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

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

Sunday, May 31, 2015

Is Age a Determinant Variable in Forgoing Treatment Decisions at the End of Life?

Guest post by Sandra Martins Pereira, Roeline Pasman and Bregje Onwuteaka-Philipsen
Journal of Medical Ethics Blog
Originally posted May 14, 2015

Decisions to forgo treatment are embedded in clinical, socio-cultural, philosophical, religious, legal and ethical contexts and beliefs, and they cannot be considered as representing good or poor quality care. Particularly for older people, it is sometimes argued that treatment is aggressive, and that there may be a tendency to continue or start treatments in situations where a shift to a focus on quality of life in light of a limited life expectancy might be preferred. Others argue that an attitude of ageism might prevent older people from receiving treatments and care from which they could benefit, thus resulting in some type of harm and compromising the ethical principles of beneficence and non-maleficence.

When the need to make a decision about treatment concerns an older person at the end of life, physicians need to reflect on the following questions: In this situation, for this person, what is the best course of action? Is this person capable of assessing the situation and making a decision about it adequately herself? What are the preferences of the person? Who needs to be involved in the decision-making process? What will be the consequences of starting or withholding this treatment?

The blog post is here.

The paper is here.

Saturday, May 30, 2015

Vignette 32: The Ghost of Internet Past

Dr. Roger Sterling is a training director at a doctoral-level training program.  The training program has rigorous admissions standards and has a prestigious reputation.  Pete Campbell is a second year student who has excelled academically.  As Pete is preparing for an off-campus pre-doctoral internship, Dr. Joan Holloway (faculty member) approaches Dr. Sterling about Pete.  Apparently, there are a number of internet sites that feature Pete as a soft-core pornography actor.  Dr. Holloway asks Dr. Sterling to prevent Pete from off-campus training experiences until the department can address the potential ethical and moral issues with Pete.

Dr. Sterling agrees to talk to Pete.  Pete openly admits that he was a soft-core pornography actor.  He is no longer in the industry.  He cannot pull down pictures of his past work because the pictures and videos are outside of his control.

What are the potential ethical and clinical issues for Dr. Sterling in this scenario?

Are there any “values” or moral issues for Dr. Sterling in dealing with Pete?

If you were Dr. Sterling, how would you feel about Pete going to off-campus training sites?

What are the career implications for Pete Campbell?

What recommendations would you make, if any, to Pete Campbell?

Are there any risk management suggestions for Dr. Sterling related to the training program?

If you were consulting with Dr. Sterling, how do your own professional, personal, and moral values influence your approach to the consultation?

Would you change your strategy or recommendations if the student were a woman?

Would you change your strategy or recommendations if the student, Pete, were involved in gay porn?

Would you change your strategy or recommendations if the student were involved in hard-core pornography in which he dominated women?

Friday, May 29, 2015

Vignette 31: The Near Death of a Salesman

Dr. Miller is a psychologist who consults with local nursing homes and hospitals when a patient’s capacity to make medical decisions is in question.  Dr. Miller receives an urgent call from an attorney to evaluate Willie Loman at a local trauma unit.  The attorney explains that Mr. Loman is looking for an objective opinion about his ability to make medical decisions.

Mr. Loman is a 52-year-old male with a wife and two kids (both in college).  He works as a financially successful salesman.  Over the previous weekend, Mr. Loman was involved in a serious boating accident.  He did not experience any head trauma; however, his physical situation is dire.  The trauma team needs his consent to perform a lifesaving surgery.  If successful, Mr. Loman can live many years.  However, there is a high probability that he will require full-time nursing care. 

Mr. Loman has been active man who enjoyed many physical activities.  Furthermore, he believes if he has the surgery and ends up confined to lifetime nursing care, he will exhaust all the funds he has saved for the benefit of his family.  Mr. Loman believes he will be an emotional burden to his family and lose his dignity.  Knowing that he will be physically compromised and a burden on his family, Mr. Loman is asking to die in peace.  He does not want to live in an incapacitated state of existence.

Without the surgery, Mr. Loman can be kept alive for about two weeks.  The family filed an emergency petition to obtain guardianship.  The trauma team believes that the patient is not thinking clearly about his demise.  They have already called in their psychiatrist-consultant.

Upon examination, Dr. Miller finds Mr. Loman’s mental status is within normal limits.  He demonstrates appropriate memory capabilities and reasoning skills.  He articulates his dilemma well and understands that he will die without surgery.  There is no evidence of hallucinations, delusions, or psychotic processes.

In order to clarify his thinking, Dr. Miller calls you to review this case.

What are competing ethical principles?

How would you feel if you were Dr. Miller?

What are the possible consequences of concluding Mr. Loman is competent and capable of making this decision?

What are the possible consequences of concluding Mr. Loman is not competent and incapable of making this decision?

How do your own professional, personal, and moral values influence how you would participate as a consultant to Dr. Miller?

Does Mr. Loman's age factor into this decision?  In other words, would you make a different decision if Mr. Loman were 72 as compared to 52?

What's Ethics Got to Do with It?

The misguided debate about mindfulness and morality

By Richard K. Payne
Tricycle Blog
Originally posted May 14, 2015

As mindfuness has made greater inroads into public life—from hospitals, to schools, to the workplace—its growing distance from Buddhist thought and practice has become a hotly contested issue. Is mindfulness somehow deficient because it lacks Buddhist ethics, and should Buddhist ethics be replicated in mindfulness programs and workshops?

Psychologist Lynette Monteiro, founder of the Ottawa Mindfulness Clinic, points out that the “seeming absence of the explicit teaching of ethics in the MBI [Mindfulness-based Intervention] curriculum” is the “thorniest” basis for criticism. Underlying the discussion of ethics in mindfulness, however, is the presumption that there exists an inherent relation between religion and morality. Yet this focus on morality—thought to define the practice as religious rather than secular, Buddhist rather than non-Buddhist—is based on Western presumptions about religion inherited from Christianity, not Buddhism.

Views on morality and mindfulness tend to fall into three categories: inherent, integral, and modular.

The entire blog post is here.

Thursday, May 28, 2015

Tarasoff's catch-22.

By Stephen R. Huey
The American Psychologist
2015 Apr;70(3):284-5. doi: 10.1037/a0039064

Abstract

Comments on the article by D. N. Bersoff (see record 2014-28692-002). Bersoff poses a much-needed challenge to the rationale of laws based on Tarasoff v. Regents of the University of California (1976), which exist in most states and require therapists to warn the intended victim, police, and/or others when a patient voices serious threats of violence. If Tarasoff-related laws were ever to be modified, research support would be required. To begin with, what is the experience of other countries that happen to address this issue differently and of the seven states that, according to Bersoff, have not adopted Tarasoff-related requirements? Another question is whether patients who are unwilling to invite the consequences of therapist disclosure ever reveal reportable intentions to their therapists anyway-say, by mistake or impulse-thus making current law marginally useful? Rules that undercut sacrosanct confidentiality create a catch-22 in which the indisputable ethical necessity of informed consent has an unintended consequence- namely, therapy is preceded by informed consent but precluded by it.

