Professional Autonomy and the Normative Structure of Medical Practice

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine.     

Young infants' expectations about hidden objects

Infants aged 3-5 months (mean of approximately 4 months) were given a novel anticipatory looking task to test object permanence understanding. They were trained to expect an experimenter to retrieve an object from behind a transparent screen upon hearing a cue ("Doors up, here comes the hand"). The experimenter then hid the object behind one of two opaque screens and after either 2 or 8s gave the "doors up" cue. Infants looked to the correct location after the two-second delay, but not after the eight-second delay. This indicates a brief memory that the object is present behind the occluder. The study provides converging evidence that infants grasp object permanence by a young age. The novel anticipatory looking paradigm helps rule out counter-explanations applied to violation-of-expectation tasks.     

Effects of domain-specific knowledge on memory for serial order

Knowledge concerning domain-specific regularities in sequential structure has long been known to affect recall for serial order. However, very little work has been done toward specifying the exact role such knowledge plays. The present article proposes a theory of serial recall in structured domains, based on Bayesian decision theory and a set of representational assumptions proceeding from recent computational and neurophysiologic research. The theory suggests that the accuracy with which a target sequence will be recalled is influenced by two interacting factors: (1) the 'goodness' of the sequence, i.e. its fit with the sequencing constraints that characterize its source domain, and (2) the sequence's neighborhood relations, i.e. the degree to which it resembles other sequences in the source domain. A specific prediction of the theory is that recall will be relatively poor for target lists with high-goodness near neighbors (the good neighbor effect). This prediction was tested and confirmed in an experiment evaluating recall for sequences based on an artificial grammar.     

Logotherapy-Enhanced REBT: An Integration of Discovery and Reason

Viktor Frankls Logotherapy and Albert Elliss Rational Emotive Behavior Therapy (REBT) are at seemingly opposite ends of the psychotherapeutic spectrum. However, a close review of the assumptions and philosophy of each school of therapy reveals that these two systems are compatible. We propose that a Logotherapy-enhanced REBT can increase human achievement and happiness by balancing the individual discovery of meaning with the pursuit of reason. This integrated and enhanced therapy will help human beings participate in positive life experiences and take greater responsibility for change. Fruitful and beneficial aspects of a Logotherapy enhanced-REBT are explored with respect to cognitions, emotions, and the reduction of rumination. Conclusions are drawn, limitations are discussed, and future recommendations are outlined.     

What's measured is not necessarily managed: cognitive contingencies of organizational measurement

Organizational measurement is necessary for managing incremental improvements or change efforts. Some have argued that indicators of financial performance measure the past and should be joined by "lead" measures such as management development and customer relations, assumed to be drivers of performance. Approaches of "lead" measures have met criticism for not contributing to operational management. The present is an empirical case study where measures from a customer satisfaction survey and a management assessment instrument were analyzed and compared to actual measures of financial performance. The effects of measures obtained seem to depend on the interpretations and reflection taking place in the organization. The pursuit of "lead" indicators did not seem to drive results. Counter-intuitively, higher scores on these measures were related to poorer financial performance. The explication of and reflection on the underlying dynamic seemed to turn the development in a profitable direction.     

The growing complexity of international policy in intellectual property

Intellectual property has historically been a self-contained policy at the international level. With the introduction of the TRIPs Agreement in 1994 and developments since the conclusion of the TRIPs Agreement, the relationship between intellectual property policy and other areas of public policy has become much more complex and interactive. This shift reflects the centrality of intellectual property in the knowledge economy, the rapid development of enabling technologies, notably the Internet and biotechnology, and the advent of the networked society. The consequences of this shift are manifold and herald the increased sophistication and complexity that may be expected of intellectual property regimes in the knowledge economy. An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

Partial Knowledge of Word Meanings: Thematic and Taxonomic Representations

The type of information (taxonomic or thematic) available at different levels of knowledge was investigated. Following extensive norming to identify taxonomic and thematic associates of low-frequency nouns, participants determined if taxonomic or thematic associates were meaningfully related to target words at three levels of knowledge: target words they correctly defined (known), recognized as familiar (frontier), or mistakenly denied as part of the language (unknown). In another experiment, participants reported which type of relationship (taxonomic or thematic) was preferred. Results indicated that both types of information were available at all levels of knowledge. However, accuracy and preference were greater for taxonomic associates across word levels. A differential increase in available thematic information relative to taxonomic information was found. Implications for the acquisition and representation of word meanings are discussed.     

Strategy choices in simple and complex addition: Contributions of working memory and counting knowledge for children with mathematical disability

Groups of first-grade (mean age = 82 months), third-grade (mean age = 107 months), and fifth-grade (mean age = 131 months) children with a learning disability in mathematics (MD, n = 58) and their normally achieving peers (n = 91) were administered tasks that assessed their knowledge of counting principles, working memory, and the strategies used to solve simple (4+3) and complex (16+8) addition problems. In all grades, the children with MD showed a working memory deficit, and in first grade, the children with MD used less sophisticated strategies and committed more errors while solving simple and complex addition problems. The group differences in strategy usage and accuracy were related, in part, to the group difference in working memory and to group and individual differences in counting knowledge. Across grade-level and group, the switch from simple to complex addition problems resulted in a shift in the mix of problem-solving strategies. Individual differences in the strategy mix and in the strategy shift were related, in part, to individual differences in working memory capacity and counting knowledge.     

Interactions between Knowledge,Action and Commitment within Agent Dynamic Logic

This paper considers a new class of agent dynamic logics which provide a formal means of specifying and reasoning about the agents activities and informational, motivational and practical aspects of the behaviour of the agents. We present a Hilbert-style deductive system for a basic agent dynamic logic and consider a number of extensions of this logic with axiom schemata formalising interactions between knowledge and commitment (expressing an agent s awareness of her commitments), and interactions between knowledge and actions (expressing no learning and persistence of knowledge after actions). The deductive systems are proved sound and complete with respect to a Kripke-style semantics. Each of the considered logics is shown to have the small model property and therefore decidable.Presented by Ewa Orlowska