Anticruelty care: commentary

The anticruelty policy is a best-interests test for treatment plans including decisions to forgo life-sustaining therapy for certain incompetent patients. In connection with specific proposed therapy, the policy requires no reference to the patient's unknowable values, subjective experiences, or quality of life. The decision to undertake a treatment plan derives from the caregiver's knowledge of burdens and benefits of that treatment when used in caring for the competent or for those incompetents capable of growth or repair. The caregiver should weigh the potentially cruel effects of treatment against the likelihood of reducing suffering or encumbrance with the treatment. The terms "burden" and "benefit," in fact, are replaced by the terms "cruelty" and "beneficence," as the relevant opposing outcomes that must be weighed. Thus, the anticruelty policy shifts our scrutiny from experiences of the patient that we cannot evaluate to the proposed actions of the competent decision makers and caregivers. Notably, it is a protreatment policy when the goals of medicine are attainable; and it is an anticruelty policy when they are not. The policy does evaluate the world of the patient to the extent that it requires a judgment based upon external appearances about patient pleasure or happiness in living. It presumes to universalize larger societal values about cruelty, beneficence, compassionate concern for the helpless, and certain rights of individuals. And it presumes to universalize on the patient's behalf specific medical values about hopeless injury, timely death, the goals of medicine, and cruelty, which should remain open to societal discussion and revision. The presented definition of hopeless injury does not require brain death, coma, or persistent vegetative state. Specifically, the policy holds that death is timely for a patient with hopeless injury, and that prevention of death for such patients is not a goal of medicine but a cruelty.     

Fast color grouping and slow color inhibition: evidence for distinct temporal windows for separate processes in preview search

The authors report 4 experiments that examined color grouping and negative carryover effects in preview search via a probe detection task (J. J. Braithwaite, G. W. Humphreys, & J. Hodsoll, 2003). In Experiment 1, there was evidence of a negative color carryover from the preview to new items, using both search and probe detection measures. There was also a negative bias against probes on old items that carried the majority color in the preview. With a short preview duration (150 ms) carryover effects to new items were greatly reduced, but probe detection remained biased against the majority color in the old items. Experiments 2 and 4 showed that the color bias effects on old items could be reduced when these items had to be prioritized relative to being ignored. Experiment 3 tested and rejected the idea that variations in the probability of whether minority or majority colors were probed were crucial. These results show that the time course of color carryover effects can be separated from effects of early color grouping in the preview display: Color grouping is fast, and inhibitory color carryover effects are slow.     

Innovative behaviour in fish: Atlantic cod can learn to use an external tag to manipulate a self-feeder

This study describes how three individual fish, Atlantic cod (Gadus morhua L.), developed a novel behaviour and learnt to use a dorsally attached external tag to activate a self-feeder. This behaviour was repeated up to several hundred times, and over time these fish fine-tuned the behaviour and made a series of goal-directed coordinated movements needed to attach the feeder’s pull string to the tag and stretch the string until the feeder was activated. These observations demonstrate a capacity in cod to develop a novel behaviour utilizing an attached tag as a tool to achieve a goal. This may be seen as one of the very few observed examples of innovation and tool use in fish.     

Intention to Participate in Predictive Genetic Testing for Hereditary Cancer: The Role of Attitude toward Uncertainty

This study aimed to identify factors predictive of intentions to participate in genetic testing for hereditary cancer. Measures of the psychosocial influences on intention were based on the theories of reasoned action (TRA) and planned behaviour (TPB) and a new measure of Attitude toward Uncertainty. The participants (the breast cancer sample, n = 124; the colon cancer sample, n = 168) were recruited via a general practitioner's patient database and asked to complete postal questionnaires. The overall response rate was 57.4% (54.7% in the colon cancer sample, 61.4% in the breast cancer sample). In the colon cancer sample, 72% of respondents stated that they would choose to participate in genetic testing for colon cancer susceptibility. In the breast cancer sample, 77% of respondents stated that they would choose to participate in genetic testing for breast cancer susceptibility. The TRA components (attitudes and subjective norms) and Attitude toward Uncertainty emerged as the strongest predictors of intention. The Attitude toward Uncertainty appears to moderate intention in that participants with more negative attitudes toward uncertainty are more likely to undergo the test than those seeking more certainty.     

Pre-counseling Education for Low Literacy Women at Risk of Hereditary Breast and Ovarian Cancer (HBOC): Patient Experiences Using the Cancer Risk Education Intervention Tool (CREdIT)

The Cancer Risk Education Intervention Tool (CREdIT) is a computer-based (non-interactive) slide presentation designed to educate low-literacy, and ethnically and racially diverse public hospital patients at risk of Hereditary Breast and Ovarian Cancer (HBOC) about genetics. To qualitatively evaluate participants’ experience with and perceptions of a genetic education program as an adjunct to genetic counseling, we conducted direct observations of the intervention, semi-structured in person interviews with 11 women who viewed CREdIT, and post-counseling questionnaires with the two participating genetic counselors. Five themes emerged from the analysis of interviews: (1) genetic counseling and testing for breast/ovarian cancer was a new concept; (2) CREdIT’s story format was particularly appealing; (3) changes in participants’ perceived risk for breast cancer varied; (4) some misunderstandings about individual risk and heredity persisted after CREdIT and counseling; (5) the context for viewing CREdIT shaped responses to the presentation. Observations demonstrated ways to make the information provided in CREdIT and by genetic counselors more consistent. In a post-session counselor questionnaire, counselors’ rating of the patient’s preparedness before the session was significantly higher for patients who viewed CREdIT prior to their appointments than for other patients. This novel educational tool fills a gap in HBOC education by tailoring information to women of lower literacy and diverse ethnic/racial backgrounds. The tool was well received by interview participants and counselors alike. Further study is needed to examine the varied effects of CREdIT on risk perception. In addition, the implementation of CREdIT in diverse clinical settings and the cultural adaptation of CREdIT to specific populations reflect important areas for future work.     

Lending a Helping Hand: The Effects of Gender Stereotypes and Gender on Likelihood of Helping1

The purpose of this study was to investigate the effects of gender and gender-role stereotypes on judgments of help-giving. As part of a 2 × 2 within-subjects design, 40 undergraduates read 4 different scenarios that described either a man or a woman needing help in either a stereotypically masculine or a stereotypically feminine situation. Although male participants felt more sympathy for men in stereotypically feminine situations and for women in stereotypically masculine situations, they were no more likely to help these individuals than they were to help those in gender-consistent situations. By contrast, women were more likely to help people in gender-inconsistent situations, despite feeling the most sympathy for people needing help in masculine situations. Implications for Weiner's (1980) attribution model of help-giving and Nadler & Fisher's (1986) threat-to-self-esteem model are discussed.     

Dissociating the effects of similarity, salience, and top-down processes in search for linearly separable size targets

In two experiments, we explored the role of foreknowledge on visual search for targets defined along the size continuum. Targets were of large, medium, or small size and of high or low similarity relative to the distractors. In Experiment 1, we compared search for known and unknown singleton feature targets as a function of their size and similarity to the distractors. When distractor similarity was high, target foreknowledge benefited targets at the end of the size continuum (i.e., large and small) relatively more than targets of medium size. In Experiment 2, participants were given foreknowledge of what the target was not The beneficial effect of foreknowledge for endpoint targets was reduced. The data indicate the role of top-down templates in search, which can be "tuned" more effectively for targets at the ends of feature dimensions.