In re Edna MF: Case Law Confusion in Surrogate Decision Making

I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires.     

Recall of short word lists presented visually at fast rates: Effects of phonological similarity and word length

Phonological similarity of visually presented list items impairs short-term serial recall. Lists of long words are also recalled less accurately than are lists of short words. These results have been attributed to phonological recoding and rehearsal. If subjects articulate irrelevant words during list presentation, both phonological similarity and word length effects are abolished. Experiments 1 and 2 examined effects of phonological similarity and recall instructions on recall of lists shown at fast rates (from one item per 0.114-0.50 sec), which might not permit phonological encoding and rehearsal. In Experiment 3, recall instructions and word length were manipulated using fast presentation rates. Both phonological similarity and word length effects were observed, and they were not dependent on recall instructions. Experiments 4 and 5 investigated the effects of irrelevant concurrent articulation on lists shown at fast rates. Both phonological similarity and word length effects were removed by concurrent articulation, as they were with slow presentation rates.     

Innate talents: reality or myth?

Talents that selectively facilitate the acquisition of high levels of skill are said to be present in some children but not others. The evidence for this includes biological correlates of specific abilities, certain rare abilities in autistic savants, and the seemingly spontaneous emergence of exceptional abilities in young children, but there is also contrary evidence indicating an absence of early precursors of high skill levels. An analysis of positive and negative evidence and arguments suggests that differences in early experiences, preferences, opportunities, habits, training, and practice are the real determinants of excellence.     

Electrodermal activity and extraversion: Caffeine,preparatory signal and stimulus intensity effects

The Eysenck hypothesis that introverts are more and extraverts less cortically aroused has been supported by the results of most electrodermal studies, though there is some inconsistency in the literature. Further tests of the hypothesis can be carried out using arousal-manipulation paradigms. Some studies have used caffeine or stimulus intensity to increase arousal, as was also the case in the present study. The latter, however, also introduced a preparatory signal, which may be expected under certain conditions, to reduce responses to the stimulus which follows it. Extraverts and introverts were randomly assigned to receive low, medium or high doses of caffeine or a placebo. Each S then heard two sets of tones with the tones in one set preceded by a preparatory signal. Results showed that the preparatory signal reduced phasic amplitudes only at the highest levels of stimulus intensity. Introverts had higher overall SCLs and response magnitudes. In addition, the preparatory signal had little effect on extraverts, but reversed dosage-related response patterns in introverts. Results were supportive of the basic Eysenck arousal hypothesis and also showed that the arousal difference leads to attentional variability between the two groups.     

Learning about water by hungry rats

In Experiments 1 and 2 hungry rats were trained in a straight alley with consistent food reward (FF), food and nonreward trials intermixed (FN), or food and water trials intermixed (FW). In Experiment 1 rats were tested with nonrewarded trials (extinction) and Groups FN and FW did not differ, both running faster then Group FF. In Experiment 2 rats were tested with consistent water reward, and Group FW ran faster then Group FN, which was superior to Group FF. In Experiment 3, one group of hungry rats was trained on a single alternating schedule of food and water in Phase 1 and was shifted to a single alternating schedule of food and nonreward in Phase 2 (Group FW); the second group (Group FN) received a single alternating schedule of food and nonreward in both phases. When Group FW was shifted to nonreward from water, performance to nonreward was temporarily disrupted. These results indicate that, contrary to previous conclusions, hungry rats can learn about water when drive is strong and food is received in the situation.     

Recency effects in memory,as a function of modality of intervening events

Summary Word lists of fifteen items were presented to eye or to ear, with recall either immediately, or after a visual task, or after an auditory one. Instructions were to recall the last items first. An intervening task using the same modality greatly reduced recall of the last items presented; whereas a visual task did not do so for acoustically presented items. An auditory task reduced visual memory. These results suggest a specific auditory memory for recent events, over-written by subsequent auditory events.This research was supported by the Medical Research Council. The experimental work was performed at the Applied Psychology Unit, Cambridge.     

Perceived probability and evaluation of balance,agreement, and attraction: Toward a solution of conflicting results

Fifty-four subjects rated sixteen hypothetical situations on four evaluative and four probability scales. The situations were of the P-O-X type, consisting of two persons and an issue. A2×2×2×2 factorial design was used to test the relative importance of attitude (P to × relation), issue (marijuana or premarital sex), agreement (P to × and O to × relations), attraction (P to O relation), and balance (agreement × attraction interaction) on the evaluation and probability variables. As predicted from a critical review of past research on balance theory, balance was the main determinant of perceived probability. Attraction was the main determinant of evalution. In light of a review of past balance research and of the present data, we propose to restrict the balance hypothesis to cognitive variables, i.e., expectancy and perceived probability. In addition, support was obtained for the hypothesis that the more dogmatic a person is, the more frequently he will perceive balanced relationships as occurring and the more positively he will evaluate balanced situations.     

Variations in gender-role equality among classes: A research note

A widely accepted view describes gender-role inequality as less prevalent among the middle class than the working class. Gender-role inequality within the intact nuclear family is asserted to be a syndrome characterized by unequal husband—wife authority, rigid division of household labor, and greater freedom in leisure pursuits for the husband. This view is generally unsupported by the findings of the present study, a secondary analysis of a sample survey conducted in Houston in 1969–1970. Two classes (working and middle) were compared, with ethnicity (Anglo, Black, Mexican-American) and sex controlled. Questionnaire items concerned leisure-time freedom for wives, gender differences in children's socialization, and sexual division of labor in the household. Differences between groups were generally small and inconsistent. In some cases, sexual and ethnic differences were greater than those of class. An intercorrelation matrix revealed few significant correlations between egalitarian responses to the various items, suggesting that egalitarianism or its opposite is not a syndrome.This paper utilized data collected on a project partially supported by NIMH Grant No. MH 15708. Computer services were provided by the Institute of Computer Sciences, Baylor College of Medicine, Houston, Texas, supported by NIH Grant No. RR 00259, and the Institute for Computer Services and Applications, Rice University, Houston, Texas. Secondary analysis of data was carried out in the Winter of 1975–1976. We wish to thank Dr. George Antunes of the University of Houston, Dr. Richard Hamilton of McGill University, and Judith Scott of Texas Research Institute of Mental Sciences for their critical reading of an earlier draft of this paper.