TOWARD A CONSTRUCTIONAL APPROACH TO SOCIAL PROBLEMS: ETHICAL AND CONSTITUTIONAL ISSUES RAISED BY APPLIED BEHAVIOR ANALYSIS

34 Unfortunately, Hilgard and Bower perpetuate the over-simplification that "the practical use of the system is based on the complementary principles of control through presenting and withholding reward." Further, "it is not necessary to worry about anything precise in the way either of experimental data or of correlated principles" (p. 144). To any investigator who has spent hours worrying his instruments to obtain precision, this statement appears strange. It must also appear strange to those working in p.i., which discusses curriculum, sequences, stimulus control, fading, prompting, etc. The occurrence of such lapses is especially regrettable and unfortunately influential when it comes from scientists whose reputation for thoroughness is well earned.

35 These include those administered by the Department of Psychiatry or affiliated with it, which include the Out-Patient Division (of which our service is an integral part), the department's ward, and the Student Mental Health Center. In addition to involvement with patients from these units, we have also supplied consultant services to Medicine and other departments. Dr. J. E. Dyrud is clinical director of the department and associate chairman. I wish to express my profound appreciation to him, and to Dr. D. X. Freedman, chairman, for their continual and unstinting support throughout. I am equally indebted to Dr. E. A. Uhlenhuth, director of OPD, for similar support. Needless to say, they are not responsible for any ideas expressed here, except for the moral rule of any hospital: when one accepts a patient, his interests come first.

36 The one exception was the response to: "What's your husband like?"-"He's the devil!"-"You mean there's something about him . . ." etc.,-"NO, he is the devil."- "You mean he stands for everything the Virgin Mary does not?"-"Darn right!" (I had finally caught on to her system of private metaphors, and thereafter they were more trite.)

37 It is often assumed that because treatment is extended or difficult, the problem must be a difficult one. The inference may not hold. The time to construct a building may be extended, but analysis of what is to go up and how may be simple. Such an outline is usually called a blueprint. It takes at least four years to get a Ph.D. What is to be done can be mapped out in less than an hour. It is called a course of study.

38 Often the behavior has ceased being functional, that is, is no longer reinforced, or the consequence has ceased being critical. In such cases, a simple eliminative procedure or program which rationalizes change will be quite effective.

39 C. Dunn was the programer.

40 R. Parry is the programer.

41 Dr. N. Brody is the programer.

42 An issue which is constantly raised is illustrated by the question: "If you were a psychoanalyst in Vienna and a Nazi requested treatment for his anxiety," presumably so that he could resume his illtreatment of Jews, "would you take the case?" It is often resolved by resort to the explanation that you would feel so uncomfortable that you could not be a good therapeutic agent. This is a pseudoanswer to a pseudo-issue, because both ignore the moral issues involved. These are obscured by posing the question in pathological terms, which suggest a conflicting moral obligation to offer relief to a human in distress. The moral issues can be clarified by reference to the outcome to be constructed, namely, return to duties we define as immoral. A Nazi, of course, might think otherwise.