Physicians,entrepreneurism and the problem of conflict of interest

This paper examines the ethical issues of conflict of interest raised by the burgeoning development of physician involvement in for-profit entrepreneurial activities outside their practice. After documenting the nature and extent of these activities, and their potential for conflicts of interest, the paper assesses the major arguments for and against physicians' referral of patients to facilities they own or in which they invest. The paper concludes that an outright ban on such activity seems ethically warranted.     

Development of Standard Anchors for Scoring Generic Past-Behaviour Questions in Structured Interviews

A structured interviewing system was developed which included an item bank of pre-written past-behaviour questions. Scoring anchors for each of 168 questions in the item bank were created from analysis of protocols from individual assessments. A concurrent validation study was conducted, focusing on the job of highway patrol sergeant. Job knowledge experts used a job analysis tool to select a subset of twelve questions from the item bank. Panel interviews were conducted with 32 highway patrol sergeants as subjects. Average inter-rater reliability was 0.65 and interview validity was 0.42 for group consensus scores and 0.44 for panel average scores. Discussion focused on practical issues affecting the interviewing system.     

The substitutability of reinforcers

Substitutability is a construct borrowed from microeconomics that describes a continuum of possible interactions among the reinforcers in a given situation. Highly substitutable reinforcers, which occupy one end of the continuum, are readily traded for each other due to their functional similarity. Complementary reinforcers, at the other end of the continuum, tend to be consumed jointly in fairly rigid proportion, and therefore cannot be traded for one another except to achieve that proportion. At the center of the continuum are reinforcers that are independent with respect to each other; consumption of one has no influence on consumption of another. Psychological research and analyses in terms of substitutability employ standard operant conditioning paradigms in which humans and nonhumans choose between alternative reinforcers. The range of reinforcer interactions found in these studies is more readily accommodated and predicted when behavior-analytic models of choice consider issues of substitutability. New insights are gained into such areas as eating and drinking, electrical brain stimulation, temporal separation of choice alternatives, behavior therapy, drug use, and addictions. Moreover, the generalized matching law (Baum, 1974) gains greater explanatory power and comprehensiveness when measures of substitutability are included.     

Literalism as a marker of hypnotic "trance": disconfirming evidence

The responses given by highly hypnotizable, hypnotic subjects and those of unhypnotizable subjects who simulated hypnosis to questions of the type, "Do you mind telling me your name?" and "Do you mind standing up?" were contrasted. The purpose was to examine Erickson's (1980) assertion that literalism (answering "yes" or "no" verbally or nonverbally without any cognitive elaboration) is a marker of hypnotic "trance." Simulators exhibited a greater rate of literalism than hypnotic "virtuosos" (i.e., extreme scorers on both group and individual hypnotizability measures). Hypnotized subjects and nonhypnotized subjects approached in the campus library responded comparably. Because less than a third of hypnotic virtuosos responded literally, our results strongly refuted Erickson's assertion that literalism is a cognitive feature of hypnosis.     

Hemispheric involvement in shadowing vs. interpretation: a time-sharing study of simultaneous interpreters with matched bilingual and monolingual controls

A time-sharing study used shadowing and interpretation/paraphrasing tasks to evaluate lateralization in professional interpreters individually matched to bilingual and monolingual controls. A two-step multivariate general linear model procedure was used to determine lateralized effects and extent of disruption produced by the tasks. Results revealed the monolingual group to be left lateralized for both tasks, but the two bilingual groups were lateralized in the LH only for shadowing. The monolingual group was significantly different from the bilingual groups in the pattern of hand asymmetry for interpretation/paraphrasing. The findings replicate outcomes of prior repeated measures analysis of variance procedures on percentage of change scores. However, new information is added by the more refined analysis. The findings are also discussed in terms of previous laterality studies using similar tasks and subject samples.     

Whose Gene Is It? A Case Discussion About Familial Conflict over Genetic Testing for Breast Cancer

A multidisciplinary group of genetic and other professionals discuss a complex case of familial conflict over access to genetic information. One twin wishes to know the results of her deceased mother's tests for BRCA1 mutations; a second twin objects to researchers making this information available. As the case discussion unfolds, the apparent facts of this case are called into question and the lines of ethical certainty become less clear.