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

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

Saturday, August 18, 2018

Rationalization is rational

Fiery Cushman
Uploaded July 18, 2018


Rationalization occurs when a person has performed an action and then concoct the beliefs and desires that would have made it rational. Then, people often adjust their own beliefs and desires to match the concocted ones. While many studies demonstrate rationalization, and a few theories identify its underlying cognitive mechanisms, we have little understanding of its its function. Why is the mind designed to construct post hoc rationalizations of its behavior, and then to adopt them? This design may accomplish an important task: to transfer information between the many different processes and representations that influence our behavior. Human decision-making does not rely on a single process; it is influenced by reason, habit, instincts, cultural norms and so on. Several of the processes that influence our behavior are not organized according to rational choice (i.e., maximizing desires conditioned on belief). Thus, rationalization extracts implicit information—true beliefs and useful desires—from the influence of these non-rational systems on behavior. This is not a process of self-perception as traditionally conceived, in which one infers the hidden contents of unconscious reasons. Rather, it is a useful fiction. It is a fiction because it imputes reason to non-rational psychological processes; it is useful because it can improve subsequent reasoning. More generally, rationalization is one example of broader class of “representational exchange” mechanisms, which transfer of information between many different psychological processes that guide our behavior. This perspective reveals connections to theory of mind, inverse reinforcement learning, and reflective equilibrium.

The paper is here.

Asking patients why they engaged in a behavior is another example of useful fiction.  Dr. Cushman suggests psychologists ask: What made that worth doing?

Friday, August 17, 2018

Ethical Dimensions of Caring Well for Dying Patients

Ilana Stol
AMA Journal of Ethics

Dying is a uniquely individual yet deeply shared and universal experience; it profoundly impacts perceptions of culture, personhood, and identity. For many Americans, it is also an experience widely discrepant from the one they want and envision for themselves and their loved ones.  Over the past decade, there has been growing awareness of the incongruence between the way Americans say they want to die and how they actually do.  But while most would agree that this reality is not the ideal that clinicians or patients strive for, what is less agreed upon is what the roles of clinicians and patients should be in defining what actually constitutes dying and good care of dying people. What do patients and clinicians need to know about dying and care at the end of life? What barriers exist to accessing and employing this knowledge in the face of difficult decisions?

To best answer these questions, it is useful to examine the social structures and supports already in place for end-of-life care and to understand how they are being utilized. To begin with, hospital palliative care programs are expanding rapidly in order to meet the physical and emotional needs of patients with serious or terminal illness. Robust evidence now exists demonstrating that early palliative care improves the dying experience for both patients and families while generally reducing health care costs and potentially prolonging survival. Despite these facts, there is significant variation in physician practice in the care of patients at the end of life and a general consensus that palliative and hospice care are underutilized by physicians.

The information is here.

Genetically modified babies given go ahead by UK ethics body

Ian Sample
The Guardian
Originally posted July 17, 2018

The creation of babies whose DNA has been altered to give them what parents perceive to be the best chances in life has received a cautious green light in a landmark report from a leading UK ethics body.

The Nuffield Council on Bioethics said that changing the DNA of a human embryo could be “morally permissible” if it was in the future child’s interests and did not add to the kinds of inequalities that already divide society.

The report does not call for a change in UK law to permit genetically altered babies, but instead urges research into the safety and effectiveness of the approach, its societal impact, and a widespread debate of its implications.

“It is our view that genome editing is not morally unacceptable in itself,” said Karen Yeung, chair of the Nuffield working group and professor of law, ethics and informatics at the University of Birmingham. “There is no reason to rule it out in principle.”

The info is here.

Thursday, August 16, 2018

Series of ethical stumbles tests NIH’s reliance on private sector for research funding

Lev Facher
Originally published August 1, 2018

Here is an excerpt:

Now, the NIH is seeking to bounce back from the hit to its reputation — and to demonstrate that the failures of recent years are isolated incidents and not emblematic of a broader cultural problem. At the same time, some congressional aides have hinted at more aggressive oversight of the foundation through which the NIH takes on many of its partnerships.

NIH officials told STAT this week the agency is completing a plan to ensure better ethical compliance and better delineate the actual process for private-sector collaboration. The officials said the plan will be presented to an advisory committee in December.

Already, as STAT reported in April, the NIH proactively nixed a long-touted plan to accept roughly $200 million from pharmaceutical manufacturers to pursue research on pain and addiction treatment, with an explicit acknowledgement that involving companies being sued for their role in the crisis could taint the perception of the research.

NIH Director Francis Collins acknowledged the setbacks in an interview with STAT this week, but defended his staff’s efforts.

The info is here.

Peer Review is Not Scientific

E Price
Originally published June 18, 2018

Here are two excerpts:

The first thing I want all lovers of science to know is this: peer-reviewers are not paid. When you are contacted by a journal editor and asked to conduct a review, there is no discussion of payment, because no payment is available. Ever. Furthermore, peer reviewing is not associated in any direct way with the actual job of being a professor or researcher. The person asking you to conduct a peer review is not your supervisor or the chair of your department, in nearly any circumstance. Your employer does not keep track of how many peer reviews you conduct and reward you appropriately.

Instead, you’re asked by journal editors, via email, on a voluntary basis. And it’s up to you, as a busy faculty member, graduate student, post-doc, or adjunct, to decide whether to say yes or not.

