Social Perceptions of Termination of Medical Treatment: Suicide or Rational Decision?

In two studies, college students read about a critically ill patient who died after CPR attempts failed, CPR was not attempted pursuant to a "Do-Not-Resuscitate" (DNR) order, he terminated all medical treatment, or he self-administered a lethal injection. Death resulting from treatment termination was perceived as significantly more unconventional than were death by CPR failure or DNR order. Ending treatment and lethal injection were perceived as equivalent acts of suicide, and resulted in the patient's being seen as less rational and less capable of making health care decisions. Timing of the patient's decisions regarding treatment, as indicated by the presence or absence of Living Will information, did not alter these perceptions. Results are discussed in light of opposing hypotheses regarding views of "naive" social perceivers toward actions with identical outcomes: that acts of commission are perceived as causal and rated more negatively than acts of omission (Spranca, Minsk, & Baron, 1991), and that acts seen as abnormal are attributed greater causal impact (Hilton & Slugoski, 1986).     

THE EFFECTS OF CONTINGENT AND NONCONTINGENT ATTENTION ON SELF-INJURY AND SELF-RESTRAINT

Self-restraint and self-injurious behavior (SIB) are two responses that can sometimes be members of the same functional response class (i.e., maintained by the same contingency). In such cases, a single treatment should be effective for both responses. In this investigation, we examined the effects of providing attention (the presumed reinforcer) both noncontingently and contingent upon either SIB or self-restraint. Results were consistent with our hypothesis that both responses were maintained by attention and suggested that noncontingent reinforcement was a potentially effective treatment.     

A PRELIMINARY PROCEDURE FOR PREDICTING THE POSITIVE AND NEGATIVE EFFECTS OF REINFORCEMENT-BASED PROCEDURES

In the current investigation, a modification was made to the preference assessment described by Pace, Ivancic, Edwards, Iwata, and Page (1985) to predict the effects of stimuli when used in a differential-reinforcement-of-other-behavior (DRO) schedule for 2 clients with severe self-injurious behavior (SIB) and profound mental retardation. Based on the results of the preference assessment, three types of stimuli were identified: (a) high-preference stimuli associated with high rates of SIB (HP/HS), (b) high-preference stimuli associated with relatively lower rates of SIB (HP/LS), and (c) low-preference stimuli associated with low rates of SIB (LP/LS). Consistent with the results of the preference assessment, the DRO schedule with HP/HS stimuli resulted in increased SIB, and the DRO schedule with LP/LS stimuli resulted in no changes in SIB. HP/LS stimuli were demonstrated reinforcers but did not result in a change in SIB when used in a DRO schedule. Thus, the stimulus preference assessment may be useful clinically in some situations for predicting both the beneficial and the negative side effects of stimuli in DRO procedures.     

CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Self-Optimization of Walking in Nondisabled Children and Children With Spastic Hemiplegic Cerebral Palsy

Children voluntarily adopt a frequency and movement pattern for walking. The force-driven harmonic oscillator (FDHO) model was used in this study for accurate prediction of the preferred walking frequency of nondisabled children and children with spastic hemiplegic cerebral palsy. Four potential optimality criteria with which the preferred walking pattern was forced to comply were examined: minimization of physiological costs, maximization of mechanical energy conservation, minimization of asymmetry in lower limb movements and minimization of variability of interlimb and intralimb coordination. Age and gender-matched nondisabled children (n = 6) and children with spastic hemiplegic cerebral palsy (n = 6) were tested under six frequency conditions of walking at a constant speed on a treadmill. For the nondisabled children, the results indicated that their preferred walking frequency could be accurately predicted by the FDHO model. They freely adopted a walking pattern that minimized physiological costs, asymmetry, and variability of inter- and intralimb coordination. For the children with spastic hemiplegic cerebral palsy, the prediction of preferred overground walking frequency required that the FDHO model be modified to account for muscle mass and leg length discrepancies between limbs and increased stiffness. Most of the children achieved the same optimality goals as the nondisabled when walking at the preferred frequency. However, the children were found to use different mechanisms to attain these goals: for example, a steeper increase observed in physiological cost at higher frequencies; a lowered center of gravity of the body, which allowed for angular symmetry; and greater variability of between-joint coordination in the nonaffected limb and less variability in the affected limb.     

Token reinforcement, choice, and self-control in pigeons.

