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

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

Tuesday, May 31, 2016

South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says

By Matt Apuzzomay
The New York Times
Originally posted May 2, 2016

When patients in South Dakota seek help for serious but manageable disabilities such as severe diabetes, blindness or mental illness, the answer is often the same: With few alternatives available, they end up in nursing homes or long-term care facilities, whether they need such care or not.

In a scathing rebuke of the state’s health care system, the Justice Department said on Monday that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago.

The Obama administration has opened more than 50 such investigations and reached settlements with eight states. One investigation, into Florida’s treatment of children with disabilities, ended in a lawsuit over policies that placed those children in nursing homes. With its report Monday, the Justice Department signaled that it might also sue South Dakota.

The article is here.

Cook County Sheriff Dart: Jailing poor, mentally ill is unjust

Madhu Krishnamurthy
Daily Herald
Originally posted April 6, 2016

The numbers of mentally ill people housed in the nation's prisons and jails are staggering, Cook County Sheriff Tom Dart says, and many of them shouldn't be there.

Dart, speaking Wednesday at Elgin Community College, has led a campaign to reduce what he calls the unjust incarceration of the poor and mentally ill. He's been recognized by health advocacy organizations for trying to change the criminal justice system, which perpetuates a revolving door at jails. His presentation was part of the college's Humanities Center Speakers series.

The article is here.

Monday, May 30, 2016

First Artificially Intelligent Lawyer Hired

The American Lawyer
First published on May 11, 2016

Here is an excerpt:

Ross, “the world’s first artificially intelligent attorney” built on IBM’s cognitive computer Watson, was designed to read and understand language, postulate hypotheses when asked questions, research, and then generate responses (along with references and citations) to back up its conclusions. Ross also learns from experience, gaining speed and knowledge the more you interact with it.

“You ask your questions in plain English, as you would a colleague, and ROSS then reads through the entire body of law and returns a cited answer and topical readings from legislation, case law and secondary sources to get you up-to-speed quickly,” the website says. “In addition, ROSS monitors the law around the clock to notify you of new court decisions that can affect your case.”

The article is here.

Here is a video ad for Watson.  For me, it is both amazing and scary.

Sunday, May 29, 2016

In ethics debate, what to disclose at issue

By David Saleh Rauf
The Houston Chronicle
Originally posted May 28, 2016

Here is an excerpt:

More than 30,350 certificates have been filed with the ethics commission, a process Capriglione says is "like watching transparency happen every single day."

However, implementing the far-reaching law has proven complicated. Regulators have been inundated with questions since the law touches on contracts approved by state agencies, cities, counties, school districts or any special districts like a water authority.

Industry groups, which unsuccessfully waged a late attempt to have Abbott veto the law, said they have been unsure of what to disclose.

The article is here.

Corruption? Here? Bill would require ethics training for N.J. elected officials

By S. P. Sullivan
NJ.com
Originally posted May 9, 2016

In an effort to stem public corruption scandals, the state Senate on Monday unanimously passed a bill that would require all New Jersey elected officials undergo ethics training as soon as they're elected.

The bill (S84) mandates elected officials take the training within six months of their first term. Officials who skip out on the ethics education would face a $5,000 fine.

Sponsors of the legislation point to investigations by the state Comptroller's Office, which over the years has detailed many examples of public corruption, as evidence that the training is needed.

The article is here.

The job of ‘ethics committees’ should be ethically informed code consistency review

Søren Holm
J Med Ethics doi:10.1136/medethics-2015-103343

Moore and Donnelly argue in the paper ‘The job of “ethics committees”’ that research ethics committees should be renamed and that their job should be specified as “review of proposals for consistency with the duly established and applicable code” only.  They raise a large number of issues, but in this comment I briefly want to suggest that two of their arguments are fundamentally flawed.

The first flawed argument is the argument related to the separation of powers. Moore and Donnelly proceed from the premise that it is pro tanto better to have an institutional arrangement that separates code-making powers and decisional powers, and then proceed to argue that this separation is not feasible for what they call ‘ethics consistency review’ because “no matter who established any prespecified review standards, the review decision maker must be empowered at review to revise those standards when this would make for an ethical improvement.

The response article is here.

Saturday, May 28, 2016

The job of ‘ethics committees’

Andrew Moore and Andrew Donnelly
J Med Ethics doi:10.1136/medethics-2015-102688

Abstract

What should authorities establish as the job of ethics committees and review boards? Two answers are: (1) review of proposals for consistency with the duly established and applicable code and (2) review of proposals for ethical acceptability. The present paper argues that these two jobs come apart in principle and in practice. On grounds of practicality, publicity and separation of powers, it argues that the relevant authorities do better to establish code-consistency review and not ethics-consistency review. It also rebuts bad code and independence arguments for the opposite view. It then argues that authorities at present variously specify both code-consistency and ethics-consistency jobs, but most are also unclear on this issue. The paper then argues that they should reform the job of review boards and ethics committees, by clearly establishing code-consistency review and disestablishing ethics-consistency review, and through related reform of the basic orientation, focus, name, and expertise profile of these bodies and their actions.

The article is here.

Thursday, May 26, 2016

Cosmopolitan ethics

Muhammad Ali Musofer
Dawn
Originally posted May 6, 2016

Here is an excerpt:

Looking at the ethical challenges of a connected world, social scientists have been seeking such ethical principles that should be inclusive and help people of diverse backgrounds live in harmony and peace. Over time, different ethical perspectives, with different terms, have been proposed to deal with ethical issues of the contemporary world, and cosmopolitan ethics is one the most discussed ethical perspectives.

The concept of cosmopolitism can be traced in different societies in history; however, after the Second World War, the term ‘cosmopolitan ethics’ received increasing attention from scholars. Broadly speaking, cosmopolitan ethics is based on the principle that all human beings belong to a single community. Cosmopolitan ethics envisage a society where inclusive morality, shared economic interest and social relationship is used to encompass cultural differences. A cosmopolitan society regards the difference of identities and values as strengths. It encourages dialogue within and between cultures and societies to make this world a better place to live in.

The article is here.

