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

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

Tuesday, September 30, 2014

How Unethical Behavior Becomes Habit

by Francesca Gino, Lisa D. Ordóñez and David Welsh
Harvard Business Review Blog
Originally posted September 4, 2014

When a former client’s secretary was arrested for embezzlement years before his own crimes were uncovered, Bernie Madoff commented to his own secretary, “Well, you know what happens is, it starts out with you taking a little bit, maybe a few hundred, a few thousand. You get comfortable with that, and before you know it, it snowballs into something big.”

We now know that Madoff’s Ponzi scheme started when he engaged in misreporting to cover relatively small financial losses. Over a 15-year period, the scam grew steadily, eventually ballooning to $65 billion, even as regulators and investors failed to notice the warning signs.

The entire article is here.

E-Health Interventions for Suicide Prevention

Helen Christensen, Philip J. Batterham, and Bridianne O'Dea
Int. J. Environ. Res. Public Health 2014, 11(8), 8193-8212
doi:10.3390/ijerph110808193

Abstract: 

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

The entire research article is here.

Monday, September 29, 2014

Episode 16: Ethics and Telepsychology (Part 2)

John welcomes Dr. Marlene Maheu back for Part 2 of Ethics and Telepsychology.  The podcast starts out with a vignette on practicing psychology over state lines using telepsychology.  John and Marlene review important aspects of informed consent, privacy and security laws, documentation, and interstate practice.  Marlene gives a variety of tips, including the need to utilize a risk management tool for telepsychology practice, additional components of informed consent, and the need to document more information.

At the end of the podcast, the listener will be able to:

1. Explain two important interjurisdictional issues with telepsychology.
2. Described three important components of informed consent with telepsychology.
3. List one relevant security law and one relevant security law related to the practice of telepsychology.

Click here to earn one APA-approved CE credit


Or listen directly below



Resources for Episode 16



HIPAA Security Standards: Technical Safeguards

HIPAA Risk Assessment Tool: HHS & HealthIT.gov

Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42, 276-283.
doi: 10.1016/j.beth.2010.07.005

Harris, E., & Younggren, J. N. (2011). Risk management in the digital world.
Professional Psychology: Research and Practice, 42, 412-418.
doi: 10.1037/a0025139

Sunday, September 28, 2014

Why Do Doctors Commit Suicide?

By Pranay Sinha
The New York Times
Originally posted September 4, 2014

The statistics on physician suicide are frightening: Physicians are more than twice as likely to kill themselves as nonphysicians (and female physicians three times more likely than their male counterparts). Some 400 doctors commit suicide every year. Young physicians at the beginning of their training are particularly vulnerable: In a recent study, 9.4 percent of fourth-year medical students and interns — as first-year residents are called — reported having suicidal thoughts in the previous two weeks.

The entire article is here.

Saturday, September 27, 2014

New Record Highs in Moral Acceptability

Premarital sex, embryonic stem cell research, euthanasia growing in acceptance

by Rebecca Riffkin
Gallup Politics
Originally posted on May 30, 2014

The American public has become more tolerant on a number of moral issues, including premarital sex, embryonic stem cell research, and euthanasia. On a list of 19 major moral issues of the day, Americans express levels of moral acceptance that are as high or higher than in the past on 12 of them, a group that also encompasses social mores such as polygamy, having a child out of wedlock, and divorce.





Friday, September 26, 2014

Did We Interpret the Milgram Study Incorrectly?

Famous Milgram 'electric shocks' experiment drew wrong conclusions about evil, say psychologists

By Adam Sherwin
The Independent
Originally published September 5, 2014

Here are two excerpts:

Now psychologists have found that the study, which showed how ordinary people will inflict extraordinary harm upon others, if someone in authority gives the orders, may have been completely misunderstood.

Instead of a latent capacity for evil, we just want to feel good about ourselves. And it is Professor Stanley Milgram’s skill as a “dramatist” which led us to believe otherwise.

(cut)

Far from being distressed by the experience, the researchers found that most volunteers said they were very happy to have participated.

Professor Haslam said: “It appears from this feedback that the main reason participants weren’t distressed is that they did not think they had done anything wrong.  This was largely due to Milgram’s ability to convince them that they had made an important contribution to science.”

The entire article is here.

Females ignored in basic medical research

By Erin White
Science Daily
Published August 28, 2014

A new study from Northwestern Medicine® has found that surgical researchers rarely use female animals or female cells in their published studies -- despite a huge body of evidence showing that sex differences can play a crucial role in medical research.

Editors of the five major surgical journals reviewed in this study have responded to this finding and will now require authors to state the sex of animals and cells used in their studies. If they use only one sex in their studies, they will be asked to justify why.

The entire article is here.

Thursday, September 25, 2014

Should Pro-Anorexia Sites Be Criminalized?

Italy’s Parliament recently proposed a bill that would criminalize pro-anorexia site authors with a $67,000 fine and up to a year in jail. But health experts say this is a bad idea.

By Carrie Arnold
The Daily Beast
Originally published August 30, 2014

Here is an excerpt:

While Pinterest, Tumblr, and Instagram banned “thinspiration” photos on the basis that they were linked to self-harm, they continue to allow healthy living advice that isn’t necessarily so healthy, extreme diet and exercise hints, and so-called “fitspiration,” which some in the eating disorder community say is thinspiration disguised in workout clothes. Many of the slogans most closely associated with pro-anorexia rhetoric (“Nothing Tastes As Good As Skinny Feels”) are actually from commercial weight loss sites, as are many of the tips the sites share. Although some use pro-anorexia sites to “learn” how to be better at their eating disorder, many of these tips also exist in stories and television shows designed to teach people about the dangers of eating disorders.

The entire article is here.

You Should Have a Say in Your Robot Car’s Code of Ethics

By Jason Millar
Wired
Originally posted September 2, 2014

Here are some excerpts:

Informed consent wasn’t always the standard of practice in healthcare. It used to be common for physicians to make important treatment decisions on behalf of patients, often actively deceiving them as part of a treatment plan.

