Human cognition increasingly is coming to be understood and studied as something that does not necessarily reside within individuals, but rather as something that evolves through interpersonal communication. Using the interpersonal event as the unit of analysis, the authors of "Collaborative Cognition" examine how children interactively co-construct knowledge and ways of knowing in social contexts. In an illustration of the idea that thinking is as much interactive as self-reflective--one that supports the cognitive developmental theories of Jean Piaget and Lev Vygotsky--this important new study examines the social origins of thought, and the inherently discursive nature of thinking itself.

The social context in question was created by the authors, who showed to pairs of children a variety of game materials and asked them to collaborate on creating a board game. Negotiating the co-construction of a game, back and forth, turn by turn, enabled the children to construct jointly a series of mutually obligatory goals and rules that sequentially defined the evolution of increasingly more complex modes of play. This innovative use of sequential analyses to study evolving streams of conversation discourse represents a fully process-oriented, rather than outcome-oriented, approach to studying cognitive development.

Medical care of the terminally ill is one of the most emotionally fraught and controversial issues before the public today. As medicine advances and technologies develop, end-of-life care becomes more individualized and uncertain, guided less by science and more by values and beliefs. The crux of the controversy is when to withhold or withdraw curative treatments--when is enough, enough?
Political debates rage about when treatment is no longer effective; difficult cases are contested in courts; and the media devour the most sensational aspects of end-of-life care. In all this excitement and controversy, what is sadly overlooked is the extreme pressure that care of the terminally ill puts on medical staff as they deal with patients and their families and make life-or-death decisions. That pressure--the psychological strain and continuing uncertainties--is magnified when the patients are children.
David Bearison looks at this controversial issue from the perspective of the medical staff caring for dying children. Not just doctors, but nurses and counselors as well. By capturing their stories--as no other book has, Bearison is able to move beyond broad, abstract ideas about end-of-life care to convey the situated contexts of such care, including the complications, disagreements, frustrations, confusions, and unexpected setbacks.
In addition to a discussion of questions surrounding whether to withhold or withdraw curative treatments, When Treatment Fails explores the crucial concerns of those medical practitioners who care for dying children: education and training, relation with one another, communicating with patients and families, and finally, coping and moving on.Ultimately, the threads connecting these themes are the great costs and rewards of this difficult work, and the lessons that can be drawn from the nitty-gritty experiences of medical practitioners who struggle to find the balance between trying to defeat death and trying to provide comfort.

As the practice of paediatric oncology continues to advance and prognoses continue to improve, the course of treatment for children with poor prognoses becomes more biologically aggressive, more stressful, and more uncertain. Even for children who cannot be cured, new treatments have prolonged the survival of those with active disease and, consequently, medical interventions have complicated the dying process. For those who are cured, there are the lingering uncertainties of having undergone medical regimens whose adverse late effects are not yet fully understood. Consequently the field of paediatric oncology now encompasses more than strictly medical concerns. The conditions of treatment, survival, and dying have become the concerns of all health-care practitioners, including psychiatrists.

This volume addresses a range of psychological issues - coping with paediatric cancer, pain and symptom management, medication compliance, sibling and family relations, care of the dying child, among others -- pertaining to the practice of paediatric oncology. Each topic encompasses a substantial body of research that not only has theoretical but applied significance. Each chapter is written by a nationally recognized investigator in his or her respective area of inquiry and (1) contextually defines the research area, (2) discusses theoretical and methodological concerns of the area, (3) critically reviews and integrates research findings in the area, and (4) discusses unresolved research issues and suggests future research. The topics included are currently supported by sufficient empirical research to allow useful generalization of findings in the clinical setting.