Fairness and health care decision making: testing the group value model of procedural justice.

Considerable research has supported the notion that procedural justice is important to individuals independent of outcome considerations. Tyler and his associates (Lind and Tyler, 1988; Lind and Earley 1992; Tyler, 1989) proposed that this is so because procedural justice serves a group value function. In the present research, we explore aspects of this group value formulation in a real life health care context. Specifically, we assessed the relationship between individuals' appraisals of procedural justice following health care treatment decisions as well ass (i) expectations for different consequences to self; (ii) estimates of how they were viewed by the health care authorities; (iii) attributions about the reasons for their treatment; and (iv) ratings of emotional reactions. Results confirmed many components of the relational, group value model of procedural justice (Lind and Tyler, 1988; Lind and Earley, 1992; Tyler, 1989). Specifically, respondents who felt that they had been treated fairly expected that their status and their relationship with the health care decision maker and others in their health care group would improve; perceived that the health care decision maker would rate them positively on a variety of personality dimensions; felt that the health care decision maker's interactions with them revealed quite a lot about the decision-maker's personality characteristics; and indicated increased levels of pride and pleasure as well as lower levels of anger as a result of their treatment. Results were discussed from several frameworks including Markus and Kitayama's (1991) concept of independent and the interdependent self.

A conceptual framework for thinking about risk assessment and case management in child protective service.

The present paper presents a broad conceptual framework for examining methodological issues in risk assessment in child protective service work. The following issues are discussed: standards for determination of risk; types of data collected; sources of information; types of possible errors; incremental validity issues; cultural context of decision making; assessment of problem origins; selection of outcome goals and implementation strategies; and treatment monitoring and case closure decisions. Risk assessment procedures vary on a number of dimensions, and the task of comparing one procedure to another is quite complex. Clearly, techniques cannot be considered from one vantage point and must take into account the general purpose of the assessment, the specific types of decisions that are to be made, and for whom, by whom, and within what context the data is to be gathered and used.