The entire article is here.

Jean-Paul Sartre and Existential Choice

The existentialist Jean-Paul Sartre thought that human beings live in anguish. Not because life is terrible. But rather because, we’re ‘condemned to be free’. We're ‘thrown’ into existence, become aware of ourselves, and have to make choices. Even deciding not to choose is a choice. According to Sartre, every choice reveals what we think a human being should be.

Narrated by Stephen Fry. Scripted by Nigel Warburton.

Release date: 13 Apr 2015

Wednesday, May 27, 2015

Being true to your true self

By David Shoemaker
OUPblog
Originally published May 24, 2015

Here is an excerpt

Philosophers who work on the nature of responsibility very often insist that ignorance of the moral status of one’s action is sufficient to excuse — or at least mitigate — one from responsibility. If you didn’t know that what you were doing was wrong, after all, how could it be appropriate to hold you responsible for not refraining from doing it?  This view is thought to hold symmetrically across negative and positive cases: not only does ignorance excuse (or mitigate) one from blame for bad actions, it also excuses (or mitigates) one from praise for good actions to the same extent.

This is not, however, how ordinary people view the matter. My colleague David Faraci and I have investigated the matter several times, and each time we get the same results. When asked about JoJo, people overwhelmingly think that his moral ignorance does mitigate his blameworthiness, albeit only a little bit (versus someone like him without that background). However, when people are asked about a case like Huck’s, they respond that his moral ignorance doesn’t mitigate his praiseworthiness at all; indeed, in some studies, we have found that people think his moral ignorance actually makes him more praiseworthy for what he did than a morally undeprived counterpart.

The entire blog post is here.

Physicians and Euthanasia: What about Psychiatric Illness, Dementia and Weltschmerz?

By Eva Bolt
BMJ Blogs
Originally posted on February 18, 2015

Here is an excerpt:

Concluding, while most Dutch physicians can conceive of granting requests for euthanasia from patients suffering from cancer or other severe physical diseases, this is not the case in patients suffering from psychiatric disease, dementia or being tired of living. This distinction is partly related to the criteria for due care. For instance, some physicians describe that it is impossible to determine the presence of unbearable suffering in a patient with advanced dementia. Other explanations for the distinction are not related to the criteria for due care. For instance, it is understandable that physicians do not agree with performing euthanasia in a patient with advanced dementia who does not fully understand what is happening, even if the patient has a clear advanced euthanasia directive.

The entire article is here.

The article in the Journal of Medical Ethics is here.

Tuesday, May 26, 2015

University of Oregon Employees Under Investigation for Misconduct in Rape Case

By Richard Read
The Oregonian
Originally posted May 8, 2015

Six University of Oregon employees, including a vice president and the school's interim top lawyer, are under investigation for alleged misconduct in the handling of therapy records of a student who says she was gang-raped by three Ducks basketball players.

The Oregon State Bar is investigating complaints against interim general counsel Douglas Park and associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating complaints against four people, including Robin Holmes, the university's vice president for student life, who is a licensed psychologist.

Jennifer Morlok, a senior staff therapist identified in legal correspondence as the clinician who counseled the woman, filed all the complaints.

The entire article is here.

The Most Depressing Discovery About the Brain, Ever

Say goodnight to the dream that education, journalism, scientific evidence, or reason can provide the tools that people need in order to make good decisions.

By Marty Kaplan
Alternet.org
Originally posted September 16, 2013

Yale law school professor Dan Kahan’s new research paper is called “Motivated Numeracy and Enlightened Self-Government,” but for me a better title is the headline on science writer Chris Mooney’s piece about it in Grist:  “Science Confirms: Politics Wrecks Your Ability to Do Math.”

Kahan conducted some ingenious experiments about the impact of political passion on people’s ability to think clearly.  His conclusion, in Mooney’s words: partisanship “can even undermine our very basic reasoning skills…. [People] who are otherwise very good at math may totally flunk a problem that they would otherwise probably be able to solve, simply because giving the right answer goes against their political beliefs.”

In other words, say goodnight to the dream that education, journalism, scientific evidence, media literacy or reason can provide the tools and information that people need in order to make good decisions.  It turns out that in the public realm, a lack of information isn’t the real problem.  The hurdle is how our minds work, no matter how smart we think we are.  We want to believe we’re rational, but reason turns out to be the ex post facto way we rationalize what our emotions already want to believe.

The entire article is here.

Monday, May 25, 2015

Q: Is privacy dead? Of course not

By Evan Selinger
Aeon Magazine - Ideas

Here is an excerpt:

But if we’re talking about informational privacy, it isn’t a thing. Informational privacy is a series of decisions individuals and groups make. Some crucial decisions are about social and ethical norms. This means we’ve got to decide which norms to value, determine when it’s appropriate for norms to be enforced and when norm violations should be allowed to slide, and figure out which sanctions are befitting of proper norm policing. In a pluralistic society, these ends are furthered by fraught and ongoing negotiation. Such negotiation is further complicated by disruptive innovation changing how people consume and share information.

The entire article is here.

A shocking number of mentally ill Americans end up in prison instead of treatment

By Ana Swanson
The Washington Post
Originally published April 30, 2015

Here is an excerpt:

For various reasons, these community treatment plans proved inadequate, leaving many of the mentally ill homeless or in jail. According to the Department of Justice, about 15 percent of state prisoners and 24 percent of jail inmates report symptoms meet the criteria for a psychotic disorder.

In its survey of individual states, the Treatment Advocacy Center found that in 44 of the 50 states and the District of Columbia, the largest prison or jail held more people with serious mental illness than the largest state psychiatric hospital (see map below). The only exceptions were Kansas, New Jersey, North Dakota, South Dakota, Washington and Wyoming. "Indeed, the Polk County Jail in Iowa, the Cook County Jail in Illinois, and the Shelby County Jail in Tennessee each have more seriously mentally ill inmates than all the remaining state psychiatric hospitals in that state combined," the report says.

The entire article is here.

Sunday, May 24, 2015

The Stubborn System of Moral Responsibility

Bruce N. Waller, The Stubborn System of Moral Responsibility, MIT Press, 2015, 294pp.
ISBN 9780262028165.

