migrants in the final days of Operation Sea Signal. Military Medicine (1997) 162:824–6. Crossref Medline, Google ScholarHavens , L. Seeing Sullivan as part of 20th century developments, Psychiatry (2000) 63: 127–31. Crossref Medline, Google ScholarHowe , E. Book essays and reviews:Clinical Handbook of Psychiatry and the Law, 3rd ed. Psychiatry (2001a) 64:168–81. Link, Google ScholarHowe , E. International practices in neonatology. The Journal of Clinical Ethics (2001b) 12: 286–9. Google ScholarKaminer , D., Stein, D. J., Mbanga, I., and Zungu, N. Forgiveness: Toward an integration of theoretical models. Psychiatry (2000) 63:344–57. Crossref Medline, Google ScholarKaminer , D., Stein, D. J., Mbanga, I., et al. The Truth and Reconciliation Commission in South Africa: Relation to psychiatric status and forgiveness among survivors of human rights abuses. British Journal of Psychiatry (2001) 178:373–7. Crossref Medline, Google ScholarKandinsky , W. Reminiscences. In R. L. Herbert, ed., Modern Artists on Art (pp. 19–44). Prentice-Hall, 1994. Google ScholarKlevit , H. D., Bates, A. C., Castaneves, T., Kirk, E. P., Sipes-Metzler, P. R., and Wopat, R. Prioritization of health care services: A progress report by the Oregon Health Services Commission. Archives of Internal Medicine (1991) 151:912–6. Crossref Medline, Google ScholarLandrigan , P. J., and Mccammon, J. B. Child labor still with us after all these years. Public Health Reports (1997, Nov.-Dec.) 112:46673. Medline, Google ScholarLifton , R. J. The Nazi Doctors. Basic Books, 1986. Google ScholarLinehan , M. M., Schmidt, H., III, Dimeff, L. A., Craft, J. C., Kanter, J., and Comtois, K. A. Dialectical behavior therapy for patients with borderline personality disorders and drug dependence. American Journal of Addictions (1999) 8: 279–92. Crossref Medline, Google ScholarLuxemburg , R. Leninism or Marxism? In R. Kerney and M. Rainwater, eds., The Continental Philosophy Reader (pp. 161–8). Routledge, 1996. Google ScholarMulligan , K. Does political correctness have a place in psychiatry? Psychiatric News (2002, June 21) 37: 14–31. Google ScholarNozick , R. Anarchy, State, and Utopia. Basic Books, 1977. Google ScholarPlato . The Republic of Plato, F. M. Cornford, trans. Oxford University Press, 1976. Google ScholarRawls , J. Theory of Justice. Belknap Press, 1971. Google ScholarRingle , K. The haunting. Washington Post (2002, June 15):C 1–C 4. Google Scholar Previous article FiguresReferencesRelatedDetails Volume 66Issue 1Mar 2003 Information© Guilford Publications Inc.PDF download

2003Psychiatry（2003）

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11Overcoming the Downside of Asymmetry.

Next article No AccessOvercoming the Downside of AsymmetryEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 3Fall 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314301 Views: 1Total views on this site © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003JOURNAL OF CLINICAL ETHICS（2003）引用：23

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12When Careproviders Should Give Advice, Disclose Personal Information, and Reveal Their Feelings

Next article No AccessWhen Careproviders Should Give Advice, Disclose Personal Information, and Reveal Their FeelingsEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 1-2Spring-Summer 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314101 © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003JOURNAL OF CLINICAL ETHICS（2003）引用：24

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13Lessons from “jay Carter”

Previous articleNext article No AccessLessons from “Jay Carter”Edmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences, Bethesda, Maryland Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 14, Number 1-2Spring-Summer 2003 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200314115 © 2003 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2003JOURNAL OF CLINICAL ETHICS（2003）引用：23

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14The Paradox of Paternalism and Three Steps Careproviders Can Take to Help All Patients

Next article No AccessThe Paradox of Paternalism and Three Steps Careproviders Can Take to Help All PatientsEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 13, Number 1Spring 2002 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200213101 © 2002 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2002The Journal of Clinical Ethics（2002）引用：23

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15Allowing Patients to Find Meaning Where They Can

Next article No AccessAllowing Patients to Find Meaning Where They CanEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 13, Number 3Fall 2002 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200213301 © 2002 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2002The Journal of Clinical Ethics（2002）引用：24

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16Challenging Patients’ Personal, Cultural, and Religious Beliefs

Next article No AccessChallenging Patients’ Personal, Cultural, and Religious BeliefsEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 13, Number 4Winter 2002 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200213401 © 2002 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2002JOURNAL OF CLINICAL ETHICS（2002）引用：25

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17Should Ethics Consultants Use Telemedicine? A Comment on Pronovost and Williams

Previous articleNext article No AccessShould Ethics Consultants Use Telemedicine? A Comment on Pronovost and WilliamsEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 12, Number 1Spring 2001 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200112110 © 2001 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2001The Journal of clinical ethics（2001）引用：23

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18Comment: Limiting Toxic Information

Previous articleNext article No AccessComment: Limiting Toxic InformationEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 12, Number 2Summer 2001 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200112209 © 2001 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2001The Journal of Clinical Ethics（2001）引用：25

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19International Practices in Neonatology

Previous articleNext article No AccessInternational Practices in NeonatologyEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 12, Number 3Fall 2001 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200112312 © 2001 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

2001The Journal of clinical ethics（2001）引用：23

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20How to Determine Competency

Next article No AccessHow to Determine CompetencyEdmund G. HoweEdmund G. HoweUniformed Services University of the Health Sciences Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Volume 12, Number 1Spring 2001 Published on behalf of the MacLean Center for Clinical Medical Ethics Article DOIhttps://doi.org/10.1086/JCE200112101 Views: 1Total views on this site Citations: 2Citations are reported from Crossref © 2001 The University of Chicago. All rights reserved.PDF download Crossref reports the following articles citing this article: Helen M. Sharp and Karen Mills In Response to “The Development and Piloting of a Capacity and Assessment Tool”, The Journal of Clinical Ethics 13, no.22 (Dec 2022): 165–167.https://doi.org/10.1086/JCE200213210 Ralph Baergen Assessing the Competence Assessment Tool, The Journal of Clinical Ethics 13, no.22 (Dec 2022): 160–164.https://doi.org/10.1086/JCE200213209

2001JOURNAL OF CLINICAL ETHICS（2001）引用：25

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