Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

This article explores the effect of women’s movement into the labor market on the gender segregation of work, using the Current Population Survey from 1972 to 1993. The author includes as working those respondents who were “keeping house” and codes keeping house as an occupation. The results show higher estimates of gender segregation, and slightly steeper declines over time, than were seen in previous studies. Analysis of one-year longitudinal changes reveals less movement out of female-dominated occupations when keeping house is (...) included as an occupation. Finally, a decomposition of the segregation trend shows that the movement of women away from keeping house contributed as much to the overall decline in gender segregation as did the desegregation of paid occupations. The author concludes that the movement of women’s work from the household to the labor market has been a driving force in the changing nature of gender inequality. (shrink)

This paper suggests the utility of studying unconscious cognition from a selectionist perspective, specifically as outlined by theory and research in the field of behavior analysis. Currently, issues surrounding the complexity of the unconscious cognitive behaviors, the number of variables involved, and the multidirectional influences of these variables, are of utmost concern to theories of mind and behavior. Unanswered questions about these factors leave us without the ability to predict outcomes in an individual case or adequately manipulate variables in order (...) to alter outcomes. Multiple examples of current work by behavior analysts are suggested as potentially fruitful ways of addressing some of these concerns. (shrink)

Using data from the 1993 Consumer Expenditure Survey to examine housework-related service consumption, the author finds that spending on housekeeping services and meals out—which helps relieve women's housework burden—is affected by dynamics within marriages as well as by family class and race-ethnicity. Other things equal, families in which women have more relative power, as reflected in their income and occupational status, consume more housekeeping services and spend more of their food dollars on meals out, as do wealthier families and white (...) families. Along with housework itself, which is well studied, these results suggest that housework service consumption is also an arena for gendered negotiation and conflict within families, and one way that gender relations vary by class and race-ethnicity. (shrink)

Nietzsche wrote that he owed his philosophy to his long sickness, which he called “the teacher of great suspicion”. The present paper considers the related ideas of the will to power and the eternal return in the light of Nietzsche’s concepts of sickness and health. This reading of Nietzsche’s works is guided by the interpretations of Gilles Deleuze and Pierre Klossowski, whose commentaries have been most influential in shaping French neo-Nietzscheanism since 1965; however, those passages literally or metaphorically employing the (...) language of physical and mental illness and health are emphasized. After introducing the key concepts of will, force, affirmation, and self, the paper develops the idea of active and reactive forces, presents the eternal return as a selective doctrine, and considers the meaning of arnor fati. It closes with remarks, based upon Nietzsche’s views, on the interpretation of philosophical texts and on the relationship between the philosopher’s life and works. (shrink)

Portraying psychological process as extended over time in multiply overlapping scales is a conceptual advance that can be understood as analogous to our understanding of spatial relationships. There may be a residual contradiction, however, when Rachlin invokes in ways that seem to imply earlier conceptions. The roles of superimposed or conditionally related stimuli also remain to be addressed.

This article examines the notion of gender neutrality in rape, its meaning and why rape definitions that include females and males as potential victims of rape have become influential in those jurisdictions that have engaged in significant levels of rape law reform over the last four decades. In so doing, several of Annabelle Mooney’s criticisms of gender neutral rape laws, published in an earlier article, will be critically examined. The second part of this article draws on themes that have been (...) identified in the linguistic analysis of rape trials involving female complainants and applies those themes to two cases of rape and sexual assault involving male complainants. Finally, this article examines whether the tactics used by defence lawyers during cross-examination can be said to be uniquely ‘gendered’ or whether similar tactics exist in cases of male rape and sexual assault. Explanations for possible similarities in treatment are also examined. (shrink)

Comparing and sharing selectionist terms and concepts from disparate domains can aid understanding in each domain. But constraints of interpretive language will make this difficult – such as the bipolar constraint of interpretive language when addressed to intrinsically tripolar phenomena. Hull et al. acknowledge that some key terms in their account remain problematic; the term, “information,” probably needs to be replaced.

How do people make deductions? The orthodox view in psychology is that they use formal rules of inference like those of a “natural deduction” system.Deductionargues that their logical competence depends, not on formal rules, but on mental models. They construct models of the situation described by the premises, using their linguistic knowledge and their general knowledge. They try to formulate a conclusion based on these models that maintains semantic information, that expresses it parsimoniously, and that makes explicit something not directly (...) stated by any premise. They then test the validity of the conclusion by searching for alternative models that might refute the conclusion. The theory also resolves long-standing puzzles about reasoning, including how nonmonotonic reasoning occurs in daily life. The book reports experiments on all the main domains of deduction, including inferences based on prepositional connectives such as “if” and “or,” inferences based on relations such as “in the same place as,” inferences based on quantifiers such as “none,” “any,” and “only,” and metalogical inferences based on assertions about the true and the false. Where the two theories make opposite predictions, the results confirm the model theory and run counter to the formal rule theories. Without exception, all of the experiments corroborate the two main predictions of the model theory: inferences requiring only one model are easier than those requiring multiple models, and erroneous conclusions are usually the result of constructing only one of the possible models of the premises. (shrink)

This article presents a fundamental advance in the theory of mental models as an explanation of reasoning about facts, possibilities, and probabilities. It postulates that the meanings of compound assertions, such as conditionals (if) and disjunctions (or), unlike those in logic, refer to conjunctions of epistemic possibilities that hold in default of information to the contrary. Various factors such as general knowledge can modulate these interpretations. New information can always override sentential inferences; that is, reasoning in daily life is defeasible (...) (or nonmonotonic). The theory is a dual process one: It distinguishes between intuitive inferences (based on system 1) and deliberative inferences (based on system 2). The article describes a computer implementation of the theory, including its two systems of reasoning, and it shows how the program simulates crucial predictions that evidence corroborates. It concludes with a discussion of how the theory contrasts with those based on logic or on probabilities. (shrink)

This paper reports three studies of temporal reasoning. A problem of the following sort, where the letters denote common everyday events: A happens before B. C happens before B. D happens while B. E happens while C. What is the relation between D and EEfficacylls for at least two alternative models to be constructed in order to give the right answer for the right reason. However, the first premise is irrelevant to this answer, and so if reasoners were to ignore (...) it, then they would need to construct only one model. Experiment 1 showed that one-model problems were answered faster and more accurately than multiple-model problems. When the question preceded the premises in the statement of the multiple-model problems there was a slight tendency for the latencies of response to speed up in the predicted way. Experiment 2 modified the procedure, in part by using practice problems with many irrelevant premises, so that reasoners might grasp the advantage of ignoring them. Its results showed that when the premises preceded the question, the multiple-model problems were significantly harder than one-model problems. But when the question was presented first, the difference was significantly reduced in line with the theory's prediction. Experiment 3 used only problems with valid conclusions, and so the construction of multiple models was never necessary. However, there was still a significant difference between one-model problems and multiple-model problems. (shrink)