Morality When the Mind is Unknowable

By Rita A. McNamara
Character and Content
Originally posted on May 2, 2016

Here is an excerpt:

Our ability to infer the presence and content of other minds is a fundamental building block underlying the intuitions about right and wrong that we use to navigate our social worlds. People living in Western societies often identify internal motives, dispositions, and desires as the causes of all human action. That these behavioral drivers are inside of another mind is not an issue because, in this Western model of mind, people can be read like books – observers can infer other people’s motives and desires and use these inferences to understand and predict behavior. Given this Western model of mind as an internally coherent, autonomous driver of action, the effort spent on determining whether Martin meant to harm Barras seems so obviously justified as to go without question. But this is not necessarily the case for all cultures.

In many societies, people focus far more on relational ties and polite observance of social duties than on internal mental states. On the other end of the cultural spectrum of mental state focus, some small-scale societies have ‘Opacity of Mind’ norms that directly prohibit inference about mental states. In contrast to the Western model of mind, these Opacity of Mind norms often suggest that it is either impossible to know what another person is thinking, or rude to intrude into others’ private mental space. So, while mental state reasoning is a key foundation for intuitions about right and wrong, these intuitions and mental state perceptions are also dependent upon cultural influences.

The information is here.

Wednesday, May 25, 2016

Should we be afraid of AI?

by Luciano Floridi
Aeon
Originally posted May 9, 2016

Here is an excerpt:

We should make AI environment-friendly. We need the smartest technologies we can build to tackle the concrete evils oppressing humanity and our planet, from environmental disasters to financial crises, from crime, terrorism and war, to famine, poverty, ignorance, inequality and appalling living standards.

We should make AI human-friendly. It should be used to treat people always as ends, never as mere means, to paraphrase Immanuel Kant.

We should make AI’s stupidity work for human intelligence. Millions of jobs will be disrupted, eliminated and created; the benefits of this should be shared by all, and the costs borne by society.

We should make AI’s predictive power work for freedom and autonomy. Marketing products, influencing behaviours, nudging people or fighting crime and terrorism should never undermine human dignity.

And finally, we should make AI make us more human. The serious risk is that we might misuse our smart technologies, to the detriment of most of humanity and the whole planet. Winston Churchill said that ‘we shape our buildings and afterwards our buildings shape us’. This applies to the infosphere and its smart technologies as well.

The article is here.

From the Immoral to the Incorruptible: How Prescriptive Expectations Turn the Powerful Into Paragons of Virtue

Miao Hu, Derek D. Rucker, Adam D. Galinsky
Personality and Social Psychology Bulletin, June 2016 vol. 42 no. 6 826-837

Abstract

Ample evidence documents that power increases unethical behavior. This article introduces a new theoretical framework for understanding when power leads to more versus less unethical behavior. Our key proposition is that people hold expectations about power that are both descriptive (how the powerful do behave) and prescriptive (how the powerful should behave). People hold descriptive beliefs that the powerful do behave more unethically than the powerless, but they hold prescriptive beliefs that the powerful should behave more ethically than the powerless. Whichever expectation—descriptive or prescriptive—is salient affects how power influences one’s behavior. Three experiments demonstrate that activating descriptive expectations for power leads the powerful to cheat more than the powerless, whereas activating prescriptive expectations leads the powerful to cheat less than the powerless. The current work offers new ideas for curbing unethical behavior by those with power: focus their attention on prescriptive expectations for power.

The article is here.

Tuesday, May 24, 2016

Junk Science on Trial

Jordan Smith
The Intercept
Originally posted May 6 2016

Here is an excerpt:

Expert Infallibility?

The Supreme Court's opinion makes little sense if you consider it critically. Under the court's reasoning, a conviction could be overturned if, for example, an eyewitness to a crime later realized he was wrong about what he saw. But if an expert who testified that DNA evidence belonged to one person later realized that the DNA belonged to someone else, nothing could be done to remedy that error, even if it was responsible for a conviction.

In the wake of that opinion, and with Richards's case firmly in mind, lawyers from across the state asked for a change in law -- one that would make it clear that a conviction can be overturned when experts recant their prior testimony as a result of scientific or technological advances.

Known as a junk science statute, the Bill Richards Bill changed the state penal code to address problematic forensic practices in individual criminal cases. Faulty forensics have been implicated in nearly half of all DNA exonerations, according to the Innocence Project, and in roughly 23 percent of all wrongful convictions, according to the National Registry of Exonerations. California's bill, which passed with bipartisan support, is only the second such statute in the country (following one in Texas), and its passage propelled the Richards case back to the Supreme Court for further consideration.

The article is here.

Pentagon perpetuates stigma of mental health counseling, study says

Gregg Zoroya
USA Today
Originally published May 5, 2016

Even as troop suicides remain at record levels, the Pentagon has failed to persuade servicemembers to seek counseling without fears that they'll damage their careers, a stinging government review concludes.

Despite six major Pentagon or independent studies from 2007 through 2014 that urged action to end the persistent stigma linked to mental health counseling, little has changed, analysts said in the April report by the Government Accountability Office.

The article is here.

Monday, May 23, 2016

Our research was key to the 10,000-hour rule, but here’s what got oversimplified

Anders Ericsson and Robert Pool
Salon.com
Originally posted April 16, 2016

Here is an excerpt:

Research has shown this to be true in field after field. It generally takes about ten years of intense study to become a chess grandmaster. Authors and poets have usually been writing for more than a decade before they produce their best work, and it is generally a decade or more between a scientist’s first publication and his or her most important publication — and this is in addition to the years of study before that first published research. A study of musical composers by the psychologist John R. Hayes found that it takes an average of twenty years from the time a person starts studying music until he or she composes a truly excellent piece of music, and it is generally never less than ten years. Gladwell’s ten-thousand-hour rule captures this fundamental truth — that in many areas of human endeavor it takes many, many years of practice to become one of the best in the world — in a forceful, memorable way, and that’s a good thing.

On the other hand, emphasizing what it takes to become one of the best in the world in such competitive fields as music, chess, or academic research leads us to overlook what we believe to be the more important lesson from the study of the violin students. When someone says that it takes ten thousand — or however many — hours to become really good at something, it puts the focus on the daunting nature of the task. While some may take this as a challenge — as if to say, “All I have to do is spend ten thousand hours working on this, and I’ll be one of the best in the world!”—many will see it as a stop sign: “Why should I even try if it’s going to take me ten thousand hours to get really good?” As Dogbert observed in one “Dilbert” comic strip, “I would think a willingness to practice the same thing for ten thousand hours is a mental disorder.”

The article is here.

