Do the bishops have it right on health care reform?

The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitable and just system for providing health care. Natural law arguments in the tradition of Roman Catholic social teaching lead to the conclusion that a just and prosperous society has a moral obligation to provide health care even if there is no such right. Further, there are strong moral grounds for concluding that the bishops are correct in their claim that health care ought not to be considered a market commodity. It is argued that if health care ought not to be considered a commodity, then national health insurance is the best available alternative for fulfilling the social obligation to distribute health care resources justly and fairly at this time in American history. The bishops' case for government involvement can be made on the strength of the Catholic tradition in theological argumentation, independent of the claim that health care is a right.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

The “good manager”: Sex-typed,androgynous, or likable?

Recent studies have indicated that people describe a “good manager” in masculine terms. It was hypothesized that this could simply reflect cultural stereotypes, rather than people's perceptions of what combination of traits is desirable in a leader. In Experiments 1 and 2, subjects were presented managerial profiles ascribing all masculine, all feminine, or a combination of masculine and feminine traits (i.e., “androgynous” profiles) to hypothetical managers. Feminine-trait combinations were rated as significantly less desirable than either masculine or androgynous combinations, which were rated as equally desirable. Thus, while femininity per se was not seen as desirable in a leader, it was not viewed as a liability when combined with masculinity, a corroboration of much behavioral research on androgyny. Experiment 3 varied trait likableness and sex-role orientation. Experiments 1 and 2 were replicated for unlikable traits. Surprisingly, the opposite pattern was obtained for likable traits: the feminine combinations were rated as the most desirable, and the masculine combinations were rated as the least desirable. The results are discussed in the context of early research on impression formation and recent work on social cognition.     

Who we are: The political origins of the medical humanities

The medical humanities were organized, beginning in the late 1960s, by a small group of people who shared a critique of medical education and a commitment to vigorous action to change it. They proposed to create several demonstration programs in humanities education at American schools. Although the group began with a religious orientation, it soon acquired a broader, more secular mission. As a result of shrewd political organizing, the group attracted members from within medicine, and was awarded a grant to promote the medical humanities. This paper describes these events and sets them in the context of the social and medical history of the 1960s and early 1970s.     

Depth of processing: When the principle of congruity fails

Two factors, level of processing (Craik & Lockhart, 1972) and congruity (Schulman, 1974), known to have large effects on the recall of experimenter-provided responses to questions, were examined in a series of five incidental learning experiments using subject-generated responses. The data show that manipulation of level of processing has the same effect on recall of subjectgenerated responses as it does on experimenter-provided responses. However, the effect of congruity is reversed for subject-generated responses. The data suggest that the difficulty of generating unrelated responses (“incongruous“ items) may account, at least in part, for the failure of the “principle of congruity“ with subject-generated responses.     

Tokens for stuttering

Four young stutterers were observed during 10 weekly sessions. Each session was divided into pretreatment, treatment, and posttreatment segments. Redeemable tokens were administered contingent upon stuttering behaviors in the treatment segment of the Experimental condition. In a Parallel Control condition, no tokens were administered during the entire session. The differences between the pretreatment and treatment segments were compared for the two conditions. Three subjects had dramatically fewer stuttering behaviors when tokens were being administered, while the fourth had more stuttering under the same condition. The subject whose stuttering increased had a history of therapy in which voluntary, “faked” stuttering had been called for, and the behaviors that increased were judged to be of this type. The decreases were interpreted as suggesting that the contingent tokens acted to countercondition the aversiveness of the stuttering experience, which reduced the anticipation of stuttering and hence the stuttering itself. The increase was felt to be simple reinforcement. The counterconditioning interpretation was borne out in two clinical applications in which money was presented contingent on stuttering behaviors judged to be aversive to the stutterer, and in which dramatically sudden, but long-lasting, improvement was seen.     

Organizational preparedness for change: Staff acceptance of an on-line computer-assisted assessment system

An on-line assessment system is briefly described. Previous positive evaluation studies are summarized. Results of studies of staff acceptance and staff preparedness for change are reported. Findings are interpreted in terms of the need for planning for change. Implications related to the acceptance of other on-line computer systems in psychology are discussed.