So far so good: Observations on the first year of Oregon's Death with Dignity Act.

The Supreme Court recognized that states may serve as social laboratories for developing procedures permitting physician-assisted suicide. Oregon has served as the first such laboratory. First-year results suggest the feasibility of implementing a statute right to physician-assisted suicide successfully in this country, without abuse or negative incident. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The first year of the Oregon Death With Dignity Act: Responses to the commentators.

This reaction article begins by differentiating the authors' data from the official Oregon Health Division Report on the Death with Dignity Act and then provides comments in response to each of the authors/teams who analyzed the original article. The authors use this opportunity to clear up some apparent misunderstandings, to highlight commonalities, and to emphasize a few fundamental differences of opinion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation under Oregon's 1994 Death With Dignity Act: Ethics and Procedures.

The Oregon 1994 Death With Dignity Act prescribes an evaluation by a psychologist or psychiatrist when the patient is suspected to be suffering from impaired judgment. Several attempts have been made to propose procedures for assessing end-of-life mental conditions and competence. The psychologist's role may include ethical considerations, protecting patients' rights to autonomy, ensuring competent judgment, preventing unnecessary suffering and inappropriate diagnoses of mental disorders, and supporting family members and the health care team. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The implementation of Oregon's Death with Dignity Act: Reassuring, but more data are needed.

Undoubtedly, empirical data from Oregon will play a key role for academics, legislators, judges, and the public as debate over the legalization of physician-assisted suicide continues. A central issue in the debate is whether a right to assisted suicide can be limited to only the truly compelling cases, or whether it will in practice be provided to patients who choose it out of depression, coercion, or misunderstanding. Empirical research can provide critical insights into this question. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Oregon's first year: The medicalization of control.

The results of Oregon's first year with physician-assisted suicide raise two questions. First, how will it be possible to evaluate what is actually going on in Oregon if there is no public access to the records and if physicians are shielded by patient confidentiality rules? The second question is whether the public understood that many, not most, of those who want physician-assisted suicide want it not to relieve suffering as ordinarily understood but to maintain control over their dying, something that may not correlate at all with suffering from illness and disease. This commentary reviews the existing evidence from the Netherlands and suggests that abuse of the vulnerable will likely occur in Oregon over time. It also reviews the insufficiency of the data emerging from Oregon. Finally, it addresses the various issues raised by the other commentators to the main article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes of Oregon psychologists toward physician-assisted suicide and the Oregon Death With Dignity Act.

Since the passage of the Oregon Death With Dignity Act (ODDA), psychologists have been grappling with how to fulfill their legally specified role in the process of physician-assisted suicide. We surveyed 423 Oregon psychologists (aged 31–76 yrs) to elicit their views on assisted suicide and the process of assessing patients who request such assistance. There was a high degree of support for assisted suicide and the ODDA, but also a minority who were highly opposed. Most survey respondents raised ethical or practical concerns with their role as assessors. Many important questions about how evaluations in this complex area should be conducted remain unanswered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician-assisted suicide: reflections on Oregon's first case

The authors analyze Oregon's first reported assisted suicide of Mrs. A as a real life application of the Oregon Death with Dignity Act. They critique the effectiveness of the Act's safeguards as illustrated by the case of Mrs. A. They point out that the Act does not require that physicians be adequately trained in palliative care in order to participate in assisted suicide. Most physicians do not have such training. Without it, they are not able to effectively present alternatives to patients requesting assisted suicide. Most physicians also lack the expertise to assess patients' decision-making capacity. Nor does the Act ensure that physicians will be in a position to assess coercion of patients' decisions. The Act requires physicians to report only minimal information about their cases, and there are no enforcement provisions to see that even this is done. Under the Act, a good faith standard rather than the more usual negligence standard immunizes physicians from civil or criminal liability even when they act negligently. The authors demonstrate that the Act protects physicians more than patients, and encourages secrecy. The authors conclude that secrecy will need to be replaced by openness to permit the kind of examination the practice of assisted suicide warrants.     

Sociability with peer and mother during the first year.

32 infants were videotaped with their mothers and a peer 9 times (3 visits at 6, 9, and 12 mo). Three hypotheses concerning the social behaviors were examined: that interactions with mother and peer differ in characteristic activities and functions, that interactions with peers grow out of earlier mother–infant interactions, and that behaviors with the 2 partners are characterized by underlying consistency. Support for the 1st and 3rd hypotheses was found. Ss were more likely to look at and vocalize to the peer but were more likely to touch the mother. A negative correlation was found between the frequencies of Ss' touching mother and touching peer. The absence of toys affected the 2 systems similarly, and similar patterns of growth were apparent over time. Significant positive correlations were found between the frequencies of the smiles and vocalizations to the 2 partners. In light of these results, a model is proposed in which underlying infant sociability is reflected somewhat differentially with mother and peer. Reasons for the lack of support of the precursor hypothesis are explored. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologist-legislator: Reflection on the first year in office.

