Parental refusals of medical treatment: the harm principle as threshold for state intervention

Minors are generally considered incompetent to provide legally binding decisions regarding their health care, and parents or guardians are empowered to make those decisions on their behalf. Parental authority is not absolute, however, and when a parent acts contrary to the best interests of a child, the state may intervene. The best interests standard is the threshold most frequently employed in challenging a parent's refusal to provide consent for a child's medical care. In this paper, I will argue that the best interest standard provides insufficient guidance for decision-making regarding children and does not reflect the actual standard used by medical providers and courts. Rather, I will suggest that the Harm Principle provides a more appropriate threshold for state intervention than the Best Interest standard. Finally, I will suggest a series of criteria that can be used in deciding whether the state should intervene in a parent's decision to refuse medical care on behalf of a child.     

Human risky choice under temporal constraints: tests of an energy-budget model

Risk-sensitive foraging models predict that choice between fixed and variable food delays should be influenced by an organism's energy budget. To investigate whether the predictions of these models could be extended to choice in humans, risk sensitivity in 4 adults was investigated under laboratory conditions designed to model positive and negative energy budgets. Subjects chose between fixed and variable trial durations with the same mean value. An energy requirement was modeled by requiring that five trials be completed within a limited time period for points delivered at the end of the period (block of trials) to be exchanged later for money. Manipulating the duration of this time period generated positive and negative earnings budgets (or, alternatively, "time budgets"). Choices were consistent with the predictions of energy-budget models: The fixed-delay option was strongly preferred under positive earnings-budget conditions and the variable-delay option was strongly preferred under negative earnings-budget conditions. Within-block (or trial-by-trial) choices were also frequently consistent with the predictions of a dynamic optimization model, indicating that choice was simultaneously sensitive to the temporal requirements, delays associated with fixed and variable choices on the upcoming trial, cumulative delays within the block of trials, and trial position within a block.     

不确定情境中的决策心理——适应与认知

不确定情境中的决策问题广受经济学家和心理学家关注,但他们对人的决策行为有不同的解释。该简要回顾了经济学和心理学视野中的决策理论,包括预期效用理论、主观预期效用理论和前景理论。主要介绍了“生态理性”观对人的决策心理的研究,着重介绍了研究发现的几种启发式策略,如“一个理由策略”,并探讨了他们在人适应过程中的作用。中最后分析了决策问题的研究现状。     

Alibi believability: Corroborator certainty,cooperativeness and relationship with the defendant

Alibi believability can be affected by characteristics of the alibi corroborator, including the relationship between the defendant and corroborator, which has been studied extensively by researchers. The corroborator's certainty that they were together at the time of the crime may also influence alibi believability, but only a few studies have examined this. Another factor that may affect believability is the corroborator's cooperativeness with the police, which is yet to be studied in the alibi context. Online U.S. participants recruited from CloudResearch (N = 280) acted as mock jurors and evaluated a mock arson case where the defendant used an alibi defence. The alibi corroborator's relationship to the defendant (brother/neighbour), the certainty that they were together at the time (65%/100%) and cooperativeness with police (cooperative/uncooperative) were manipulated between participants. The participants were evenly split when it came to verdict (p > .05) but were more likely to vote guilty when the corroborator was a brother rather than a neighbour (p < .01) and when the brother was uncooperative versus cooperative (p < .05). As expected, alibis were more believable when they were corroborated by a neighbour rather than a brother and when the corroborator was 100% certain that they were together versus 65% certain (ps < .01). Alibis were also more believable when the corroborator cooperated than when he was uncooperative (p < .01). Cooperative (vs. uncooperative) corroborators led to more positive defendant and corroborator views on all six character trait measures (ps < .01). Implications and future directions are discussed.     

