Physician-assisted suicide: the role of mental health professionals

A review of the literature was conducted to better understand the (potential) role of mental health professionals in physician-assisted suicide. Numerous studies indicate that depression is one of the most commonly encountered psychiatric illnesses in primary care settings. Yet, depression consistently goes undetected and undiagnosed by nonpsychiatrically trained primary care physicians. Noting the well-studied link between depression and suicide, it is necessary to question giving sole responsibility of assisting patients in making end-of-life treatment decisions to these physicians. Unfortunately, the use of mental health consultation by these physicians is not a common occurrence. Greater involvement of mental health professionals in this emerging and debated area is advocated. Beyond describing mental health professionals' role in the assessment of patient competency or decision making capacity, other areas of potential involvement are described. A discussion of ethical principles relevant to this area follows, along with comments on the training necessary to adequately serve patient needs.     

Case vignette: cybertherapy

Dr. Neuro Transmitter, a psychotherapist in Paramus, New Jersey, provides services through an online, real-time consultation service known as CyberShrink, Inc., of Dallas, Texas. He is paid by the hour for his consultation services to subscribers who are billed by credit card through CyberShrink. One afternoon he logs on and is connected via private "chat channel" to a new subscriber to the service. She is Ann Hedonia of Simi Valley, California. Ten minutes into the session, Dr Transmitter recognizes that Ms. Hedonia is seriously depressed with suicidal ideation and is feeling on the edge of her ability to cope. He gently suggests that perhaps she ought to think about hospitalization near her home. Ms. Hedonia replies, "Even you don't care about me! That's it. I'm going to do it!" and disconnects. Discussion questions: Is offering psychotherapy services online ethical? What are Dr. Transmitter's obligations in general and at this particular moment to Ms. Hedonia? Suppose Ms. Hedonia has a complaint about Dr. Transmitter. From whom can she seek a remedy? Which state's laws apply regarding professional practice, confidentiality, or licensing qualifications? Must Dr. Transmitter be licensed in any state to offer this service?     

早期年龄儿童短时记忆的发展

有关短时记忆的发展问题,如果说在种系发展上已经完成了大量的研究工作,并且做了充分令人信服的、关于在进化中短时记忆不断改善的结论的话,那么,在个体发展上,人的早期短对记忆的发展问题的研究,还是个空白。有关记忆的实验心理学研究,是从儿童生后的第三、四年开始的。以往有关个体发育的早期阶段记忆的发展材料,主要来自《母亲日记》一类的资料,在这类资料中,有关记忆的记述,带有偶然性。在这个时期,记忆的某些形式,其中包括短时记忆,一般地说,还没有研究。     

关于思维活动对识记的作用

我们这篇文章专门用来论讨在直接再现和延缓再现中,记忆和思维相互关系这个当前必须解决的问题А·А·斯米尔诺夫早就证实过,积极的思维活动是提高不随意识记效率的基础。积极思维活动的内容越复杂,就越容易识记。     

把普通教育和职业训练提高到新的水平

学校改革——这是历史发展的必然规律的体现。教育是为了使人适应生活而培养人的,而生活又在不断地发展,它对人的要求也在不断地变化,因此,教育也应当不断地变化。这一改革将根据本世纪末、下世纪初发达的社会主义社会对学校教育的要求来进行。     

法国关于马克思的逻辑学的讨论

六十年代中期,资本主义国家里出现了一场意识形态的运动,七十年代正式形成,此后不断扩大。这场运动基本上是以对马克思的经济学的主要著作《资本论》、《政治经济学批判大纲》的理解为基础,同时又是对马克思的著作,特别是对马克思的早期著作所作的人道主义-存在主义的解释的反映。     

现代科学中人的问题

在控制论出现的时代,大多数科学家认为,控制的中心问题同控制的数学理论、算法理论、自动机和自动调节的研究相联系,同自组织系统的数学模式的创造相联系,有时还同应用数学的一些部门,如线性程序、实验设计等的发展相联系。另一方面,又把控制的技术手段——计算机及其工程保证和数学保证的研究列为控制科学的最重要问题。近来已经明显看     

Positive conditioned suppression: Transfer of performance between contingent and noncontingent reinforcement situations

Five homing pigeons were trained on concurrent variable-interval schedules. A fixed-duration stimulus was occasionally presented on one key; and, in various conditions, this stimulus terminated (a) without reinforcement, (b) in noncontingent reinforcement, (c) with reinforcement contingent on a response on the key on which the stimulus was presented, and (d) with reinforcement contingent on a response on the key on which the stimulus was not presented. Initially, a stimulus terminating in noncontingent reinforcement generally produced decreased response rates on both keys during the stimulus. Contingencies, however, reliably produced increased rates during the stimulus on the key on which the contingency was arranged, relative to the rate on the concurrently available key. Contingency conditions were followed by noncontingency conditions in which the separation of rates caused by contingencies was maintained. When rates during the stimulus were compared with response rates on the same keys in the absence of the stimulus, contingency-caused rate increases and decreases were again found, but only the rate decreases were maintained in subsequent noncontingency conditions. Further data suggested that the contingency-caused rate changes were not maintained when the stimulus terminated without reinforcement, and that they were unaffected by a threefold decrease in the reinforcement rate provided by the baseline schedules. The results support the suggestion that performance in the positive conditioned suppression procedure results from concurrent and multiple schedule interactions. They further suggest that the production of either acceleration or suppression is dependent on adventitious and historical contingencies.