As a Massachusetts State Representative, the author describes how being a psychologist affected her campaign and 1st year in office. Her history of past and current political interests in women, education, labor, and human services has contributed to her legislative and political agenda. This article reports how the Massachusetts Psychological Association played a significant role in her campaign and how mental health issues have been her top priority. Serving as a state legislator has integrated her 2 passions: political activism and psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Very long-term memories of the first year in college.

College alumnae who had graduated 2, 12, or 22 years earlier completed questionnaires in which they recounted the first four memories to come to mind of their freshman year and provided ratings of each remembered experience. For all three alumnae groups, the temporal distribution of memories peaked in September, the beginning of college. Mean ratings of emotional intensity were high, mean ratings of surprise and life impact were below the moderate level and substantial numbers of memories had never been recounted previously. The proportion of memories that focused on specific episodes rather than on general experiences decreased as the number of years since graduation increased. The incidence of specific memories also declined as a function of memory order: Memories reported first were more likely to be specific than memories reported later. The results suggest that transitional and emotional episodes are especially likely to persist in memory for many years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

St.Agnes--the first year as the team sees it

The St. Agnes Community Health Centre was established in October 1974, in the rapidly growing area of Tea Tree Gully, South Australia. It was built to provide additional facilities to an already existing comprehensive medical centre. The embryo centre is described during the first year of operation through the eyes of the health team.     

Psychophysiological correlates of emotional reactivity during the first year of life.

Emotional reactivity is an important dimension thought to underlie individual differences in infant temperament. In a series of studies, we have examined the relation between behaviors reflecting this dimension and measures of heart rate variability. In the current study, longitudinal behavioral data on two groups of infants selected for their pattern of heart period variability are presented: those with high vagal tone (high heart rate variability) and those with low vagal tone (low heart rate variability) at 14 months of age. The data suggest that infants with high vagal tone were more reactive to both positive and negative events at 5 months and more sociable and approachful at 14 months. Infant reactivity to mildly stressful events seems to be a stable dimension during the first year, and there is a strong association between differences in reactivity and the degree to which the autonomic nervous system is influenced by vagal tone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pulmonary cytopathology of former asbestos workers. Report of the first year

Five hundred fifty-four workers, 84% of whom are chronic cigarette smokers, have been examined during the past year with emphasis on the role of sputum cytopathology in the early detection and diagnosis of lung cancer. Of the 554, 232 (42%) have shown squamous metaplasia, 44 (8%), mild to moderate atypias, 18 (3.2%), severe atypias, and two (0.4%), squamous carcinoma. Both of the carcinomas were in x-ray negative, cytopathology-positive elderly cigarette smokers. Ferruginous bodies have been found in the sputa of 187 (33%) workers. Ferruginous bodies in the sputum do not appear to be a marker for severe atypias; rather, their presence correlates best with duration and extent of industrial exposure to asbestos.     

Social support and stress during the first year of graduate school.

Describes the effects of varying levels of social interaction on 22 1st-yr graduate students' reports of stressful events and on their health and emotional problems during the 1st 6 mo of graduate study. Ss completed 2 questionnaires partially drawn from the Graduate Student Questionnaire. They also recorded their social contacts. An inverse relationship was found between frequency of social interactions with peers and faculty during the 1st 10 wks of study and the incidence of stressful life events and the number of reported physical and psychological disturbances throughout the next 6 mo. The quality of faculty–student interactions also emerged as an important factor that moderated the negative consequences of the major life changes associated with beginning graduate school. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accommodative esotropia during the first year of life

Two infants developed accommodative esotropia during their first six months of life. One infant, whose age at onset was 4 1/2 months, had 4.50 diopters of hyperopia. The second infant, whose age at onset was 5 months, had 3.50 diopters of hyperopia. In both infants, the eyes completely aligned with hyperopic correction. Two points are stressed. First, when the amount of hyperopia exceeds +3.00, consideration should be given to an accommodative element as the cause of the esotropia, even if the child is only 4 to 6 months old. Second, even with small angles of esotropia, an accommodative element should be considered, if there is a substantial amount of hyperopia.