Ethical and legal issues in conducting research involving elderly subjects

Older people are increasingly the focus of biomedical and behavioral research not only because the elderly constitute the fastest growing segment of our population but because there is a societal concern to improve the elderly's quality of life. The profound need to advance that research carries with it an equally profound obligation to protect the rights and welfare of elderly research subjects, and thus raises difficult ethical and legal issues. Against a background of foundational principles for the protection of human subjects, we discuss whether older subjects should be treated as a special class, the ethical and legal issues over informed consent, capacities for consent, and special problems related to cognitive impairment. We discuss surrogate/proxy consent procedures in research, recruitment of elderly subjects, conflicts of interest, special problems regarding institutional research, and risk/benefit analyses. We offer recommendations and practical guidelines for conducting current and future research involving elderly participants.     

Dr. high on Dr. Pastore on “Dr. high on history”: James's theory of space perception

Criticisms are made of Nicholas Pastore's comments on High, „Shadworth Hodgson and William James's Formulation of Space Perception.”︁ Dr. Pastore's comments appeared in JHBS 17 (1981): 486–489.     

Examining Family Communication Patterns and Seeking Social Support Direct and Indirect Effects Through Ability and Motivation

Seeking social support remains a relatively understudied aspect of supportive communication. By integrating the literatures on family communication patterns (FCPs) and supportive communication, this study examines dispositional factors that influence support seeking in particular situations. Specifically, communicative ability and motivation to seek support were theorized to mediate the relationship between FCPs and recalled strategies of support seeking. Results from a sample (N = 352) of undergraduate students not only demonstrate that people's FCPs impart different levels of communicative ability and motivation to seek support, but also indirectly influence people's strategies of support seeking. Ability and motivation also directly influence support seeking, and several of these effects are moderated by participants' sex.     

Caring for decisionally incapacitated elderly

Although treating the elderly occasion the same kinds of ethical issues as treating other patients, specific problems do arise when making decisions for persons, once competent, who no longer can express their values. I examine the problem of decisional incapacity and offer a critique of the principles, such as substituted judgment, and the instruments, such as advance directives, living wills, other instructional directives, as well as surrogate decision-makers.     

A randomized control trial of integrated care for families managing infant colic

This article presents a randomized clinical trial examining the effectiveness of a unique model of integrated care for the treatment of infant colic. Families seeking help for infant colic were randomized to either the family‐centered treatment (TX; n = 31) or standard pediatric care (SC; n = 31). All parents completed 3 days of Infant Behavior Diaries (Barr et al., 1998) and the Colic Symptom Checklist (Lester, 1997 ), Beck Depression Inventory (Beck & Steer, 1984 ), and Parenting Stress Index 3rd ed.‐SF (Abidin, 1995 ). TX families were seen three times by a pediatrician and a mental health clinician within 1, 2, and 6 weeks of baseline data. TX families received individualized treatment plans addressing problem areas of sleep, feeding, routine, and family mental health. SC families were seen only by their own healthcare provider. All families were visited at home by a research assistant to retrieve data at 2, 6, and 10 weeks after baseline. Family‐based treatment accelerated the rate of reduction of infant crying faster than did standard pediatric care. Infants in the TX group had more hours of sleep at 2 weeks posttreatment and spent less time feeding at 2, 6, and 10 weeks posttreatment than did SC infants. Results indicate that individualized family‐based treatment reduces infant colic more rapidly than does standard pediatric care.