(cut)

For starters, we could choose to consider a manufacturer’s failure to obtain informed consent from a user, in situations involving deep moral commitments, a kind of product defect. Just as a doctor would be liable for failing to seek a patient’s informed consent before proceeding with a medical treatment, so too could we consider manufacturers liable for failing to reasonably respect user’s explicit moral preferences in the design of autonomous cars and other technologies. This approach would add considerably to the complexity of design. Then again, nobody said engineering robots was supposed to be simple.

The entire article is here.

Wednesday, September 24, 2014

8 Malpractice Dangers in Your EHR

By Neil Chesanow
MedScape
Originally published August 26, 2014

Many physicians are so concerned about being sued for malpractice that they routinely order unnecessary tests and procedures to practice defensive medicine. And yet, when it comes to legal risks in using their electronic health records (EHRs), their concern is often nonexistent, experts assert.

Many doctors use their EHRs in nonstandard ways, without considering how this may affect them in a liability suit. Or they gloss over other aspects of using an EHR.

"Every aspect of EHR selection, implementation, and use may be examined in the course of medical malpractice discovery to uncover the source of the incident, or undermine the records that are being presented in defense of the malpractice claim," warns Ronald B. Sterling, CPA, MBA, an EHR expert in Silver Spring, Maryland, and author of Keys to EMR Success.

"Anything could be a malpractice issue," Sterling says, "from the product itself, to the way it was set up, to how you've been using it."

Are your EHR practices setting you up for a rude awakening should a patient sue you for malpractice? Let's take a look.

The entire article is here.

Linguistic Traces of a Scientific Fraud: The Case of Diederik Stapel

By David Markowitz and Jeffrey Hancock
Published: August 25, 2014
DOI: 10.1371/journal.pone.0105937

Abstract

When scientists report false data, does their writing style reflect their deception? In this study, we investigated the linguistic patterns of fraudulent (N = 24; 170,008 words) and genuine publications (N = 25; 189,705 words) first-authored by social psychologist Diederik Stapel. The analysis revealed that Stapel's fraudulent papers contained linguistic changes in science-related discourse dimensions, including more terms pertaining to methods, investigation, and certainty than his genuine papers. His writing style also matched patterns in other deceptive language, including fewer adjectives in fraudulent publications relative to genuine publications. Using differences in language dimensions we were able to classify Stapel's publications with above chance accuracy. Beyond these discourse dimensions, Stapel included fewer co-authors when reporting fake data than genuine data, although other evidentiary claims (e.g., number of references and experiments) did not differ across the two article types. This research supports recent findings that language cues vary systematically with deception, and that deception can be revealed in fraudulent scientific discourse.

The entire article is here.

Tuesday, September 23, 2014

Perspectives on Juvenile Detention and Solitary Confinement

By Antonia Cartwright
Juvenile Justice Information Exchange
Originally posted August 27, 2014

Juvenile solitary confinement is a poignant indictment of our dependence on incarceration. The practice is pervasive in the United States, despite the fact that it damages our youth and, by causing higher recidivism, harms our society. Many other countries avoid or prohibit juvenile solitary confinement, viewing it as torture.

Disguised under a barrage of euphemisms, including segregation and secure housing, juvenile solitary confinement is pervasive in the United States, but lacks legal definition and practice guidelines. Recent legislation in California sought to restrict juvenile isolation to addressing urgent risks only. Unfortunately this has stalled, but advocates must continue to address the issue. Many states segregate juveniles for protection or punishment, for weeks or even months at a time.

The entire Op-Ed piece is here.

When Leaders Lie

By Cynthia Schoeman
The Ethics Monitor
Originally published September 2014

Telling a lie is arguably something that everyone does from time to time. This can amount to a small exaggeration or a “white” lie that is apparently harmless. A lie can even be shaped by good intentions, for example to avoid hurting someone. (“Of course you look good in that new dress.” / "No, you have definitely not gained weight.”) But the “slippery slope” argument maintains that a relatively small first step can develop gradually until it amounts to something much more significant, when the lie is no longer harmless.

The other factor that exacerbates the impact of lying is when leaders lie. This stems from the fact that leaders exert the greatest influence on the conduct of others. But the ideal of being a good role model who influences his/her followers positively is, unfortunately, not always the case.

The entire blog post is here.

Monday, September 22, 2014

Full disclosure

Do individuals have a right for their medical records to remain private after death, or can public interest prevail?

By Jack El-Hai
Aeon
Originally published September 1, 2014

Here is an excerpt:

Putting aside my thoughts on whether Göring deserved any common courtesies and consideration, I explained to the questioner that I’m not a medical provider, and I do not have to follow the ethics of another profession that places a premium on the privacy of patients, living or dead. I have never sworn by the Hippocratic Oath in all my years as a writer. Furthermore, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, a federal US law that regulates the disposition of medical records and protects the privacy of patients, applies to hospitals, medical providers and insurers – but not to writers. Even if it did apply to writers, HIPAA’s privacy protections last for only 50 years past a patient’s death, making the records of Göring and most of his fellow Nazi defendants clearly free from any restrictions on their use.

‘Don’t private medical records deserve more permanent protections?’ my questioner persisted.

The entire article is here.

The Dark Side of Emotional Intelligence

By Adam Grant
The Atlantic
Originally published January 2, 2014

Here is an excerpt:

Emotional intelligence is important, but the unbridled enthusiasm has obscured a dark side. New evidence shows that when people hone their emotional skills, they become better at manipulating others. When you’re good at controlling your own emotions, you can disguise your true feelings. When you know what others are feeling, you can tug at their heartstrings and motivate them to act against their own best interests.