Pigeons were exposed to self-control procedures that involved illumination of light-emitting diodes (LEDs) as a form of token reinforcement. In a discrete-trials arrangement, subjects chose between one and three LEDs; each LED was exchangeable for 2-s access to food during distinct posttrial exchange periods. In Experiment 1, subjects generally preferred the immediate presentation of a single LED over the delayed presentation of three LEDs, but differences in the delay to the exchange period between the two options prevented a clear assessment of the relative influence of LED delay and exchange-period delay as determinants of choice. In Experiment 2, in which delays to the exchange period from either alternative were equal in most conditions, all subjects preferred the delayed three LEDs more often than in Experiment-1. In Experiment 3, subjects preferred the option that resulted in a greater amount of food more often if the choices also produced LEDs than if they did not. In Experiment 4, preference for the delayed three LEDs was obtained when delays to the exchange period were equal, but reversed in favor of an immediate single LED when the latter choice also resulted in quicker access to exchange periods. The overall pattern of results suggests that (a) delay to the exchange period is a more critical determinant of choice than is delay to token presentation; (b) tokens may function as conditioned reinforcers, although their discriminative properties may be responsible for the self-control that occurs under token reinforcer arrangements; and (c) previously reported differences in the self-control choices of humans and pigeons may have resulted at least in part from the procedural conventions of using token reinforcers with human subjects and food reinforcers with pigeon subjects.     

Erikson,psychology, and religion

The writings of the late Erik H. Erikson (1) have contributed directly to the psychological study of religion, (2) were amenable to the efforts of others to develop normative theological arguments, and (3) might be seen as themselves examples of contemporary, nontheological accounts of the religious dimension of human existence. This paper begins by reviewing the principal contributions that Erikson made to the psychological study of religion, followed by a review of the uses that have been made of Erikson's work for normative/constructive activities in such areas as practical theology and pastoral counseling. I will then argue that Erikson's writings — when viewed in the vein of William James's radical empiricism and functionalist accounts of human religiosity — identify an irreducibly religious dimension to normative human functioning. Erikson's functionalism constitutes a form of nontheological religious thinking that speaks directly to concerns presenting themselves in contemporary culture.     

THE DANTO-WOLLHEIM MEANING THEORY OF ART

Arthur Danto in The Transfiguration of the Commonplace and Richard Wollheim in Painting as an Art have each advanced a certain meaning theory of art (MT), more specifically, a theory according to which something is a work of art just in case it expresses a proposition. The first part of this essay sets out that view in more detail, with textual support that Danto and Wollheim do in fact hold that theory. The second part offers reasons against accepting MT. (1) There seem to be persuasive counterexamples to MT: objects that are clearly works of art but which do not appear to exhibit any tendency towards propositionality. (2) Neither theorist provides an explanation as to why someone with something to say would choose to, as it were, hide his thought behind a painting. (3) MT will force a theory of the evaluation of art that parallels the evaluation of (say) scientific or philosophical thought. Artworks will be judged according to the profundity of the thoughts they express rather than by their aesthetic features – which would make Duchamp a greater artist than Monet!     

Expressing a Good Will: Kant on the Motive of Duty

If any action is to be morally good it is not enough that it should conform to the moral law-it must also be done for the sake of the moral law: where this is not so, the conformity is only too contingent and precarious, since the nonmoral ground at work will now and then produce actions which accord with the law, but very often actions which transgress it.     

Group aggregates and individual reliability: The case of verbal short-term memory

Two experiments examined the generalizability of the effects of word length and phonological similarity with visual and auditory presentation in immediate verbal serial ordered recall. In Experiment 1, data were collected from 251 adult volunteers drawn from a broad cross-section of the normal population. Word length and phonological similarity in both presentation modes significantly influenced the group means. However, 43% of the subjects failed to show at least one of the effects, and the likelihood that effects appeared was highly correlated with verbal memory span. In Experiment 2, 40 subjects of the original sample were retested, 20 of whom had failed to show one or more effects in Experiment 1. Whether or not an effect had appeared for individual subjects on the first test session was a poor predictor of whether the effect would appear on retest. Finally, an analysis of subject reports demonstrated that the patterns of experimental data could be accounted for in part by the strategies that subjects reported using, and the effect of strategy was independent of the effect of span. The implications of these findings for theories of verbal short-term memory are discussed.