Choice in the repeated-gambles experiment

Humans chose 10 times between two roulette wheels projected on a monitor. During the first trial, the left wheel provided a hypothetical $100 with p = .94, and the right wheel provided $250 with p = .39. A titration procedure adjusted the probability of a $250 win across trials to permit estimation of an indifference point between alternatives. In Experiment 1, intertrial-interval duration (25 vs. 90 s) and whether sessions began with an intertrial interval or a trial were varied in a 2 × 2 design in this risky-choice procedure. Risk aversion (preference for the $100 wheel) increased with intertrial interval but was unaffected by whether sessions began with a trial or an intertrial interval. In Experiment 2, all sessions began with a trial, and subjects were informed that the experiment ended after 10 trials. Intertrial-interval duration had no effect on choice. In Experiment 3, intertrial-interval duration and whether subjects were given $10 or $10,000 before beginning were varied among four groups in a 2 × 2 design. In all other ways, the procedure was unchanged from Experiment 2. Intertrial interval had no effect on choice, but the $10,000 groups showed less risk aversion than the $10 groups. These results can be explained more readily in terms of Kahneman and Tversky's (1984) notion of “framing of the prospect” than in terms of Rachlin, Logue, Gibbon, and Frankel's (1986) behavioral account of risky choice.     

Negotiating criteria and setting limits: The case of aids

The classification of clinical problems, such as AIDS, requires choices. Choices are made on epistemic (i.e., knowledge-based) and non-epistemic (i.e., action-based) grounds. That is, the ways in which we classify clinical problems, such as AIDS, involve a balancing of different understandings of clinical reality and of clinical values among participants of the clinical community. On this view, the interplay between epistemic and non-epistemic interests occurs within the embrace of particular clinical contexts.The ways in which we classify AIDS is the topic of this paper. We consider the extent to which we construct clinical reality; we examine a suggested classification of AIDS; and we conclude suggesting that the choice regarding how to classify AIDS is the result of negotiation among participants in the clinical community.     

Courting on the beach: how team position implicitly influences decision-making in beach volleyball serves

Masters, van der Kamp, and Jackson [2007. Imperceptibly off-centre goalkeepers influence penalty-kick direction in soccer. Psychological Science, 18, 222–223] demonstrated that a goalkeeper in soccer penalty kicking standing marginally to one side of the goal’s centre unconsciously influences a penalty takers’ goal side selection. In two experiments, we examined whether the positions of the receiving players in beach volleyball affect a player’s decision to what area of court to play. Both experiments differed in the degree of attention participants directed to the largest court area. Results showed that participants made decisions favouring the larger court area although they were unaware of the receivers’ asymmetrical positioning. This effect was more pronounced in Experiment 1, suggesting that the degree to which attention is directed to the critical information (i.e. largest court area) can be considered an important moderator. These observations indicate that implicit effects of positioning reflect a more general phenomenon in and outside of sports that can be exploited for improving chances of success.     

A model of caregiver paediatric HIV disclosure decision-making

Many of the over 3 million HIV-positive children will only be told of their status as adolescents. Knowing one’s status may increase treatment adherence, reduce onward HIV transmission, increase trust in caregivers and maximise available support. Yet deciding whether, what, how and when to tell HIV-positive children about their condition is challenging for caregivers. We systematically review HIV disclosure theories before presenting a process model of caregiver paediatric HIV disclosure decision-making. The model, consisting of both a pre-intention and a post-intention stage, integrates individual and contextual determinants. It aims to be situationally specific, broadly applicable and consistent with the empirical literature. Research and practice implications are discussed.     

Eyes on the Prize? Evidence of Diminishing Attention to Experienced and Foregone Outcomes in Repeated Experiential Choice

Recently, there has been increased interest in decisions‐from‐experience (where decision makers learn from observing the outcomes of previous choices), which provide valuable insights into the learning and preference construction processes underlying many daily decisions. Several process models have been developed to capture these processes, and while such models often fit the data well, many assume that the decision maker is a vigilant observer, processing each outcome. In two studies, we provide a critical test of this assumption using eye tracking to record directed visual attention when participants choose repeatedly among two options, each time being shown the outcome for their chosen option and for the foregone option. Consistently, we find that the vigilance assumption is not supported, with decision makers often not attending to outcome information. Moreover, (in)attention to outcomes is predictable, with vigilance decreasing as more choices are made, and being greater for obtained than for foregone outcomes, and when options deliver only gains as opposed to losses or a mixture of gains and losses. Furthermore, we find that this variation in attentional allocation plays a central role in the apparent indecisiveness (inconsistency) in choice, with increased attention to foregone outcomes predicting switches to that option on the next choice. Together, these findings highlight the value of eye tracking in investigations of decisions‐from‐experience, providing novel insight into the cognitive processes underlying them. Copyright © 2015 John Wiley & Sons, Ltd.