Act First and Look Up the Law Afterward?: Medical Malpractice and the Ethics of Defensive Medicine

This essay examines the so-called phenomenon of "defensive medicine" and the problematic aspects of attempting to maintain the safest legal position possible. While physicians face genuine litigation threats they frequently overestimate legal peril. Many defensive practices are benign, but others alter patient care and increase costs in ways that are ethically suspect. Physicians should learn to evaluate realistically the legal risks of their profession and weigh the emotional, physical, and financial costs to the patient before employing a defensive measure.     

Evaluative Conditioning Is a Form of Associative Learning: On the Artifactual Nature of Field and Davey's (1997) Artifactual Account of Evaluative Learning

Field and Davey (1997) claimed that evaluative conditioning (EC), rather than being a genuine type of Pavlovian associative learning, represents nothing but an experimental artifact. They come to this conclusion by first identifying the prototypical experimental procedure of EC research, by next pointing to the potential methodological shortcomings of this prototypical procedure in order to infer associative learning, and by finally demonstrating that when the appropriate controls are added to this prototypical procedure, it becomes clear that apparent EC results represent nothing but an experimental artifact. In this paper, we first demonstrate that what Field and Davey identify as the “prototypical procedure” is, as a matter of fact, the exception rather than the rule in EC research, such that the potential scope of their criticism is rather limited. Next, we show how the results of their own experiment are actually due to an artifact that is not present in any EC study. Finally, we discuss how Field and Davey's criticism of EC research has its roots in a misconception of the appropriate within or between subject controls for Pavlovian associative learning.     

Frustration and instrumentality of aggression

The influence of two different reinforcers of aggression was investigated: Frustration (intrinsic primary reinforcement) and instrumental value of aggression (extrinsic primary reinforcement). In the first part of the experiment frustration was manipulated on two levels by having the stooge interfere very often or seldom in the ?building a village' task of the subject. In the second part of the study the stooge had to judge distances in traffic while the subject was allowed to give him electrical shocks in order to startle and hinder the stooge in his estimation task. The aggression score of the subject was formed by the number and the intensity of the shocks delivered. Instrumentality of aggression was manipulated on two levels by indicating or not that the subjects could earn more money the more and stronger they shocked their partner. Confirming the predictions, significantly more aggression was expressed when this could lead to earning more money than in those conditions where this was not the case. Also confirming predictions, the impact of instrumentality on aggression was stronger than the influence of frustration. Frustration did not lead to a significant increase in the level of aggression.