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

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

Thursday, July 27, 2017

First Human Embryos Edited in U.S.

Steve Connor
MIT Technology News
Originally published July 26, 2017

The first known attempt at creating genetically modified human embryos in the United States has been carried out by a team of researchers in Portland, Oregon, Technology Review has learned.

The effort, led by Shoukhrat Mitalipov of Oregon Health and Science University, involved changing the DNA of a large number of one-cell embryos with the gene-editing technique CRISPR, according to people familiar with the scientific results.

Until now, American scientists have watched with a combination of awe, envy, and some alarm as scientists elsewhere were first to explore the controversial practice. To date, three previous reports of editing human embryos were all published by scientists in China.

Now Mitalipov is believed to have broken new ground both in the number of embryos experimented upon and by demonstrating that it is possible to safely and efficiently correct defective genes that cause inherited diseases.

Although none of the embryos were allowed to develop for more than a few days—and there was never any intention of implanting them into a womb—the experiments are a milestone on what may prove to be an inevitable journey toward the birth of the first genetically modified humans.

The article is here.

Psychiatry Group Tells Members They Can Ignore ‘Goldwater Rule’ and Comment on Trump’s Mental Health

Sharon Begley
Global Research
Originally published July 25, 2017

A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president.

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump’s mental health.

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago.

“We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

The article is here.

Wednesday, July 26, 2017

Everybody lies: how Google search reveals our darkest secrets

Seth Stephens-Davidowitz
The Guardian
Originally published July 9, 2017

Everybody lies. People lie about how many drinks they had on the way home. They lie about how often they go to the gym, how much those new shoes cost, whether they read that book. They call in sick when they’re not. They say they’ll be in touch when they won’t. They say it’s not about you when it is. They say they love you when they don’t. They say they’re happy while in the dumps. They say they like women when they really like men. People lie to friends. They lie to bosses. They lie to kids. They lie to parents. They lie to doctors. They lie to husbands. They lie to wives. They lie to themselves. And they damn sure lie to surveys. Here’s my brief survey for you:

Have you ever cheated in an exam?

Have you ever fantasised about killing someone?

Were you tempted to lie?

Many people underreport embarrassing behaviours and thoughts on surveys. They want to look good, even though most surveys are anonymous. This is called social desirability bias. An important paper in 1950 provided powerful evidence of how surveys can fall victim to such bias. Researchers collected data, from official sources, on the residents of Denver: what percentage of them voted, gave to charity, and owned a library card. They then surveyed the residents to see if the percentages would match. The results were, at the time, shocking. What the residents reported to the surveys was very different from the data the researchers had gathered. Even though nobody gave their names, people, in large numbers, exaggerated their voter registration status, voting behaviour, and charitable giving.

The article is here.

Using Virtual Reality to Assess Ethical Decisions in Road Traffic Scenarios

Leon R. Sütfeld, Richard Gast, Peter König and Gordon Pipa
Front. Behav. Neurosci., 05 July 2017

Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date. Models of ethics for self-driving cars should thus aim to match human decisions made in the same context. We employed immersive virtual reality to assess ethical behavior in simulated road traffic scenarios, and used the collected data to train and evaluate a range of decision models. In the study, participants controlled a virtual car and had to choose which of two given obstacles they would sacrifice in order to spare the other. We randomly sampled obstacles from a variety of inanimate objects, animals and humans. Our model comparison shows that simple models based on one-dimensional value-of-life scales are suited to describe human ethical behavior in these situations. Furthermore, we examined the influence of severe time pressure on the decision-making process. We found that it decreases consistency in the decision patterns, thus providing an argument for algorithmic decision-making in road traffic. This study demonstrates the suitability of virtual reality for the assessment of ethical behavior in humans, delivering consistent results across subjects, while closely matching the experimental settings to the real world scenarios in question.

The article is here.

Tuesday, July 25, 2017

Should a rapist get Viagra or a robber get a cataracts op?

Tom Douglas
Aeon Magazine
Originally published on July 7, 2017

Suppose a physician is about to treat a patient for diminished sex drive when she discovers that the patient – let’s call him Abe – has raped several women in the past. Fearing that boosting his sex drive might lead Abe to commit further sex offences, she declines to offer the treatment. Refusal to provide medical treatment in this case strikes many as reasonable. It might not be entirely unproblematic, since some will argue that he has a human right to medical treatment, but many of us would probably think the physician is within her rights – she’s not obliged to treat Abe. At least, not if her fears about further offending are well-founded.

But now consider a different case. Suppose an eye surgeon is about to book Bert in for a cataract operation when she discovers that he is a serial bank robber. Fearing that treating his developing blindness might help Bert to carry off further heists, she declines to offer the operation. In many ways, this case mirrors that of Abe. But morally, it seems different. In this case, refusing treatment does not seem reasonable, no matter how well-founded the surgeon’s fear. What’s puzzling is why. Why is Bert’s surgeon obliged to treat his blindness, while Abe’s physician has no similar obligation to boost his libido?