Why this lab-grown human embryo has reignited an old ethical debate

By Patrick Monahan
Science
May. 4, 2016

It’s easy to obey a rule when you don’t have the means to break it. For decades, many countries have permitted human embryos to be studied in the laboratory only up to 14 days after their creation by in vitro fertilization. But—as far as anyone knows—no researcher has ever come close to the limit. The point of implantation, when the embryo attaches to the uterus about 7 days after fertilization, has been an almost insurmountable barrier for researchers culturing human embryos.

Now, two teams report growing human embryos about a week past that point. Beyond opening a new window on human biology, such work could help explain early miscarriages caused by implantation gone awry. As a result, some scientists and bioethicists contend that it’s time to revisit the so-called 14-day rule. But that won’t be welcomed by those who consider the rule to have a firm moral grounding—or by those who oppose any research on human embryos.

The article is here.

Sunday, May 22, 2016

Is Deontology a Moral Confabulation?

Emilian Mihailov
Neuroethics
April 2016, Volume 9, Issue 1, pp 1-13

Abstract

Joshua Greene has put forward the bold empirical hypothesis that deontology is a confabulation of moral emotions. Deontological philosophy does not stem from "true" moral reasoning, but from emotional reactions, backed up by post hoc rationalizations which play no role in generating the initial moral beliefs. In this paper, I will argue against the confabulation hypothesis. First, I will highlight several points in Greene’s discussion of confabulation, and identify two possible models. Then, I will argue that the evidence does not illustrate the relevant model of deontological confabulation. In fact, I will make the case that deontology is unlikely to be a confabulation because alarm-like emotions, which allegedly drive deontological theorizing, are resistant to be subject to confabulation. I will end by clarifying what kind of claims can the confabulation data support. The upshot of the final section is that confabulation data cannot be used to undermine deontological theory in itself, and ironically, if one commits to the claim that a deontological justification is a confabulation in a particular case, then the data suggests that in general deontology has a prima facie validity.

The article is here.

Saturday, May 21, 2016

Ghosting on Freud: why breaking up with a therapist is so tricky

Alana Massey
The Guardian
Originally posted May 2, 2016

Here is an excerpt:

Carole Lieberman, a psychiatrist in California, said that patients need to take on some responsibility in letting therapists know when things aren’t working out. “Patients need to come for at least one more session when they are thinking of breaking up with their therapist. Oftentimes, the therapist can resolve a misunderstanding that occurred, or help them to understand why it’s important for them to delve into their past. Even if the patient still decides to leave, they will do so with more insight into themselves and with an open door to return.”

But this expectation demands a great deal, too. Is it really the job of the patient to offer tips and tricks on how the therapist can improve their approach, particularly if the patient is already in a vulnerable or wounded state? Therapists who expect everyone to be experts at the therapeutic process are going to miss or dismiss the patients who need therapy the most.

The article is here.

Friday, May 20, 2016

Making it moral: Merely labeling an attitude as moral increases its strength

Andrew Luttrella, Richard E. Pettya, Pablo Briñolb, & Benjamin C. Wagner
Journal of Experimental Social Psychology
Available online 27 April 2016

Abstract

Prior research has shown that self-reported moral bases of people's attitudes predict a range of important consequences, including attitude-relevant behavior and resistance in the face of social influence. Although previous studies typically rely on self-report measures of such bases, the present research tests the possibility that people can be induced to view their own attitudes as grounded in moral bases. This perception alone leads to outcomes associated with strong attitudes. In three experiments, participants were led to view their attitudes as grounded in moral or non-moral bases. Merely perceiving a moral (vs. non-moral) basis to one's attitudes led them to show greater correspondence with relevant behavioral intentions (Experiment 1) and become less susceptible to change following a persuasive message (Experiments 2 and 3). Moreover, these effects were independent of any other established indicators of attitude strength.

Highlights

  • Mere perceptions of moral (vs. non-moral) attitude bases were manipulated.
  • Perceiving a moral basis increased attitude–intention consistency.
  • Perceiving a moral basis also led to greater resistance to persuasion.
  • These effects were not mediated by other established attitude strength indicators.

The article is here.

Sleep Deprivation and Advice Taking

Jan Alexander Häusser, Johannes Leder, Charlene Ketturat, Martin Dresler & Nadira Sophie Faber
Scientific Reports 6, Article number: 24386 (2016)
doi:10.1038/srep24386

Abstract

Judgements and decisions in many political, economic or medical contexts are often made while sleep deprived. Furthermore, in such contexts individuals are required to integrate information provided by – more or less qualified – advisors. We asked if sleep deprivation affects advice taking. We conducted a 2 (sleep deprivation: yes vs. no) ×2 (competency of advisor: medium vs. high) experimental study to examine the effects of sleep deprivation on advice taking in an estimation task. We compared participants with one night of total sleep deprivation to participants with a night of regular sleep. Competency of advisor was manipulated within subjects. We found that sleep deprived participants show increased advice taking. An interaction of condition and competency of advisor and further post-hoc analyses revealed that this effect was more pronounced for the medium competency advisor compared to the high competency advisor. Furthermore, sleep deprived participants benefited more from an advisor of high competency in terms of stronger improvement in judgmental accuracy than well-rested participants.

The article is here.

Thursday, May 19, 2016

Anticipating artificial intelligence

Editorial Board
Nature
Originally posted April 26, 2016

Here is an excerpt:

So, what are the risks? Machines and robots that outperform humans across the board could self-improve beyond our control — and their interests might not align with ours. This extreme scenario, which cannot be discounted, is what captures most popular attention. But it is misleading to dismiss all concerns as worried about this.

There are more immediate risks, even with narrow aspects of AI that can already perform some tasks better than humans can. Few foresaw that the Internet and other technologies would open the way for mass, and often indiscriminate, surveillance by intelligence and law-enforcement agencies, threatening principles of privacy and the right to dissent. AI could make such surveillance more widespread and more powerful.

Then there are cybersecurity threats to smart cities, infrastructure and industries that become overdependent on AI — and the all too clear threat that drones and other autonomous offensive weapons systems will allow machines to make lethal decisions alone.

The article is here.

FDA Reconsiders Training Requirement for Painkillers

BY Matthew Perrone
AP HEALTH WRITER
Originally published April 29, 2016

The Food and Drug Administration is reconsidering whether doctors who prescribe painkillers like OxyContin should be required to take safety training courses, according to federal documents.

