Jason Adam Wasserman

Problematics of grounded theory: innovations for developing an increasingly rigorous qualitative method:

Our purpose in this article is to identify and suggest resolution for two core problematics of grounded theory. First, while grounded theory provides transparency to one part of the conceptualization process, where codes emerge directly from the data, it provides no such systematic or transparent way for gaining insight into the conceptual relationships between discovered codes. Producing a grounded theory depends not only on the definition of conceptual pieces, but the delineation of a relationship between at least two of those pieces. Second, the conceptualization process of grounded theory is done in hierarchical fashion, where individual codes emerge from the data but then are used to generate insight into more general concepts and thematic statements. But various works on grounded theory have failed to provide any systematic way of using data specific levels of scale (the codes) to gain insight into more macro levels of scale (concepts and themes). We offer fractal concept analysis as a means of resolving both of these issues. By using a logic structure generator, fractal concept analysis delineates self-similar conceptual frameworks at various levels of abstraction, yielding a method for linking concepts together within and between levels of scale encountered in the grounded theory coding and categorization process. We conclude that this fractal analytic technique can bolster the aims of grounded theory as a formalized and systematic process for generating theory from empirical data.

Rasing the ivory tower: the production of knowledge and distrust of medicine among African Americans

African American distrust of medicine has consequences for treatment seeking and healthcare behaviour. Much work has been done to examine acute events (eg, Tuskegee Syphilis Study) that have contributed to this phenomenon and a sophisticated bioethics discipline keeps watch on current practices by medicine. But physicians and clinicians are not the only actors in the medical arena, particularly when it comes to health beliefs and distrust of medicine. The purpose of this paper is to call attention not just to ethical shortcomings of the past, but to the structural contexts of those events and the contributions and responsibilities of popular media and academic disciplines in the production of (often mythic) knowledge. We argue that ignoring context and producing inaccurate work has real impacts on health and healthcare, particularly for African Americans, and thus engenders ethical obligations incumbent on disciplines traditionally recognised as purely academic.

Housing Patterns of Homeless People: The Ecology of the Street in the Era of Urban Renewal:

In this article, the authors examine the political and economic community dynamics of the street homeless as well as other groups involved in conflicts regarding the process of urban renewal. Since postwar suburban flight, homeless people have lived largely in the shadows of vacated city centers. But “not-in-my-backyard” (NIMBY) battles over the homeless have become increasingly common, especially as the influx of comfortably housed residents bring suburban expectations to urban centers, generating conflicts that affect homeless urban camp communities. Drawing on four years of ethnographic data, the authors describe social conflicts revolving around homelessness and urban renewal. Moreover, through examining the patterns of economy and polity among sectors with different economic positions in the city, the authors illustrate how “problematic” groups of people, such as the homeless, are not antithetical to community. Instead, they are key stakeholders in urban communities with goals, concerns, and desired boundaries similar to those who “legitimately” live downtown.

A SCALE TO ASSESS ATTITUDES TOWARD EUTHANASIA

The topic of euthanasia has been a matter of public debate for several decades. Although empirical research should inform policy, scale measurement is lacking. After analyzing shortcomings of previous work, we offer a systematically designed scale to measure attitudes toward euthanasia. We attempt to encompass previously unspecified dimensions of the phenomenon that are central to the euthanasia debate. The results of our pretest show that our attitude towards euthanasia (ATE) scale is both reliable and valid. We delineate active and passive euthanasia, no chance for recovery and severe pain, and patients autonomy and doctors authority. We argue that isolating these factors provides a more robust scale capable of better analyzing sample variance. Internal consistency is established with Cronbachs alpha = .871. Construct external consistency is established by correlating the scale with other predictors such as race and spirituality.