Reviewed by Seth Shabo, University of Delaware

This book is a spirited and engaging broadside against ordinary belief in moral responsibility. Specifically, Bruce Waller challenges the entrenched belief that people bear the kind of moral responsibility for their conduct that would justify punishing them on the grounds that they deserve it. What needs explaining, in Waller's view, is why so many philosophers continue to defend this orthodoxy in the face of such powerful counterevidence. His proposed explanation encompasses a range of psychological and social factors that powerfully reinforce this belief. These include the animal impulse to strike back when harmed, an impulse that often inhibits deeper reflection into the causes of the offender's conduct; the desire to justify expressions of this strike-back impulse; the broader belief in a just universe in which wrongdoers have retribution coming to them; a heuristic tendency to substitute simpler problems for hard ones (in this case, the question of how we can correctly attribute bad qualities to people with the intractable problem of how people can truly deserve punishment); and the ascendancy of an individualistic, neoliberal political culture that downplays the role of societal conditions in shaping how people turn out.

The entire book review is here.

Saturday, May 23, 2015

Gene-Editing Human Embryos Is Ethical

Bioethicists and scientists who say otherwise are wrong.

By Ronald Bailey
Reason.com
Originally published May 1, 2015

Here are two excerpts:

The Chinese scientists essentially ignored recent calls for a moratorium on editing human reproductive cells and embryos. The month before their paper appeared, Science recommended that such research be "strongly discourage[d]" while the "societal, environmental, and ethical implications of such activity are discussed among scientific and governmental organizations." Meanwhile, Nature had editorialized that "genome editing in human embryos using current technologies could have unpredictable effects on future generations. This makes it dangerous and ethically unacceptable....At this early stage, scientists should agree not to modify the DNA of human reproductive cells." Some 40 countries have preemptively banned germline genetic engineering. (The United States is not among them.)

(cut)

In what terrible bioethical violations did the Chinese researchers engage? None. The embryos were grown to the eight-cell stage, and none of them could ever have developed into babies. No germline cells with any potential to develop into people were modified. Of the 71 embryos that survived the experiment, 54 were genetically tested. Of these, 28 embryos had the target gene "spliced." Only four contained all of the replacement genetic material, and even those were mosaics—that is, not every cell had been modified.

The entire article is here.

Friday, May 22, 2015

The Perspective Gap Is Killing Your Business. Here’s How to Fix It

Empathy is a basic quality that we all crave. So why is it so difficult to demonstrate ourselves?

By Justin Bariso
Inc.com
Originally published April 29, 2015

Getting designers to show consideration for those taking care of warranty problems proved difficult. Initially, the company attempted a process-based solution, designing 26 new KPIs (including a 'repairability' scorecard and incentive), along with variable compensation.

The result? In the end, the process had almost zero impact. So the company decided to try something different.

The next time around, design engineers were informed that in three years (once the car was launched on the market) they would move to the after sales network and take charge of the warranty budget. In essence, they would deal with any problems caused by their own design.

This inspired what I like to call 'self-empathy'--empathy for your future self. The designers were moved to invest extra effort now to promote easy repairability later, since they were the ones who would have to deal with negative consequences.

Although very different in concept, the goal of these two methods is the same: See things from another perspective.

The entire article is here.

Expansion of ‘Right to Try’ legislation raises ethical, safety concerns

By HemOnc Today
Originally published April 25, 2015

Early access to experimental drugs has historically been reserved for patients enrolled on clinical trials.

In 2009, the FDA revamped its 1980’s expanded access program, which allows terminally ill patients ineligible for clinical trials and for whom no alternative, approved therapies exist to ask pharmaceutical companies for access to an investigational drug in their pipeline. More than 1,500 patients received an experimental treatment through the FDA’s program in 2014.

Now, some legislatures are going a step further by adopting so-called “Right to Try” legislation, intended to give terminally ill patients comparable access to investigational drugs but removing the FDA from the process.

Since 2014, thirteen states have passed Right to Try laws, and legislators in 20 more states have plans to introduce similar legislation this year.

The entire article is here.

Thursday, May 21, 2015

Mental-Health Crunch on Campus

By Melissa Korn and  Angela Chen
The Wall Street Journal
Originally published April 28, 2015

Universities are hiring more social workers, psychologists and psychiatrists as demand for campus mental-health services rises. But persistent budget gaps mean that students in some cases foot much of the cost of the positions.

Students at George Washington University will be charged an additional $1,667 in tuition next year, a jump of 3.4%. More than $830,000 of the resulting new revenue will pay for mental-health services.

(cut)

“The demand [by students] so outpaces the supply of appointments that it’s very hard to get a weekly appointment, even for students having pretty serious symptoms that interfere with their academic function,” said Elizabeth Gong-Guy, executive director of counseling and psychological services at UCLA and president of the Association for University and College Counseling Center Directors.

The entire article is here.

Philosophers’ Biased Judgments Persist Despite Training, Expertise and Reflection

By Eric Schwitzgebel and Fiery Cushman
In press

Abstract

We examined the effects of framing and order of presentation on professional philosophers’
judgments about a moral puzzle case (the “trolley problem”) and a version of the Tversky &
Kahneman “Asian disease” scenario. Professional philosophers exhibited substantial framing
effects and order effects, and were no less subject to such effects than was a comparison group of
non-philosopher academic participants. Framing and order effects were not reduced by a forced
delay during which participants were encouraged to consider “different variants of the scenario
or different ways of describing the case”. Nor were framing and order effects lower among
participants reporting familiarity with the trolley problem or with loss-aversion framing effects,
nor among those reporting having had a stable opinion on the issues before participating the
experiment, nor among those reporting expertise on the very issues in question. Thus, for these
scenario types, neither framing effects nor order effects appear to be reduced even by high levels
of academic expertise.

The entire article is here.

Wednesday, May 20, 2015

An ethics lesson for psychologists: don’t participate in torture

By J Wesley Boyd
The Conversation
Originally posted April 29, 2015

The Senate’s Report on the CIA’s Detention and Interrogation Program (commonly known as the torture report) released in December 2014, confirmed that doctors and psychologists were complicit in the torture of detainees.

Two psychologists, unnamed in the report, but confirmed to be James Mitchell and Bruce Jessen, designed some of the “enhanced interrogation” techniques. Other psychologists monitored interrogations.

A few weeks after the release of the report the president of the American Psychological Association (APA) stated that because Jessen and Mitchell are not members of the APA, the organization has no jurisdiction over them and cannot sanction them in any way. But Mitchell and Jessen weren’t the only psychologists to violate ethical standards, and the APA has yet to fully denounce psychologists' participation in torture.