The review comes as regulators disclosed that the number of doctors who completed voluntary training programs is less than half that targeted by the agency.

A panel of FDA advisers meets next week to review risk-management plans put in place nearly four years ago to reduce misuse and abuse of long-acting painkillers, powerful opioid drugs at the center of a national wave of abuse and death.

The article is here.

Wednesday, May 18, 2016

Biological determinism and its enemies

Radosław Zyzik
Philosophy in Neuroscience, eds. Jerzy Stelmach, Bartosz Brożek, Łukasz Kurek, Copernicus Center Press 2012.

Here is an excerpt:

Little research (if any) has addressed the problem of determinism from more than one perspective at the same time. On the one hand, one can read about the neuroscience of free will and the renaissance
of determinism due to the work of neuroscientists. On the other, a new face of genetic determinism is discussed as a result of the progress made in genetics. Moreover, today we can also learn about the impact of biological factors on the development of model organisms in neurogenetics. With this in mind, we have tried to investigate how determinism is understood in neuroscience, behavioural genetics and in a new discipline which combines knowledge from many disciplines – neurogenetics.

We believe that only such a broad perspective will eventually allow an understanding of determinism in biology with all of its shortcomings. Therefore, the aim of our study is to evaluate the philosophical interpretations of neuroscientific, genetic and neurogenetic experiments that can be seen to be in line with the thesis of biological determinism. The paper re-examines the tacit philosophical assumptions, applied methodology and interpretation of the results of the experiments.

The book chapter is here.

Will These 2 Court Cases Finally Hold Our Torturers Accountable?

By David Cole
The Nation
Originally posted May 9, 2016

Here is an excerpt:

Torture and cruel, inhuman, or degrading treatment, by contrast, are not committed to the political branches’ discretion. As the district court in Washington recognized, the very fact that Congress has made torture a crime and, under the Torture Victim Protection Act, grounds for a civil action for damages, refutes the notion that it is an inappropriate subject for courts. The fact that at the margins it may be difficult to decide whether particular actions constitute torture or cruel, inhuman, or degrading treatment does not make them “political questions.” Courts every day must decide whether particular conduct meets statutory definitions; that is what they do.

The district court in the CACI case ruled that because the military supervised the contractors at Abu Ghraib, the case must be dismissed as political because it would necessitate judicial intrusion on sensitive military judgments. But in doing so, it relied on cases that alleged only negligent action by contractors engaged in otherwise lawful and authorized military operations.

The article is here.

Tuesday, May 17, 2016

America’s Suicide Epidemic Is a National Security Crisis

Fredrik Deboer
Foreign Policy
Originally published April

Here is an excerpt:

Too many in our culture, meanwhile, still place the blame for suicide on its victims. It’s common, after high-profile suicides like that of actor and comedian Robin Williams, for some to argue that suicide is “the coward’s way out,” that taking one’s own life is somehow a cowardly act. Such attitudes are a flagrant failure of empathy, as well as a misunderstanding about the relationship between suicide and mental illness and addiction, both of which are strongly associated with suicide risk. Like many social problems, suicide does not have single and obvious causes but rather a concert of contributing factors working together. To blame suicide on a lack of personal character demonstrates ignorance about the nature of the problem. But such thinking contributes to the country’s persistent and deep inability to grapple with suicide in an open and healthy way.

The article is here.

Later Career Remedial Supervision - The Practice Event Audit

Jon Amundson
The Practitioner Scholar: Journal of Counseling and Professional Psychology 32 
Volume 5, 2016

Abstract

Clinical supervision has for the most part focused upon early career preparation and training. Fundamental to this process is emphasis upon emerging competency. However, supervision can also be required in relation to enduring competency. Where lapses in professional practice are of a subtle or non-egregious nature, supervision may arise as a remedial route. Through hearing, tribunal mandate or negotiation, arising from Alternative Dispute Resolution (ADR), remedial supervision may be the outcome. In this article mandated or negotiated remedial supervision is discussed with a specific description of a means for such – the Practice Event Audit. Issues related to ethics, conduct and competency, remedial supervision and the Professional Event Audit are discussed in light of a case example.

The paper is here.

Monday, May 16, 2016

Embedding Ethical Principles in Collective Decision Support Systems

Joshua Greene, Francesca Rossi, John Tasioulas, Kristen Brent Venable, & Brian Williams
Proceedings of the Thirtieth AAAI Conference on Artificial Intelligence (AAAI-16)

Abstract

The future will see autonomous machines acting in the same environment as humans, in areas as diverse as driving, assistive technology, and health care. Think of self-driving cars, companion robots, and medical diagnosis support systems.  We also believe that humans and machines will often need to work together and agree on common decisions. Thus hybrid collective decision making systems will be in great need.  In this scenario, both machines and collective decision making systems should follow some form of moral values and ethical principles (appropriate to where they will act but always aligned to humans’), as well as safety constraints. In fact, humans would accept and trust more machines that behave as ethically as other humans in the same environment. Also, these principles would make it easier for machines to determine their actions and explain their behavior in terms understandable by humans. Moreover, often machines and humans will need to make decisions together, either through consensus or by reaching a compromise. This would be facilitated by shared moral values and ethical principles.

The article is here.

Inside OpenAI

Cade Metz
Wired.com
Originally posted April 27, 2016

Here is an excerpt:

OpenAI will release its first batch of AI software, a toolkit for building artificially intelligent systems by way of a technology called “reinforcement learning”—one of the key technologies that, among other things, drove the creation of AlphaGo, the Google AI that shocked the world by mastering the ancient game of Go. With this toolkit, you can build systems that simulate a new breed of robot, play Atari games, and, yes, master the game of Go.

But game-playing is just the beginning. OpenAI is a billion-dollar effort to push AI as far as it will go. In both how the company came together and what it plans to do, you can see the next great wave of innovation forming. We’re a long way from knowing whether OpenAI itself becomes the main agent for that change. But the forces that drove the creation of this rather unusual startup show that the new breed of AI will not only remake technology, but remake the way we build technology.

The article is here.

Sunday, May 15, 2016

Legal Insanity and Executive Function

Katrina Sifferd, William Hirstein, and Tyler Fagan
Under review to be included in The Insanity Defense: Multidisciplinary Views on Its History, Trends, and Controversies (Mark D. White, Ed.) Praeger (expected Nov. 2016)

1. The cognitive capacities relevant to legal insanity

Legal insanity is a legal concept rather than a medical one. This may seem an obvious point, but it is worth reflecting on the divergent purposes and motivations for legal, as opposed to medical, concepts. Medical categories of disease are shaped by the medical professions’ aims of understanding, diagnosing, and treating illness. Categories of legal excuse, on the other hand, serve the aims of determining criminal guilt and punishment.

