What is the moral basis of the authority of family members to act as surrogates for incompetent patients?

...The authority of family members should be understood as presumptive; that is, there is a moral presumption that a close family member should serve as surrogate for an incompetent patient. That presumption can be overcome or rebutted in a particular case, either when there is sufficient evidence that the usual reasons supporting this presumption do not hold or when the surrogate's decision exceeds appropriate limits of surrogates' decision-making discretion. In order to clarify these hard cases and appropriate public policy, we need a much deeper and more complex analysis than either the conventional view, or the alternative account that Pearlman and colleagues provide. I have sought here only to point toward some of the other grounds that a full account of family members' authority as surrogates would have to develop and explore in much more detail....     

Erotic Materials: A Commodity Theory Analysis of the Enhanced Desirability that May Accompany Their Unavailability

This report analyzes one dimension of the pornography-control issue, i.e., the probable reactions of individuals who are confronted with information that is not freely or easily available to all. After a review of commodity theory and related research, it is concluded that making erotic materials more difficult to obtain, harassing and punishing pornographers and purveyors of pornography, and restricting certain materials to certain age groups may increase interest in the materials and render them more desirable than would have been the case without the restriction, harassment, or difficulty.     

Urinary incontinence and psychological distress among older adults

We examined the relationship between urinary incontinence and psychological distress in a sample of community-dwelling older adults. The data are from a probability sample of Washtenaw County, Michigan residents ages 60 years and older, who were interviewed in 1983 and 1984. A total of 747 women and 541 men were included in the analyses. Experiencing urinary incontinence, particularly in a severe form, was weakly related to depression, negative affect, and low life satisfaction. These relationships are partly explained by the fact that incontinent respondents are less healthy than are continent respondents.     

Constraints on effective pictorial and verbal elaboration

Three experiments investigated the conditions under which pictures facilitate learning. In Experiment 1, confusing verbal relationships were supplemented with pictures that illustrated the key concepts in each verbal relationship (base pictures), illustrated the key concepts in more elaborate arbitrary relationships (pictures of arbitrary elaborations), or illustrated the key concepts in ways that helped clarify the verbal relationships (pictures of explanatory elaborations). All three types of pictures facilitated the retention of the verbal relationships, although pictures of explanatory elaborations were superior to other types of visual illustrations. In Experiment 2, the facilitative effects of base pictures depended on a schematically unique illustration of the key concepts in a single image. In Experiment 3, picture facilitation effects were constrained by the type of verbal elaborations that accompanied the pictures. Specifically, base pictures and pictures of arbitrary elaborations did not facilitate the retention of confusing verbal relationships that were elaborated with explanatory information, and actually interfered with the retention of those explanatory elaborations. The implications of these results are discussed.     

Perceptual similarity in autism

People with autism have consistently been found to outperform controls on visuo-spatial tasks such as block design, embedded figures, and visual search tasks. Plaisted, O'Riordan, and others (Bonnel et al., 2003; O'Riordan & Plaisted, 2001; O'Riordan, Plaisted, Driver, & Baron-Cohen, 2001; Plaisted, O'Riordan, & Baron-Cohen, 1998a, 1998b) have suggested that these findings might be explained in terms of reduced perceptual similarity in autism, and that reduced perceptual similarity could also account for the difficulties that people with autism have in making generalizations to novel situations. In this study, high-functioning adults with autism and ability-matched controls performed a low-level categorization task designed to examine perceptual similarity. Results were analysed using standard statistical techniques and modelled using a quantitative model of categorization. This analysis revealed that participants with autism required reliably longer to learn the category structure than did the control group but, contrary to the predictions of the reduced perceptual similarity hypothesis, no evidence was found of more accurate performance by the participants with autism during the generalization stage. Our results suggest that when all participants are attending to the same attributes of an object in the visual domain, people with autism will not display signs of enhanced perceptual similarity.     

Examining Sex Differences in Altering Attitudes About Rape: A Test of the Elaboration Likelihood Model

This intervention sought to improve first-year college students' attitudes about rape. The Elaboration Likelihood Model (ELM) was used to examine men and women's attitude change processes. Both quantitative and qualitative methodologies were used to examine how men and women construed rape prevention messages. Results indicated numerous sex differences in the ways in which men and women experienced and changed during and after the rape prevention intervention. Women seemed to use more central-route attitude change processes and showed more lasting change from the intervention at 2-month follow-up, whereas men seemed to attend more to peripheral cues of the speaker and demonstrated more transient attitude change.     

EFFECTS OF TRANSMITTER TUNING ON ATTITUDE CHANGE PERSISTENCE:

Abstract— assiter, Petto, and Apple (this issue) replicated the effect of transmitter tuning on attitude change persistence (Boninger, Brock, Cook, Cruder, & Romer, 1990) and included an additional condition as the basis for an alternative explanation. Although their independent replication is an important contribution that provides significant empirical corroboration, a superficial rendering of the interrupted-task literature (Zeigarnik, 1927/1938) and ambiguity in the operationalization of the additional condition appear to weaken their proposed interruption-perseveration explanation. We also summarize ancillary data from our earlier work (Boninger et al., 1990) that shed further doubt on this alternative explanation.     

Justice, health care, and the elderly

Concern over rising health costs in the United States has led to an intensifying policy debate over health care for the elderly and a rethinking of questions on intergenerational justice and the claims of the aged on social resources. Major contributions to this debate have been made by Daniel Callahan in his Setting Limits (Simon & Schuster; 1987) and by Norman Daniels in his Am I My Parents' Keeper? (Oxford University Press; 1988). Brock reviews Callahan's and Daniels' work, identifying the central focus of both as the age-group problem of resource allocation. He sees Callahan as calling upon a communitarian political philosophy and Daniels as arguing from a tradition of political liberalism. While disagreeing in part with both authors, Brock identifies compatible elements in their arguments that contribute significantly to the public debate over health care and the aged.