When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect

Nocebo effects occur when an adverse effect on the patient arises from the patients own negative expectations. In accordance with informed consent, providers often disclose information that results in unintended adverse outcomes for the patient. While this may adhere to the principle of autonomy, it violates the doctrine of “primum non nocere,” given that side-effect disclosure may cause those side effects. In this article we build off previous work, particularly by Wells and Kaptchuk (2012) and by Cohen (2013), to suggest ethical guidelines that permit nondisclosure in the case when a nocebo effect is likely to occur on of the basis of nonmaleficence. We accept that that autonomy vis-à-vis informed consent must be forestalled, but salvage much of its role by elaborating a practical clinical approach to postencounter follow-up. In doing so, we reconcile a clinically practicable process of determining conditions of disclosure with long-standing ethical commitments to patients.

The religious person revisited: cross-cultural evidence from the HEXACO model of personality structure

The relationship of religiousness with the HEXACO (Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, Openness) model of personality was studied in Iran and the United States. Correlations of personality factors and religiousness were generally similar across the two societies. In both countries, religiousness was associated with higher scores on Honesty-Humility, Extraversion, Agreeableness, and Conscientiousness. The Honesty-Humility factor was one of the strongest correlates of religiousness in both countries. These findings support Saroglous observation that the main personality characteristics of religiousness are consistent across different religious contexts and personality measures and models.

Racial Differences in Attitudes toward Euthanasia

This article examines racial differences in attitudes toward euthanasia. Many researchers assert distrust of medicine as a substantive explanation for less favorable attitudes toward euthanasia among African Americans, although quantitative measurement has been unsuccessful in showing this. In this article, spiritual meaning, perceived capacity for discrimination (distrust), individual experiences with physicians, and access to healthcare are hypothesized as intervening variables in the relationship between race and attitudes toward euthanasia. With a distinction between individual and collective experiences with discrimination we use path analysis to test previous assertions that African American distrust of medicine leads to more negative attitudes toward euthanasia. Results indicate that while African Americans exhibit higher levels of distrust of medicine, this is not related to attitudes toward euthanasia, which seem predominantly to be a spiritual matter. Our findings have implications for legislative policy, treatment interventions, doctor-patient relations, and sociological understanding of the interaction of race, spirituality, experience, and attitudes.

Reasons to Amplify the Role of Parental Permission in Pediatric Treatment

Two new documents from the Committee on Bioethics of the American Academy of Pediatrics (AAP) expand the terrain for parental decision making, suggesting that pediatricians may override only those parental requests that cross a harm threshold. These new documents introduce a broader set of considerations in favor of parental authority in pediatric care than previous AAP documents have embraced. While we find this to be a positive move, we argue that the 2016 AAP positions actually understate the importance of informed and voluntary parental involvement in pediatric decision making. This article provides a more expansive account of the value of parental permission. In particular, we suggest that an expansive role for parental permission may (1) reveal facts and values relevant to their childs treatment, (2) encourage resistance to suboptimal default practices, (3) improve adherence to treatment, (4) nurture childrens autonomy, and (5) promote the interests of other family members.

The Medicalization of Homelessness and the Sociology of the Self: A Grounded Fractal Analysis

The purpose of this chapter is to illustrate the centrality of the tabula rasa concept of self for the medical model of homeless service provision. Using four years of ethnographic data analyzed with a grounded fractal methodology, we illustrate the logical interconnections between the particular phenomena of homeless service institutions and broad cultural contexts. While social science has been somewhat critical of the medicalization of homelessness, its shared supposition about the self has relegated it to structural critiques that offer little to the currently homeless and those who want to help them. In contrast, we illuminate a path toward the development of an alternative pedagogy of individualism that is more directly responsive to the problematics of the medical model of homeless service provision.

Personality Factors and Attitudes Toward Euthanasia in Iran: Implications for End-of-Life Research and Practice

This article reports on the relationship of personality and euthanasia attitudes. Results from a survey of 165 Iranian students showed that religiosity, honesty–humility, agreeableness, and extraversion were related to negative attitudes toward euthanasia, whereas openness was related to acceptance of euthanasia, with the unconventionality facet driving this relationship. Moreover, openness explained additional variance when added to a multivariate model containing religiosity and HEXACO factors. This study illustrates the possibility of accounting for variation beyond the traditional group level predictors of attitudes toward euthanasia and promoting future cross-cultural studies into personality and end-of-life issues and informing end-of-life conversations at the bedside.