A Legacy of Silence: Bioethics and the Culture of Pain

For over 20 years the medical literature has carefully documented the undertreatment of all types of pain by physicians. During this same period, as the field of bioethics came of age, the phenomenon of undertreated pain received almost no attention from the bioethics literature. This article takes bioethicists to task for failing to recognize the undertreatment of pain as a major ethical, and not merely a clinical, failing of the medical profession. The nature and extent of the problem of undertreated pain is examined, as well as possible reasons for its disregard by bioethicists. The factors contributing to undertreated pain in the clinical setting are considered, as well as the hazards posed by recent failures to address ethically questionable clinical practices. Finally, suggestions are offered for refocusing the attention of bioethicists to this significant problem.     

Deterrence, Opportunity, and Choice

Traditional studies of deterrence have focused on punishment with less regard for the rewards of both crime and noncrime. Influenced by work in economics and behavioral psychology, more recent studies have departed from tradition by incorporating rewards for crime. To this extent, they should be regarded as advances over the more traditional approaches. Notwithstanding these advances, variations in both the probability and magnitude of reward for noncrime have not been systematically included in these more recent theories of choice. In an attempt to determine whether opportunities for noncrime are either central or trivial to the criminal decision-making process, the present study fitted two alternative models to experimental data involving risk-taking: (a) the economic utility model employed by Piliavin, Gartner, Thornton, and Matsueda (1986) in their study of criminal choice; and (b) the satisfaction balance model developed by Gray and Tallman (1984). Results showed that while both models explained significant amounts of variation in the dependent variable, the Gray-Tallman model provided a substantially better fit of the data. Despite limitations inherent in experimental studies as, for example, limitations surrounding the issue of external validity, the findings strongly suggest that opportunities for noncrime are as important as rewards and costs for crime in the process by which criminal decisions are made.     

Confirmatory factor analysis of The Aggression Questionnaire

A confirmatory factor analysis of the factor structure of The Aggression Questionnaire created by Buss and Perry (1992) [Journal of Personality and Social Psychology, 63, 452–459] was conducted to assess whether the scale's purported 4 factors emerged. The results generally supported the 4-factor model. However, the hostility factor may be improved if 2 items pertaining to suspicion are removed from the scale. These items had relatively low loadings on that factor and decreased the hostility scale's internal reliability.     

A possible genetic basis of accuracy in personality perception

An analysis was conducted to assess whether individuals are more accurate in perceiving those personality characteristics of other' that have a larger genetic component. Adult monozygotic (MZ) twins (63 pairs) and same-sex dizygotic (DZ) twins (35 pairs) completed the Personality Research Form-E (PRF) and the Sibling Evaluation of Personality Characteristics (SEPC) which consists of 20 sets of adjectives corresponding to the 20 trait scales of the PRF. Subjects also evaluated their co-twin with the SEPC. Self-other agreement correlations were then correlated with the heritability estimates of the PRF traits calculated on the same twin sample. The results suggest that accuracy in perceiving the co-twin's personality does increase with the heritability component of the personality dimension.     

Challenges confronting cross-sex friendships: “Much ado about nothing?”

This research was an investigation into four challenges purported to confront cross-sex friends. One hundred and thirty eight individuals (females = 86, males = 52) completed two surveys designed to explore the extent to which the sexual, emotional bond, audience, and equality challenges were present in their cross-sex friendships. Over 98% of the participants were heterosexual, 99% were Caucasian, and approximately 5% were Hispanic. Data gathered from the first survey were analyzed using a three-way analysis of variance, with gender, type of friendship, and romantic status as the independent variables, and three of the four challenges as the dependent variables. The first survey also included open-ended questions designed to explore the nature and existence of the challenges. The second survey was in a diary format. Respondents kept a frequency count for three weeks of discussions they had with their cross-sex friend concerning the challenges, and thoughts that they had as individuals concerning those challenges. Results from both surveys indicate that though the challenges exist and have powerful effects on a small percentage of individuals in cross-sex friendships, for the majority of participants the challenges are not perceived as salient.     

Gts and interrogative tableaux

A variant of the standard deductive tableau system is introduced, and interrogative rules are added, resulting in a so-called interrogative tableau system. A game-theoretical account of entailment is sketched, and the deductive tableau system is interpreted in these terms. Finally, it is shown how to extend this account of entailment into an account of interrogative entailment, thereby providing a semantics for the interrogative tableau system.     

Human sensitivity to temporal proximity: The role of spatial and temporal speed gradients

Estimates of temporal proximity (sometimes called time-to-collision) from random-dot flow patterns are shown to be based upon retinal speed, rather than upon changes in dot density. Neither the spatial nor the temporal gradient of motion is essential to the task, but estimates can be made from either alone. Performance is unaffected by the addition of rotational motion, suggesting that observers axe capable of extracting the radial component of motion, which contains all the relevant information, from complex stimuli.     

Gender and aggression II: Personal aggressiveness

To investigate how gender, ethnicity, age and education influence aggressiveness, we surveyed 115 male and female college students (56% male; 50% Anglo and 26% Hispanic) and 79 persons (72% male; 92% Anglo) working on a military base. Participants were administered the Buss-Perry Aggression Questionnaire and asked about their own aggressive behaviors. In both samples, men scored significantly higher than women on the Physical Aggression scale of the Aggression Questionnaire but not on the other scales. In the military sample, men indicated that they expected to behave more aggressively than women. Positive correlations among different aspects of aggressiveness were found for both men and women. Increasing age and education were associated with lower aggressiveness in both genders, suggesting that aggressiveness may be susceptible to modification over the course of one's life.We would like to thank Angela Bennett, Gail Bliss, Kayleigh Carabajal, Julie Depree, Carmen Gonzales, Deborah Good, Scott Griffin, Gladys Herrera, George Selix, Ruth Tangman, and Jon Woodland for their assistance with the development, distribution, and coding of the questionnaire.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

Evidence that blocking is due to associative deficit: Blocking history affects the degree of subsequent associative competition

Rats were trained on an appetitive discriminated operant procedure according to a blocking design, in which training with a compound stimulus (A + B) was given with or without prior training with A alone. Stimulus B was then presented in compound with a new stimulus (B + C compound). The ability of Stimulus B to block acquisition of control by Stimulus C was decreased by B having itself been blocked by A during the prior training. The results imply that the mechanism of blocking during the initial blocking procedure was a reduced association between Stimulus B and the reinforcer, and not a performance deficit such as that postulated by comparator models of learning.