Political and interpersonal aspects of ethics consultation

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record.     

Induction,focused sampling and the law of small numbers

Hilary Kornblith (1993) has recently offered a reliabilist defense of the use of the Law of Small Numbers in inductive inference. In this paper I argue that Kornblith's defense of this inferential rule fails for a number of reasons. First, I argue that the sort of inferences that Kornblith seeks to justify are not really inductive inferences based on small samples. Instead, they are knowledge-based deductive inferences. Second, I address Kornblith's attempt to find support in the work of Dorrit Billman and I try to show that close attention to the workings of her computational model reveals that it does not support Kornblith's argument. While the knowledge required to ground the inferences in question is perhaps inductively derived, Billman's work does not support the notion that small samples provide a reliable basis for our generalizing inferences.     

NONCONTINGENT ESCAPE AS TREATMENT FOR SELF-INJURIOUS BEHAVIOR MAINTAINED BY NEGATIVE REINFORCEMENT

We extended research on the role of noncontingent positive reinforcement following a functional analysis of attention-maintained self-injurious behavior to self-injury maintained by negative reinforcement in 2 young males with developmental disabilities. During a pretreatment functional analysis, each participant's self-injury was shown to be differentially sensitive to escape from instructional activities as negative reinforcement. During noncontingent escape, escape from learning activities was provided on a fixed-time schedule that was not influenced by the participant's behavior. One participant was also exposed to differential negative reinforcement of other behavior. During this condition, escape from instructional activities was provided contingent on the omission of self-injury for prespecified intervals. Results showed that the provision of escape, even when noncontingent, resulted in significant reductions in self-injury. These results are particularly interesting in light of the experimental history of noncontingent reinforcement as a control rather than as a therapeutic procedure. Noncontingent escape is discussed as a form of extinction that may be less likely than other forms of extinction to produce severe side effects.     

NEGATIVE SIDE EFFECTS OF NONCONTINGENT REINFORCEMENT

Noncontingent reinforcement (NCR) has emerged as a treatment package for severe behavior problems. Although concerns about potential side effects (such as incidental reinforcement) have been raised, there have been few reported negative side effects in published studies to date. In this article, we report an NCR treatment evaluation for severe aggression that produced (a) an extinction burst and (b) incidental reinforcement. These side effects were evaluated by examining within-session response patterns and response distributions. As a solution, a brief omission contingency was added to the reinforcement schedule. The omission contingency resulted in decreased aggression rates.     

BERTRAND RUSSELL'S 1897 CRITIQUE OF THE TRADITIONAL THEORY OF MEASUREMENT

Synthese - The transition from the traditional to the representational theory of measurement around the turn of the century was accompanied by little sustained criticism of the former. The most...     

Sex-role preferences in four age levels

Brown's (1956a; 1956b) influential finding that girls of all ages exhibit masculine rather than feminine sex-role preferences has been challenged by the argument that the scale used in his studies—the It Scale for Children (ITSC)—is masculine biased. The present investigation reexamined this issue with an instrument designed to be free of the limitations inherent in the ITSC. Boys and girls from grades 2, 5, 8, and 11 examined drawings of activities scaled for sex-role stereotypy and selected those activities they would like to engage in. Consistent with Brown's earlier work, boys exhibited strong masculine preferences at all ages. Contrary to Brown, however, girls did not show similar masculine preferences. Instead, their choices reflected strong feminine preferences throughout the spectrum of ages tested.