Imagining the End of Life: On the Psychology of Advance Medical Decision Making

Near the end of life, individuals often become too ill to express their wishes about the use of life-sustaining medical treatment. Instructional advance directives (i.e., livings wills) are widely advocated as a solution to this problem based on the assumption that healthy people can predict the types of medical treatment they will want to receive if they become seriously ill. In this paper, we review a large body of research from the psychological and medical literatures that challenges this assumption. This research demonstrates that across a wide variety of decision contexts people show limited ability to predict their affective and behavioral reactions to future situations. We outline several ways that policy and law regarding the use of advance directives could be informed by this research, and suggest a number of issues involved in advance medical decision making that could benefit from additional empirical and conceptual attention.

Architectural design of a secure forensic state psychiatric hospital

This article describes the architectural design of a secure forensic state psychiatric hospital. The project combined input from staff at all levels of the client organization, outside consultants, and a team of experienced architects. The design team was able to create a design that maximized patient dignity and privacy on one hand, and the ability of staff to observe all patient activity on the other. The design centers around 24-bed units, broken into smaller living wings of eight beds each. Each eight-bed living wing has its own private bathrooms (two) and showers (two), as well as a small living area solely reserved for these eight patients and their guests. An indoor-outdoor dayroom allows patients to go outside whenever they choose, while allowing staff to continue observing them. The heart of the facility is a large treatment mall, designed to foster the acquisition of social, emotional, cognitive, and behavioral skills that will help patients to safely return to their communities.     

A dynamical systems interpretation of a dimensional model of emotion

The dimensional structure of emotion was investigated using self reports of induced mood and idiographic and nomothetic analyses. Subjects attended four experimental sessions during which an array of affective states was induced via auditory, visual, and imaginal channels. For each of 118 stimulus events, subjects self-rated their response. Factor analysis yielded the predicted bipolar factors of valence and arousal: these were obtained in group-aggregated analysis and subsequently confirmed as change dimensions at the intraindividual level. Controversy over the fundamental dimensions of affective space was considered with respect to methodological issues such as factor rotation and sampling of data space. Valence and arousal are discussed as motivational, driving parameters of affective experience and a dynamical systems conceptualization of emotion is proposed.     

Employee theft in the restaurant trade: Forms of ripping off by waiters at work

The variety of part‐time theft techniques used by waiters in the restaurant trade is examined using a self‐report methodology. Using twelve hypothetical cases of ripping off in restaurants, three potential theft targets are assessed: the restaurant, customers of the restaurant, and co‐workers. Predictions about the frequency of involvement of these theft activities are tested using a sample of waiters in four “prime rib” restaurants. Hypotheses dealing with working conditions and the ability to neutralize moral controls against theft are presented to explain which waiters will be involved in employee theft. The theoretical implications of “amateur trading” and pecuniary‐based theft are developed in order to show the critical role that theft activities play in the work setting of the restaurant. The findings have implications for the “controlled larceny” solution to the problem of employee theft suggested by some observers.     

Perceptions of punishment for crime

A survey questionnaire administered to 662 university undergraduates is used to assess patterns of perceptions of punishment. Results show that the nature of the crime, characteristics of criminal offenders, and characteristics of respondents affect the nature of punishment assigned for 25 criminal offenses.     

Trying But Failing: Implicit Attitude Transfer Is Not Eliminated by Overt or Subtle Objectivity Manipulations

People with mental illness experience discrimination, paternalistic treatment, and avoidance. To facilitate assessment of such experiences, the authors developed the Multifaceted Stigma Experiences Scale. It assesses four dimensions of experienced stigma in interpersonal interaction: hostile discrimination, benevolent discrimination, taboo, and denial. The influence of stigma experiences on mental health was modeled in a two-wave panel with persons with mental illness (N = 367, 79% repeated response rate). Results indicate that both subtle and blatant forms of stigma constitute a barrier to recovery and may be interpreted as attempts to increase social distance and reinforce the existing social order.     

TRANSCENDING OUR BIOLOGY: A VIRTUE ETHICS INTERPRETATION OF THE APPEAL TO NATURE IN TECHNOLOGICAL AND ENVIRONMENTAL ETHICS

“Arguments from nature” are used, and have historically been used, in popular responses to advances in technology and to environmental issues—there is a widely shared body of ethical intuitions that nature, or perhaps human nature, sets some limits on the kinds of ends that we should seek, the kinds of things that we should do, or the kinds of lives that we should lead. Virtue ethics can provide the context for a defensible form of the argument from nature, and one that makes proper sense of its enduring role in debates concerning our relationship to technology and the environment. However, the notion of an ethics founded upon an account of the essential features of human nature is controversial. On the one hand, contemporary biological science no longer defines species by their essential characteristics, so from a biological point of view there just are no essential characteristics of human beings. On the other hand, it might be argued that humans have, in some sense, “transcended our biology,” so an understanding of humans as a biological species is extraneous to ethical questions. In this article, I examine and defend the argument from nature, as a way to ground an ethic of virtue, from some of the more common criticisms that are made against it. I argue that, properly interpreted as an appeal to an evaluative account of human nature, the argument from nature is defensible with the context of virtue ethics and, in this light, I show how arguments from nature made in popular responses to technological and environmental issues are best understood.     

Working memory, fluid intelligence, and impulsiveness in heavy media multitaskers

Ophir, Nass, and Wagner (Proceedings of the National Association of Sciences 106:15583–15587, 2009) reported that individuals who routinely engage in multiple forms of media use are actually worse at multitasking, possibly due to difficulties in ignoring irrelevant stimuli, from both external sources and internal representations in memory. Using the media multitasking index (MMI) developed by Ophir et al., we identified heavy media multitaskers (HMMs) and light media multitaskers (LMMs) and tested them on measures of attention, working memory, task switching, and fluid intelligence, as well as self-reported impulsivity and self-control. We found that people who reported engaging in heavy amounts of media multitasking reported being more impulsive and performed more poorly on measures of fluid intelligence than did those who did not frequently engage in media multitasking. However, we could find no evidence to support the contention that HMMs are worse in a multitasking situation such as task switching or that they show any deficits in dealing with irrelevant or distracting information, as compared with LMMs.     

Disclaimer labels on fashion magazine advertisements: Effects on social comparison and body dissatisfaction

Recent proposals across a number of Western countries have suggested that idealised media images should carry some sort of disclaimer informing readers when these images have been digitally enhanced. The present studies aimed to experimentally investigate the impact on women's body dissatisfaction of the addition of such warning labels to fashion magazine advertisements. Participants were 120 and 114 female undergraduate students in Experiment 1 and Experiment 2 respectively. In both experiments, participants viewed fashion magazine advertisements with either no warning label, a generic warning label, or a specific more detailed warning label. In neither experiment was there a significant effect of type of label. However, state appearance comparison was found to predict change in body dissatisfaction irrespective of condition. Unexpectedly, trait appearance comparison moderated the effect of label on body dissatisfaction, such that for women high on trait appearance comparison, exposure to specific warning labels actually resulted in increased body dissatisfaction. In sum, the present results showed no benefit of warning labels in ameliorating the known negative effect of viewing thin-ideal media images, and even suggested that one form of warning (specific) might be harmful for some individuals. Accordingly, it was concluded that more extensive research is required to guide the most effective use of disclaimer labels.