A theory of legal responsibility and its criteria should exhibit symmetry between the capacities it posits as necessary for moral, and more specifically, legal agency, and the capacities that, when dysfunctional or compromised, qualify a defendant for an excuse. To put this point more strongly, the capacities necessary for legal agency should necessarily disqualify one from legal culpability when sufficiently compromised. Thus one’s view of legal insanity ought to reflect whatever one thinks are the overall purposes of the criminal law.  If the purpose of criminal punishment is social order, then legal agency entails the capacity to be law-abiding such that one does not undermine the social order. If the purpose is institutionalized moral blame for wrongful acts, then legal agency entails the capacities for moral agency. If a criminal code embraces a hybrid theory of criminal law, then all of these capacities are relevant to legal agency.

In this chapter we will argue that the capacities necessary to moral and legal agency can be understood as executive functions in the brain.

The chapter is here.

Saturday, May 14, 2016

On the Source of Human Irrationality

Oaksford, Mike et al.
Trends in Cognitive Sciences , Volume 20 , Issue 5 , 336 - 344

Summary

Reasoning and decision making are error prone. This is often attributed to a fast, phylogenetically old System 1. It is striking, however, that perceptuo-motor decision making in humans and animals is rational. These results are consistent with perceptuo-motor strategies emerging in Bayesian brain theory that also appear in human data selection. People seem to have access, although limited, to unconscious generative models that can generalise to explain other verbal reasoning results. Error does not emerge predominantly from System 1, but rather seems to emerge from the later evolved System 2 that involves working memory and language. However language also sows the seeds of error correction by moving reasoning into the social domain. This reversal of roles suggests key areas of theoretical integration and new empirical directions.

Trends

System 1 is supposedly the main cause of human irrationality. However, recent work on animal decision making, human perceptuo-motor decision making, and logical intuitions shows that this phylogenetically older system is rational.

Bayesian brain theory has recently proposed perceptuo-motor strategies identical to strategies proposed in Bayesian approaches to conscious verbal reasoning, suggesting that similar generative models are available at both levels.

Recent approaches to conditional inference using causal Bayes nets confirm this account, which can also generalise to logical intuitions.

People have only imperfect access to System 1. Errors arise from inadequate interrogation of System 1, working memory limitations, and mis-description of our records of these interrogations. However, there is evidence that such errors may be corrected by moving reasoning to the social domain facilitated by language.

The article is here.

Friday, May 13, 2016

Madness

By Eyal Press
The New Yorker
Originally posted May 2, 2016

Here are two excerpts:

By the nineties, prisons had become America’s dominant mental-health institutions. The situation is particularly extreme in Florida, which spends less money per capita on mental health than any state except Idaho. Meanwhile, between 1996 and 2014, the number of Florida prisoners with mental disabilities grew by a hundred and fifty-three per cent.

(cut)

After the Herald article appeared, Jerry Cummings, the warden, was placed on administrative leave, and many people questioned whether the Department of Corrections had tried to cover up a case of lethal abuse. Far less attention was paid to why an inmate had exposed it, rather than one of the prison’s mental-health or medical professionals. The duty to protect patients from harm is a core principle of medical ethics. According to the National Commission on Correctional Health Care, an offshoot of the American Medical Association which issues standards of care for prisons, any mental-health professional who is aware of abuse is obligated “to report this activity to the appropriate authorities.”

The article is here.

Relaxing Moral Reasoning to Win: How Organizational Identification Relates to Unethical Pro-Organizational Behavior.

Mo Chen, Chao C. Chen, and Oliver J. Sheldon
Journal of Applied Psychology, Apr 21 , 2016

Abstract

Drawing on social identity theory and social–cognitive theory, we hypothesize that organizational identification predicts unethical pro-organizational behavior (UPB) through the mediation of moral disengagement. We further propose that competitive interorganizational relations enhance the hypothesized relationships. Three studies conducted in China and the United States using both survey and vignette methodologies provided convergent support for our model. Study 1 revealed that higher organizational identifiers engaged in more UPB, and that this effect was mediated by moral disengagement. Study 2 found that organizational identification once again predicted UPB through the mediation of moral disengagement, and that the mediation relationship was stronger when employees perceived a higher level of industry competition. Finally, Study 3 replicated the above findings using a vignette experiment to provide stronger evidence of causality. Theoretical and practical implications are discussed.

An excerpt from the Managerial Implications section:

"In addition to these theoretical contributions, it is also worth briefly touching upon some implications of the present research for managerial practice. Unethical behaviors have proven costly for organizations (Cialdini et al., 2004), especially those behaviors conducted in the name of the organization, which are more likely to undermine stakeholders' organizational trust or even cause the collapse of an organization. In view of the dark side of organizational identification, managers should be aware of blind allegiance and loyalty to the organization among their employees and instead emphasize the importance of social responsibility and caring for all stakeholders. The linkage between organizational identification and moral disengagement we document here suggests that loyal organizational members are under greater pressure to relax their moral reasoning to execute their citizenship behavior, especially when stakes are high in a competitive environment. To counterbalance the tendency toward moral disengagement, organizations and managers need to clearly highlight the importance of hyper ethical values in organizational policies and practices and integrate such ethical standards into managerial decision-making. At the same time, organizations should strive to create a culture of social responsibility so as to reduce UPB (May et al., 2015) and reinforce ethical pro-organizational behavior."

The article is here.

Thursday, May 12, 2016

Harm Mediates the Disgust-Immorality Link

Chelsea Schein, Ryan Ritter, & Kurt Gray
Emotion, in press

Abstract

Many acts are disgusting, but only some of these acts are immoral. Dyadic morality predicts that
disgusting acts should be judged as immoral to the extent that they seem harmful. Consistent
with this prediction, three studies reveal that perceived harm mediates the link between feelings
of disgust and moral condemnation—even for ostensibly harmless “purity” violations. In many
cases, accounting for perceived harm completely eliminates the link between disgust and moral
condemnation. Analyses also reveal the predictive power of anger and typicality/weirdness in
moral judgments of disgusting acts. The mediation of disgust by harm holds across diverse acts
including gay marriage, sex acts, and religious blasphemy. Revealing the endogenous presence
and moral relevance of harm within disgusting-but-ostensibly-harmless acts argues against
modular accounts of moral cognition such as moral foundations theory. Instead, these data
support pluralistic conceptions of harm and constructionist accounts of morality and emotion.
Implications for moral cognition and the concept of “purity” are discussed.

