Stéphane Jouffre

Background: While following patients' advance directives (ADs) is legally binding, French physicians in Intensive Care Unit (ICU) perceive them as complicating their decision. Decision making and ICU residents benefit from personalizing the dying process. In France, ADs can include personal information. Objective: Whether personalizing ADs affects ICU residents' decisions and perception of the patient. Subjects and Design: Sixty-six ICU residents assigned to three experimental groups and presented with a case file for an ICU patient. The files were identical except for the patient's AD, which was manipulated to give three conditions: No Personal Information, Sociodemographic Information, and Agency Information (ability to plan and act upon the world). Measurements: Residents evaluated the relevance of the AD, assessed its influence on medical decisions, and decided whether to stop treatment, postpone the decision, or consult the family. Finally, they evaluated the patient with respect to two dimensions of personhood (agency and experience). Results: Residents in all conditions considered the AD to be highly relevant and influential. Residents in both Information conditions perceived the patient as having more capacities for agency and for experience than those in the No Information condition. They were also less likely to stop treatment and more likely to postpone their decision. Consulting the family was not sensitive to the information condition. Conclusion: Personalizing ADs of an unknown patient leads ICU residents to be less prone to follow them, but does not affect whether or not they decide to consult the patient's family. Hence, promoting shared decision making by including the incapacitated patients' families in treatment decisions is a major challenge, especially in countries such as France, where ADs are legally binding.

Our daily interactions are influenced by the social roles we endorse. People however underestimate these role constraints in their everyday explanation relying on individual dispositions to make sense of behaviors. Two studies investigated whether this bias is exacerbated when role structure is legitimated and when power matches the advantages conferred by the social roles of a quiz game. Legitimacy as well as power increased the tendency for both advantaged (questioner) and disadvantaged (answerer) actors (Study 1) as well as naïve observers of the quiz game (Study 2) to attribute to ability the behaviors elicited by social roles. These results extend previous findings. People are more prone to explain constrained behaviors by differences in ability when role structure is legitimated and when power asymmetry matches role structure. Legitimacy and power may then play an important role in the translation of role constraints into inferences about ability.

Individuals attempting to label their emotions look for a plausible source of their physiological arousal. Co-occurrence of plausible sources can lead to the misattribution of real (or bogus) physiological arousal, resulting in physically attractive individuals being perceived as more attractive than they actually are. In two experiments, female participants heard bogus heart rate feedback while viewing photos of attractive male models. Compared with low-power and control participants, high-power participants rated reinforced photos (increased heart rate) more attractive than non-reinforced photos (stable heart rate) to a greater extent when they heard their own bogus heart rate feedback (Experiments 1 and 2) and to a lesser extent when they heard a recording of another participant’s heart rate (Experiment 2). These findings, which suggest that power increases the tendency to misattribute one’s physiological arousal to physically attractive individuals, are discussed with reference to theories linking power and social perception.