Social scientists have begun to document this dark side of emotional intelligence. In emerging research led by University of Cambridge professor Jochen Menges, when a leader gave an inspiring speech filled with emotion, the audience was less likely to scrutinize the message and remembered less of the content. Ironically, audience members were so moved by the speech that they claimed to recall more of it.

The authors call this the awestruck effect, but it might just as easily be described as the dumbstruck effect. One observer reflected that Hitler’s persuasive impact came from his ability to strategically express emotions—he would “tear open his heart”—and these emotions affected his followers to the point that they would “stop thinking critically and just emote.”

The entire article is here.

Sunday, September 21, 2014

Moral decision-making and the brain

NEURO.tv - Episode 11
Published on Aug 16, 2014

What experiments do psychologists use to identify the brain areas involved in moral decision-making? Do moral truths exist? We discuss with Joshua D. Greene, Professor of Psychology at Harvard University and author of Moral Tribes.




Saturday, September 20, 2014

When Mental Health Professionals are on Facebook

By Steven Petrow
The Washington Post
Originally posted on August 25, 2014

For the past two weeks, whenever I’ve scrolled through my Facebook newsfeed I’ve come to the section “People You May Know.” The suggestions offered have included relatives, co-workers, some people I don’t even like in “real” life — and my current psychologist. “OMG!” I’ve winced repeatedly at the profile photo of my shrink, who for the sake of his privacy I’ll just call Dr. E.

Still, being the curious sort, I clicked to view his page, which isn’t very well protected from eyes like mine. For starters, there are 12 photos of him available for all the world to enjoy, several of them shirtless and one that had a “friend” of his posting “Woof!” underneath it. I also discovered pictures of Dr. E from high school with two nice-looking young ladies. Although I’ve known he was gay, I started to wonder: Was he bisexual then? When did he come out? I found myself thinking much more about his personal life than any patient should.

Among Dr. E’s Facebook friends was another psychologist, one who seemed to deploy no privacy safeguards whatsoever. Any patient clicking on his Facebook page could see tons of photos, including those of his wedding and honeymoon, and even his attendance at a celebration of “Bush 43’s” last night in office. (That makes it a good bet he’s a Dem, which might be TMI for a GOP patient.)

The entire article is here.

Friday, September 19, 2014

Using metacognitive cues to infer others’ thinking

André Mata and Tiago Almeida
Judgment and Decision Making 9.4 (Jul 2014): 349-359.

Abstract

Three studies tested whether people use cues about the way other people think--for example, whether others respond fast vs. slow--to infer what responses other people might give to reasoning problems. People who solve reasoning problems using deliberative thinking have better insight than intuitive problem-solvers into the responses that other people might give to the same problems. Presumably because deliberative responders think of intuitive responses before they think of deliberative responses, they are aware that others might respond intuitively, particularly in circumstances that hinder deliberative thinking (e.g., fast responding). Intuitive responders, on the other hand, are less aware of alternative responses to theirs, so they infer that other people respond as they do, regardless of the way others respond.

The entire article is here.

This article is important when contemplating ethical decision-making.

Thursday, September 18, 2014

Free Will and Punishment

Azim F. Shariff, Joshua D. Greene,  and others
Psychological Science 2014 25: 1563 
originally published online 10 June 2014
DOI: 10.1177/0956797614534693

Abstract

If free-will beliefs support attributions of moral responsibility, then reducing these beliefs should make people less retributive in their attitudes about punishment. Four studies tested this prediction using both measured and manipulated free-will beliefs. Study 1 found that people with weaker free-will beliefs endorsed less retributive, but not consequentialist, attitudes regarding punishment of criminals. Subsequent studies showed that learning about the neural bases of human behavior, through either lab-based manipulations or attendance at an undergraduate neuroscience course, reduced people’s support for retributive punishment (Studies 2–4). These results illustrate that exposure to debates about free will and to scientific research on the neural basis of behavior may have consequences for attributions of moral responsibility.

(cut)

As part of the discussion section:

Retributivism plays an important role in the justice system. Historically, much of the motivation for legal punishment has been an institutionalized attempt to sate the public’s retributive desires (Smith, 1759). Legal historian Stephen (1883) famously wrote that “the sentence of the law is to the moral sentiment of the public what a seal is to hot wax” (p. 423). In recent years, justice researchers and advocates have argued for a switch from retributive to restorative justice—a consequentialist approach aimed at repairing the moral imbalances caused by transgressions (Braithwaite, 2002). The current findings suggest that changing attitudes about free will and responsibility may be important to this evolution of legal thinking.

The entire article is here, complete with paywall.

Use and Misuse of Mental Health Professionals in Custody Cases

By Stephen Gassman and David A. Martindale
New York Law Journal
Originally published August 29, 2014

Here is an excerpt:

As is evident from the decision, the trial court found the mother misused numerous mental health professionals in pursuit of her goal of cutting the father out of the child's life. While accepting the evaluator's findings and most of his conclusions concerning the mother's ongoing alienation, the court did not adopt the evaluator's specific recommendation on the ultimate issue of what custodial arrangement would serve the child's best interests.

The court carefully delineated its reasons for so doing, articulating those facts of which the evaluator had been unaware. Particularly noteworthy is the court's statement that one of the "salient facts revealed during the course of the Hearing" and, therefore, unknown to the evaluator, was that the mother had "received extensive—over 50 hours—of preparation for her forensic interview…from…Dr. Jonathan Gould," a well-known forensic consultant from North Carolina. Justice Colangelo stated that this intensive preparation was "to the detriment of [the mother's] position…." in terms of assessing credibility.

The entire article is here.

Wednesday, September 17, 2014

Navy Nurse Faces Discipline for Actions at Guantanomo

By Kevin Gosztola
Firedoglake Blog
Originally published August 27, 2014

The first and only officer on the medical staff at Guantanamo Bay to conscientiously object to force-feeding prisoners on hunger strike has reportedly had his assignment ended. He has been sent back to Naval Health Clinic New England, his “parent command,” while an investigation is completed, which may result in discipline or a court-martial.

