The shared leadership process in decision-making teams

The present study examined the process of shared leadership in 45 ad hoc decision-making teams. Each team member's leadership behavior (n = 180) was assessed by behaviorally coding videotapes of the teams' discussions. The within-team patterns of leadership behavior were examined using cluster analysis. Results indicated that the likelihood of a team experiencing a full range of leadership behavior increased to the extent that multiple team members shared leadership, and that teams with shared leadership experienced less conflict, greater consensus, and higher intragroup trust and cohesion than teams without shared leadership. This study supports previous findings that shared leadership contributes to overall team functioning, and begins to delineate the extent to which team members may naturally share leadership.     

Bearing bad news: Dealing with the mimics of denial

Denial is a common label for certain reactions to bad news. However, true denial is rare, and most cases actually represent a variety of responses with very different causes and needs. Three of these, disbelief, deferral, and dismissal, are characterized according to origins and needs. Failure to differentiate between these seemingly similar behaviors can result in inappropriate counseling, and interfere with attempts to convey information and provide support during a time of crisis.     

Ethical dilemmas in pharmacy practice

The purpose of this study was to document the responses of pharmacy students and pharmacists to various ethical dilemmas. The responses of the first professional year students, third professional year students and pharmacists were evaluated and compared. In most instances, responses indicated a high priority for patient/client welfare. Pharmacists and students reportedly act with regard to the dignity of life, individual freedom, and an inner sense of right.     

患者亲属——医疗决策的重要主体

在医患关系中,患者亲属起着重要作用,是医疗行为及后果生理和心理的承担者,患者的疾病本身和康复情况会直接对家庭生活产生影响。患者亲属也是患者医疗费用的主要承担者。由于医疗决策会涉及到患者的家庭利益,患者患病会对其决定能力产生不利的影响,在法律上确立患者亲属在医患关系中的主体地位,甚至在必要时赋予亲属医疗决定权是必要的和现实的。     

患者亲属——医疗决策的重要主体

在医患关系中,患者亲属起着重要作用,是医疗行为及后果生理和心理的承担者,患者的疾病本身和康复情况会直接对家庭生活产生影响.患者亲属也是患者医疗费用的主要承担者.由于医疗决策会涉及到患者的家庭利益,患者患病会对其决定能力产生不利的影响,在法律上确立患者亲属在医患关系中的主体地位,甚至在必要时赋予亲属医疗决定权是必要的和现实的.     

When good evidence goes bad: the weak evidence effect in judgment and decision-making

An indispensable principle of rational thought is that positive evidence should increase belief. In this paper, we demonstrate that people routinely violate this principle when predicting an outcome from a weak cause. In Experiment 1 participants given weak positive evidence judged outcomes of public policy initiatives to be less likely than participants given no evidence, even though the evidence was separately judged to be supportive. Experiment 2 ruled out a pragmatic explanation of the result, that the weak evidence implies the absence of stronger evidence. In Experiment 3, weak positive evidence made people less likely to gamble on the outcome of the 2010 United States mid-term Congressional election. Experiments 4 and 5 replicated these findings with everyday causal scenarios. We argue that this “weak evidence effect” arises because people focus disproportionately on the mentioned weak cause and fail to think about alternative causes.     

Emotions associated with counterfactual comparisons drive decision-making in Footbridge-type moral dilemmas

Based on the dual-process theory of moral judgment, it has been suggested that in Footbridge-type dilemmas the anticipation of the emotional consequences of causing intentional harm might contribute to the decision of rejecting utilitarian resolutions. However, no empirical data have been reported on the emotions felt by participants after their decisions, and the role played by emotions in Trolley-type dilemmas remains to be determined. The present study investigated the specific emotions engaged both after decision choices and after the generation of the counterfactual scenario in Trolley- and Footbridge-type dilemmas. The results support the idea that in Footbridge-type dilemmas decision-making is driven by the attempt to minimize the aversive emotional state evoked by the decision outcome. A greater increase in emotional intensity was found overall for Footbridge-type than Trolley-type dilemmas after the counterfactual generation following typical (non-utilitarian) choices, with guilt, regret, and shame being the emotions that increased most. Critically, in Footbridge-type dilemmas only, typical choices were predicted by the increase in regret intensity experienced after counterfactual generation.     

Heuristics in medical and non-medical decision-making

Pairs of hypothetical medical and non-medical problems were given to 44 pediatric residents at three levels of hospital training. Each problem was designed to detect a specific heuristic-based bias in making diagnoses. Discounting, disregarding base rate, and over-confidence in contextually embedded redundant information were more evident on medical than on non-medical problems. In particular, a greater number of third-year residents disregarded base-rate information than did first- and second-year residents on medical but not on non-medical problems. On medical problems, a greater number of first-year residents expressed greater confidence in redundant information that was contextually embedded than in information that was presented in a listed format. Over one-third of the residents confused prospective and retrospective probabilities; three-fourths showed evidence of augmentation; virtually all residents expressed greater confidence in a diagnosis based on redundant rather than on non-redundant listed information. These latter effects were consistent across training level and occurred on both medical and non-medical problems. The results are discussed in terms of prototype theory and the nature of medical training.     

The practice of psychology in rural communities: potential ethical dilemmas

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.     

The perception of ethical dilemmas in clinical practice

The empirical diagnosis presented in this paper is based on interviews with nurse practitioners and physicians designed to elicit their perceptions on the nature and role of ethical dilemmas in clinical practice. Having selected five of these perceptions or views which were common and significant, the philosophical therapy offered consists in, first, a general discussion of ethical dilemmas and, second, a critical analysis of each of the five views with the aim of pointing out confusions and errors, the recognition of which can be of applied and practical help in the clinical setting.     

The meaning of bad news in HIV disease: Counselling about dreaded issues revisited

HIV disease is a slow, progressive immunological disorder. As there is neither a cure nor a vaccine, morbidity and mortality arising from HIV infection will continue to challenge health care providers, including those who counsel these patients. Psychological preparation for ‘bad news’ and support for those whose health is deteriorating is an important task in HIV counselling. This paper describes what may be considered bad news for people living with HIV, how to prepare them for unwelcome changes in their medical condition and how to give bad news, should the need arise.     

Morality in flux: medical ethics dilemmas in the People's Republic of China.

The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia...More research and discussion among people from various fields is needed. Progress will be made one step at a time, and I recommend that we proceed now to win acceptance of brain death criteria; to make clear the distinctions between passive and active euthanasia,...to encourage the use of living wills; and to protect the interests of newborns who are not terminally ill, including those with mild defects. In the changing context of modernization, in which different and even incompatible value systems must coexist, it is best for us to approach the ethical dilemmas facing us with mutual respect and understanding.     

Spirituality in nursing theory and practice: dilemmas for Christian bioethics.

Moral strangerhood is due in part to competing worldviews. The profession of nursing is experiencing a paradigm shift which creates ethical dilemmas for both Christian nurses and Christian patients. Nursing's new focus on spirituality and spiritual care presents itself as broadly defining a desired state or patient outcome -- spiritual integrity -- supposed to be applicable to all patients of all faiths. Analysis of nursing's definition of spirituality reveals assumptions and values consistent with an Eastern/New Age worldview which may cause hostility towards Christian patients stereotyped as dogmatic or noncompliant.