Den kliniska etikens dimensioner – en översikt

En svårhanterlig paradox ryms i vårt sätt att tala och tänka om medicinsk etik i relation till klinisk praxis. Ofta beskriver vi etiken som något som, så att säga, ska tillföras medicinen utifrån, en ”bit” som ska fogas till de många andra pus- selbitarna som tillsammans utgör medicinens kunskapsbas. Vi vill ”ha in” etiken på utbildningarna, vi vill ha ”etisk reflektion” utöver de förment rena medicinskaövervägandena

A study of flotation-REST (restricted environmental stimulation therapy) as an insomnia treatment

Objectives: Flotation-REST is a treatment for deep relaxation, where a person is contained in a stimuli-restricted environment and floats in water with high salt content. The aim was to investigate the effects from flotation-REST on people with insomnia diagnosis, as previous studies of flotation-REST have demonstrated some effects on sleep but have limitations regarding sample selections and sleep measures. Material and Methods: Six participants were recruited through an outpatient psychiatry clinic and posters on a university campus. All participants fulfilled criteria for insomnia diagnosis and four fulfilled criteria for major depressive disorder. Using a single case experimental design, daily changes were investigated on sleep logs regarding sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency over the course of 12 sessions consisting of 45 min of flotation-REST. No other treatments were offered simultaneously. Questionnaire data on insomnia severity (the ISI) and depressive severity (the MADRS) were also collected. Results: Three participants improved on their most salient insomnia symptom (long SOL or WASO), and two improved on sleep efficiency. The improvements were maintained 2 months after treatment. Insomnia severity decreased for three patients, whereas depressive severity decreased for five. No changes in TST were found and two patients did not improve on any sleep measure. The two participants who benefitted the most were students in their 20s. Discussion: The results were mixed. Flotation-REST may be beneficial for young adults with sleep-onset insomnia but more research is warranted

Rapport av den empiriska delen av projektet The Phenomenology of Suffering in Medicine: Explorations in the Baltic Sea Region vid Södertörns högskola

Utgångspunkten för det treåriga projektet The Phenomenology of Suffering in Medicine: Explorations in the Baltic Sea Region är den centrala roll lidan­de intar i medicinsk praxis, och därmed också i den medicinska etiken. Den teoretiska grunden för projektet är den breda tradition inom huma­nistisk reflektion och forskning under 1900-talet som innefattar fenome­no­logi, hermeneutik och narrativitet. I projektets empiriska del har fem medicinska fakulteter runt Östersjön valts ut, delvis beroende på etablerade kontakter, delvis för att på dessa orter pågår intressant undervisning och forskning inom ovan beskrivna fält. Med hjälp av kontaktpersoner på respektive orter har sedan studiebesök genomförts, med informella samtal och formella inter­vjuer. Intervjuerna har analyserats för teman som belyser forsknings­projektets grundläggande fråga om hur fenomenet lidande upp­märk­sam­mas, tolkas och hanteras inom dels medicinsk undervisning och i någon mån även i forskning inom medicinsk humaniora på respektive orter

Narrativity and medicine : Some critical reflections

During the last three decades there has been a wave of interest in narrative and narrativity in the humanistic and the social sciences. This narrative turn has spilled over to medicine, where narrative medicine has gained a considerable influence.However, there have also appeared second thoughts on the role of narratives in our lives, as well as on what narratives may mean in relation to clinical medicine.This article presents some influential voices in this debate and scrutinizes the assumptions of narrative medicine in the light of these. It is concluded that there are sound reasons to tread this path with some caution and avoid the too far reaching ambitions on behalf of narrativity in relation to clinical medicine. However, narrative medicine should still be seen as a promising attempt within the broader scope of medical humanities to emphasize the importance of human subjectivity in clinical medicine

A study of flotation-REST (restricted environmental stimulation therapy) as an insomnia treatment

Objectives: Flotation-REST is a treatment for deep relaxation, where a person is contained in a stimuli-restricted environment and floats in water with high salt content. The aim was to investigate the effects from flotation-REST on people with insomnia diagnosis, as previous studies of flotation-REST have demonstrated some effects on sleep but have limitations regarding sample selections and sleep measures. Material and Methods: Six participants were recruited through an outpatient psychiatry clinic and posters on a university campus. All participants fulfilled criteria for insomnia diagnosis and four fulfilled criteria for major depressive disorder. Using a single case experimental design, daily changes were investigated on sleep logs regarding sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency over the course of 12 sessions consisting of 45 min of flotation-REST. No other treatments were offered simultaneously. Questionnaire data on insomnia severity (the ISI) and depressive severity (the MADRS) were also collected. Results: Three participants improved on their most salient insomnia symptom (long SOL or WASO), and two improved on sleep efficiency. The improvements were maintained 2 months after treatment. Insomnia severity decreased for three patients, whereas depressive severity decreased for five. No changes in TST were found and two patients did not improve on any sleep measure. The two participants who benefitted the most were students in their 20s. Discussion: The results were mixed. Flotation-REST may be beneficial for young adults with sleep-onset insomnia but more research is warranted