The Associated Press reported on August 26 that Navy Captain Maureen Pennington, who is “his commander at the network clinics, indicated, “An investigation has been conducted into his conduct while stationed at Guantanamo but it has not yet been determined if he will face any discipline.” He is “now on leave and military officials declined to provide details about him or any allegations he may face.”

The entire story is here.

Expansion of Mental Health Care Hits Obstacles

By Abby Goodnough
The New York Times
Originally published August 28, 2014

Here is an excerpt:

The new law is a big opportunity for mental health providers to reach more people of all income levels. But in Kentucky and the 25 other states that chose to expand Medicaid, the biggest expansion of mental health care has been for poor people who may have never had such treatment before.

Still, private providers face considerable headaches in taking on Medicaid patients, beyond the long-term deterrent of low reimbursement. Ms. Wright, for instance, is still waiting to be approved by some of the managed care companies that provide benefits to Medicaid recipients. Eager to build her client base, Ms. Wright has taken on a handful of new Medicaid enrollees for free while she waits for those companies to approve her paperwork.

“It’s been months and months,” she said. “It’s always there in my mind: Am I going to make it?”

The entire article is here.

Tuesday, September 16, 2014

Rethinking Hospital Restraints

Thousands of patients are physically restrained every day for their own safety—but evidence suggests that the practice may be ineffective and even harmful.

By Ravi Parikh
The Atlantic
Originally published August 18, 2014

Here is an excerpt:

Most of us who have been hospitalized have never seen physical restraints, as they are rarely used outside the ICU. Examples include wrist and ankle belts, vests, mitts, and full-length side rails attached to the bed. According to Medicare guidelines, restraints should only be used to ensure the safety of patients and staff and should be removed as early as possible. There are only a handful of situations where Medicare and other physician groups recommend using restraints, including patient violence towards himself or others and a threat of a patient disrupting his or her life-saving therapy, such as a breathing tube.

The entire article is here.

The status of NeuroLaw: A plea for current modesty and future cautious optimism

By Stephen J. Morse
Journal of Psychiatry and Law
39/Winter 2011

Abstract

Legislators, jurists, and advocates often turn to science to solve complicated normative problems addressed by the law.  This article addresses what motivates these parties, surveys the psychology of law and its concepts of the person and responsibility, and describes the general relation of neuroscience to law in terms of the issue of “translation.”  Numerous distractions have clouded our understanding of the relationship between scientific, causal accounts of behavior and responsibility. The notion of “NeuroLaw” is examined here in detail, with the conclusion that a cautious optimism regarding the contributions of neuroscience to the law is warranted.

The entire article is here.

Monday, September 15, 2014

Episode 15: Ethics and Telepsychology (Part 1)

Ethics and Telepsychology involves the rise of technology in the healthcare sector.  There are about 21 states that mandate insurance companies cover telehealth services.  John is joined by Dr. Marlene Maheu, trainer, author, researcher, and the Executive Director of the TeleMental Health Institute, Inc., where she has overseen the delivery of professional training in telemental health to more than 5000 professionals in 39 countries since 2010.  John and Marlene discuss the supporting research for telepsychology and its limitations; practitioner competencies; reimbursable, evidence-based models for telepsychology; and limitations with telepsychology.

At the end of this podcast, the listener will be able to:

1. Outline the general research findings on the usefulness of telepsychology,
2. Describe requirements of competent telepsychology practice,
3. List at least four reimbursable, evidence-based models for legal and ethical telepractice.

Click here to earn one APA-approved CE credit


Or listen directly below



Resources for Episode 15



by Marlene Maheu, Myron L. Pulier, Frank H. Wilhelm and Joseph P. McMenamin 

Bibliography from TeleMental Health Institute, Inc.

Marlene Maheu SlideShare

Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42, 276-283. 
doi: 10.1016/j.beth.2010.07.005

Harris, E., & Younggren, J. N. (2011). Risk management in the digital world.
Professional Psychology: Research and Practice, 42, 412-418.
doi: 10.1037/a0025139

Sunday, September 14, 2014

On Rage As a Moral Emotion

By Antti Kauppinen
PEA Soup Blog
Originally posted August 25, 2014

It is not rare to see groups of enraged people engaged in destructive behavior when you turn on the news these days. Such behavior is puzzling when we think of the agents as rational choosers, since it is often obviously counterproductive. The agents end up in many respects worse off – the neighborhoods that get damaged in riots tend to be the ones rioters live or work in, above all, and violent resistance often invites a brutal response from those who hold the power and control the drones. So what’s the deal with rage? Does it make sense to act out of rage? Can rage be warranted? In this tentative exploration of the issue (I haven’t come across any philosophical literature on it), I’ll argue that it can be, and that when it is, much of the moral responsibility for the wrongful harm that results from acting out of rage belongs to those who have created the rage-warranting situation.

The entire blog post is here.

Saturday, September 13, 2014

Oxford professor thinks artificial intelligence will destroy us all

By Dylan Matthews
Interview on Vox
Updated August 19, 2014

Here is an excerpt:

The basic argument is simple. At some point, many experts believe that artificial intelligence will advance to a point where it not only exceeds human intelligence, but is capable of expanding its own intelligence, setting off an exponential "intelligence explosion." In theory, these hyper-intelligent machines could be used to serve human ends. They could cure diseases and resolve intractable scientific quandaries. In an extreme case, they could wholly replace human workers, enabling humankind to quit working and live comfortably off the robots' labor.

But the problem is that, Bostrom argues, superintelligent machines will be so much more intelligent than humans that they most likely won't remain tools. They'll become goal-driven actors in their own right, and their goals may not be compatible with those of humans. Indeed, they might not be compatible with the continued existence of humans. Please consult the Terminator franchise for more on how that situation plays out.

The entire article and interview is here.