The article is here.

Business students: time for a compulsory ethics major?

Erica Cervini
Sydney Morning Herald
Originally posted on April 24, 2016

Here are two excerpts:

While it is commendable that universities are attempting to make students think about business ethics, one unit can only scratch the surface. And, then it depends on how much theory students are getting and to what extent this is applied to real-world cases.

Universities are failing students and society if they see ethics units as separate to students' accounting, banking and entrepreneurship subjects. Ethics has to be embedded in business and management subjects so that it is reinforced.

(cut)

She explained there are scholars who are against teaching business ethics while there are others who argue that students' views can be swayed in ethics classes.

Dr Issa concludes that business school academics need to be "more aware of our impact on those individuals whom we graduate into the business world, and what impact they have on their communities and societies".

The article is here.


Wednesday, May 11, 2016

Judge Grants Torture Victims Their First Chance to Pursue Justice

Jenna McLaughlin
The Intercept
Originally published April 22, 2016

A civil suit against the architects of the CIA’s torture program, psychologists James Mitchell and Bruce Jessen, will be allowed to proceed, a federal judge in Spokane, Washington, decided on Friday.

District Judge Justin Quackenbush denied the pair’s motion to dismiss a lawsuit launched against them on behalf of three victims, one dead, of the brutal tactics they designed.

“This is amazing, this is unprecedented,” Steven Watt, a senior staff attorney for the American Civil Liberties Union representing the plaintiffs, told The Intercept after the hearing. “This is the first step towards accountability.”

The article is here.

Procedural Moral Enhancement

G. Owen Schaefer and Julian Savulescu
Neuroethics  pp 1-12
First online: 20 April 2016

Abstract

While philosophers are often concerned with the conditions for moral knowledge or justification, in practice something arguably less demanding is just as, if not more, important – reliably making correct moral judgments. Judges and juries should hand down fair sentences, government officials should decide on just laws, members of ethics committees should make sound recommendations, and so on. We want such agents, more often than not and as often as possible, to make the right decisions. The purpose of this paper is to propose a method of enhancing the moral reliability of such agents. In particular, we advocate for a procedural approach; certain internal processes generally contribute to people’s moral reliability. Building on the early work of Rawls, we identify several particular factors related to moral reasoning that are specific enough to be the target of practical intervention: logical competence, conceptual understanding, empirical competence, openness, empathy and bias. Improving on these processes can in turn make people more morally reliable in a variety of contexts and has implications for recent debates over moral enhancement.

Tuesday, May 10, 2016

Cadaver study casts doubts on how zapping brain may boost mood, relieve pain

By Emily Underwood
Science
Originally posted April 20, 2016

Here is an excerpt:

Buzsáki expects a living person’s skin would shunt even more current away from the brain because it is better hydrated than a cadaver’s scalp. He agrees, however, that low levels of stimulation may have subtle effects on the brain that fall short of triggering neurons to fire. Electrical stimulation might also affect glia, brain cells that provide neurons with nutrients, oxygen, and protection from pathogens, and also can influence the brain’s electrical activity. “Further questions should be asked” about whether 1- to 2-milliamp currents affect those cells, he says.

Buzsáki, who still hopes to use such techniques to enhance memory, is more restrained than some critics. The tDCS field is “a sea of bullshit and bad science—and I say that as someone who has contributed some of the papers that have put gas in the tDCS tank,” says neuroscientist Vincent Walsh of University College London. “It really needs to be put under scrutiny like this.”

The article is here.

Editor's note:

This article represents the importance of science in the treatment of human suffering. No one wants sham interventions.

However, the stimulation interventions may work, and work effectively, in light of other models of how the brain functions. The brain creates an electromagnetic field that moves beyond the skull.  If the cadaver's brain is shut off, this finding may be irrelevant as the stimulation affects the field that moves beyond the skull.  In other words, how these stimulation procedures influence the electromagnetic field of the brain may be a better model to explain improvement.

Therefore, using dead people to nullify what happens in living people may not be the best standard to evaluate a procedure when researching brain activity.  It is a step to consider and may help develop a better working model of what actually happens with TMS.

By the way, scientists are not exactly certain how lithium or antidepressants work, either.

Where do minds belong?

by Caleb Scharf
Aeon
Originally published March 22, 2016

As a species, we humans are awfully obsessed with the future. We love to speculate about where our evolution is taking us. We try to imagine what our technology will be like decades or centuries from now. And we fantasise about encountering intelligent aliens – generally, ones who are far more advanced than we are. Lately those strands have begun to merge. From the evolution side, a number of futurists are predicting the singularity: a time when computers will soon become powerful enough to simulate human consciousness, or absorb it entirely. In parallel, some visionaries propose that any intelligent life we encounter in the rest of the Universe is more likely to be machine-based, rather than humanoid meat-bags such as ourselves.

These ruminations offer a potential solution to the long-debated Fermi Paradox: the seeming absence of intelligent alien life swarming around us, despite the fact that such life seems possible. If machine intelligence is the inevitable end-point of both technology and biology, then perhaps the aliens are hyper-evolved machines so off-the-charts advanced, so far removed from familiar biological forms, that we wouldn’t recognise them if we saw them. Similarly, we can imagine that interstellar machine communication would be so optimised and well-encrypted as to be indistinguishable from noise. In this view, the seeming absence of intelligent life in the cosmos might be an illusion brought about by our own inadequacies.

The article is here.

Monday, May 9, 2016

How Animals Think

By Alison Gopnik
The Atlantic
May 2016

Here is an excerpt:

Psychologists often assume that there is a special cognitive ability—a psychological secret sauce—that makes humans different from other animals. The list of candidates is long: tool use, cultural transmission, the ability to imagine the future or to understand other minds, and so on. But every one of these abilities shows up in at least some other species in at least some form. De Waal points out various examples, and there are many more. New Caledonian crows make elaborate tools, shaping branches into pointed, barbed termite-extraction devices. A few Japanese macaques learned to wash sweet potatoes and even to dip them in the sea to make them more salty, and passed that technique on to subsequent generations. Western scrub jays “cache”—they hide food for later use—and studies have shown that they anticipate what they will need in the future, rather than acting on what they need now.

