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Decisions near the end of life: resource allocation implications for hospitals.

CONCLUSION: At a time when hospitals are having predictable difficulty accommodating infinite expectations with finite resources, there are still some observers who abhor even the possibility that the cost and volume of hospital services to the terminally ill be scrutinized. However, more assertive attention is justified on the basis of qualitative as well as quantitative evidence. Neither unrestricted medical paternalism nor total patient autonomy should be unequivocally endorsed. Both the physician and the patient have a mutual obligation and incentive to achieve a proper balance. This balance is dynamic rather than static because attitudes and values change, and advance directives are not immutable documents. Hospitals have a moral imperative to create an organizational environment in which a genuine collaborative decision-making process will ultimately benefit all participants.

Administrative Personnel↗

Evidence for a priming effect on maternal resource allocation: implications for interbrood competition.

It is commonly assumed that there exists interbrood competition mediated by in utero growth. This could be manifested by a female reallocating saved resources to future broods. Here, we report results of a manipulation experiment designed to detect such reallocation. Two groups of female mice were allowed each to produce two broods. In the first brood, the test females were mated with phenotypically normal males heterozygous for an insulin-like growth factor 2 (Igf2) null allele, while the control females were mated to a wild-type male. The test sample females invested 20% less into their first brood than did the control sample. In both test and control groups the females were mated with a wild-type male in the second round of mating. Surprisingly, we found that females that invested little into their first brood also invested little (compared with other second broods) into their second brood. This 'priming' effect suggests that the assumptions of classical models of parent-offspring conflict are overly simplistic but cannot disprove the existence of interbrood competition.

Animals↗

Resource-allocation rules and the heritability of traits.

I hypothesize that the heritability of a trait, and thus its evolutionary responsiveness to natural selection, should be positively related to the priority with which resources are allocated to that trait. Low-priority traits are more sensitive to environmental effects, thus reducing the relative effect of genetic differences on phenotypic variation of these traits. This allocation-priority hypothesis explains why life-history traits, such as those involving growth and reproduction, generally have lower heritabilities than higher-priority morphological and physiological traits related to body maintenance. This hypothesis also shows how an organism-centered approach, as used in physiological ecology, can contribute to the development of evolutionary theory.

Animals↗