Consulting the Many and the Wise

Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they play compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics committees report that they play a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies.     

Enlarging the Societal Pie Through Wise Legislation

ABSTRACT— We offer a psychological perspective to explain the failure of governments to create near-Pareto improvements. Our tools for analyzing these failures reflect the difficulties people have trading small losses for large gains: the fixed-pie approach to negotiations, the omission bias and status quo bias, parochialism and dysfunctional competition, and the neglect of secondary effects. We examine the role of human judgment in the failure to find wise trade-offs by discussing diverse applications of citizen and government decision making, including AIDS treatment, organ-donation systems, endangered-species protection, subsidies, and free trade. Our overall goal is to offer a psychological approach for understanding suboptimality in government decision making.     

Baby X

The present study investigated adult behavior while interacting with a three-month-old infant under conditions in which the child was introduced as a boy, as a girl, or with no gender information given. Gender labels did not elicit simple effects, but rather interacted significantly with the sex of the subject on both toy usage and physical contact measures. There was a stronger tendency for both male and female adults to utilize sex-stereotyped toys when the child was introduced as a girl. Most of the findings, however, reflected a differential response of men and women to the absence of gender information. In this condition, male subjects employed a neutral toy most frequently and handled the child least; in contrast, females used more stereotyped toys and handled the child more. All subjects attempted to guess the gender of the child (with “boy” guesses more frequent, although the child was actually female) and all justified their guess on the basis of stereotyped behavioral or physical cues like strength or softness.     

Baby Wordsmith

ABSTRACT— How do infants acquire their first words? Word reference , or how words map onto objects and events, lies at the core of this question. The emergentist coalition model (ECM) represents a new wave of hybrid developmental theories suggesting that the process of vocabulary development changes from one based in perceptual salience and association to one embedded in social understanding. Beginning at 10 months, babies learn words associatively, ignoring the speaker's social cues and using perceptual salience to guide them. By 12 months, babies attend to social cues, but fail to recruit them for word learning. By 18 and 24 months, babies recruit speakers' social cues to learn the names of particular objects speakers label, regardless of those objects' perceptual attraction. Controversies about how to account for the changing character of word acquisition, along with the roots of children's increasing reliance on speakers' social intent, are discussed.     

Baby cries

In this report the history of cry studies will be reviewed and various phenomena associated with neonatal vocalization, including the processes of audition, respiration, phonation, and reflexive noisemaking are described. Some of the causes of crying are discussed, along with changes in the acoustical structure of cries as these relate to an infant's maturation. It may be concluded that crying has a powerful evocative effect generally. Cries also can arouse specific physiological responses (e.g., increased lactation) in mothers, and have a diagnostic value for the pediatrician. In the field of developmental linguistics, detailed analysis of crying, cooing, babbling, and other vocalizations of early life may shed light on the verbal and nonverbal aspects of speech, particularly as these grow out of the first few years of life. Rhythmic and musical elements of infant behavior seem to contribute to what has been called “postural conformity” in the infant-mother relationship, undoubtedly an important ingredient in attachment behavior and in the emotional development of the infant.     

The Dead Baby

The ghosts of Nazi history haunted my work with a German patient. The burnt landscape of the unresolved tragedy between Nazis and Jews saturated our work with transgenerational excess of unspeakable violence. My patient came to discover that she has not been able to avoid reenacting a horrific cycle of crime and punishment. Together we struggled to maintain solidarity and narrate history despite a pull towards reenacting an international tribune. The case brings to the fore the challenge of maintaining an ongoing analytic space and subjective sovereignty when powerful collective issues flood the field. When such a space is created, psychoanalytic work has the potential to join the forces that mend history.     

Baby X revisited

The present study is a replication of a study reported by Seavy, Katz, and Zalk (1975) in which subjects interacted with a 3-month-old female infant who was either introduced as a boy, a girl, or without any specific gender information. In the present study infants of both genders were used as stimuli, and 60 college undergraduates served as subjects. The results of the present study are similar to the findings of the original investigators. The gender labels provided to the subject resulted in highly sex-stereotyped behavior concerning toy choice.     

Killing Baby Suzy

In her (1996) Kadri Vihvelin argues that autoinfanticide is nomologically impossible and so that there is no sense in which time travelers are able to commit it. In response, Theodore Sider (2002) defends the original Lewisian verdict (Lewis 1976) whereby, on a common understanding of ability, time travelers are able to kill their earlier selves and their failure to do so is merely coincidental. This paper constitutes a critical note on arguments put forward by both Sider and Vihvelin. I argue that although Sider’s criticism starts out promisingly he doesn’t succeed in establishing that Vihvelin’s analysis fails, because (a) he neglects to rule out a class of counterfactuals to which Vihvelin’s sample-case may belong; and (b) (together with Lewis) he is wrong to suggest that future facts are irrelevant in the evaluation of time travelers’ abilities. I show instead that Vihvelin’s argument is viciously circular, indicating that even if there are nomological constraints on autoinfanticide these cannot be established a priori.

100 Years of Trauma: the Armenian Genocide and Intergenerational Cultural Trauma

The events of the Armenian Genocide of 1915, during which more than 1.5 million Armenians were massacred by the Ottoman Turkish Empire, has left a deep, painful scar on this small but prominent culture. Those who lived through the Armenian Genocide survived death marches, rapes, drownings, physical mutilation, and other such heinous crimes. As they have passed, it is being recognized that subsequent generations continue to fight for justice, manifesting their ancestral pain, sadness, and mourning for the loss of their family members. As sociocultural trauma has a multigenerational impact within families and communities and affects the feeling of membership and belonging within that community, understanding how previous traumas shape future generations of that group is important for clinicians. This article reviews the scarce research on intergenerational trauma in the Armenian community within the United States after the Armenian Genocide, using the constructivist self-development theory to provide clinical implications and suggestions.