Informed Consent Revisited: Japan and the U.S.

Informed consent, decision-making styles and the role of patient–physician relationships are imperative aspects of clinical medicine worldwide. We present the case of a 74-year-old woman afflicted with advanced liver cancer whose attending physician, per request of the family, did not inform her of her true diagnosis. In our analysis, we explore the differences in informed-consent styles between patients who hold an “independent” and “interdependent” construal of the self and then highlight the possible implications maintained by this position in the context of international clinical ethics. Finally, we discuss the need to reassess informed-consent styles suitable to the needs of each patient regardless of whether he or she resides in the United States or in Japan.     

Informed consent revisited: Japan and the U.S

Informed consent, decision-making styles and the role of patient-physician relationships are imperative aspects of clinical medicine worldwide. We present the case of a 74-year-old woman afflicted with advanced liver cancer whose attending physician, per request of the family, did not inform her of her true diagnosis. In our analysis, we explore the differences in informed-consent styles between patients who hold an "independent" and "interdependent" construal of the self and then highlight the possible implications maintained by this position in the context of international clinical ethics. Finally, we discuss the need to reassess informed-consent styles suitable to the needs of each patient regardless of whether he or she resides in the United States or in Japan.     

Triangulation and adolescent development in the U.S. and Japan.

Using an indirect measure of family structure, relationships between parents and adolescents were studied in 99 U. S. and 60 Japanese families. As two-person relationships tend toward instability under stress, a third person may be drawn in to stabilize the system. Parents, for example, may avoid the tension in the marital relationship by focusing together on an adolescent's problem, or pull the adolescent into a coalition with one parent. Either way the parents are said to have "triangled" the adolescent. In this study, a relationship is found between parents avoiding tension in their own relationship and their tendency to triangle an adolescent. Triangled daughters, in both cultures, had lower scores on ego development, supporting the hypothesis that such patterns can be detrimental to the adolescent's personal development. The discussion includes comments on cross-cultural research.     

Gun Culture and Symbolism Among U.K. and U.S. Women

Abstract

The authors explored attitudes of young women in the United Kingdom (n = 108) and the United States (n = 91) toward (a) the possession and use of guns through the Attitude to Guns Scale (N. R. Branscombe, J. A. Weir, & P. Crosby, 1992) and (b) guns' perceived functional and symbolic significance through the Symbolic Nature of Guns Scale (C. A. Cooke & J. E. Puddifoot, 1997). There were significant differences in beliefs concerning the right to own a gun and the protective effect of guns but not in the perceived contribution of guns to crime. Although neither group strongly equated guns symbolically with power or control, the U.S. women were more likely to perceive guns as expressions of freedom or independence, and the U.K. women were more likely to view guns as expressions of danger and violence. The findings were contextualized by comparison with samples of male control participants of similar ages.     

An unsupported common view: Comparing Japan and the U.S. on individualism/collectivism

It has long been believed that the Japanese are more collectivistic than the Americans. To assess the validity of this common view, we reviewed 15 empirical studies that compared these two nations on individualism/collectivism. Surprisingly, 14 studies did not support the common view; the only study that supported it turned out to bear little relevance to the ordinary definition of individualism/collectivism. An examination of the supportive evidence of the common view disclosed that this view had been formed on an unexpectedly flimsy ground. It further turned out that the wide acceptance of the common view may have been the result of the fundamental attribution error, which may have led to an underestimation of situational factors in interpreting the past obviously collectivistic behavior of the Japanese.     

Culture and the organization of infant sleep: A study in the Netherlands and the U.S.A.

This study investigates differences in the amount and structure of infant sleep in two cultural places with previously documented, divergent parental beliefs and practices. Eight-month-old infants (n = 24 per site) were recruited from towns in the Netherlands and the eastern U.S.A. To evaluate sleep, infants’ physical activity was recorded at home for 24 h using a miniature actigraph, while parents kept a diary of infant activities. Measures derived from actigraphy include total sleep, longest sleep episode, longest wake episode, number of sleep episodes, and percent of sleep during nighttime, as well as time in the stages of Quiet and Active Sleep. Measures based on the parental diaries include most of these aspects as well, except those related to sleep stages. Results based on the more precise actigraphy method indicate that (1) the Dutch infants averaged 13.65 h of sleep per 24 h, 1.67 h more than the U.S. infants; this difference was mostly due to daytime sleep; (2) The Dutch infants’ longest wake episode averaged less than that of the U.S. infants, while their longest sleep episode appeared slightly longer. (3) The Dutch infants, compared to the U.S. sample, spent more time in the Quiet, rather than the Active phase of sleep; (4) They began their Quiet sleep earlier in the evening than did their U.S. counterparts. Measures derived from parental diaries are largely in agreement with the actigraph findings. These results are consistent with reported and observed practices and beliefs in the two communities. The pattern of differences – less apparent maturity among the Dutch in the amount of sleep, but greater apparent maturity in the structure of sleep -- illustrates that behavioral and neurological maturity can be assessed only in the context of the developing child’s adaptation to the specific demands and affordances of the culturally structured developmental niche.     