From an evolutionary perspective, it makes sense that these human abilities also appear in other species. After all, the whole point of natural selection is that small variations among existing organisms can eventually give rise to new species. Our hands and hips and those of our primate relatives gradually diverged from the hands and hips of common ancestors. It’s not that we miraculously grew hands and hips and other animals didn’t. So why would we alone possess some distinctive cognitive skill that no other species has in any form?

The article is here.

What I Learned From Tickling Apes

By Franz de Waal
New York Times Sunday Review
Originally posted on April 8, 2016

Here is an excerpt:

One reason this whole debate is as heated as it is relates to its moral implications. When our ancestors moved from hunting to farming, they lost respect for animals and began to look at themselves as the rulers of nature. In order to justify how they treated other species, they had to play down their intelligence and deny them a soul. It is impossible to reverse this trend without raising questions about human attitudes and practices. We can see this process underway in the halting of biomedical research on chimpanzees and the opposition to the use of killer whales for entertainment.

Increased respect for animal intelligence also has consequences for cognitive science. For too long, we have left the human intellect dangling in empty evolutionary space. How could our species arrive at planning, empathy, consciousness and so on, if we are part of a natural world devoid of any and all steppingstones to such capacities? Wouldn’t this be about as unlikely as us being the only primates with wings?

The article is here.

Sunday, May 8, 2016

Neuroscience is changing the debate over what role age should play in the courts

By Tim Requarth
Newsweeek
Originally posted April 18, 2016

Here is an excerpt:

The Supreme Court has increasingly called upon new findings in neuroscience and psychology in a series of rulings over the past decade (Roper v. Simmons, Graham v. Florida, Miller v. Alabama and Montgomery v. Louisiana) that prohibited harsh punishments—such as the death penalty and mandatory life without parole—for offenders under 18. Due to their immaturity, the argument goes, they are less culpable and so deserve less punishment than those 18 or older. In addition, because their wrongdoing is often the product of immaturity, younger criminals may have a greater potential for reform. Now people are questioning whether the age of 18 has any scientific meaning.

“People are not magically different on their 18th birthday,” says Elizabeth Scott, a professor of law at Columbia University whose work was cited in the seminal Roper case. “Their brains are still maturing, and the criminal justice system should find a way to take that into account.”

The article is here.

Saturday, May 7, 2016

Letting them die: parents refuse medical help for children in the name of Christ

by Jason Wilson
The Guardian
Originally published April 15, 2016

Here is an excerpt:

Mariah is 20 but she’s frail and permanently disabled. She has pulmonary hypertension and when she’s not bedridden, she has to carry an oxygen tank that allows her to breathe. At times, she has had screws in her bones to anchor her breathing device. She may soon have no option for a cure except a heart and lung transplant – an extremely risky procedure.

All this could have been prevented in her infancy by closing a small congenital hole in her heart. It could even have been successfully treated in later years, before irreversible damage was done. But Mariah’s parents were fundamentalist Mormons who went off the grid in northern Idaho in the 1990s and refused to take their children to doctors, believing that illnesses could be healed through faith and the power of prayer.

As she grew sicker and sicker, Mariah’s parents would pray over her and use alternative medicine. Until she finally left home two years ago, she did not have a social security number or a birth certificate.

The article is here.

Friday, May 6, 2016

Complex ideas can enter consciousness automatically

Science Daily
Originally posted April 18, 2016

Summary

New research provides further evidence for 'passive frame theory,' the groundbreaking idea that suggests human consciousness is less in control than previously believed. The study shows that even complex concepts, such as translating a word into pig latin, can enter your consciousness automatically, even when someone tells you to avoid thinking about it. The research provides the first evidence that even a small amount of training can cause unintentional, high-level symbol manipulation.

Here is an excerpt:

This surprising effect offers further evidence that the contents of our consciousness -- the state of being awake and aware of our surroundings -- are often generated involuntarily, said Morsella, an assistant professor of psychology. In fact, the study published in the journal Acta Psychologica provides the first demonstration that even a small amount of training can cause unintentional, high-level symbol manipulation.

The article is here.

How Not to Explain Success

By Christopher Chabris and Joshua Hart
The New York Times - Gray Matter
Originally posted April 8, 2016

Here is an excerpt:

This finding is exactly what you would expect from accepted social science. Long before “The Triple Package,” researchers determined that the personality trait of conscientiousness, which encompasses the triple package’s impulse control component, was an important predictor of success — but that a person’s intelligence and socioeconomic background were equally or even more important.

Our second finding was that the more successful participants did not possess greater feelings of ethnocentrism or personal insecurity. In fact, for insecurity, the opposite was true: Emotional stability was related to greater success.

Finally, we found no special “synergy” among the triple package traits. According to Professors Chua and Rubenfeld, the three traits have to work together to create success — a sense of group superiority creates drive only in people who also view themselves as not good enough, for example, and drive is useless without impulse control. But in our data, people scoring in the top half on all three traits were no more successful than everyone else.

The article is here.

Thursday, May 5, 2016

Why Believing in Luck Makes You a Better Person

By Jesse Singal
New York Magazine
Originally posted April 14, 2016

Here is an excerpt:

In an unexpected twist, we may even find that recognizing our luck increases our good fortune. Social scientists have been studying gratitude intensively for almost two decades, and have found that it produces a remarkable array of physical, psychological, and social changes. Robert Emmons of the University of California at Davis and Michael McCullough of the University of Miami have been among the most prolific contributors to this effort. In one of their collaborations, they asked a first group of people to keep diaries in which they noted things that had made them feel grateful, a second group to note things that had made them feel irritated, and a third group to simply record events. After 10 weeks, the researchers reported dramatic changes in those who had noted their feelings of gratitude. The newly grateful had less frequent and less severe aches and pains and improved sleep quality. They reported greater happiness and alertness. They described themselves as more outgoing and compassionate, and less likely to feel lonely and isolated.

The article is here.

We are zombies rewriting our mental history to feel in control

By Matthew Hutson
Daily News
Originally posted April 15 2016

Here is an excerpt:

Another possibility, one Bear prefers, is that we misperceive the order of events in the moment due to inherent limitations in perceptual processing. To put it another way, our brain isn’t trying to trick us into believing we are in control – just that it struggles to process a rapid sequence of events in the correct order.