The entire story is here.

How is the doctor-patient relationship changing? It’s going electronic.

By Suzanne Allard Levingston
The Washington Post
Originally posted April 27, 2015

Here are two excerpts:

Almost three-quarters of American adults use the Internet to search online for health information each year, according to the Pew Research Center. While patients are digging through new information, so are doctors. A “tsunami of knowledge” from hundreds of journals pours over doctors, says Jack Cochran, executive director of the Permanente Federation.

All this information changes the culture. “Doctors say they’re taught to know things that others don’t,” said Dave deBronkart, a cancer survivor and advocate for patient engagement. Today, thanks to online searches and communities, a patient may know about advances before a doctor does.

(cut)

Not only should you read your electronic health record, you should check for errors. “Most people’s records contain mistakes,” deBronkart said. His 2009 blog about mistakes in his Google Health record led to a front-page story in the Boston Globe and a career as an advocate known as e-Patient Dave. (Google Health, a free service intended to help consumers pull together medical and wellness information, was discontinued in 2013 because it failed to generate broad interest.)

The entire article is here.

Tuesday, May 19, 2015

Replication, falsification, and the crisis of confidence in social psychology

By Brian D. Earp & David Trafimow
Front. Psychol. | doi: 10.3389/fpsyg.2015.00621

Abstract

The (latest) “crisis in confidence” in social psychology has generated much heated discussion about the importance of replication, including how such replication should be carried out as well as interpreted by scholars in the field. What does it mean if a replication attempt “fails”—does it mean that the original results, or the theory that predicted them, have been falsified? And how should “failed” replications affect our belief in the validity of the original research? In this paper, we consider the “replication” debate from a historical and philosophical perspective, and provide a conceptual analysis of both replication and falsification as they pertain to this important discussion. Along the way, we introduce a Bayesian framework for assessing “failed” replications in terms of how they should affect our confidence in purported findings.

The entire article is here.

Cultural Evolution As Dialectic

By John Hartigan
Savage Minds
Originally posted April 21, 2015

Here is an excerpt:

A primary outcome is the recognition that culture “is an evolutionary player,” in the words of Kevin Laland. That is, culture drives and shapes so many aspects of evolution that it can destabilize reductivist assertions about human biology. The dialectic possibilities involve thinking about the key concept of phenotypic plasticity and how that vacillates along a continuum of fixity and fluidity, particularly as influenced by domestication (whether the version practiced by humans or not). And this gets back to a point the Fuentes stressed: “The mutual mutability of form and function in becoming human with other humans and nonhuman others is a central tenet in human evolution and should be recognized as a locus for the anthropological gaze …one where we can influence scientific practice in fields outside our own.” The way to challenge and change the way evolution operates in public discourse as an explanatory frame—see evolutionary psychology and economics—won’t improve until we fashion a more cultural account of how it operates.

The entire article is here.

Monday, May 18, 2015

Social psychologist relinquishes chair after data manipulation charges

By Frank van Kolfschooten
ScienceInsider
Originally published April 20, 2015

Here are two excerpt:

In the controversial studies, Förster investigated how "priming" by subtle cues—such as a smell or hearing a poem—can change a person's cognitive response. Suspicions against his work were first raised in 2012 by a whistleblower who filed a complaint at UvA. In June 2013, an integrity committee at the university concluded that data patterns in the studies were “practically impossible,” and recommended the publication of “expressions of concern” in the journals involved.

(cut)

"I will leave the materialistic and soulless production approach in science," the text reads, however. "I am going my own way now.” Förster didn’t respond to e-mailed questions from ScienceInsider about his decision.

The entire article is here.

Why Many Doctors Don't Follow 'Best Practices'

By Anders Kelto
NPR News - All Things Considered
Originally published April 22, 2015

Here is an excerpt:

Imagine, for example, that a healthy, 40-year-old woman walks into your office and asks about a mammogram.

"If that woman were to develop breast cancer or to have breast cancer, you can imagine what might happen to you if you didn't order the test," Wu says. "Maybe you'd get sued."

Doctors often hear stories like this, he says, and that can affect their judgment.

"Emotion and recent events do influence our decision-making," he says. "We are not absolutely rational, decision-making machines."

The entire article is here.

Sunday, May 17, 2015

Deceased clients and their wills

When a treating psychologist receives a bequest, what ethical considerations come into play?

By Stephen Behnke, JD, PhD, MDiv
The Monitor on Psychology
May 2015, Vol 46, No. 5
Print version: page 72

Here is an excerpt:

Most risk managers — people who work for insurance carriers, for example, whose primary goal is to lower a psychologist's exposure to risk — will advise the psychologist to decline the property. This advice makes good sense. The situation invites a claim that the psychologist exercised undue influence over the client, which is a relevant legal standard for overturning the bequest. The likelihood that a claim of undue influence will be made against the psychologist rises exponentially if the client had heirs, or potential beneficiaries of the estate who are found. If a complaint is made to an ethics committee or licensing board, the psychologist will bear the burden of demonstrating that there has been no exploitation:

The entire article is here.

Saturday, May 16, 2015

Errors in Moral Forecasting

Perceptions of Affect Shape the Gap Between Moral Behaviors and Moral Forecasts

Rimma Teper, Alexa M. Tullett, Elizabeth Page-Gould, and Michael Inzlicht
Personality and Social Psychology Bulletin 1–14
DOI: 10.1177/0146167215583848

Abstract
Research in moral decision making has shown that there may not be a one-to-one relationship between peoples’ moral forecasts and behaviors. Although past work suggests that physiological arousal may account for part of the behavior forecasting discrepancy, whether or not perceptions of affect play an important determinant remains unclear. Here, we investigate whether this discrepancy may arise because people fail to anticipate how they will feel in morally significant situations. In Study 1, forecasters predicted cheating significantly more on a test than participants in a behavior condition actually cheated. Importantly, forecasters who received false somatic feedback, indicative of high arousal, produced forecasts that aligned more closely with behaviors. In Study 2, forecasters who misattributed their arousal to an extraneous source forecasted cheating significantly more. In Study 3, higher dispositional emotional awareness was related to less forecasted cheating. These findings suggest that perceptions of affect play a key role in the behavior-forecasting dissociation.

The entire article is here.

