The patient-physician relationship and the allocation of scarce resources: a law and economics approach

Patients with insufficient financial resources place physicians in a conflict of interest between the patients' needs and the financial interests of the physician, other patients, and society. Not only must physicians act ethically, but they must avoid liability for violating their legal duties to their patients. The traditional rules of contract and malpractice law that govern the patient-physician relationship do not provide satisfactory guidelines. Better answers are found in the rules of fiduciary law, but only with regard to direct conflicts between patients and physicians and only at the risk of reducing patient access to care. Certain types of legislative action can resolve these conflicts by altering the traditional legal rules, but care must be taken to preserve patient-physician trust, which the legal rules were designed to enhance.     

Success,social comparison,and self-assessment: Parents' midlife evaluations of sons,daughters, and self

The literatures on sex-role socialization and social comparison theory were used to predict how parents would evaluate the life success of adult sons and daughters and how parents' assessments of themselves would be influenced by comparisons with these children. Although parents (N=215) did not report different levels of life success for 291 adult sons versus 251 adult daughters, parental well-being was more closely tied to assessments of sons' success. In addition, although parents' reported that both sons and daughters had exceeded their own life success, theparent-child comparison with daughters was the better predictor of parents' well-being. Findings are discussed in terms of parents' individual development, family processes at midlife, and cohort differences between parents and their children.     

Bearing bad news: Dealing with the mimics of denial

Denial is a common label for certain reactions to bad news. However, true denial is rare, and most cases actually represent a variety of responses with very different causes and needs. Three of these, disbelief, deferral, and dismissal, are characterized according to origins and needs. Failure to differentiate between these seemingly similar behaviors can result in inappropriate counseling, and interfere with attempts to convey information and provide support during a time of crisis.     

Reflections on change in science and religion

Science and the Catholic church are both conservative, slow-to-change institutions. However, science has institutionalized procedures that ensure that ample amounts of criticism of currently accepted theories and methodologies will always be present. This arrangement of continuous conjectures and refutation in science ensures often slow but steady change. Because supporters often think of religions as trafficking in timeless truths, criticism of church beliefs and practices (even when intended to stimulate reflection and improvement) is frequently seen as being disloyal to the institution. Because of the growing crises caused by world overpopulation, I argue that the Catholic church's opposition to all artificial methods of birth control now lacks whatever moral force it might have had when originally promulgated. By highlighting theological perspectives that might be appropriate for the ecological realities of the 21st century, I hope the church will see the wisdom of reevaluating many of its positions in the light of rapidly approaching ecological imperatives.     

Teaching the Rescorla-Wagner model using STELLA-II

Although the Rescorla-Wagner model is widely taught in learning courses, most textbooks present a simplified version that does not contain all of its parameters. On the basis of Rescorla and Wagner 1972) and the Turbo PASCAL program by Lachnit, Schneider, Lipp, and Kimme! (1988), we created a simulation using STELLA-II, an icon-based program by High Performance Systems, Inc. We argue that this simulation facilitates teaching the complete Rescorla-Wagner model. Using trans-switching (Kimmel & Ray, 1978; Lachnit, 1986; Murrin & Kimmel, 1986) as an example, we demonstrate the effectiveness of the STELLA-II version of the Rescorla-Wagner model as a heuristic tool.     

Resetting the pitch-analysis system: 1. Effects of rise times of tones in noise backgrounds or of harmonics in a complex tone

The question of whether sudden increases in the amplitude of pure-tone components would perceptually isolate them from a more complex spectrum was investigated in two experiments. In Experiment 1, a 3.5-sec noise was played as a masker. During the noise, two pure-tone components of different frequencies appeared in succession. Subjects were asked to judge whether the pitch sequence went up or down. The rise time of these components had only a small and inconsistent effect on discrimination. In Experiment 2, the 3.5-sec background signal was a complex tone. The amplitudes of two of its components were incremented in succession. Again, subjects judged whether the pitch pattern went up or down. This time there was a sizable, monotonic effect of the rise time of the increments, with more rapid increments leading to better discrimination. The difference between the two results is interpreted in terms of the auditory system’s response to changing and unchanging signals and the role of its “sudden-change” responses in attracting perceptual processing to certain spectral regions.     

Contextual influences on interactive processing: Effects of discriminability,quantity, and uncertainty

Three contextual factors—(1) the discriminability of stimuli in pitch, (2) the number of stimuli differing in pitch, and (3)the uncertainty regarding which stimuli or tasks would appear—were manipulated as subjects performed speeded loudness classifications in each of six experiments. The magnitude of Garner interference and effects of congruity were used to gauge the degree of interactive processing. Enhancing pitch discriminability caused monotonic increases in interference and congruity. Stimulus-task uncertainty mediated the changes in Garner interference wrought by increased discriminability. Uncertainty also caused a surprising shift in congruity from strongly positive to strongly negative as uncertainty grew. Increasing stimulus quantity lowered interference, but had inconsistent effects on congruity. Regression analyses suggested that, collectively, these three contextual variables underlie most failures of selective attention in speeded classification.