Death, organ transplantation and medical practice

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to "strong irreversibility" (death beyond the reach of resuscitative efforts to restore life) as a necessary criterion that patients must meet before physicians can declare them to be dead. Sam Shemie, who defends our current practice of NHBD, holds that in fact physicians consider patients to be dead or not according to physician intention to resuscitate or not. We suggest that criteria for a concept are not necessarily truth conditions for assertions involving the concept. Hence, non-heart beating donors may be declared dead without meeting the criterion of strong irreversibility even though strong irreversibility is implied by the concept of death. Our perception that a concept applies in a given case is determined not by the concept itself but by our necessary skill and judgment when using it. In the case of deciding that a patient is dead, such judgment is learned by physicians as they learn the practice of medicine and may vary according to circumstances. Current practice of NHBD can therefore be defended without abandoning death as an empirical concept, as Shemie appears to do. We conclude that the dead donor rule continues to be viable and ought to be retained so as to guarantee what the public most cares about as regards organ donation: that physicians can be trusted to make determinations of eligibility for organ donation in the interests of patients and not for other purposes such as increasing the availability of organs.     

Psychotropic medication from an object relations theory perspective: an analysis of vignettes from group psychotherapy

In this article we explore the content and dynamics of patients' verbalizations within a "living with medications" group. Patients' perceptions of their psychotropic medications are interpreted and classified within the framework of object relations theory. One's perception of the role of medication in one's life can serve as a gateway to one's inner world and the way that he or she perceives authority figures, peers, and oneself. We suggest that working through patients' relationships with their medications can help them to achieve better integration of internal object relations. Discussing patients' views about medications should therefore be seen as an important part of psychotherapy with many individuals. Such a discussion may enhance and improve efficacy of both psychotherapy and pharmacotherapy. It is of particular importance in group therapy, within milieu environments and with individuals reluctant to explicitly discuss interpersonal matters. Vignettes from the group sessions illustrate the way in which discussing medication advances group process.     

Telling a story or telling it straight: the effects of entertaining versus accurate retellings on memory

People retell events for different reasons. Sometimes they try to be accurate, other times entertaining. What characterizes retellings from different perspectives? How does retelling perspective affect later recall of events? In the current research, participants retold a story either three times or not at all. By instruction, retellings were either entertaining or accurate. Compared to accurate retellings, entertaining retellings contained more affect, but fewer sensory references. On a subsequent memory test, participants who retold with an accuracy goal recalled the greatest number of story events, and their recall protocols were the most accurate and detailed, and least exaggerated. However, recognition memory did not differ across groups, suggesting that differences in retrieval structures (necessary for recall but not recognition) were key to understanding later differences in memory. Compared to telling it straight, the creative process of telling a story leads to qualitative and quantitative changes in later recall. Copyright © 2004 John Wiley & Sons, Ltd.     

Intellectual ability and aggressive behavior in nonclinical-nonforensic males

The purpose of this study was to test the relationship between IQ and physical aggression in a nonclinical-nonforensic male sample in a laboratory setting. Thirty males completed an abbreviated version of the Wechsler Adult Intelligence Scale—Revised. Aggression was measured using a modified version of the Taylor reaction-time (RT) aggression paradigm in which subjects competed on a RT task and both received and delivered shocks to a fictitious opponent in provoking and nonprovoking conditions. Provocation conditions (High and Low) were defined by the intensity of shocks the subjects received. Results demonstrated strong inverse correlations between IQ and aggressive behavior under both High and Low Provocation conditions.     

Spatial versus tree representations of proximity data

In this paper we investigated two of the most common representations of proximities, two-dimensional euclidean planes and additive trees. Our purpose was to develop guidelines for comparing these representations, and to discover properties that could help diagnose which representation is more appropriate for a given set of data. In a simulation study, artificial data generated either by a plane or by a tree were scaled using procedures for fitting either a plane (KYST) or a tree (ADDTREE). As expected, the appropriate model fit the data better than the inappropriate model for all noise levels. Furthermore, the two models were roughly comparable: for all noise levels, KYST accounted for plane data about as well as ADDTREE accounted for tree data. Two properties of the data proved useful in distinguishing between the models: the skewness of the distribution of distances, and the proportion of elongated triangles, which measures departures from the ultrametric inequality, Applications of KYST and ADDTREE to some twenty sets of real data, collected by other investigators, showed that most of these data could be classified clearly as favoring either a tree or a two-dimensional representation.A portable PASCAL program implementing the Sattath and Tversky [1977] ADDTREE algorithm is available from J. Corter, Department of Psychology, Stanford University, Stanford, California 94305.     

Categories of environmental scenes

Environmental scenes are the settings in which human action occurs; since they constrain behavior, they are of interest to social, personality, and environmental psychologists. Scenes can also be viewed as a spatial generalization of objects, as well as the spatial contexts in which objects appear. As such, they are studied in perception and memory. Previous approaches to characterizing environments have relied on scaling techniques to yield a manageable number of dimensions or attributes by which environments can be compared. In contrast, the present research demonstrates development of a taxonomy of kinds of environmental scenes, where perceived attributes are obtained as a byproduct. A basic or preferred level of categorization in the taxonomy is also identified, based on measures of cognition, behavior, and communication. The basic level, for example, school, home, beach, mountains, corresponds to the level commonly used in the study of scene schemas in perception, memory, and environmental psychology, as well as to the level apparently most useful in other domains of knowledge concerned with environments, for example, architecture and geography.     

Eye fixations in prediction of recognition and recall

Eye fixations were recorded at viewing of picture-label stimuli presented under either recall or recognition instructions; both retention tests were administered. Ss performed substantially better on the retention test of which they were informed, indicating differential encoding of the same stimuli in anticipation of test type. There was no correlation between recognition and recall of items, evidence that different information from the encoded stimuli was utilized in performing each test. Encoding strategies had no effect on how Ss regarded the stimuli, but viewing patterns were related to memory performance: More word fixations was associated with better verbal recall, while fewer picture fixations was associated with better recall and with better picture recognition.     

Recall of common and distinctive features of verbal and pictorial stimuli

Subjects first rated similarity of verbal and of pictorial stimuli. The same pairs of stimuli were presented again, without one common component and one distinctive component. Subjects were asked to recall the missing components and identify them as common or distinctive. The results show that components encoded as common are recalled relatively better than components encoded as distinctive, and the difference in recall is significantly greater in verbal than in pictorial stimuli.     

Pictorial representations in adults and children

Reaction time to make same-object judgements was measured for pairs of identical pictures, picture synonyms, identical words, word synonyms, and picture-word combinations in adults and children. At all ages, synonym comparisons took longer than identical comparisons. Adults, but not children responded no faster to picture-word pairs than to picture synonym pairs. This is taken as evidence for the use of abstract pictorial information by adults but not by children. Children seem to compare two different exemplars of the same object verbally in the absence of well-integrated abstract pictorial representations.