Friday, May 15, 2015

Navigating the Google Blind Spot

An Emerging Need for Professional Guidelines to Address Patient-Targeted Googling

By Maria J. Baker, Daniel R. George and Gordon L. Kauffman
Journal of General Internal Medicine
Originally published September 17, 2014

Many physicians would agree that seeking information about their patients via Google seems to be an invasion of privacy, violating trust between patients and their healthcare providers. However, it may be viewed as ethically valid, and even warranted under certain circumstances. Although guidelines developed by the American Medical Association and the Federation of State Medical Boards (FSMB) provide general guidance on the appropriate use of the Internet, they do not specifically address the crucial issue of whether physicians should ‘google’ their patients, and, if so, under what circumstances. As a result, physicians are left to navigate this “google blind spot” independently, and to decipher on a case-by-case basis where the boundary of professionalism lies with regard to patient-targeted googling.

Two case scenarios illustrate the moral ambiguity present within this “blind spot.”

The entire article is here.

Why Be Good? Well, Why Not?

By Jay L. Garfield
Big Ideas at Slate.com

Here is an excerpt:

The central problem of ethics is to provide reasons to override rational self-interest—acting for the sake of others, perhaps, or for the sake of duty, or in accordance with divine commandment, or for the sake of some other transcendent value. Sometimes the argument for doing so involves showing that it is really in our own self-interest to do so (everlasting life in heaven, for instance). Sometimes it involves arguing that there are more important things than our own rational interest (duty, for instance). In any case, the burden of proof is taken to rest squarely on the moralist to convince the immoralist to do what is, at least at first glance, irrational.

But why take acting in one’s own narrow self-interest to be rational in the first place? It is not self-evident that it is. And why take our own interests to be either independent of those of others or in competition with them? That is not self-evident, either. If we can offer a more compelling account of rational choice than that offered by the economists and decision theorists, we might find that care for others is the default rational basis for action, not a value in competition with it.

The entire article is here.

Thursday, May 14, 2015

Do Killer Robots Violate Human Rights?

When machines are anthropomorphized, we risk applying a human standard that should not apply to mere tools.

By Patrick Lin
The Atlantic
Originally published April 20, 2015

Here is an excerpt:

What’s objectionable to many about lethal autonomous weapons systems is that, even if the weapons aim only at lawful targets, they seem to violate a basic right to life. This claim is puzzling at first, since killing is so commonplace and permitted in war. If you’re a combatant, you are legally liable to be killed at any time; so it’s unclear that there’s a right to life at all.

But what we mean is that, in armed conflicts, a right to life means a right not to be killed arbitrarily, unaccountably, or otherwise inhumanely. To better understand the claim, a right to life can be thought of as a right to human dignity. Human dignity is arguably more basic than a right to life, which can be more easily forfeited or trumped. For instance, even lawful executions should be humane in civilized society.

The entire article is here.

Why Aristole Wants You to Be Good

By Kristjan Kristjansson
Big Ideas at Slate.com

Here is an excerpt:

Many social scientists consider this philosophical question quirky at best. The reason? An abundance of psychological evidence demonstrates the extrinsic benefits of moral choices over immoral ones, even for psychology’s Eldorado: subjective well-being. Of course, even though social scientists pride themselves on their value-neutrality, they are rarely neutral with regard to what they consider the “ungrounded grounder” of all human strivings, namely happiness, and they typically understand happiness as subjective well-being.

A case in point here is the copious literature on the benefits of the moral emotion of gratitude for subjective well-being. We now know with certainty—at least the sort of certainty to which any social scientific inquiry can aspire—that grateful people are in general happy people. Over and above that, meticulous empirical research on gratitude has shown all sorts of instrumental benefits for what social scientists call “pro-social ends.” Thus, as a moral barometer, gratitude attends affirmatively to a positive moral change in our environment; as a moral motivator, gratitude urges us to contribute to the welfare of our benefactor (or even third parties) in the future; as a moral reinforcer, gratitude makes benefactors more likely to replicate their benevolent acts at later junctures and in different contexts.

The entire article is here.


Wednesday, May 13, 2015

Born this way? How high-tech conversion therapy could undermine gay rights

By Andrew Vierra and Brian Earp
The Conversation
Originally published on April 21, 2015

Here is an excerpt:

We fully agree with the President and believe that this is a step in the right direction. Of course, in addition to being unsafe as well as ethically unsound, current conversion therapy approaches aren’t actually effective at doing what they claim to do – changing sexual orientation.

But we also worry that this may be a short-term legislative solution to what is really a conceptual problem.

The question we ought to be asking is “what will happen if and when scientists do end up developing safe and effective technologies that can alter sexual orientation?”

Based on current scientific research, it is not unlikely that medical researchers – in the not-too-distant future – will know enough about the genetic, epigenetic, neurochemical and other brain-level factors that are involved in shaping sexual orientation that these variables could in fact be successfully modified.

The entire article is here.

Science Cannot Teach Us to Be Good

By Daniel Jacobson
Big Ideas at Slate.com

Here is an excerpt:

Consider first the relativist conception of morality, on which goodness consists in conformity with the widely accepted practices of one’s society. Sometimes such behavior is called pro-social, a tendentious term that seems to imply that non-conformity is antisocial. If to be virtuous is to be fully enculturated, as this view claims, then moral dissent must be both mistaken (since moral facts are at bottom sociological facts) and vicious (since goodness is conformity).

Although many social scientists advocate this view, it rests on a premise that cannot claim any scientific backing: the normative principle that it is always illegitimate to criticize another culture by standards it does not accept. This is widely seen as a failure of tolerance, as cultural imperialism or ethnocentrism. The relativists don’t seem to notice that their own principle puts such criticism out of bounds, since conformity to widely accepted ethnocentrism is virtuous by their lights. In fact, no one holds the relativist principle consistently.

The entire article is here.

Tuesday, May 12, 2015

A Drug Trial’s Frayed Promise

By Katie Thomas
The New York Times
Originally published April 17, 2015

Here is an excerpt:

The University of Minnesota’s clinical trial practices are now under intense scrutiny. In February, a panel of outside experts excoriated the university for failing to properly oversee clinical trials and for paying inadequate attention to the protection of vulnerable subjects. The review, commissioned by the university after years of criticism of its research practices, singled out Dr. Schulz and his department of psychiatry, describing “a culture of fear” that pervaded the department.

In March, after another critical report by Minnesota’s legislative auditor, the university announced that it would halt all drug trials being conducted by the psychiatry department until outside experts could review them. And this month, the university announced that Dr. Schulz would step down as head of the psychiatry department. The dean of the medical school, Dr. Brooks Jackson, said in a statement to reporters that Dr. Schulz’s decision “was completely his own” and that he would “remain a valued member of our faculty.”

The entire article is here.

