Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, philosophy and health care

Wednesday, May 24, 2017

Roger Penrose On Why Consciousness Does Not Compute

Steve Paulson
Originally posted May 4, 2017

Here is an excerpt:

As we probed the deeper implications of Penrose’s theory about consciousness, it wasn’t always clear where to draw the line between the scientific and philosophical dimensions of his thinking. Consider, for example, superposition in quantum theory. How could Schrödinger’s cat be both dead and alive before we open the box? “An element of proto-consciousness takes place whenever a decision is made in the universe,” he said. “I’m not talking about the brain. I’m talking about an object which is put into a superposition of two places. Say it’s a speck of dust that you put into two locations at once. Now, in a small fraction of a second, it will become one or the other. Which does it become? Well, that’s a choice. Is it a choice made by the universe? Does the speck of dust make this choice? Maybe it’s a free choice. I have no idea.”

I wondered if Penrose’s theory has any bearing on the long-running philosophical argument between free will and determinism. Many neuroscientists believe decisions are caused by neural processes that aren’t ruled by conscious thought, rendering the whole idea of free will obsolete. But the indeterminacy that’s intrinsic to quantum theory would suggest that causal connections break down in the conscious brain. Is Penrose making the case for free will?

“Not quite, though at this stage, it looks like it,” he said. “It does look like these choices would be random. But free will, is that random?” Like much of his thinking, there’s a “yes, but” here. His claims are provocative, but they’re often provisional. And so it is with his ideas about free will. “I’ve certainly grown up thinking the universe is deterministic. Then I evolved into saying, ‘Well, maybe it’s deterministic but it’s not computable.’ But is it something more subtle than that? Is it several layers deeper? If it’s something we use for our conscious understanding, it’s going to be a lot deeper than even straightforward, non-computable deterministic physics. It’s a kind of delicate borderline between completely deterministic behavior and something which is completely free.”

Ethics office rejects White House attempt to halt inquiry into lobbyists

Associated Press
Originally posted May 23, 2017

Donald Trump’s administration says the government ethics office lacks the authority to force the president to reveal how many waivers he’s granted to ex-lobbyists in his new administration.

Trump’s budget director, Mick Mulvaney, is asking that the office of government ethics (OGE) director, Walter Shaub, halt his inquiry into lobbyists-turned-Trump administration employees. Mulvaney wrote in a letter last week to Shaub: “This data call appears to raise legal questions regarding the scope of OGE’s authorities.”

Shaub fired back Monday that OGE’s request was well within bounds. The ethics director says he expects to see the waiver information within 10 days.

The article is here.

Tuesday, May 23, 2017

Trump moves to block ethics inquiry centered on ex-lobbyists

Brandon Carter
The Hill
Originally published May 22, 2017

The White House is looking to block an effort from the government’s top ethics office to disclose the names of former lobbyists who have been granted waivers to work in the federal government, according to a new report.

The New York Times reports that the White House sent a letter to the head of the Office of Government Ethics (OGE) challenging its legal authority to request that information.

“It is an extraordinary thing,” Walter Shaub Jr., the director of the ethics office, told the Times. “I have never seen anything like it.”

The letter sent by Mick Mulvaney, the head of the Office of Management and Budget, questions whether the ethics office has the authority to demand information regarding ex-lobbyists who are currently working in the federal government.

The article is here.

Psychologist contractors say they were following agency orders

Pamela MacLean
Bloomberg News
Originally posted May 5, 2017

A pair of U.S. psychologists accused of overseeing the torture of terrorism detainees more than a decade ago face reluctance from a federal judge to let them question the CIA’s deputy director to show they were only following orders.

The judge indicated at a hearing Friday that the psychologists should be able defend themselves in the 2015 lawsuit without compromising government secrecy around the exact role Gina Haspel played in the agency’s overseas interrogation program years before she was tapped to be second in command by the Trump administration.

The American Civil Liberties Union, which filed the case on behalf of three ex-prisoners, one of whom died in custody, is urging the judge not to let the psychologists’ lawyers question Haspel and a retired Central Intelligence Agency official. While the defendants want to demonstrate their actions were approved by the agency, the ACLU says that won’t shield them from liability.

The article is here.

Monday, May 22, 2017

Half of US physicians receive industry payments

Michael McCarthy
BMJ 2017; 357

Nearly half of US physicians receive payments from the drug, medical device, and related medical industries, and surgeons and male physicians are more likely to do so, a US study has found.

The study leader, Jona A Hattangadi-Gluth, of the University of California, San Diego, based in La Jolla, said that most payments were relatively small but that many specialists receive more than $10 000 (£7750; $9160) a year from industry, including 11% of orthopedic surgeons, 12% of neurologists, and 13% of neurosurgeons.

She said, “The data suggest that these payments are much more pervasive than we thought and [that] there is much more money going directly to physicians than maybe people recognized.”

