What care should be covered?

The answer to the question of what health care services should be covered by a managed care plan is straightforward; the plan should cover whatever the consumer is willing to pay for. From the plan's perspective, the consumer is the payer, that is, the employer who negotiates the plan; not the individual patient whose personal preferences and interests may be quite different. Since managed care organizations contract with payers to arrange for health care services within a defined set of benefits, there is a broader question as well: Within the benefits chosen by the payer, what actually is covered? Criteria for determining "medical necessity," which managed care plans frequently use as the basis for coverage, are discussed.     

Lucky agents,big and little: should size really matter?

This essay critically examines Alfred R. Mele’s attempt to solve a problem for libertarianism that he calls the problem of present luck. Many have thought that the traditional libertarian belief in basically free acts (where the latter are any free A-ings that occur at times at which the past up to that time and the laws of nature are consistent with the agent’s not A-ing at that time) entail that the acts are due to luck at the time of the act (present luck) rather than to the kind of agent control required for genuinely free, morally responsible action. While libertarians frequently have tried to rebut the claim that basically free acts are due to present luck, Mele argues for the daring thesis that they should embrace present luck rather than try to explain it away. His strategy is to argue that the assumption of present luck in the decisions of very young children (or “little agents”) does not preclude us from attributing to them a small amount of moral responsibility and that this makes it possible to conceive of moral development as a gradual process in which as the frequency of the indeterministically caused free actions increases, the agents take on greater and greater moral responsibility. In this paper I give several possible reconstructions of Mele’s argument and analyze in detail why none of them succeeds.     

What should we expect after the next attack?

A test of any science is its ability to predict events under specified conditions. A test for the psychology represented in this special issue of the American Psychologist is its ability to predict individual and social behavior in the aftermath of a next terror attack. This article draws on that science to make such predictions. These predictions are conditioned on both the nature of the attack and our institutional preparations for it. Some attacks will test our resilience more than others. Whatever the attack, we will reduce its impacts if our institutions take advantage of psychological science. That science can reduce the scope of attacks by limiting terrorists' ability to organize their operations and by enhancing our ability to restrain them. It can reduce the impacts of any attacks that do occur by strengthening the institutions and civil society that must respond to them. Realizing these possibilities will require our social institutions to rely on science, rather than intuition, in dealing with these threats. It will require our profession to provide psychologists with rewards for public service, applied research, and interdisciplinary collaboration, as demanded by complex problems. Responding to these challenges could strengthen society and psychology.     

What does naming a picture do? Effects of prior picture naming on recognition of identical and same-name alternatives

Three experiments investigated the effects of naming pictures of objects during study on the subsequent recognition of physically identical, name-match, and new objects. Prior naming improved correct classification of all three item types at recognition. For line drawings and for photographs of functionally distinct objects, prior naming reduced the tendency to confuse identical and same-name alternatives. In Experiment 2, prior naming eliminated the right visual field/left hemisphere advantage for speeded recognition of name-match pictures, suggesting that prior naming reduces the likelihood that pictures are named at recognition. The implications of these results for dual-encoding (Paivio, 1971) and sensory-semantic (Nelson, Reed, & McEvoy, 1977) models of picture and word processing are discussed. The results suggest that the semantic representations of objects that are perceptually distinct but share a common name are not identical, and that the effect of naming such objects is to insure that a distinct semantic representation becomes a part of the resulting memory code.     

When is a picture?

Philosophical discussions of depiction sometimes suffer from a lack of differentiation between several questions concerning the ‘nature’ of pictorial representation. To provide a suitable framework I distinguish six such questions and several levels on which one might want to proceed in order to answer some of them. With this background, I reconstruct Goodman's and Elgin's answer to the specific question: ‘What distinguishes the pictorial from the verbal or linguistic?’ I try to reveal some major motivations behind their system-oriented approach and to indicate some reasons why a strategy of this kind is to a certain extent mandatory to grasp the ‘nature of the pictorial’. The system-relative and functional character of depiction has to be captured by every adequate theory.     

Which opinion should a clinical ethicist give: Personal viewpoint or professional consensus?

When clinical ethicists are called upon to give a recommendation regarding patient care, they may be faced with a dilemma of their own. If their own personal opinion is not widely shared, the ethicist will have three options. These include: (1) giving their own opinion; (2) giving the widely shared opinion; and (3) giving both opinions, leaving the physician to select which opinion to accept. The intentions of this article are to evaluate strengths and weaknesses of these three alternatives and to suggest that ethics consultants recognize and deal with this issue. Two cases are presented to explore the limitations of each option. The author suggests that when the views of ethics consultants differ from the consensus view, the consultant should give the consensus view, their own dissenting view and the arguments in support of each position.     

What is conditionalization,and why should we do it?

Philosophical Studies - Conditionalization is one of the central norms of Bayesian epistemology. But there are a number of competing formulations, and a number of arguments that purport to...     