Such findings may also imply that many of the choices we believe we make only appear to be signs of free will after the fact.

Everyday examples of this “postdictive illusion of choice” abound. You only think that you consciously decided to scratch an itch, make a deft football play, or blurt out an insult, when really you’re just taking credit for reflexive actions.

The article is here.

Wednesday, May 4, 2016

Surgeon General Concerned About Physician Burnout

by Joyce Frieden
MedPage Today
Originally posted April 10, 2016

Here is an excerpt:

But in the months since he has taken office, a growing concern about emotional well-being emerged "from conversations I had with community members, and it is based on the science developed over the years that tells us emotional well-being is an important driver of health."

"People think that emotional well-being is something that happens to you -- things line up in your life, you have the right job, and your health is good, and [you are in] a happy family and in a good relationship and you're happy in your emotional life," he said. "But there's a growing body of science that tells us there are things we can do to develop our emotional well-being proactively, and that in turn can have a positive impact on our health."

Murthy noting that promoting well-being doesn't require reinventing the wheel as there are already programs focused on emotional well-being that have significant outcomes for health and education, but people just don't know about them.

The article is here.

Nurses Say Stress Interferes With Caring For Their Patients

By Alan Yu
NPR.org
Originally posted April 15, 2016

Here is an excerpt:

Almost 20 percent of newly registered nurses leave a hospital within the first year for the same job elsewhere, or a different job in a different organization, according to a 2014 study. Rushton says to her, that means health care organizations aren't investing enough in their nursing staff.

Nurse burnout also is linked to moral distress, Rushton says, from situations where nurses know what they should do for their patients but can't act on it. For example, nurses might have to give a patient at the end of life a treatment that causes suffering without any medical benefit. She just started a program called the Mindful Ethical Practice and Resilience Academy to try to help new nurses deal with moral distress.

It's a series of in-person workshops, some of which involve nurses using simulations to practice how to make their ethical concerns heard at work. One scenario includes a patient with a complex medical condition and a nurse has been caring for him and talking to him for days following the recommended treatment.

The article is here.

Note: There are several significant areas that apply to mental health professionals in terms of stress, moral distress, professional respect, and overwork.

Tuesday, May 3, 2016

The Challenge of Determining Whether an A.I. Is Sentient

By Carissa Véliz
Slate.com
Originally posted April 14, 2016

Here is an excerpt:

Sentience is important because it warrants moral consideration. Whether we owe any moral consideration to things is controversial; things cannot be hurt, they have no interests, no preferences. Paraphrasing philosopher Thomas Nagel, there is nothing it is like for a thing to be a thing, an inanimate object. In contrast, there is something it is like to be a sentient being. There is a quality to experience; there is a comforting warmth in pleasure and a disagreeable sharpness in pain. There is something it is like to be thirsty, afraid, or joyful. Because sentient beings can feel, they can be hurt, they have an interest in experiencing wellbeing, and therefore we owe them moral consideration. Other things being equal, we ought not to harm them.

It is not easy to determine when an organism is sentient, however. A brief recount of past and present controversies and mistakes makes it clear that human beings are not great at recognizing sentience.

The article is here.

What Kind of Legal Rights Should Robots Have?

By Jessie Guy-Ryan
Atlas Obscura
Originally posted March 12, 2016

Here is an excerpt:

So, to summarize the above: robots can’t give performances, aren’t animate objects, but can take possession of items as extensions of their operators. The entire paper is full of interesting, sometimes contradictory, cases, and well worth reading. But the varying precedents established combined with judicial metaphors advancing the idea that robots inherently lack autonomy, may create difficulties as robots—and, inevitably, legal cases involving robots—become more and more common and these narrow decisions and definitions become less and less accurate.

“The mismatch between what a robot is and how courts are likely to think of robots will only grow in salience and import over the coming decade,” Calo writes. He emphasizes the importance of exploring existing case law and establishing new institutions and agencies to provide knowledge and information to help guide courts.

The article is here.

Monday, May 2, 2016

Panelists Debate Morality Of Assisted Suicide Bill

By Jenna Rudolfsky
The Cornell Daily Sun
Originally posted April 18, 2016

Panelists from the Cornell Law School hosted a discussion entitled “Death with Dignity” to debate the controversial issue of assisted suicide and pending New York state legislation last Thursday.

If the “Death with Dignity” bill passes, New York will become the sixth state to allow terminally ill patients to end their own lives with prescribed lethal medication, according to MSNBC.

Panelist Prof. Daryl Bem, psychology, whose wife committed assisted suicide, discussed her struggles with Alzheimer’s disease in explaining why he is in favor of assisted suicide.

The article is here.

Mental illness: Families cut out of care

Liz Szabo
USA TODAY
Originally posted April 14, 2016

Here is an excerpt:

The federal law, called the Health Insurance Portability and Accountability Act, or HIPAA, forbids health providers from disclosing a patient’s medical information without consent.

Unlike patients with physical conditions, people with serious mental illness often need help making decisions and taking care of themselves, because their illness impairs their judgement, says Jeffrey Lieberman,chairman of psychiatry at the Columbia University College of Physicians and Surgeons and director of the New York State Psychiatric Institute. In some cases, patients may not even realize they’re sick.

Excluding families can have a devastating impact on patients like these, Lieberman says.

Many health providers don’t understand what HIPAA actually allows them to say. As a result, they often shut families out, even in circumstances in which they’re legally allowed to share information, says Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors.

The article is here.

Sunday, May 1, 2016

The patient called me ‘colored girl.’ The senior doctor training me said nothing

By Jennifer Adaeze Anyaegbunam
Stat
Originally posted April 11, 2016

Medicine struggles with a chronic disease: racism.

Medical schools try to combat this disease with diversity initiatives and training in unconscious bias and cultural sensitivity. I’m about to graduate from the University of Virginia School of Medicine, so I’ve been through such programs.

They’re not enough.

Every one of us needs to own the principles that protect us and our patients from racism and bias. That means learning to see prejudice and speaking up against it. But that is far, far easier said than done.

Again and again during my four years of training, I encountered racism and ignorance, directed either at patients or at me and other students of color. Yet it was very hard for me to speak up, even politely, because as a student, I felt I had no authority — and didn’t want to seem confrontational to senior physicians who would be writing my evaluations.

The article is here.