Rape Myths and Hookup Culture: An Exploratory Study of U.S. College Students' Perceptions

The present study provides the first known systematic examination of the association of hookup culture endorsement and rape myth acceptance. Multivariate regression analysis was conducted to test the primary hypothesis that hookup culture endorsement would be the primary predictor of rape myth acceptance levels among a sample of 422 U.S. college students. Findings indicated the existence of a complex relationship in which rape myth acceptance increases or decreases based upon the form of hookup culture endorsement examined. Beliefs that hookups are harmless and elevate social status increased rape myth acceptance, whereas beliefs that hookups express sexual freedom decreased rape myth acceptance. Furthermore, results supported the hypothesis that hookup culture endorsement was the largest predictor of rape myth acceptance. Consistent with previous studies, the predictive power of gender and religiosity in determining levels of rape myth acceptance were shown to be significant. When controlling for levels of hookup culture endorsement, the explanatory power of these variables decreased, and hookup culture endorsement had the largest effect upon rape myth acceptance levels.     

简评美国的“信仰外交”与我国文化安全

冷战结束以来,西方列强的核心话语,已经转向＂以宗教自由为基石＂的人权。基督教的＂普世价值＂不断被抽象化,成为西式民主制度的图腾,美国基督教新基要主义势力和政治新保守主义势力结盟,共同推动国会通过《1998年国际宗教自由法案》,使其成为以国家力量进行基督教全球战略扩张的工具。美国前国务卿说＂宗教自由是民主的核心＂。这种符号化的＂普世价值＂,企图将社会核心价值体系,从各国基本的社会关系中剥离出来,成为国际舞台上＂新干涉主义＂的武器。这种宗教意识形态化的倾向,影响了国际社会文化多元化的发展,造成世界的动荡不安。如果说,西藏、新疆地区的民族分裂势力与宗教极端思想相结合,形成分裂祖国领土的恐怖主义暴力威胁,那么,国际宗教右翼势力利用合法渠道,向我国的文化教育领域持续渗透,已经开始形成挑战社会主义意识形态的软实力。宗教渗透已经成为国外文化渗透的主要内容。而文化问题,宗教问题,以至意识形态问题,毕竟需要思想上的应对。我们应该掌握话语权,应该培植我们的学术优势。     

School psychology in the U.S.S.R.

Soviet psychologists perform various tasks and provide useful psychological services for pupils and educators. This article describes the general characteristics of education and the preparation and research of psychologists in the U.S.S.R. Also discussed are current practices and emerging trends relating to the establishment of school-based psychological services as well as future developments that may lead to the enhancement of the profession of school psychology in the Soviet Union.     

Environmental psychology in the U.S.S.R.

A preliminary version of this paper was presented at the 19th National Convention of the American Association for the Advancement of Slavic Studies, Boston, November, 5, 1987.     

Suicide in the U.S. Army: epidemiological and periodic aspects

An overview of suicide in the U.S. Army is presented in two sections: (1) the epidemiology of U.S. Army suicides, based on biennium reports, and (2) the temporal aspects of those suicides compared with the data for the United States as a whole. A brief historical review documents some of the changes in contemporary military suicide rates compared to those of the past century. The cycles in the number of suicides by day of the week, day of the month, and the month of the year for the U.S. Army are computed and contrasted with those reported for the U.S. resident population.     

The Gender Difference in the Association Between Early Onset of Drinking and Problem Drinking Between the U.S. and Japan

Using comparable survey data from the GENACIS Project, collected from representative samples of people aged 20 to 70 years old in the U.S. (n = 2,598) and Japan (n = 1,734), this study examined, across these two diverse societies, the gender difference in the association between the early onset of drinking and the development of drinking problems. The results of this study suggest that there does not appear to be a cross-national causal relationship between the early onset of drinking and problem drinking because of significant country and gender variations in this association and because there is no association found among Japanese females. As hypothesized, the early onset of drinking predicted problem drinking among males more strongly than among females in both countries.     

Quality of care and cost containment in the U.S. and U.K.

Many activities of doctors in the acute hospital sector do not improve patient outcome because they are inappropriate. Curtailing interventions that are unnecessary (because the patient is not bad enough) or are unsuccessful (because the condition is too advanced) could both save resources and improve care. Rational rationing depends on knowledge about the expected benefits of various technologies when used in different clinical circumstances.     

School psychology in the U.S.: A quantitative survey

Thirty-two states and the District of Columbia responded to a survey on their school psychology services programs in the period 1966–1974. Ratios of workers to students averaged 1 to 21,900 in the base period, improving to 1 to 8,100 by school year 1974–1975. Rates of growth and rankings are given by state, as well as projected goals for responding states.     

Flickering admissibility: neuroimaging evidence in the U.S. courts

This article explores the admissibility of neuroimaging evidence in U.S. courts, recognizing various trends in decisions about such evidence.While courts have routinely admitted some neuroimages, such as CT scans and MRI, as proof of trauma and disease, they have been more circumspect about admitting the PET and SPECT scans and fMRI evidence. With the latter technologies, courts have often expressed reservations about what can be inferred from the images. Moreover, courts seem unwilling to find neuroimaging sufficient to prove either insanity or incompetency, but are relatively lenient about admitting neuroimages in death penalty hearings. Some claim that fMRI and "brain fingerprinting" are able to detect deception. Other scholars argue that brain fingerprinting is a dubious concept and that fMRI is not yet sufficiently reliable. Moreover, there are substantial concerns about privacy and the perils of mind reading implicit in such technology. Yet, there is a movement to try to make these new technologies "courtroom ready" in the near future, raising a host of legal, policy, and ethical questions to be answered.