Legal briefing: organ donation and allocation

This issue's "Legal Briefing" column covers legal developments pertaining to organ donation and allocation. This topic has been the subject of recent articles in JCE. Organ donation and allocation have also recently been the subjects of significant public policy attention. In the past several months, legislatures and regulatory agencies across the United States and across the world have changed, or considered changing, the methods for procuring and distributing human organs for transplantation. Currently, in the U.S., more than 100,000 persons are waiting for organ transplantation. In China, more than 1.5 million people are waiting. Given the chronic shortage of available organs (especially kidneys and livers) relative to demand, the primary focus of most legal developments has been on increasing the rate of donation. These and related developments are usefully divided into the following 12 topical categories: 1. Revised Uniform Anatomical Gift Act. 2. Presumed Consent and Opt-Out. 3. Mandated Choice. 4. Donation after Cardiac Death. 5. Payment and Compensation. 6. Donation by Prisoners. 7. Donor Registries. 8. Public Education. 9. Other Procurement Initiatives. 10. Lawsuits and Liability. 11. Trafficking and Tourism. 12. Allocation and Distribution.     

Apparent movement in phenomenal space

The spatial and temporal variables in Korte’s third law of apparent movement were studied in pictorial arrays in which size constancy could be expected to prevail. The thresholds for apparent movement were determined under conditions in which two squares appeared on a plane either with or without perspective information for depth. The results suggest that apparent movement varies with the perceived depth separation only if the size of the stimulus pair is congruent with contextual depth representations. The obtained psychophysical function relating thresholds for third-dimensional movement to pictorial depth scale supports the view that apparent movement preserves gradient-of-texture information.     

Automobile Driving as Seen by the Actor,the Active Observer,and the Passive Observer1

This research utilizes the actor-observers paradigm (Jones & Nisbett, 1971) to study driving interactions from the actor, active observer, and passive observer perspectives. Videos of interactions in three driving situations were used to elicit personal and situational causal attributions from subjects. For each interaction, three videos were made, corresponding with each of the three perspectives. Results for two of the interactions were in accordance with the Jones and Nisbett hypothesis, while those of the third were not. Of note was that passive observers gave consistently lower attributional ratings, both personal and situational, compared to actors and active observers. The results are discussed in terms of their relevance to driving behavior and education.     

Higher Education,Knowledge for Its Own Sake,and an African Moral Theory

I seek to answer the question of whether publicly funded higher education ought to aim intrinsically to promote certain kinds of “blue-sky” knowledge, knowledge that is unlikely to result in “tangible” or “concrete” social benefits such as health, wealth and liberty. I approach this question in light of an African moral theory, which contrasts with dominant Western philosophies and has not yet been applied to pedagogical issues. According to this communitarian theory, grounded on salient sub-Saharan beliefs and practices, actions are right insofar as they respect relationships in which people both share a way of life, or identify with one another, and care for others’ quality of life, or are in solidarity with each other. I argue that while considerations of identity and solidarity each provide some reason for a state university to pursue blue-sky knowledge as a final end, they do not provide conclusive reason for it to do so. I abstain from drawing any further conclusion about whether this provides reason to reject the Afro-communitarian moral theory or the intuition that blue-sky knowledge is a proper final end of public higher education. I do point out, however, that the dominant Western moral theories on the face of it do no better than the African one at accounting for this intuition.     

Meta‐analytic Investigations of the Relation Between Intuition and Analysis

Over 50 years of research on cognitive style has converged on the importance of individual differences in use of intuition and analysis. This program of research is characterized, however, by two incompatible perspectives about the relation between intuition and analysis. The distinction concerns whether intuition and analysis are opposite poles of a single dimension or whether they are orthogonal constructs. Two studies report meta‐analytic investigations of the relation between intuition and analysis. A meta‐analysis of the existing research base (k = 80; n = 27 501) showed that intuition and analysis are uncorrelated. A second meta‐analysis of combinations of subscales from different cognitive style measures (n = 511) supported the results of the first meta‐analysis. Confirmatory factor analysis also supported the existence of two uncorrelated constructs. Overall, the findings support the view that intuition and analysis are independent constructs, rather than opposite ends of a bipolar continuum. In addition, the findings suggest measures of analysis or rationality are not interchangeable. Copyright © 2015 John Wiley & Sons, Ltd.     

Ancillary care obligations in light of an African bioethic: from entrustment to communion

Henry Richardson recently published the first book ever devoted to ancillary care obligations, which roughly concern what medical researchers are morally required to provide to participants beyond what safety requires. In it, Richardson notes that he is presenting the ‘only fully elaborated view out there’ on this topic, which he calls the ‘partial-entrustment model’. In this article, I provide a new theory of ancillary care obligations, one that is grounded on ideals of communion salient in the African philosophical tradition and that is intended to rival and surpass Richardson’s model, which is a function of Western considerations of autonomy. I argue that the relational approach of the former has several virtues in comparison to the basic individualism of the latter.     

Predicting increases in readiness to quit smoking: A prospective analysis using the contemplation ladder

Abstract

Most smokers are not motivated to quit. The transtheoretical model posits mechanisms (processes of change and pros and cons) by which smokers might increase their stage of readiness to quit. While cross-sectional relationships among the stages of change, processes of change, and pros and cons are well established, there is little evidence that processes of change and pros and cons predict progressive stage movements. This study uses data from a large worksite-based cancer prevention study (the Working Well Trial) to test the hypothesis that processes of change and the pros and cons of smoking predict progressive movement up the contemplation ladder, which is an alternative measure of motivation to quit smoking based on social cognitive theory. The results indicate that experiential processes of change promote increases in readiness to quit smoking. This study provides further evidence for the predictive validity of the contemplation ladder and sheds light on how unmotivated, nonvolunteer smokers can be motivated to consider cessation.     

Just the beginning for ubuntu: reply to Matolino and Kwindingwi

In an article titled ‘The end of ubuntu’ recently published in this journal, Bernard Matolino and Wenceslaus Kwindingwi argue that contemporary conditions in (South) Africa are such that there is no justification for appealing to an ethic associated with talk of ‘ubuntu’. They argue that political elites who invoke ubuntu do so in ways that serve nefarious functions, such as unreasonably narrowing discourse about how best to live, while the moral ideals of ubuntu are appropriate only for a bygone, pre-modern age. Since there is nothing ethically promising about ubuntu for today's society, and since elite appeals to it serve undesirable purposes there, the authors conclude that ubuntu in academic and political circles ‘has reached its end’. In this article, I respond to Matolino and Kwindingwi, contending that, in fact, we should view scholarly enquiry into, and the political application of, ubuntu as projects that are only now properly getting started.     

Cognitive-Based Compassion Training: A Promising Prevention Strategy for At-Risk Adolescents

Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a “mental health” approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans. The present study examined whether a 6-week CBCT intervention would improve psychosocial functioning among adolescents in foster care. Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in generalized anxiety. Qualitative results indicated that participants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standardized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects. Practical issues surrounding implementation of such programs in high-risk youth populations are identified. Recommendations are provided for further development.