Jewish medical ethics in the care of the cancer patient

The care of the patient with cancer requires the development not only of a medical plan, but an ethical plan as well. This plan should integrate the physician's and the patient's perceptions of medical and ethical propriety. Jewish biomedical ethical principles are based on the teaching of the Old Testament and its various interpretations. In this paper, I discuss how these principles can be used to help guide the physician caring for the patient with cancer. Other ethical systems could be applied in a similar fashion.     

Bias in the use of base rates: Racial prejudice in decision-making

Two studies investigated biases in the use of base rate information when assessing the probability of a witness' accurate identification of a white or West Indian as a burglar. An adapted version of the Kahneman-Tversky cab problem was used, to provide a social decision in which biases could be measured against some normative standard. Ethnicity of youth (white/West Indian) and nature of base rate (incidental/causal) were manipulated in a 2 × 2 between-subjects design. A significant interaction effect revealed that subjects took no account of the base rate for a West Indian subject, but used the base rate only when it was causal and the youth was white. This ‘prejudice effect’ against a West Indian youth and ‘exoneration effect’ for a white youth were replicated in a second study, using a microcomputer and chronometric analyses. Results are discussed in terms of heuristic decision-making, social schemata, and the cognitive versus motivational bases of bias in the use of base rates.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

The precaution adoption process

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.