Answering 'Why be good?" for a Three-Year-old

By Christian B. Miller
Big Ideas at Slate.com

Here is an excerpt:

I would also mention to my son that the question of, “Why be good?” is especially important because most of us—myself included—are simply not good, morally speaking. We do not have a virtuous or good character. Why do I say that? You might think it is obvious based on watching the nightly news. But my answer is based on hundreds of psychological studies from the last 50 years. In a famous experiment, for instance, Yale psychologist Stanley Milgram found that many people would willingly shock an innocent person, even to the point of death, if pressured from an authority figure. Less well known but also important, are the findings by Lisa Shu of the London Business School. She and her colleagues have found that cheating on tests dramatically increases when it becomes clear to the test-takers that they will not get caught.

So there is a virtuous way to be—honest, compassionate, etc.—and then there is how we tend to actually be, which is not virtuous. Instead our characters are very much a mixed bag, with many good moral tendencies and many bad ones too. Given that most of us are not virtuous people, the question becomes: Why should we bother to try to develop a better character? Why should we care about it? Does developing better character even matter?

The entire article is here.

Monday, May 11, 2015

The Problem With Satisfied Patients

A misguided attempt to improve healthcare has led some hospitals to focus on making people happy, rather than making them well.

Alexandra Robbins
The Atlantic
Originally published April 17, 2015

Here is an excerpt:

Patient-satisfaction surveys have their place. But the potential cost of the subjective scores are leading hospitals to steer focus away from patient health, messing with the highest stakes possible: people’s lives.

The vast majority of the thirty-two-question survey, known as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) addresses nursing care. For example, in a section about nurses, the survey asks, “During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?”

This question is misleading because it doesn’t specify whether the help was medically necessary. Patients have complained on the survey, which in previous incarnations included comments sections, about everything from “My roommate was dying all night and his breathing was very noisy” to “The hospital doesn’t have Splenda.” A nurse at the New Jersey hospital lacking Splenda said, “This somehow became the fault of the nurse and ended up being placed in her personnel file.” An Oregon critical-care nurse had to argue with a patient who believed he was being mistreated because he didn’t get enough pastrami on his sandwich (he had recently had quadruple-bypass surgery). “Many patients have unrealistic expectations for their care and their outcomes,” the nurse said.

The entire article is here.

Can Adversity Make Us Good?

By Eranda Jayawickreme
Big Ideas at Slate.com

Here is an excerpt:

Nevertheless, we know that adversity can help answer the question, “Why be good?” Psychologist Johanna Ray Vollhardt at Clark University has claimed that traumatic life events may in fact enhance the motivation to help other disadvantaged members of society, including people outside the groups with which you identify. One possible explanation for this “altruism born of suffering” is that trauma often forces people to recognize how limited their time on Earth is, which in turn clarifies their values and promotes moral behavior. Blackie found this to be the case in a study she published in Psychological Science, where experimentally manipulating thoughts about death—in this case, asking participants to imagine dying in an apartment fire—predicted increased charitable giving behavior (in this case, the intention to donate blood).

In other words, as the philosopher Valerie Tiberius at the University of Minnesota has argued, we want to be good because we care about having good lives, and adversity can help provide the necessary knowledge and perspective. I would call this knowledge and perspective wisdom.

The entire article is here.

Sunday, May 10, 2015

How Does Reasoning (Fail to) Contribute to Moral Judgment? Dumbfounding and Disengagement

Frank Hindriks
Ethical Theory and Moral Practice
April 2015, Volume 18, Issue 2, pp 237-250

Abstract

Recent experiments in moral psychology have been taken to imply that moral reasoning only serves to reaffirm prior moral intuitions. More specifically, Jonathan Haidt concludes from his moral dumbfounding experiments, in which people condemn other people’s behavior, that moral reasoning is biased and ineffective, as it rarely makes people change their mind. I present complementary evidence pertaining to self-directed reasoning about what to do. More specifically, Albert Bandura’s experiments concerning moral disengagement reveal that moral reasoning often does contribute effectively to the formation of moral judgments. And such reasoning need not be biased. Once this evidence is taken into account, it becomes clear that both cognition and affect can play a destructive as well as a constructive role in the formation of moral judgments.

The entire paper is here.

Saturday, May 9, 2015

The Point of Studying Ethics According to Kant

Lucas Thorpe
The Journal of Value Inquiry (2006) 40:461–474
DOI 10.1007/s10790-006-9002-3

Many readers of Kant’s ethical writings take him to be primarily concerned with offering guidelines for action. At the least, they write about Kant as if this were the purpose of his ethical writings. For example, Christine Korsgaard, in her influential article Kant’s Analysis of Obligation: The Argument of Groundwork I, writes that, ‘‘the argument of Groundwork I is an attempt to give what I call a ‘motivational analysis’ of the concept of a right action, in order to discover what that concept applies to, that is, which actions are right.’’  Similar comments are not hard to find in the secondary literature. This, however, is a fundamentally misguided way of reading Kant, since he repeatedly asserts that we do not need to do moral philosophy in order to discover which actions are right.  We already know how to behave morally and do not need philosophers to tell us this. ‘‘Common human reason,’’ Kant argues, ‘‘knows very well how to distinguish in every case that comes up what is good and what is evil, what is in conformity to duty or contrary to duty.’’  Because people with pre-philosophical understanding know how to act morally, the purpose of moral philosophy cannot be to provide us with a set of rules for correct behavior. If we take Kant’s claims about common human reason seriously, then his aim in the Groundwork of the Metaphysics of Morals cannot be to discover which actions are right.

The article is here.

Friday, May 8, 2015

How Goodness Arises from Evolutionary Competition

By Martin A. Nowak
Big Ideas from Slate.com

Here is an excerpt:

In the human sphere, cooperation means helping each other. In some contexts cooperation can imply “being good.” And suddenly the conundrum disappears. The moral imperative of world religions and philosophical systems seems to make sense.  It simply asks us to be true to our cooperative heritage, to cooperate and not only to compete.

The evolutionary process among humans is not only genetic but also cultural. We have language. We write books, articles, and emails, come up with ideas, replicate knowledge. A group of humans learning from each other instantiate a cultural evolutionary process with mutation and selection. And cooperation.

What makes cooperation a possible strategy among humans? The answer is repetition and reputation. Most of our crucial social interactions occur repeatedly with the same people or in situations where we are known, where actions can be observed by others, and thus affect our reputation.

The entire piece is here.

