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The results are in line with findings concerning distress in caregivers of patients suffering from personality disorders in general, posttraumatic stress disorder or schizophrenia. The mechanism behind the increased levels of distress in our sample is not clear, however. Either exposure to the problematic behaviour of the patient, selective mating or a combination of both might have been responsible for the effect.

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Case conference Limits of confidentialityl A patient is described, a woman of 6o, who at that age was diagnosed as having Huntington's chorea, a genetic disease which is transmitted as an autosomal dominant2. She had one daughter, who was married

I want to argue for two propositions. First, I suggest that what some researchers may take to be a simple trade-off between minor violations of the truth for the sake of access to far greater truths represents a profound miscalculation with far-reaching and cumulative reverberations. Second, I submit that today's research environment, as demanding, competitive, and sometimes bewildering as it is, offers genuine scope for what Murdoch calls truth-seeking, for imagining and questioning, and for relating to facts through both truth and truthfulness; but that, in so doing, it presents hard choices with respect to methods, and, in turn, to personal integrity—not only in particular research projects but also with respect to that fragile research environment in its own right.

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