Projection in surrogate decisions about life-sustaining medical treatments.

To honor the wishes of an incapacitated patient, surrogate decision makers must predict the treatment decisions patients would make for themselves if able. Social psychological research, however, suggests that surrogates' own treatment preferences may influence their predictions of others' preferences. In 2 studies (1 involving 60 college student surrogates and a parent, the other involving 361 elderly outpatients and their chosen surrogate decision maker), surrogates predicted whether a close other would want life-sustaining treatment in hypothetical end-of-life scenarios and stated their own treatment preferences in the same scenarios. Surrogate predictions more closely resembled surrogates' own treatment wishes than they did the wishes of the individual they were trying to predict. Although the majority of prediction errors reflected inaccurate use of surrogates' own treatment preferences, projection was also found to result in accurate prediction more often than counterprojective predictions. The rationality and accuracy of projection in surrogate decision making is discussed.     

CORRESPONDENCE

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How Adolescent Children of African Jamaican Immigrants Living in Canada Perceive and Negotiate their Roles within a Matrifocal Family

This research project examined the adolescent/young adult-parent relationships of African Jamaican immigrants currently living in Canada. Specifically, we focused on the transmission of cultural values and beliefs within these relationships and how the adolescents navigated and negotiated potential changes in these values because of their acculturative experiences. An examination of various mundane family/cultural practices provided insight into perceived transmission attempts by parents and the adolescent/young adult interpretation of these attempts. Twenty in-depth interviews were conducted with adolescent/young adult members of African Jamaican immigrant families living in Canada. Using Grounded Theory methodology (Glaser & Strauss, 1967), several themes emerged during the analysis of the interviews—the most significant being the issue of matrifocality within the African Jamaican family. Issues of respect and adolescent agency are also discussed as they related to the manner in which the adolescent/young adult attempted to negotiate various roles within the family.     

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Sometimes therapists assume that gender equality is not relevant when working with couples from traditional cultures. This study of couples in Iran suggests more complexity. The authors identify a variety of views and practices regarding equality between men and women in relationships. Some aspired to traditional roles; others attempted to create mutually supportive relationships. Yet others were somewhere in-between. This study helps identify important dimensions that may be overlooked when we define couple equality only by American standards or understand it only through a Western lens. The study provides insight into the dilemmas couples face when ideals of equality intersect with societal structures that maintain gendered power and offers suggestions for addressing gender when working with couples with traditional cultural backgrounds.     

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