TMS affects moral judgment, showing the role of DLPFC and TPJ in cognitive and emotional processing

Jeurissen D, Sack AT, Roebroeck A, Russ BE and Pascual-Leone A (2014) TMS affects moral judgment, showing the role of DLPFC and TPJ in cognitive and emotional processing.
Front. Neurosci. 8:18. doi: 10.3389/fnins.2014.00018

Decision-making involves a complex interplay of emotional responses and reasoning processes. In this study, we use TMS to explore the neurobiological substrates of moral decisions in humans. To examining the effects of TMS on the outcome of a moral-decision, we compare the decision outcome of moral-personal and moral-impersonal dilemmas to each other and examine the differential effects of applying TMS over the right DLPFC or right TPJ. In this comparison, we find that the TMS-induced disruption of the DLPFC during the decision process, affects the outcome of the moral-personal judgment, while TMS-induced disruption of TPJ affects only moral-impersonal conditions. In other words, we find a double-dissociation between DLPFC and TPJ in the outcome of a moral decision. Furthermore, we find that TMS-induced disruption of the DLPFC during non-moral, moral-impersonal, and moral-personal decisions lead to lower ratings of regret about the decision. Our results are in line with the dual-process theory and suggest a role for both the emotional response and cognitive reasoning process in moral judgment. Both the emotional and cognitive processes were shown to be involved in the decision outcome.

The entire article is here.

Thursday, May 7, 2015

Moral Responsibility and Free Will: A Meta-Analysis

By Adam Feltz and Florian Cova
Academia.edu

Abstract

Fundamental beliefs about free will and moral responsibility are often thought to shape our ability to have healthy relationships with others and ourselves. Emotional reactions have also  been shown to have an important and pervasive impact on judgments and behaviors. Recent research suggests that emotional reactions play a prominent role in judgments about free will, influencing judgments about determinism’s relation to free will and moral responsibility. However, the extent to which affect influences these judgments is unclear. We conducted a meta-analysis to estimate the impact of affect. Our meta-analysis indicates that beliefs in free will are largely robust to emotional reactions.

The entire meta-analysis is here.

10 years of mindlines: a systematic review and commentary

By Sietse Wieringa and Trisha Greenhalgh
Implementation Science 2015, 10:45
doi:10.1186/s13012-015-0229-x
Published: 9 April 2015

Abstract

Background

In 2004, Gabbay and le May showed that clinicians generally base their decisions on mindlines—internalised and collectively reinforced tacit guidelines—rather than consulting written clinical guidelines. We considered how the concept of mindlines has been taken forward since.

Methods

We searched databases from 2004 to 2014 for the term ‘mindline(s)’ and tracked all sources citing Gabbay and le May’s 2004 article. We read and re-read papers to gain familiarity and developed an interpretive analysis and taxonomy by drawing on the principles of meta-narrative systematic review.

Results

In our synthesis of 340 papers, distinguished between authors who used mindlines purely in name (‘nominal’ view) sometimes dismissing them as a harmful phenomenon, and authors who appeared to have understood the term’s philosophical foundations. The latter took an ‘in-practice’ view (studying how mindlines emerge and spread in real-world settings), a ‘theoretical and philosophical’ view (extending theory) or a ‘solution focused’ view (exploring how to promote and support mindline development). We found that it is not just clinicians who develop mindlines: so do patients, in face-to-face and (potentially) online communities.

Theoretical publications on mindlines have continued to challenge the rationalist assumptions of evidence-based medicine (EBM). Conventional EBM assumes a single, knowable reality and seeks to strip away context to generate universal predictive rules. In contrast, mindlines are predicated on a more fluid, embodied and intersubjective view of knowledge; they accommodate context and acknowledge multiple realities. When considering how knowledge spreads, the concept of mindlines requires us to go beyond the constraining notions of ‘dissemination’ and ‘translation’ to study tacit knowledge and the interactive human processes by which such knowledge is created, enacted and shared. Solution-focused publications described mindline-promoting initiatives such as relationship-building, collaborative learning and thought leadership.

Conclusions

The concept of mindlines challenges the naïve rationalist view of knowledge implicit in some EBM publications, but the term appears to have been misunderstood (and prematurely dismissed) by some authors. By further studying mindlines empirically and theoretically, there is potential to expand EBM’s conceptual toolkit to produce richer forms of ‘evidence-based’ knowledge. We outline a suggested research agenda for achieving this goal.

The entire article is here.

Wednesday, May 6, 2015

What we say and what we do: The relationship between real and hypothetical moral choices

By O. FeldmanHall, D. Mobbs, D. Evans, L. Hiscox, L. Navrady, & T. Dalgleish
Cognition, Volume 123, Issue 3, June 2012, Pages 434–441

Abstract

Moral ideals are strongly ingrained within society and individuals alike, but actual moral choices are profoundly influenced by tangible rewards and consequences. Across two studies we show that real moral decisions can dramatically contradict moral choices made in hypothetical scenarios (Study 1). However, by systematically enhancing the contextual information available to subjects when addressing a hypothetical moral problem—thereby reducing the opportunity for mental simulation—we were able to incrementally bring subjects’ responses in line with their moral behaviour in real situations (Study 2). These results imply that previous work relying mainly on decontextualized hypothetical scenarios may not accurately reflect moral decisions in everyday life. The findings also shed light on contextual factors that can alter how moral decisions are made, such as the salience of a personal gain.

The entire article is here.

Deontic and instantive morality

By Adrienne Martin
PEA Soup blog
Originally published April 10, 2015

Morality is not exclusively deontic.  There are, after all, many things that are morally good to do though not required, or morally bad though not forbidden. However, a deontic conception has gotten a grip on the contemporary conception of interpersonal morality, or morality insofar as it has to do with proper relations between persons in virtue of their personality. One presently popular conception of interpersonal morality runs along these lines: Interpersonal morality consists in obligations or duties that are incumbent on all persons; to have a duty is to be accountable to somebody. If I am accountable to somebody, then she has standing or authority to demand my compliance; and to exercise this authority is to be disposed to respond to noncompliance with Strawsonian reactive attitudes and practices expressive of them.

The entire blog post is here.

Tuesday, May 5, 2015

For one VA whistleblower, getting fired was too much

By Donovan Slack
http://www.wausaudailyherald.com
Originally posted April 12, 2015

Here are two excerpts:

There, officers found the body of Christopher Kirkpatrick, a 38-year-old clinical psychologist who had shot himself in the head after being fired from the Tomah Veterans Affairs Medical Center.

Kirkpatrick had complained some of his patients were too drugged to treat properly, but like other whistleblowers at the facility, he was ousted and his concerns of wrongdoing were disregarded.

Retaliation against whistleblowers has become a major problem at VA facilities across the country. The U.S. Office of Special Counsel is investigating 110 retaliation claims from whistleblowers in 38 states and the District of Columbia.

