Stephen E. Lammers

In Your Skin You are Different: Women Living with Ovarian Cancer During Childbearing Years

The purpose of this study was to understand what it is like to live with ovarian cancer during childbearing years. The primary researcher (PR) conducted three to four in-depth interviews, lasting 60 to 90 minutes each, with five women living with ovarian cancer for 1 to 10 years. Van Manen’s method of reflection and writing guided the inquiry. The process of existential investigation expanded the inquiry. Trustworthiness was assured through member checking, reflective journaling, coinvestigators checking the logic of the PR’s analysis, and the achievement of consensus through dialogue. Analysis of the data revealed the themes of serendipitous diagnosis, managing treatment, horrible hair experience, hysterectomy violating one’s sense of being, unfairness of menopause, body changes, intimate dreaming, being with others, being normal/different, being vigilant, being heard, and trying to make sense of it. The stories revealed provide us with a window into the experience of women with ovarian cancer.

Are physicians a “delinquent community?” Issues in professional competence, conduct and self-regulation: Commentary

I would like to thank Dr. Swazey for her paper. It seems to me that it is a valuable contribution, valuable because it is a candid and thoughtful reflec tion on the profession of medicine by someone who is informed by a conception of a profession as something more than a career. It is valuable too because it does not privilege, or in this case, deprivi lege, any profession, in its discussion of the failures she recounts. Let me say further that the paper rings true, rings true in the sense that I can think of like examples both from my experience of following around physicians as well as my experience of spend ing some thirty years in higher education. I would like to be clear about one difference in experience between Dr. Swazey and myself. Her stories concern academic medicine, although there are clear clinical components. My focus will be community clinical medicine, on the one hand, and the academy, on the other. Rather than asking questions about some central premise or argument of the paper, I propose instead to reflect on a number of themes contained within the paper and try to develop a point about which the paper was silent. In that way, I hope that we might have some discussion. Let me try to develop three points around some of the difficulties which Dr. Swazey identified. The three issues which are of interest to me are the following. First, the excessive individualism of modern professions such that the modern professional thinks of him or herself as a self-sufficient monad in terms of their profes sional practice. Second, there is the corresponding

Voices in the Wilderness@@@Theological Voices in Medical Ethics

Book reviewed in this article: Theological Voices in Medical Ethics. Edited by Allen Verhey and Stephen E. Lammers

Case Studies: A Cardiac Arrest and a Second-Hand Report

A resident was ordered to discontinue resuscitation procedures on a 65-year-old man who had suffered cardiac arrest. A chaplains assistant and a nurse had alerted the primary physician to the spouses statements that her husband did not want his life prolonged by extraordinary means. A lack of communication among all the parties aggravated the conflicts in this case in which the patient was unable to state his desires, the resident and physician found out about his wishes second-hand, and only the chaplains assistant spoke about the issue with the wife. Physicians are urged to take the initiative in discussing resuscitation with patients and/or family members as soon as potentially terminal situations arise. Other health personnel should participate in decisions about emergency care. In cases where such communication has not occurred, a resident should not stop resuscitative efforts without more information about the patients wishes.