The process is typically anonymized, and tends to be relatively thankless — no one except the editor who has asked you to conduct the review will know that you were involved in the process. There is no quota of reviews a faculty member is expected to provide. Providing a review cannot really be placed on your resume or CV in any meaningful way.


The level of scrutiny that an article is subjected to all comes down to chance. If you’re assigned a reviewer who created a theory that opposes your own theory, your work is likely to be picked apart. The reviewer will look very closely for flaws and take issue with everything that they can. This is not inherently a bad thing — research should be closely reviewed — but it’s not unbiased either.

The information is here.

Wednesday, August 15, 2018

Four Rules for Learning How to Talk To Each Other Again

Jason Pontin
Originally posted

Here is an excerpt:

Here’s how to speak in a polity where we loathe each other. Let this be the Law of Parsimonious Claims:

1. Say nothing you know to be untrue, whether to deceive, confuse, or, worst of all, encourage a wearied cynicism.

2. Make mostly falsifiable assertions or offer prescriptions whose outcomes could be measured, always explaining how your assertion or prescription could be tested.

3. Whereof you have no evidence but possess only moral intuitions, say so candidly, and accept you must coexist with people who have different intuitions.

4. When evidence proves you wrong, admit it cheerfully, pleased that your mistake has contributed to the general progress.

Finally, as you listen, assume the good faith of your opponents, unless you have proof otherwise. Judge their assertions and prescriptions based on the plain meaning of their words, rather on than what you guess to be their motives. Often, people will tell you about experiences they found significant. If they are earnest, hear them sympathetically.

The info is here.

Thinking about Karma and God reduces believers’ selfishness in anonymous dictator games

Cindel White John Kelly Azim Shariff Ara Norenzayan
Originally posted on June 23, 2018


In a novel supernatural framing paradigm, three repeated-measures experiments (N = 2347) examined whether thinking about Karma and God increases generosity in anonymous dictator games. We found that (1) thinking about Karma increased generosity in karmic believers across religious affiliations, including Hindus, Buddhists, Christians, and non-religious Americans; (2) thinking about God also increased generosity among believers in God (but not among non-believers), replicating previous findings; and (3) thinking about both Karma and God shifted participants’ initially selfish offers towards fairness, but had no effect on already fair offers. Contrary to hypotheses, ratings of supernatural punitiveness did not predict greater generosity. These supernatural framing effects were obtained and replicated in high-powered, pre-registered experiments and remained robust to several methodological checks, including hypothesis guessing, game familiarity, demographic variables, and variation in data exclusion criteria.

Tuesday, August 14, 2018

Natural-born existentialists

Ronnie de Sousa
Originally posted December 10, 2017

Here are two excerpts:

Much the same might be true of some of the emotional dispositions bequeathed to us by natural selection. If we follow some evolutionary psychologists in thinking that evolution has programmed us to value solidarity and authority, for example, we must recognise that those very same mechanisms promote xenophobia, racism and fascism. Some philosophers have made much of the fact that we appear to have genuinely altruistic motives: sometimes, human beings actually sacrifice themselves for complete strangers. If that is indeed a native human trait, so much the better. But it can’t be good because it’s natural. For selfishness and cruelty are no less natural. Again, naturalness can’t reasonably be why we value what we care about.

A second reason why evolution is not providence is that any given heritable trait is not simply either ‘adaptive’ or ‘maladaptive’ for the species. Some cases of fitness are frequency-dependent, which means that certain traits acquire a stable distribution in a population only if they are not universal.


The third reason we should not equate the natural with the good is the most important. Evolution is not about us. In repeating the well-worn phrase that is supposed to sum up natural selection, ‘survival of the fittest’, we seldom think to ask: the fittest what? It won’t do to think that the phrase refers to fitness in individuals such as you and me. Even the fittest individuals never survive at all. We all die. What does survive is best described as information, much of which is encoded in the genes. That remains true despite the fashionable preoccupation with ‘epigenetic’ or otherwise non-DNA-encoded factors. The point is that ‘the fittest’ refers to just whatever gets replicated in subsequent generations – and whatever that is, it isn’t us. Every human is radically new, and – at least until cloning becomes routine – none will ever recur.

The article is here.

The developmental and cultural psychology of free will

Tamar Kushnir
Philosophy Compass
Originally published July 12, 2018


This paper provides an account of the developmental origins of our belief in free will based on research from a range of ages—infants, preschoolers, older children, and adults—and across cultures. The foundations of free will beliefs are in infants' understanding of intentional action—their ability to use context to infer when agents are free to “do otherwise” and when they are constrained. In early childhood, new knowledge about causes of action leads to new abilities to imagine constraints on action. Moreover, unlike adults, young children tend to view psychological causes (i.e., desires) and social causes (i.e., following rules or group norms, being kind or fair) of action as constraints on free will. But these beliefs change, and also diverge across cultures, corresponding to differences between Eastern and Western philosophies of mind, self, and action. Finally, new evidence shows developmentally early, culturally dependent links between free will beliefs and behavior, in particular when choice‐making requires self‐control.

Here is part of the Conclusion:

I've argued here that free will beliefs are early‐developing and culturally universal, and that the folk psychology of free will involves considering actions in the context of alternative possibilities and constraints on possibility. There are developmental differences in how children reason about the possibility of acting against desires, and there are both developmental and cultural differences in how children consider the social and moral limitations on possibility.  Finally, there is new evidence emerging for developmentally early, culturally moderated links between free will beliefs and willpower, delay of gratification, and self‐regulation.

The article is here.