Standardized or simple effect size: What should be reported?

It is regarded as best practice for psychologists to report effect size when disseminating quantitative research findings. Reporting of effect size in the psychological literature is patchy – though this may be changing – and when reported it is far from clear that appropriate effect size statistics are employed. This paper considers the practice of reporting point estimates of standardized effect size and explores factors such as reliability, range restriction and differences in design that distort standardized effect size unless suitable corrections are employed. For most purposes simple (unstandardized) effect size is more robust and versatile than standardized effect size. Guidelines for deciding what effect size metric to use and how to report it are outlined. Foremost among these are: (i) a preference for simple effect size over standardized effect size, and (ii) the use of confidence intervals to indicate a plausible range of values the effect might take. Deciding on the appropriate effect size statistic to report always requires careful thought and should be influenced by the goals of the researcher, the context of the research and the potential needs of readers.     

Can synaesthesia research inform cognitive science?

The renaissance of synaesthesia research has produced many insights regarding the aetiology and mechanisms that might underlie this intriguing phenomenon, which abnormally binds features between and within modalities. Synaesthesia is interesting in its own right, but whether it contributes to our knowledge of neurocognitive systems that underlie non-synaesthete experience is an open question. In this review, we show that results from the field of synaesthesia can constrain cognitive theories in numerical cognition, automaticity, crossmodal interaction and awareness. Therefore, research of synaesthesia provides a unique window into other domains of cognitive neuroscience. We conclude that the study of synaesthesia could advance our understanding of the normal and abnormal human brain and cognition.     

Interoception and gender: What aspects should we pay attention to?

Interoception is involved in both somatic and mental disorders with different prevalence between genders; however, gender differences are often neglected. To examine the potential gender differences in interoceptive awareness, we recruited 376 healthy subjects (51% males, aged 17–30 years), to fill in the Multidimensional Assessment of Interoceptive Awareness (MAIA). Of that sample, in a subgroup of 40 subjects (50% males), interoceptive accuracy was assessed by heartbeat counting task (HCT).The results on interroceptive awareness suggest that females tend to notice bodily sensations more often, better understand relations between bodily sensations and emotional states, worry or experience more emotional distress with sensations of pain or discomfort and see body as less safe. The results of interoceptive accuracy further suggest that females are less efficient in consciously detecting heartbeats. Therefore, gender should be considered when interoceptive evaluation is performed in disorders associated to bodily sensations and to the emotional/mood states.     

How big is big? Relative and absolute properties in memory

Previous studies of semantic memory have overlooked an important distinction among so-called “property statements”. Statements with relative adjectives (e.g., Flamingos are big) imply a comparison to a standard or reference point associated with an immediate superordinate category (a flamingo is big for a bird), while the truth of statements with absolute adjectives (e.g., Flamingos are pink) is generally independent of such a standard. To examine the psychological consequences of this distinction, we asked subjects in Experiment 1 to verify sentences containing either relative or absolute adjectives embedded in either predicate-adjective (PA) constructions (e.g., A flamingo is big (pink)) or predicate-noun (PN) constructions (e.g. A flamingo is a big (pink) bird), where the predicate noun was the immediate superordinate. Reaction times (RTs) and errors for relative sentences decreased when the superordinate was specified, but remained constant for absolute sentences. These data also suggest that the truth value of relative sentences depends, not just on the superordinate, but also on a more global standard for everyday, human-oriented objects. Experiment 2 extends these results in showing that ratings of the truth of relative sentences are a function of the difference in size between an instance and its superordinate standard (e.g., between the size of a flamingo and that of an average bird) and the difference between the instance and the standard for everyday objects. Experiment 3 replicated these findings using reaction time as the dependent measure.     

When do professional psychologists need professional programmers’ tools?

It is fairly straightforward to write a small program for a small computer, even using a relatively slow and unstructured language such as BASIC. However, current experiments in psychopharmacology require the system integration and data management services provided by large programs running on 256K microcomputers, and the efficient development of such programs requires the use of structured languages such as Pascal.     

What can we learn by looking for the first code of professional ethics?

The first code of professional ethics must: (1)be a code of ethics; (2) apply to members of a profession; (3) apply to allmembers of that profession; and (4) apply only to members of that profession. The value of these criteria depends on how we define “code”, “ethics”, and “profession”, terms the literature on professions has defined in many ways. This paper applies one set of definitions of “code”, “ethics”, and “profession” to a part of what we now know of the history of professions, there by illustrating how the choice of definition can alter substantially both our answer to the question of which came first and (more importantly) our understanding of professional codes (and the professions that adopt them). Because most who write on codes of professional ethics seem to take for granted that physicians produced the first professional code, whether the Hippocratic Oath, Percival’s Medical Ethics, the 1847 Code of Ethicsof the American Medical Association (AMA), or some other document, I focus my discussion on these codes. This revised version was published online in June 2006 with corrections to the Cover Date.