Friday, September 12, 2014

Against Empathy

By Paul Bloom
Boston Review
Originally published August 26, 2014

Here is an excerpt:

Most people see the benefits of empathy as akin to the evils of racism: too obvious to require justification. I think this is a mistake. I have argued elsewhere that certain features of empathy make it a poor guide to social policy. Empathy is biased; we are more prone to feel empathy for attractive people and for those who look like us or share our ethnic or national background. And empathy is narrow; it connects us to particular individuals, real or imagined, but is insensitive to numerical differences and statistical data. As Mother Teresa put it, “If I look at the mass I will never act. If I look at the one, I will.” Laboratory studies find that we really do care more about the one than about the mass, so long as we have personal information about the one.

In light of these features, our public decisions will be fairer and more moral once we put empathy aside. Our policies are improved when we appreciate that a hundred deaths are worse than one, even if we know the name of the one, and when we acknowledge that the life of someone in a faraway country is worth as much as the life a neighbor, even if our emotions pull us in a different direction. Without empathy, we are better able to grasp the importance of vaccinating children and responding to climate change. These acts impose costs on real people in the here and now for the sake of abstract future benefits, so tackling them may require overriding empathetic responses that favor the comfort and well being of individuals today. We can rethink humanitarian aid and the criminal justice system, choosing to draw on a reasoned, even counter-empathetic, analysis of moral obligation and likely consequences.

The entire article is here.

Who Can Consent to Neuroscience Research?

By Nick Seaver
blog.bioethics.org
Originally posted on August 20, 2014

Here is an excerpt:

“Generally, a researcher has to obtain a legally effective informed consent of the subject or the subject’s legally authorized representative,” said Menikoff. However, he went on to explain that while the definition does not sound complicated, its implementation can be.

“If you conclude that they did have the capacity and it’s correct, you’re pretty good,” continued Menikoff. “Once you’ve concluded they do not have the capacity, we are now in the area, as you all know, where the rules are very unclear.”

The entire article is here.

Thursday, September 11, 2014

The Morality Hallucination

By Robert Kurzban
Center for Humans and Nature
Originally published in August 2014

Here is an excerpt:

Moral principles are unlike physical principles. Moral principles are more like songs. Songs don’t exist for people to find. No one could conduct a research project and discover “Let it Be.”  Songs are produced by human minds. The relationship between human minds and morality is one of creation: human minds create morality.

This position is not uncontroversial, and some people think that moral rules are more like the laws of motion than they are like songs. There are a number of reasons to take the morality-as-songs view, but I’ll just mention two. First, moral rules are very, very diverse. There is very little debate about whether or not force equal mass times acceleration. In contrast, debates rage about what’s right and what’s wrong. In some places, for instance, homosexuality is still considered to be wrong. In other places, the moral condemnation of homosexuality is itself considered a moral failing.

The entire article is here.

Wednesday, September 10, 2014

“Philosophical Superficiality” Has Harmed Physics

By John Horgan
Scientific American
Originally posted August 21, 2014

Here is an excerpted quote from Carlo Rovelli, theoretical physicist, in the article:

"Look: Einstein, Heisenberg, Newton, Bohr…. and many many others of the greatest scientists of all times, much greater than the names you mention, of course, read philosophy, learned from philosophy, and could have never done the great science they did without the input they got from philosophy, as they claimed repeatedly.  You see: the scientists that talk philosophy down are simply superficial: they have a philosophy (usually some ill-digested mixture of Popper and Kuhn) and think that this is the “true” philosophy, and do not realize that this has limitations.

Here is an example: theoretical physics has not done great in the last decades. Why? Well, one of the reasons, I think, is that it got trapped in a wrong philosophy: the idea that you can make progress by guessing new theory and disregarding the qualitative content of previous theories.  This is the physics of the “why not?”  Why not studying this theory, or the other? Why not another dimension, another field, another universe?    Science has never advanced in this manner in the past.  Science does not advance by guessing. It advances by new data or by a deep investigation of the content and the apparent contradictions of previous empirically successful theories.  Quite remarkably, the best piece of physics done by the three people you mention is Hawking’s black-hole radiation, which is exactly this.  But most of current theoretical physics is not of this sort.  Why?  Largely because of the philosophical superficiality of the current bunch of scientists."

The entire article is here.

Morality and the Religious Mind: Why Theists and Nontheists Differ

By Azim Shariff, Jared Piazza, and Stephanie R. Kramer
Science and Society

Religions have come to be intimately tied to morality and much recent research has shown that theists and nontheists differ in their moral behavior and decision making along several dimensions.  Here we discuss how these empirical trends can be explained by fundamental differences in group commitment, motivations for pro-sociality, cognitive styles, and meta-ethics. We conclude that by elucidating key areas of moral congruence.

The entire article is here.

Tuesday, September 9, 2014

When Do Doctors Have the Right to Speak?

Room for Debate
The New York Times
Updated August 22, 2014

Here are two great questions to debate in any ethics class, from the New York Times.

Two federal appellate court decisions, one allowing Florida to prevent doctors from discussing gun safety with patients, the other letting California ban “gay-conversion” therapy, raise questions about health professionals’ First Amendment rights.

Do occupational-licensing laws trump the First Amendment? What limits, if any, does the First Amendment impose on government’s ability to restrict advice?


Here is one response:

As a physician, it is important to remember the guiding principle of medicine: "first, do no harm." Barring physicians from discussing whether or not lethal weapons exist in the home is wrong. It is well understood that the simple presence of a firearm in the home is associated with a greater risk of bodily harm - either to oneself or any children in the home. Asking about weapons is a usual (standard and accepted) practice as part of the screening assessment for depression; since those with easy access to a firearm and who have suicidal thoughts are significantly more likely to harm themselves. Here, the physician's role is simple: protect human life. Contrast this to the ban on "gay-conversion," therapy, which has been scientifically proven to have more harm than benefit to the individual. In both cases, the tenet being upheld here is to "first, do no harm." It is tragically ironic that those who are often supporting both of these causes are one usually crying to "get the government out of my healthcare," yet they seem perfectly willing to impede the practice of good medicine when it is politically expedient. I can only hope that those supporting the "opposite" views from those expressed here will have a caring physician him/herself that will ignore these political debates in order to provide care that is in the best interest of the patient.

