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.     

WORKING MEMORY CAPACITY DISSOCIATES LEXICAL AND SENTENTIAL CONTEXT EFFECTS

Abstract— Semantically associated and unassociated word pairs were embedded in normal meaningful sentences and in sentences that were semantically anomalous throughout The influence of lexical context was isolated via comparison of responses to the second words of the associated and unassociated pairs. The influence of sentence-level context was isolated by comparing responses to the same words in the two sentence types Subjects of high, medium and low working memory capacity (as evaluated by the reading span test) showed modulations of event-related brain potentials in response so lexical context. In contrast, only the high- and medium-capacity groups were responsive to purely sentence-level semantic context. The results demonstrate that sentential context influences the processing of words in intermediate sentence positions at normal reading speeds but that the on-line utilization of this context is more demanding of working memory than single-word contexts.     

Changes in Newcomers' Person–Climate Fit following the First Stage of Socialization

The development of attitudes and activities of newcomers in the 18 months following the first period of socialization was investigated. At two points in time, persons' preferences for seven work climates were compared with perceived climate. Changes in person-climate fit were assessed, using a squared difference index, after alternative fit-indices were tested with hierarchical regression analysis. Person-climate fit and work attitudes at T1 (eight to ten months after entry) were examined by comparing three groups of respondents who did not change jobs, changed jobs within the organization or changed organizations. Results showed no alpha, beta or gamma changes for the total group of 108 respondents. Alpha changes were only found for respondents who changed jobs. They showed higher ratings for job satisfaction at T2. Finally, work attitudes at T1 were related to turnover. Organizational changers showed higher turnover intentions and higher discrepancies between preferred and perceived risk orientation and work pressure at T1.     

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.