A cost-benefit analysis of demand for food.

Laboratory studies of consumer demand theory require assumptions regarding the definition of price in the absence of a medium of exchange (money). In this study we test the proposition that the fundamental dimension of price is a cost-benefit ratio expressed as the effort expended per unit of food value consumed. Using rats as subjects, we tested the generality of this "unit price" concept by varying four dimensions of price: fixed-ratio schedule, number of food pellets per fixed-ratio completion, probability of reinforcement, and response lever weight or effort. Two levels of the last three factors were combined in a 2 x 2 x 2 design giving eight groups. Each group was studied under a series of six FR schedules. Using the nominal values of all factors to determine unit price, we found that grams of food consumed plotted as a function of unit price followed a single demand curve. Similarly, total work output (responses x effort) conformed to a single function when plotted in terms of unit price. These observations provided a template for interpreting the effects of biological factors, such as brain lesions or drugs, that might alter the cost-benefit ratio.     

Effects of response requirement and alcohol on human aggressive responding.

Nine men participated in two experiments to determine the effects of increased response requirement and alcohol administration on free-operant aggressive responding. Two response buttons (A and B) were available. Pressing Button A was maintained by a fixed-ratio 100 schedule of point presentation. Subjects were instructed that completion of each fixed-ratio 10 on Button B resulted in the subtraction of a point from a fictitious second subject. Button B presses were defined as aggressive because they ostensibly resulted in the presentation of an aversive stimulus to another person. Aggressive responses were engendered by a random-time schedule of point loss and were maintained by initiation of intervals free of point loss. Instructions attributed these point losses to Button B presses of the fictitious other subject. In Experiment 1, increasing the ratio requirement on Button B decreased the number of ratios completed in 4 of 5 subjects. In Experiment 2, the effects of placebo and three alcohol doses (0.125, 0.25, and 0.375 g/kg) were determined when Button B presses were maintained at ratio values of 20, 40 and 80. Three subjects who reduced aggressive responding with increasing fixed-ratio values reduced aggressive responding further at higher alcohol doses. One subject who did not reduce aggressive responding with increasing fixed-ratio values increased aggressive responding at the highest alcohol dose. The results of this study support suggestions that alcohol alters aggressive behavior by reducing the control of competing contingencies.     

Inelastic supply: An economic approach to simple interval schedules

Economic theory predicts an inverse relationship between the quantity of a commodity supplied to the marketplace and the equilibrium market price of that commodity. This prediction was tested in three experiments. Pigeons responded on simple variable-interval schedules, and quantity of reinforcement supplied was varied in a different way in each experiment. In Experiment 1, quantity supplied was varied by manipulating reinforcement rate while keeping session length constant. In Experiment 2, quantity supplied was varied by manipulating reinforcement rate while keeping reinforcers per session constant. In Experiment 3, quantity supplied was varied by manipulating reinforcer magnitude while keeping number of reinforcers constant. As predicted by economic theory, the obtained behavioral cost (responses per reinforcer) increased as supply decreased. The results could not be explained by simple artifacts such as satiation and time available to respond. In addition, the function relating response rate to reinforcement rate was bitonic in 7 of 9 animals in Experiments 1 and 2, which supports economic and regulatory theories over more traditional reinforcement theories.     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

Ethics in health care and medical technologies

In this paper a case is used to demonstrate how ethical analysis enables health care professionals, patients and family members to make treatment decisions which ensure that medical technologies are used in the overall best interests of the patient. The claim is made and defended that ethical analysis can secure four beneficial outcomes when medical technologies are employed: (1) not allowing any medical technologies to be employed until the appropriate decision makers are identified and consulted; (2) insisting that medical technologies be employed not merely to promote the medical interests of the patient but rather on the basis of their ability to contribute to the overall well-being of the patient; (3) challenging caregivers to reflect on the dynamic interplay between their conscious and unconscious values and consequent determinations of what is in the patient's best interests; and (4) providing a justification for selected interventions which makes possible rational dialogue between caregivers espousing different viewpoints about treatment options.     

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.     

Medical hermeneutics: Where is the “text” we are interpreting?

The present paper is a commentary on an article by Drew Leder [1]. Leder identifies a series of texts in the clinical encounter, emphasizes the central role of interpretation in making sense of each of these texts, and articulates ordering principles to guide the interpretive work.The metaphor of clinical work as textual explication, however, creates the expectation that there is a text somewhere to be found. Such an expectation invites doctors and patients to search for the text and runs the risk of conceptualizing patients as more static than they are. If one is to use the textual metaphor, one must appreciate the radical extent to which the clinical encounter is a mutually produced and shifting entity. The qualities of mutuality and indeterminacy are not those one usually associates with texts. One might ultimately be better served by a different metaphor based more directly on uncertainty.     

Praxis makes perfect: Illness as a bridge between biological concepts of disease and social conceptions of health

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy.