Withdrawal Aversion and the Equivalence Test

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test.     

FOCUS GROUPS

Focus groups are little used in feminist psychology, despite their methodological advantages. Following a brief introduction to the method, the article details three key ways in which the use of focus groups addresses the feminist critique of traditional methods in psychology. Focus groups are relatively naturalistic and so avoid the charge of artificiality; they offer social contexts for meaning-making and so avoid the charge of decontextualization; and they shift the balance of power away from the researcher toward the research participants and so avoid the charge of exploitation. The final section of the article, which evaluates the potential of focus groups for feminist research, identifies some other benefits of the method and also discusses some problems in the current use of focus groups. It concludes that the use—and development—of focus group methods offer feminist psychology an excellent opportunity for the future.