The dead donor rule: should we stretch it, bend it, or abandon it?

The dead donor rule--that persons must be dead before their organs are taken--is a central part of the moral framework underlying organ procurement. Efforts to increase the pool of transplantable organs have been forced either to redefine death (e.g., anencephaly) or take advantage of ambiguities in the current definition of death (e.g., the Pittsburgh protocol). Society's growing acceptance of circumstances in which health care professionals can hasten a patient's death also may weaken the symbolic importance of the dead donor rule. We consider the implications of these efforts to continually revise the line between life and death and ask whether it would be preferable to abandon the dead donor rule and rely entirely on informed consent as a safeguard against abuse.     

Toward a new conceptualization and operationalization of risk perception within the genetic counseling domain

The purpose of this paper is twofold. First, it provides an historical overview of studies of risk, risk perception, and decision making under risk within the genetic counseling domain. Second, it proposes an alternative conceptualization and operationalization for the study of risk perception. The conceptualization involves probability, adversity, incompleteness, and ambiguity. Prior studies of risk perception focus on the recurrence risk and operationalize risk perception by asking for interpretations of the magnitude of the probability of the outcome. Their focus is on the probability of a particular outcome. We formulate the problem in terms of a gamble and suggest that risk perception be operationalized in terms of the riskiness of the gamble. Our focus is on the riskiness of a decision option which entails two or more outcomes.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

The role of haptic versus visual volume cues in the size-weight illusion

Three experiments establish the size-weight illusion as a primarily haptic phenomenon, despite its having been more traditionally considered an example of vision influencing haptic processing. Experiment 1 documents, across a broad range of stimulus weights and volumes, the existence of a purely haptic size-weight illusion, equal in strength to the traditional illusion. Experiment 2 demonstrates that haptic volume cues are both sufficient and necessary-for a full-strength illusion. In contrast, visual volume cues are merely sufficient, and produce a relatively weaker effect. Experiment 3 establishes that congenitally blind subjects experience an effect as powerful as that Of blindfolded sighted observers, thus demonstrating that visual imagery is also unnecessary for a robust size-weight illusion. The results are discussed in terms of their implications for both sensory and cognitive theories of the size-weight illusion. Applications of this work to a human factors design and to sensor-based systems for robotic manipulation are also briefly considered.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.     

Transitional phenomena as evidenced in prayer

In this paper, we demonstrate that the study of prayer facilitates understanding of the deeply personal object related nature of religious experience. Within prayer, individuals enter the transitional sphere and meet their God representation. Both conscious and unconscious aspects of prayer can be made available through the use of a projective test developed by the authors, known as STARR: Spiritual Themes and Religious Responses test. The data obtained suggest the usefulness of Winnicottian concepts of transitional phenomena, playing, communicating, and capacity to be alone as a contemporary psychoanalytic framework for interpreting religious experience.     

What is a difficult mental health case? An empirical study of relationships among domain variables

A difficult case in psychotherapy can be defined in many ways. This study proposes a model for that definition, in which three domains (patient characteristics, case characteristics, and therapist characteristics) are considered to impact on that definition. A total of 264 professionals received a questionnaire to assess the relative importance of a series of variables within and across these domains. Wilcoxon Matched-Pairs Signed-Ranks tests indicated that patient characteristics were considered more important than therapist or case characteristics in defining a difficult case. Case characteristics were considered more important than therapist characteristics. Pearson correlations, however, suggested that the three domains in the model are related. Correlations (for years of experience) and Kruskal-Wallis one-way ANOVA for ranks (for professions) also indicated that participants were able to identify variables within domains as important in that definition regardless of years of experience or professions. Across domains, the most important variables included the motivation of the client (a patient characteristic), dropout/attrition and multiple diagnoses (case characteristics), and the degree of therapist-client racial similarity (a therapist characteristic).