Suicide tourism: a pilot study on the Swiss phenomenon

By S. Gauthier, J. Mausbach, T. Reisch, and C. Bartsch
J Med Ethics doi:10.1136/medethics-2014-102091

Abstract

While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people—‘suicide tourists’—coming to Switzerland, mainly to the Canton of Zurich, for the sole purpose of committing suicide. Political debate regarding ‘suicide tourism’ is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries; and (3) to compare our results with those of earlier studies in Zurich. We did a retrospective data analysis of the Zurich Institute of Legal Medicine database on AS of non-Swiss residents in the last 5 years (2008–2012), and internet research for current legislation and political debate in the three foreign countries most concerned. We analysed 611 cases from 31 countries all over the world. Non-terminal conditions such as neurological and rheumatic diseases are increasing among suicide tourists. The unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries.

The entire story is here.

Monday, September 8, 2014

Mill's Moral and Political Philosophy

Brink, David, "Mill's Moral and Political Philosophy"
The Stanford Encyclopedia of Philosophy (Fall 2014 Edition)
Edward N. Zalta (ed.), forthcoming

Here is an excerpt:

2.6 Utilitarianism as a Standard of Conduct

We might expect a utilitarian to apply the utilitarian principle in her deliberations. Consider act utilitarianism. We might expect such a utilitarian to be motivated by pure disinterested benevolence and to deliberate by calculating expected utility. But it is a practical question how to reason or be motivated, and act utilitarianism implies that this practical question, like all practical questions, is correctly answered by what would maximize utility. Utilitarian calculation is time-consuming and often unreliable or subject to bias and distortion. For such reasons, we may better approximate the utilitarian standard if we don't always try to approximate it. Mill says that to suppose that one must always consciously employ the utilitarian principle in making decisions

… is to mistake the very meaning of a standard of morals and confound the rule of action with the motive of it. It is the business of ethics to tell us what are our duties, or by what test we may know them; but no system of ethics requires that the sole motive of all we do shall be a feeling of duty; on the contrary, ninety-nine hundredths of all our actions are done from other motives, and rightly so done if the rule of duty does not condemn them. (U II 18)

Later utilitarians, such as Sidgwick, have made essentially the same point, insisting that utilitarianism provides a standard of right action, not necessarily a decision procedure (Methods 413).

If utilitarianism is itself the standard of right conduct, not a decision procedure, then what sort of decision procedure should the utilitarian endorse, and what role should the principle of utility play in moral reasoning? As we will see, Mill thinks that much moral reasoning should be governed by secondary precepts or principles about such things as fidelity, fair play, and honesty that make no direct reference to utility but whose general observance does promote utility. These secondary principles should be set aside in favor of direct appeals to the utilitarian first principle in cases in which adherence to the secondary precept would have obviously inferior consequences or in which such secondary principles conflict (U II 19, 24–25).

The entire entry is here.

Can You Call a 9-Year-Old a Psychopath?

By Jennifer Kahn
The New York Times
Originally published May 11, 2012

Here is an excerpt:

For the past 10 years, Waschbusch has been studying “callous-unemotional” children — those who exhibit a distinctive lack of affect, remorse or empathy — and who are considered at risk of becoming psychopaths as adults. To evaluate Michael, Waschbusch used a combination of psychological exams and teacher- and family-rating scales, including the Inventory of Callous-Unemotional Traits, the Child Psychopathy Scale and a modified version of the Antisocial Process Screening Device — all tools designed to measure the cold, predatory conduct most closely associated with adult psychopathy. (The terms “sociopath” and “psychopath” are essentially identical.) A research assistant interviewed Michael’s parents and teachers about his behavior at home and in school. When all the exams and reports were tabulated, Michael was almost two standard deviations outside the normal range for callous-unemotional behavior, which placed him on the severe end of the spectrum.

Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5. Crucial to this diagnosis are callous-unemotional traits, which most researchers now believe distinguish “fledgling psychopaths” from children with ordinary conduct disorder, who are also impulsive and hard to control and exhibit hostile or violent behavior.

The entire article is here.

Sunday, September 7, 2014

responsibility and punishment

Katrina Sifferd interviewed by Richard Marshall
3:AM Magazine
Originally posted

Here is an excerpt:

KS: Well, for one, we won’t be able to make responsibility assessments. When you show a jury a picture of a brain lighting up in such-and-such a way it means absolutely nothing to them until somebody translates the scientific data into folk psychological terms. Expert witnesses in a trial cannot just point to a dark spot on a PET scan and sit down: the scientific data is irrelevant to the defendant’s culpability until is it translated into folk concepts that push and pull responsibility assessments in different directions. For example, an expert might note that the dark spot is a brain tumor likely to result in a severe lack of impulse control, which the jury might feel undermines attribution of the highest levels of criminal intent.

I think it is interesting that some scientific data actually seems to push responsibility assessments in both directions, or in ways unanticipated by the side offering the evidence in a criminal trial. In one high profile capital sentencing hearing, the defense offered neuroscientific evidence of psychopathy in an attempt to prove diminished capacity (and thus a mitigating factor); but instead, the jury seemed to think the data made the defendant more culpable for his actions, and sentenced him to death. Is a person whose brain shows clear signs of psychopathy less responsible because of their abnormal brain function or more responsible because their brain is abnormal (and thus they are likely to be dangerous in the future)? I think it depends on the way in which the brain is dysfunctional, and maybe the reasons why it is dysfunctional. There is a lot of important work to be done making reliable translations of neuroscientific data into folk descriptions relevant to responsibility.

