Humanitarian Point Research Articles

Prioritizing among patients seeking subsidized psychotherapy

SUMMARY Prioritizing patients for subsidized psychotherapy is necessary when resources are scarce. In this study, three groups of ten judges each, representing the professional, clinical perspective, the political decision-making perspective, and the layman's perspective, respectively, were given the task of deciding which of fifteen patients on a waiting-list for psychotherapy and psychoanalysis they would recommend for subsidization. Statistical analyses showed similarities between the priorities of laymen and decision-makers, whereas clinicians prioritized the patients differently. The regression weights of patient variables in explaining the groups' priorities suggest that laymen and decision-makers tend to focus on the urgency of a case from a humanitarian point of view, whereas clinicians try to balance such considerations against the apparent suitability of the case for psychotherapeutic treatment.

The Book of Surprises, or Natural Science from the Humanitarian Point of View, or Images of Science

The Book of Surprises, or Natural Science from the Humanitarian Point of View, or Images of Science

Prospects for United States Ratification of Additional Protocol I to the 1949 Geneva Conventions

Protocol I Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts, concluded in Geneva in 1977, is the most important treaty codifying and developing international humanitarian law since the adoption of the four Conventions themselves; and it is the first such treaty since 1907 to deal with methods and means of warfare and the protection of the civilian population from the effects of warfare. As such, its contributions to the law were long overdue and, on the whole, are both positive from the humanitarian point of view and practicable from the military point of view. Moreover, it offers the prospect of improved compliance with international humanitarian law, which would greatly benefit the victims of war and would bring the law in action closer to the law in the books. Yet, in January 1987, the President of the United States informed the Senate that he would not submit the Protocol to the Senate for its advice and consent to ratification, calling it “fundamentally and irreconcilably flawed.” It is apparent that President Reagan’s decision resulted from misguided advice that exaggerated certain flaws in the Protocol, ignored the statements of understanding that would have remedied them, and misconstrued a humanitarian and antiterrorist instrument as one that could give aid and comfort to “terrorists.”

Einzelhaft als Risikofaktor für psychiatrische Hospitalisierung

The subjects of this study are prisoners who were hospitalized from custody in a psychiatric clinic. All of such patients of one psychiatric clinic during the period from 1976 till 1978 were compared with a random sample of other psychiatric patients using case reports and other data. Differences were found concerning social, personal, psychiatric, and criminal history as well as psychopathological state and diagnosis. Compared to the complete population of prisoners of the area, prisoners from solitary confinement (mostly remanding custody) were overrepresented. Other risk factors for psychiatric hospitalization of prisoners are described. The results are discussed from prophylactic, therapeutic, and humanitarian points of view.

Iii FØRste Asylland

Iii FØRste Asylland

Health as an investment in developing countries

The fact that improved health has an independent value for individuals implies that the health facilities available are an important item in the country's standard of living. At the same time, the availability of almost every other item of consumption including foodstuffs, housing, clothing, sanitation and educational facilities is relevant to health conditions. Improved health conditions should increase labour input and efficiency; they can in some circumstances also increase the acreage of cultivable land. The integration of health sector planning into a system of accelerating development may often confirm the belief that differences between the sound economic point of view and the bona fide humanitarian point of view are more apparent than real. In all events it will not be possible to ignore consistently either humanitarian or economic considerations ( Frederiksen, 1969) . The best way of ensuring health as an effective investment is to replace the older project-by-project approach to planning with integrated public investment planning, whereby health services and investments become integral parts of a multi-sectorial system for accelerating the development of the economy and society. Such integrated public investment plans start with individual projects which are combined into sector programmes and then into an investment plan for the public sector ( Waterston, 1969) . In this way, health would be associated closely with all other sector development and resources from the economic sector of the development budget would become available for the health sector. In the health sector much still has to be learned. Within the profession we have to be interested in health as well as disease. We have to be prepared to invest in health rather than continually to budget for disease. We have to develop communication with other disciplines and sciences, especially with the economist. As Klarman (1967) has shown, the problem of measurement still has to be tackled by both sides. It is for the economist, employing all of his traditional tools, plus those of the operations researcher and sociologist, to try to measure the value of the productive and consumption aspects of health services. It is for the epidemiologist and the clinical trial and survey to determine the effects produced by the investment in health. It is finally for the administrator to continue to strive for good balanced judgment in making decisions, especially when major elements of the cost-benefit calculations are missing, or when conflict exists between economic and health planning.

CURRENT TRENDS IN INDUSTRIAL PSYCHIATRY

In addition to its basic function as an integral part of the preventive arm of industrial medicine, industrial psychiatry has an active rôle to play in the rapidly growing field of industrial human relations. As the consulting, advisory, educational and therapeutic functions of the industrial psychiatrist are becoming more and more clearly defined, both in the clinical and in the personnel areas, the value of this type of service is becoming firmly established from the economic as well as from the humanitarian point of view.

TURKEY

<h3>The Opium Question</h3> In regard to publications made recently by some foreign papers, especially Egyptian, concerning the illicit introduction of opium from Turkey, the Turkish official press replies: Because the object of the international opium convention of the League of Nations in 1921 was the ultimate restriction of opium cultivation, and considering from the economic point of view that the cultivation of opium is of importance to Turkey, we did not accept the league's invitation at the time. Besides, there are in Istanbul three commercial laboratories concerned with the manufacture of opium preparations and derivatives for medicinal use. That makes Turkey not only an exporter of opium but also a manufacturer of opium preparations and derivatives. On the other hand, Turkey, being through no convention under any obligation, has never lost sight of the humanitarian point of view and under no circumstances has this point of view been departed from.

Industrial Lighting

IN his lecture at the British Scientific Products Exhibition on July 28, Mr. L. Gaster traced the growth of interest in industrial lighting, which had now come to be regarded as essential to the health of the workers, to the avoidance of accidents, and to efficient work. The extension of night-work during the war and the great demands made on British factories had rendered good artificial lighting specially important; and various factors likely to operate in the future, such as the fuller use of the “three-shift” system and the development of the manufacture of accurately made standardised and interchangeable parts, also tended in: the same direction. Another important consideration at present was the saving in fuel that might be brought about by the general use of more scientific and efficient methods of lighting, whereby the consumption of gas or electricity necessary to produce a given illumination on the work could be reduced. The case for adequate industrial lighting, both from the economic and humanitarian points of view, was very strong. There was no doubt that both the output and the quality of work suffered if the illumination was defective. Cases were on record in which the output had increased by 8-27 per'cent., and even more, when the illumination was improved. In general, the cost of lighting formed' only a small proportion (often less than i per cent.) of the wages bill, so that even a small gain in output more than compensated for the expenditure on good lighting.