Dilemmas in military medical ethics since 9/11

The attack on the United States by terrorists on 9/11 and the war with Iraq have raised new ethical questions for the military and for military physicians (Herman 2002; Elshtain 2003). How and when attacks may occur now is less predictable. Planes have been hijacked, and persons dressed as civilians may carry bombs to blow themselves and others up. These dangers pose an increased threat, and, thus, there is a need for new defensive measures. How far these measures should go is, however, greatly open to debate. One of the most difficult ethical question raised for the military and military doctors by these developments is what interrogation methods are permissable when questioning captured terrorists. The licitness of different interrogation practices is, however, only one of the ethical problems potentially encountered by military physicians now having to treat terrorists and POWs. The following discussion presents the major concerns regarding this and other issues.     

Intentional pre-cueing does not influence the Simon effect

Choice reactions can be performed more quickly if the response corresponds spatially to the stimulus, even when the stimulus location is irrelevant for the task (Simon effect). It is assumed that the Simon effect is related to interference between spatial stimulus and response codes in a response selection stage. A central finding for such a response selection account is the increase in the effect if the most probable response location is given in advance by an intentional pre-cue. However, Hasbroucq and Possamaï (1994) assumed that the increase in the Simon effect in such a task may be due to an unmeant pre-cueing of the stimulus location, which has been recently supported by an electroencephalography (EEG) study by Wascher and Wolber (2004). In the present study this notion has been tested experimentally. In Experiment 1, a centrally presented symbolic cue served as an intentional cue. As a result, the enhancement of the Simon effect in valid cueing almost disappeared. When tactile cues were used (Experiment 2), the increase in the Simon effect disappeared completely. Thus, the influence of intentional cueing reported in previous studies can be assigned to attentional factors and does not support a response selection account.     

Revisiting the role of bad news in maintaining human observing behavior

Results from studies of observing responses have suggested that stimuli maintain observing owing to their special relationship to primary reinforcement (the conditioned-reinforcement hypothesis), and not because they predict the availability and nonavailability of reinforcement (the information hypothesis). The present article first reviews a study that challenges that conclusion and then reports a series of five brief experiments that provide further support for the conditioned-reinforcement view. In Experiments 1 through 3, participants preferred occasional good news (a stimulus correlated with reinforcement) or no news (a stimulus uncorrelated with reinforcement) to occasional bad news (a stimulus negatively correlated with reinforcement). In Experiment 4 bad news was preferred to no news when the absence of stimulus change following a response to the bad-news option was reliably associated with good news. When this association was weakened in Experiment 5 the results were intermediate. The results support the conclusion that information is reinforcing only when it is positive or useful. As required by the conditioned-reinforcement hypothesis, useless information does not maintain observing.     

Partial Reinforcement in a Bar-Pressing Situation with Preschool Children

Forty fifth- and sixth-grade children were given a list of names which they had prerated for Reinforcement Value in a free recall format. The prediction was made that high self-esteem children will learn their liked names more rapidly than their disliked names, but that low self-esteem children would show the reverse tendency. Although an RV-positive effect is noted in the sample, the expected reversal did not occur. A confounding factor proved to be intelligence, since it was impossible to divorce self-esteem from IQ in the sample investigated. The presentation closes with a discussion of the “logical learning theory” on which RV study is based, and the implications that this theory has for the role of self-induced behavior.     

Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

Probability matching: encouraging optimal responding in humans.

Two hundred undergraduate students participated in a repeated-trials binary choice procedure in which choice of one outcome was correct on 75% of trials. Subjects received 192 trials and were divided into five conditions: (1) control; (2) subjects were given the actual probabilities; (3) subjects were told if they did well they could leave early; (4) competition condition; (5) midway through the task subjects were asked to recommend a strategy for another subject. Half of the subjects in each group were told that the best they could do was to be correct on 75% of the trials. This manipulation permitted assessment of the hypothesis that subjects in probability-matching tasks are seeking a strategy that will be correct on 100% of the trials. The results partially confirmed this hypothesis. In addition, two of the variables improved performance significantly (giving probabilities and asking subjects to recommend a strategy). However, while subjects in all groups improved significantly over trials, optimal choice did not occur in this task.