(cut)

KS: Different theories of punishment seem to emphasize different aspects of our cognitive capacities as most important to culpability. Bill and I have argued that deontological accounts which postulate emotional response or empathy as crucial to moral knowledge and decision-making might be more likely to excuse all psychopaths because of their apparent lack of relevant affective data. Some deontological theorists believe that a lack of appropriate emotional response translates into a wholesale lack of legal rationality. A consequentialist theory of punishment, however, may be more likely to hold some psychopaths responsible, because it emphasizes the need for rational capacities as a means to grasp and reflect upon the consequences of action given ones goals and relevant social norms (a skill successful psychopaths may possess), and not the way one feels about these consequences.

The entire interview is here.

Saturday, September 6, 2014

Understanding Heidegger on Technology

By Mark Blitz
The New Atlantis: A Journal of Technology and Society
Originally published in 2014

Here is an excerpt:

Technology as Revealing

Heidegger’s concern with technology is not limited to his writings that are explicitly dedicated to it, and a full appreciation of his views on technology requires some understanding of how the problem of technology fits into his broader philosophical project and phenomenological approach. (Phenomenology, for Heidegger, is a method that tries to let things show themselves in their own way, and not see them in advance through a technical or theoretical lens.) The most important argument in Being and Time that is relevant for Heidegger’s later thinking about technology is that theoretical activities such as the natural sciences depend on views of time and space that narrow the understanding implicit in how we deal with the ordinary world of action and concern. We cannot construct meaningful distance and direction, or understand the opportunities for action, from science’s neutral, mathematical understanding of space and time. Indeed, this detached and “objective” scientific view of the world restricts our everyday understanding. Our ordinary use of things and our “concernful dealings” within the world are pathways to a more fundamental and more truthful understanding of man and being than the sciences provide; science flattens the richness of ordinary concern. By placing science back within the realm of experience from which it originates, and by examining the way our scientific understanding of time, space, and nature derives from our more fundamental experience of the world, Heidegger, together with his teacher Husserl and some of his students such as Jacob Klein and Alexandre Koyré, helped to establish new ways of thinking about the history and philosophy of science.

The entire story is here.

Friday, September 5, 2014

Is Technology Shifting Our Moral Compass?

The Big Question
The Atlantic Video
Originally published August 22, 2014

At this year's Aspen Ideas Festival, we asked a group of experts what new technologies like self-driving cars and drones might mean for our collective conscience. "When a technology first comes into the marketplace, there are always unintended consequences," says Ping Fu, chief strategy officer for 3D Systems. Other panelists include Sebastian Thrun, Alex Reben, Missy Cummings, Jonathan Harris, Jennifer Pahlka, Danny Hillis.

Here’s a Terrible Idea: Robot Cars With Adjustable Ethics Settings

By Patrick Lin
Wired
Originally posted August 18, 2014

Here is an excerpt:

So why not let the user select the car’s “ethics setting”? The way this would work is one customer may set the car (which he paid for) to jealously value his life over all others; another user may prefer that the car values all lives the same and minimizes harm overall; yet another may want to minimize legal liability and costs for herself; and other settings are possible.

Plus, with an adjustable ethics dial set by the customer, the manufacturer presumably can’t be blamed for hard judgment calls, especially in no-win scenarios, right? In one survey, 44 percent of the respondents preferred to have a personalized ethics setting, while only 12 percent thought the manufacturer should predetermine the ethical standard. So why not give customers what they want?

The entire story is here.

Thursday, September 4, 2014

Should We Teach Plato in Gym Class?

By Mark Edmundson
The New York Times
Originally published August  15, 2014

Here is an excerpt:

Evidence of our neglect is everywhere. Day after day we see athletes, especially male athletes, behaving badly. The players of the most violent sports, football in particular, are too often finding their way to the front pages of the newspaper for crimes like rape and assault. These are young men who have been encouraged to develop speed and strength and, most of all, aggression. Their spiritedness has been amped up by their training.

We need a more thoughtful and sound philosophy of educating the body and the spirit than we currently possess. The athletes who are raising their quotient of thymos with every collision need to be helped to understand what a wonderful but dangerous power they are unleashing in themselves.

The entire story is here.

Moral Distress in Medical Education and Training

by Berger, Jeffrey T
Journal of General Internal Medicine, Volume 29, Issue 2
doi: 10.1007/s11606-013-2665-0

Abstract

Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one’s moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators’ efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.

Introduction

Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress is common in clinical practice, because caring for the ill is an inherently moral activity. Medical students and junior practitioners may be particularly challenged by morally distressing situations. Their development into attending physicians involves a process that is complex intellectually, sociologically, and culturally, and is no less complex in its moral dimensions.

(cut)

Academic health institutions whose leadership presupposes that moral distress affects all of its clinicians will be best positioned to mitigate this stress and to promote moral wellness and professionalism. Programs should expect that their trainees will experience moral distress and trainees should be aware of this expectation.

The entire article is here.

Wednesday, September 3, 2014

Who Is the Client and Who Controls Release of Records in a Forensic Evaluation?

By Bruce Borkosky
Psychological Injury and Law
August 2014
DOI: 10.1007/s12207-014-9199-6

Abstract

Forensic psychologists often refuse to release evaluation records, especially to the evaluee. One justification for this practice is based on the ethical positions that the referral source “is the client” and “controls release of records” (also found in the Specialty Guidelines for Forensic Psychology). To determine whether these ethical positions are shared by the field of forensic mental health, official documents from forensic mental health organizations were used as a proxy for these views. Thirty-four supporting arguments for either position were identified from the literature; it was postulated that official documents would support both positions and utilize supporting arguments. Fifty-four official documents were discovered, and qualitative analysis was used to construct a 17-category model of official views. Neither position was supported by a majority of documents, and few of the supporting arguments were utilized by supportive documents. The positions are unsupported because official documents espouse a wide diversity of views, there are a number of logical flaws in supporting arguments, and even official APA documents hold conflicting views. Ethical arguments are advanced for contrary positions, and the referral-source-control of records release is contrary to law. A more ethical view is that the psychologist may have multiple, possibly conflicting responsibilities to multiple entities; the psychologist’s roles and responsibilities should be clarified with each entity using an informed consent process. Psychologists should release records at the behest of the evaluee, lest they be subject to licensing discipline, Health Insurance Portability and Accountability Act (HIPAA) complaints, and/or civil sanctions. Recommendations are offered for psychologists, future ethics codes and professional practice guidelines, and test security practices.