The researchers analyzed data from 2015 collected from Open Payments, a program created by the 2010 Affordable Care Act that requires biomedical manufacturers and group purchasing organizations to report all general payments, ownership interests, and research payments paid to allopathic and osteopathic physicians in the US.

The article is here.

The morality of technology

Rahul Matthan
Live Mint
Originally published May 3, 2017

Here is an excerpt:

Another example of the two sides of technology is drones—a modern technology that is already being deployed widely—from the delivery of groceries to ensuring that life saving equipment reaches first responders in high density urban areas. But for every beneficent use of drone tech, there are an equal number of dubious uses that challenge our ethical boundaries. Foremost among these is development of AI-powered killer drones—autonomous flying weapons intelligent enough to accurately distinguish between friend and foe and then, autonomously, take the decision to execute a kill.

This duality is inherent in all of tech. But just because technology can be used for evil, that should not, of itself, be a reason not to use it. We need new technology to better ourselves and the world we live in—and we need to be wise about how we apply it so that our use remains consistent with the basic morality inherent in modern society. This implies that each time we make a technological breakthrough we must assess afresh, the contexts within which they could present themselves and the uses to which they should (and should not) be put. If required, we must take the trouble to re-draw our moral boundaries, establishing the limits within which they must be constrained.

The article is here.

Sunday, May 21, 2017

What do we evaluate when we evaluate moral character?

Erik G. Helzer & Clayton R. Critcher


Despite growing interest in the topic of moral character, there is very little precision
and a lack of agreement among researchers as to what is evaluated when people evaluate
character. In this chapter we define moral character in novel social cognitive terms and offer
empirical support for the idea that the central qualities of moral character are those deemed
essential for social relationships.

Here is an excerpt:

We approach this chapter from the theoretical standpoint that the centrality of character
evaluation is due to its function in social life. Evaluation of character is, we think, inherently a
judgment about a person’s qualifications for being a solid long-term social investment. That is,
people attempt to suss out moral character because they want to know whether a particular agent
is the type of person who likely possesses the necessary (even if not sufficient) qualities they
expect in a social relationship. In developing these ideas theoretically and empirically, we
consider what form moral character takes, discuss what this proposal suggests about how people
may and do assess others’ moral character, and identify an assortment of qualities that our
perspective predicts will be central to moral character.

The book chapter is here.

Saturday, May 20, 2017

Conflict of Interest and the Integrity of the Medical Profession

Allen S. Lichter
JAMA. 2017;317(17):1725-1726.

Physicians have a moral responsibility to patients; they are trusted to place the needs and interests of patients ahead of their own, free of unwarranted outside influences on their decisions. Those who have relationships that might be seen to influence their decisions and behaviors that may affect fulfilling their responsibilities to patients must be fully transparent about them. Two types of interactions and activities involving physicians are most relevant: (1) commercial or research relationships between a physician expert and a health care company designed to advance an idea or promote a product, and (2) various gifts, sponsored meals, and educational offerings that come directly or indirectly to physicians from these companies.

Whether these and other ties to industry are important is not a new issue for medicine. Considerations regarding the potential influence of commercial ties date back at least to the 1950s and 1960s. In 1991, Relman reminded physicians that they have “a unique opportunity to assume personal responsibility for important decisions that are not influenced by or subordinated to the purposes of third parties.” However, examples of potential subordination are easily found. There are reports of physicians who are paid handsomely to promote a drug or device, essentially serving as a company spokesperson; of investigators who have ownership in the company that stands to gain if the clinical trial is successful; and of clinical guideline panels that are dominated by experts with financial ties to companies whose products are relevant to the disease or condition at hand.

The article is here.

Friday, May 19, 2017

Conflict of Interest: Why Does It Matter?

Harvey V. Fineberg
JAMA. 2017;317(17):1717-1718.

Preservation of trust is the essential purpose of policies about conflict of interest. Physicians have many important roles including caring for individual patients, protecting the public’s health, engaging in research, reporting scientific and clinical discoveries, crafting professional guidelines, and advising policy makers and regulatory bodies. Success in all these functions depends on others—laypersons, professional peers, and policy leaders—believing and acting on the word of physicians. Therefore, the confidence of others in physician judgment is of paramount importance. When trust in physician judgment is impaired, the role of physicians is diminished.

Physicians should make informed, disinterested judgments. To be disinterested means being free of personal advantage. The type of advantage that is typically of concern in most situations involving physicians is financial. When referring to conflict of interest, the term generally means a financial interest that relates to the issue at hand. More specifically, a conflict of interest can be discerned by using a reasonable person standard; ie, a conflict of interest exists when a reasonable person would interpret the financial circumstances pertaining to a situation as potentially sufficient to influence the judgment of the physician in question.

The article is here.