Here’s an initial suggestion: diminished libido, it might be said, is not a ‘real disease’. An inconvenience, certainly. A disability, perhaps. But a genuine pathology? No. By contrast, cataract disease clearly is a true pathology. So – the argument might go – Bert has a stronger claim to treatment than Abe. But even if reduced libido is not itself a disease – a view that could be contested – it could have pathological origins. Suppose Abe has a disease that suppresses testosterone production, and thus libido. And suppose that the physician’s treatment would restore his libido by correcting this disease. Still, it would seem reasonable for her to refuse the treatment, if she had good grounds to believe providing it could result in further sex offences.

A new breed of scientist, with brains of silicon

John Bohannon
Science Magazine
Originally published July 5, 2017

Here is an excerpt:

But here’s the key difference: When the robots do finally discover the genetic changes that boost chemical output, they don’t have a clue about the biochemistry behind their effects.

Is it really science, then, if the experiments don’t deepen our understanding of how biology works? To Kimball, that philosophical point may not matter. “We get paid because it works, not because we understand why.”

So far, Hoffman says, Zymergen’s robotic lab has boosted the efficiency of chemical-producing microbes by more than 10%. That increase may not sound like much, but in the $160-billion-per-year sector of the chemical industry that relies on microbial fermentation, a fractional improvement could translate to more money than the entire $7 billion annual budget of the National Science Foundation. And the advantageous genetic changes that the robots find represent real discoveries, ones that human scientists probably wouldn’t have identified. Most of the output-boosting genes are not directly related to synthesizing the desired chemical, for instance, and half have no known function. “I’ve seen this pattern now in several different microbes,” Dean says. Finding the right genetic combinations without machine learning would be like trying to crack a safe with thousands of numbers on its dial. “Our intuitions are easily overwhelmed by the complexity,” he says.

The article is here.

Monday, July 24, 2017

GOP Lawmakers Buy Health Insurance Stocks as Repeal Efforts Move Forward

Lee Fang
The Intercept
Originally posted July 6, 2017

Here is an excerpt:

The issue of insider political trading, with members and staff buying and selling stock using privileged information, has continued to plague Congress. It gained national prominence during the confirmation hearings for Health and Human Services Secretary Tom Price, when it was revealed that the Georgia Republican had bought shares in Innate Immunotherapeutics, a relatively obscure Australian biotechnology firm, while legislating on policies that could have impacted the firm’s performance.

The stock advice had been passed to Price from Rep. Chris Collins, R-N.Y., a board member for Innate Immunotherapeutics, and was shared with a number of other GOP lawmakers, who also invested in the firm. Conaway, records show, bought shares in the company a week after Price.

Conaway, who serves as a GOP deputy whip in the House, has a long record of investing in firms that coincide with his official duties. Politico reported that Conaway’s wife purchased stock in a nuclear firm just after Conaway sponsored a bill to deal with nuclear waste storage in his district. The firm stood to directly benefit from the legislation.

Some of the biggest controversies stem from the revelation that during the 2008 financial crisis, multiple lawmakers from both parties rearranged their financial portfolios to avoid heavy losses. In one case, former Rep. Spencer Baucus, R-Ala., used confidential meetings about the unfolding bank crisis to make special trades designed to increase in value as the stock market plummeted.

The article is here.

Even the Insured Often Can't Afford Their Medical Bills

Helaine Olen
The Atlantic
Originally published June 18, 2017

Here is an excerpt:

The current debate over the future of the Affordable Care Act is obscuring a more pedestrian reality. Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchanges, that figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.

Even a gold-plated insurance plan with a low deductible and generous reimbursements often has its holes. Many people have separate—and often hard-to-understand—in-network and out-of-network deductibles, or lack out-of-network coverage altogether.  Expensive pharmaceuticals are increasingly likely to require a significantly higher co-pay or not be covered at all. While many plans cap out-of-pocket spending, that cap can often be quite high—in 2017, it’s $14,300 for a family plan purchased on the ACA exchanges, for example. Depending on the plan, medical care received from a provider not participating in a particular insurer’s network might not count toward any deductible or cap at all.

The article is here.

Sunday, July 23, 2017

Stop Obsessing Over Race and IQ

John McWhorter
The National Review
Originally published July 5, 2017

Here are three excerpts:

Suppose that, at the end of the day, people of African descent have lower IQs on average than do other groups of humans, and that this gap is caused, at least in part, by genetic differences.

(cut)

There is, however, a question that those claiming black people are genetically predisposed to have lower IQs than others fail to answer: What, precisely, would we gain from discussing this particular issue?

(cut)

A second purpose of being “honest” about a racial IQ gap would be the opposite of the first: We might take the gap as a reason for giving not less but more attention to redressing race-based inequities. That is, could we imagine an America in which it was accepted that black people labored — on average, of course — under an intellectual handicap, and an enlightened, compassionate society responded with a Great Society–style commitment to the uplift of the people thus burdened?

I am unaware of any scholar or thinker who has made this argument, perhaps because it, too, is an obvious fantasy. Officially designating black people as a “special needs” race perpetually requiring compensatory assistance on the basis of their intellectual inferiority would run up against the same implacable resistance as condemning them to menial roles for the same reason. The impulse that rejects the very notion of IQ differences between races will thrive despite any beneficent intentions founded on belief in such differences.

The article is here.