The entire article is here.

Is One of the Most Popular Psychology Experiments Worthless?

By Olga Khazan
The Atlantic
Originally published July 24, 2014

Here is an excerpt:

But one group of researchers thinks it might be time to retire the trolley. In an upcoming paper that will be published in Social and Personality Psychology Compass, Christopher Bauman of the University of California, Irvine, Peter McGraw of the University of Colorado, Boulder, and others argue that the dilemma is too silly and unrealistic to be applicable to real-life moral problems. Therefore, they contend, it doesn't tell us as much about the human condition as we might hope.

In a survey of undergraduates, Bauman and McGraw found that 63 percent laughed "at least a little bit" in the fat-man scenario and 33 percent did so in the track-switching scenario. And that's an issue, because "humor may alter the decision-making processes people normally use to evaluate moral situations," they note. "A large body of research shows how positivity is less motivating than negativity."

The entire article is here.

Tuesday, September 2, 2014

Episode 14: Ethics and Quality Enhancement Strategies

In Episode 14, John welcomes Dr. Sam Knapp back to the podcast.  Sam was fresh off his Lifetime Achievement Award in Ethics Education from the American Psychological Association.  After John's first attempt at listener mail, the topic moves toward ethics education and ways to contemplate positive ethics.  Rather than looking at remedial ethics or the ethical floor, John and Sam give examples about striving for the ethical ceiling.  The focus on quality enhancement strategies grew out of risk management strategies.  From a quality enhancement perspective, Sam and John give several examples of what may trigger the need for quality enhancement strategies.  They also review four quality enhancement strategies: 1) consultation, 2) empowered collaboration, 3) documentation, and 4) redundant protections.  Sam and John also talk about psychologists' emotional reactions to patients.

At the end of this podcast, the listener will be able to:

1. Outline three quality enhancement strategies,
2. Describe how to prepare for a helpful consultation, and,
3. List the reasons why redundant protections are helpful in clinical practice.

Click here to earn one APA-approved CE credit


Or listen directly below




Resources for this podcast


Sam Knapp and John Gavazzi

John Gavazzi, PsyD ABPP


Ken Pope and Barbara G. Tabachnick

Monday, September 1, 2014

5 Ethical Responsibilities of Corporate Boards

By Kirk O. Hanson
Markkula Center for Applied Ethics Blog
Originally published August 14, 2014

Most corporate boards have learned to act quickly when a scandal breaks. General Motors’ board is moving much more quickly to clean up the fallout from its vehicles’ ignition failures than Toyota’s board did to address its rapid acceleration problems of several years ago. It is now the rare board that doesn’t launch an independent investigation quickly when misbehavior is reported.

But the responsibility of the board to prevent scandals is more important than the responsibility to clean up the mess once it has emerged. Here most boards are still at the starting gate. Recent legislation and guidance embodied in the Federal Sentencing Guidelines clearly require the board to take a key role in preventing ethics failures before they happened. This is more complicated than calling in the outside lawyers once disaster happens.

The entire article is here.

Thought Experiments

Stanford Encyclopedia of Philosophy
Substantive revision on August 12, 2014

Thought experiments are devices of the imagination used to investigate the nature of things. They are used for diverse reasons in a variety of areas, including economics, history, mathematics, philosophy, and the sciences, especially physics. Most often thought experiments are communicated in narrative form, frequently with diagrams. Thought experiments should be distinguished from thinking about experiments, from merely imagining any experiments to be conducted outside the imagination, and from psychological experiments with thoughts. They should also be distinguished from counterfactual reasoning in general, as they seem to require an experimental element, which seems to explain the impression that something is experienced in a thought experiment. In other words, though many call any counter-factual or hypothetical situation a thought experiment, this seems too encompassing. It seems right to demand that they also be visualized (or perhaps smelled, tasted, heard, touched); there should be something experimental about a thought experiment.

The primary philosophical challenge of thought experiments is simple: How can we learn about reality (if we can at all), just by thinking? More precisely, are there thought experiments that enable us to acquire new knowledge about the intended realm of investigation without new empirical data? If so, where does the new information come from if not from contact with the realm of investigation under consideration? Finally, how can we distinguish good from bad instances of thought experiments? These questions seem urgent with respect to scientific thought experiments, because most philosophers and historians of science “recognize them as an occasionally potent tool for increasing our understanding of nature. […] Historically their role is very close to the double one played by actual laboratory experiments and observations. First, thought experiments can disclose nature's failure to conform to a previously held set of expectations. Second, they can suggest particular ways in which both expectation and theory must henceforth be revised.” (Kuhn, 1977, p. 241 and 261) The questions are urgent regarding philosophical thought experiments, because they play an important role in philosophical discourse. Philosophy without thought experiments seems almost hopeless.

There is widespread agreement that thought experiments play a central role both in philosophy and in the natural sciences. General acceptance of the importance of some of the well-known thought experiments in the natural sciences, like Maxwell's demon, Einstein's elevator or Schrödinger's cat. Probably more often than not, these, and many other thought experiments have led the careful analysis of their epistemic powers to the conclusion that we should not portray science as an exclusively empirical activity (see Winchester, 1990, p. 79).

The entire entry is here.