Marginally Represented Patients and the Moral Authority of Surrogates

Abstract

Incapacitated adult patients are commonly divided into two groups for purposes of decision making; those with a surrogate and those without. Respectively, these groups are often referred to as represented and unrepresented, and the relative ethics of decision making between them raises two particular issues. The first issue involves the differential application of the best interests standard between groups. Second is the prevailing notion that representedness and unrepresentedness are categorical phenomena, though it is more aptly understood as a multidimensional and continuous variable based on relational moral authority. This paper examines the nature of representedness as it relates to ethical norms of surrogate decision making.     

A Laughing Matter? The Uses of Humor in Medical Interactions

Motivation and Emotion - As Coser (1962) demonstrated in her landmark hospital study, a humor is one of the great tools of reassurance on the hospital ward. After all, if something is ridiculous,...     

Dr. Susan W. Gray

While Susan W. Gray is known primarily for her work with the Early Training Project, a pioneering early intervention program with low-income black children, she has also influenced the development of school psychology and the creation of Early Childhood Education as a discipline. In addition, in her own quiet way, she has supported the career development of a number of professional women who have had impact on child development, early childhood education, and school psychology. Four major themes are used to present Susan Gray's biography: (1) being ahead of her time in terms of thinking which allowed her to take advantage of opportunities; (2) the role of serendipity versus long-range planning of career trajectories; (3) specific influences on her as a woman; and (4) a lifetime of courage and dedication. Examples of work which was in advance of psychology included work in early intervention with low-income children, an emphasis on the use of scientific experimental methodology in field research, an eclectic approach which crossed disciplinary boundaries, a consultative approach to school psychology, and the inclusion of affective and cognitive education in inter-     

Cooperative social coordination and aggression: II. Effects of sex and housing among three strains of intact laboratory rats differing in aggressiveness

Pairs of laboratory rats were rewarded with sugar solution for cooperating by means of synchronized shuttling in a rectangular chamber. Learning and performance were compared in males and females of three strains--S3, Charles River, and Wistar--ordered in terms of decreasing levels of aggressiveness. In addition, same-sex pairs of each strain were housed either together or individually. When housed together, males and females of all strains eventually cooperated at comparable levels, with rates of acquisition across strains inversely related to their aggressiveness. Individual housing, in contrast, was associated with severe deficits in males of the S3 and CR strains linked to violent fighting and prolonged freezing by animals who had previously been defeated. All other individually housed groups, including males of the Wistar strain and females of all strains, were able to cooperate, including S3 females whose violent fighting was not associated with immobility by defeated animals. In general, the majority of groups were able to cooperate despite differences in aggressiveness associated with sex, strain, and housing. Possible processes in this accommodation are discussed.