(cut)

VA officials said since Kirkpatrick's death, the agency has implemented online whistleblower training for 32,000 managers and executives at the agency, and now requires all employees to take a course every other year that includes a component about whistleblower rights. VA spokeswoman Genevieve Billia said notices of termination should contain language informing the affected employee of those rights. She did not respond to a message asking if that was mandatory.

The entire article is here.

Markingson case: University of Minnesota can't regain trust under current leadership

By Arne H. Carlson
The Star Tribune
Originally published April 10, 2015

Here is an excerpt:

Ever since the violent suicide of Dan Markingson in 2004, the administration of the University of Minnesota has received repeated calls for the release of more details about the care and protection afforded the victim. These calls have come from faculty members at the university, from local community members and from researchers from around the world. But instead of being transparent and forthright, the administration created a standard response similar to that expressed by the university’s former general counsel, Mark Rotenberg: “As we’ve stated previously, the Markingson case has been exhaustively reviewed by Federal, State and academic bodies since 2004. The FDA, the Hennepin County District Court, the Minnesota Board of Medical Practice, the Minnesota Attorney General’s office and the University’s Institutional Review Board have all reviewed the case. None found fault with any of our faculty.”

The entire article is here.

Monday, May 4, 2015

Outlook: Gloomy

Humans are wired for bad news, angry faces and sad memories. Is this negativity bias useful or something to overcome?

By Jacob Burak
Aeon Magazine
Originally published September 4, 2014

Here are two excerpts:

Hundreds of scientific studies from around the world confirm our negativity bias: while a good day has no lasting effect on the following day, a bad day carries over. We process negative data faster and more thoroughly than positive data, and they affect us longer. Socially, we invest more in avoiding a bad reputation than in building a good one. Emotionally, we go to greater lengths to avoid a bad mood than to experience a good one. Pessimists tend to assess their health more accurately than optimists. In our era of political correctness, negative remarks stand out and seem more authentic. People – even babies as young as six months old – are quick to spot an angry face in a crowd, but slower to pick out a happy one; in fact, no matter how many smiles we see in that crowd, we will always spot the angry face first.

(cut)

The psychologist Roy Baumeister, now professor at Florida State University, has expanded on the concept. ‘Centuries of literary efforts and religious thought have depicted human life in terms of a struggle between good and bad forces,’ he wrote in 2001. ‘At the metaphysical level, evil gods or devils are the opponents of the divine forces of creation and harmony. At the individual level, temptation and destructive instincts battle against strivings for virtue, altruism, and fulfilment. “Good” and “bad” are among the first words and concepts learnt by children (and even by house pets).’ After reviewing hundreds of published papers, Baumeister and team reported that Kahneman’s find extended to every realm of life – love, work, family, learning, social networking and more. ‘Bad is stronger than good,’ they declared in their seminal, eponymous paper.

The entire article is here.

Editor's note: The negative bias may likely influence how you see certain patients, how you view ethics, or how you make ethical and clinical decisions.

Informed Consent and the First Amendment

Wendy K. Mariner, and George J. Annas
N Engl J Med 2015; 372:1285-1287
April 2, 2015
DOI: 10.1056/NEJMp1501190

Here is an excerpt:

Medical services are analogous to commercial practices for purposes of the First Amendment. The government has an interest in regulating medical practice to ensure safe and effective care. It also has an interest in ensuring that patients have enough accurate information to make voluntary, informed treatment decisions. Hence, it is the physician's duty under the doctrine of informed consent to provide material information about the benefits and risks of both the recommended treatment and its alternatives. However, the First Amendment prohibits the government from compelling people to make false or misleading statements or to express the government's point of view as their own.

Relying on the 1992 Supreme Court decision, North Carolina contended that the required fetal sonogram descriptions are merely statements of fact. The Fourth Circuit, however, found that North Carolina's display provision represented “quintessential compelled speech,” calling the required description “ideological; it conveys a particular opinion.” The court, finding that the “state's avowed intent and the anticipated effect” were to discourage abortion, said that the provision compelled physicians to serve as a mouthpiece for the state's point of view.

The entire article is here.

Sunday, May 3, 2015

What if a bionic leg is so good that someone chooses to amputate?

By Jemima Kiss
The Guardian
Originally published April 9, 2015

Here is an excerpt:

Bionics will become so appealing that some people may choose to amputate just so that they can augment their bodies; our own legs might begin to feel heavy and stupid, he thinks. Given cosmetic surgery now, how would we feel about going under the knife for an arguably more justifiable benefit? This raises some intensely challenging issues about whether we will see a far more profound human digital divide, already hinted at in sci-fi countless times: the augmented, and the unaugmented.

In this view of the body as a biological machine, the parts that don’t work can be replaced, improved, remodelled.

The entire article is here.

Saturday, May 2, 2015

Free Will and Autonomous Medical DecisionMaking

Butkus, Matthew A. 2015. “Free Will and Autonomous Medical Decision-Making.”
Journal of Cognition and Neuroethics 3 (1): 75–119.

Abstract

Modern medical ethics makes a series of assumptions about how patients and their care providers make decisions about forgoing treatment. These assumptions are based on a model of thought and cognition that does not reflect actual cognition—it has substituted an ideal moral agent for a practical one. Instead of a purely rational moral agent, current psychology and neuroscience have shown that decision-making reflects a number of different factors that must be considered when conceptualizing autonomy. Multiple classical and contemporary discussions of autonomy and decision-making are considered and synthesized into a model of cognitive autonomy. Four categories of autonomy criteria are proposed to reflect current research in cognitive psychology and common clinical issues.

The entire article is here.

Friday, May 1, 2015

Obama Administration Report Slams Digital Health Records

By Melinda Beck
The Wall Street Journal
Originally published on April 10, 2015

The Obama administration took vendors of electronic health records to task for making it costly and cumbersome to share patient information and frustrating a $30 billion push to use digital records to improve quality and cut costs.

The report, by the Office of the National Coordinator for Health Information Technology, listed a litany of complaints it has received about vendors allegedly charging hefty fees to set up connections and share patient records; requiring customers to use proprietary platforms; and making it prohibitively expensive to switch systems.

The report also cited complaints that some hospital systems make it difficult to transfer patient records to rival systems or physicians as a way to control referrals and enhance their market dominance.

The entire article is here.

The experts' step-by-step guide to cyber security

By Kitty Dann
The Guardian
Originally published April 2 2015

Where does cyber security fall on your to-do list? If it’s not a priority, it should be because 60% of small businesses suffered a breach in the year leading up to October 2014. The worst of these breaches disrupted operations for an average of seven to 10 days.

We recently held a live Q&A on the topic, with a panel of experts on hand to answer your questions. From risk assessment to keeping your business safe on a budget, here are some of their suggestions:

The entire article is here.