Conscience and conscientious actions in the context of MCOs

Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.     

Book reviews

Socializing Epistemology: The Social Dimensions of Knowledge, Frederick F. Schmitt, Ed., 1994. Lanham, MD, Rowman and Littlefield, ix + 315 pp., US$22.95, ISBN: 0847679594

A Dynamic Systems Approach to the Development of Cognition and Action, Esther Thelen & Linda B. Smith. Cambridge, MA, MIT Press, xxii + 376 pp., $50, ISBN 0–262–20095–3 cloth

From Kant to Hilbert: A Source Book in the Foundations of Mathematics, William B. Ewald, Ed., 1996. Oxford, Oxford University Press. xviii+ 1340 pp., £195.00, two volumes, ISBN 0–19–853271–7 (the set)     

Chaos and God's Abundance: An Ontology of Variety in the Divine Life

The primordial chaos of Genesis 1 may be understood as the Pandemonium Tremendum (or PT), the infinite field of variety or abundance within God. The concept of variety is taken from Claude Shannon's theory of communication. Especially significant is Shannon's notion that communication is the limitation of variety through decision processes. In one model of the divine life suggested by the theory, the PT is the boundless source of potential reaped by an agential God in the act of creation as a communication process. Other models for creation include the PT in a biased mode and creatures themselves as decision agents.     

CLUSTERS PRECEDE SHAPES IN PERCEPTUAL ORGANIZATION

Abstract —Does perceptual grouping require attention? Recent controversy on this question may be caused by a conflation of two aspects of grouping: element clustering (determining which elements belong together) and shape formation (determining cluster boundaries). In Experiment 1, observers enumerated diamonds that were drawn with either lines or dots. These two types of stimuli were subitized (enumerated rapidly and accurately in the range from one to three items) equally well, suggesting that clustering dots into countable entities did not detnand attention. In contrast, when target diamonds were enumerated among distractor squares in Experiment 2. only line-drawn items could be subitized. We propose that clustering and shape formation not only involve different perceptual processes, but play different functional roles in vision.     

Adjusting Social Inferences in Familiar and Unfamiliar Domains: The Generality of Response to Situational Pragmatics

Two experiments investigated the influence of situational pragmatics on the selective use of specific instances and generalized knowledge structures to make social inferences. In Experiment 1, social inferences were made in an unfamiliar domain similar in structure to a typical situation of social greetings and address, but devoid of useful cues to social schemas. Participants were told that either one or another of the features of the situation was more pragmatically important for deriving inferences about appropriate social behaviour; consistent with predictions from a computational model of analogical mapping (ACME), they made reliable inferences based on analogies to specific instances, with the situational importance of relations guiding the selection of the optimal analogue. In Experiment 2, social inferences were examined in the more familiar domain of predicting social behavior between low and high status persons and between members of an ingroup and an outgroup in Japan. The availability of specific examples was varied, as was the perceived importance of status and group membership. The situation was isomorphic to that in the first experiment, except for the availability of generalized knowledge structures to guide inferences. Participants made relatively veridical inferences that were sensitive to variations in the pragmatic importance of dimensions. Provision of specific analogues had little impact on inferences, suggesting that participants were relying instead on more general and cross-culturally applicable knowledge about adjusting social relations according to situational pragmatics.     

Social Dominance Orientation, Hierarchy Attenuators and Hierarchy Enhancers: Social Dominance Theory and the Criminal Justice System

This study investigated differences in social dominance orientation between incumbents of different social roles (police officers vs. public defenders) and ethnic groups known to differ in general social status (i.e., whites vs. blacks and Hispanics). Consistent with theoretical expectations: (a) Police were significantly more social-dominance oriented than either jurors or public defenders. (b) Public defenders tended to be less social-dominance oriented than jurors. (c) Euro-Americans were significantly more social dominance oriented than Afro- and Hispanic-Americans, (d) Euro-American police officers had, by far, the highest levels of social dominance orientation. Furthermore, all of the effects above held even when controlling for demographic factors such as gender, social class, age, education, and ethnic group. The theoretical implications of these findings are discussed.     

Loomingness and the Fear of AIDS: Perceptions of Motion and Menace

The authors examined the role of "perceived loomingness" in fear of HIV. Perceived loomingness refers to perceptions of rapid forward movement and instantaneous changes in the distance and danger of a potential threat (Riskind, 1992). One hundred and twenty undergraduates rated vignettes of two public encounters with an HIV-positive stranger. High-HIV fear subjects perceived greater loomingness and danger in these vignettes than did low-HIV fear subjects. Regression analyses that tested for a mediated model confirmed that the perceptions of loomingness may spark threat cognitions (such as the probability and imminence of harm), which, in turn, lead to fear. As predicted by the harm-looming model, loomingness also had some effects on fear that were not mediated by such standard threat cognitions.     

Jurors' Decisions in Trials of Battered Women Who Kill: The Role of Prior Beliefs and Expert Testimony1

The present research explored the influence of four factors on mock jurors' decisions in a homicide trial involving a battered woman who killed her abusive husband: (a) jurors' preexisting beliefs about wife abuse, (b) the presence of expert testimony on the battered woman syndrome, (c) jurors' beliefs in a just world, and (d) gender. Mock jurors listened to a trial involving a woman who had killed her abuser, which either contained expert testimony or did not, and then rendered various judgments about the case. Results indicated that those individuals who were more informed about the dynamics of abuse and those exposed to the expert testimony, compared to their respective counterparts, were more believing of the battered woman's account of what occurred. In general, weak believers in a just world were more lenient in their judgments, with verdicts of not guilty being associated with weaker beliefs in a just world than guilty verdicts. Weak believers in a just world also felt that the expert testimony applied more to the defendant than did strong believers. Finally, women who were weak believers in a just world were less likely to hold the defendant responsible for the events and to be more informed about the dynamics of abuse following the experiment.