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

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

Saturday, September 30, 2017

What is New In Psychotherapy & Counseling in the Last 10 Years



Sam Knapp and I will be presenting this unique blend of small group learning, research, and lecture.

It has been estimated that the half-life for a professional psychologist is 9 years. Thus, professional psychologists need to work assiduously to keep up to date with the changes in the field. This continuing education program strives to do that by having participants reflect on the most significant changes in the field in the last 10 years. To facilitate this reflection, the presenter offers his update in the psychotherapy and counseling literature in the last 10 years as an opportunity for participants to reflect on and consider their perceptions of the important developments in the field. This focuses on changes in psychotherapy and counseling and does not consider changes in other fields, except as they influence psychotherapy or counseling. There will be considerable participant interaction.

Ethics office: Anonymous gifts to legal defense funds are not allowed

Megan Wilson
The Hill
Originally posted September 28, 2017

The Office of Government Ethics (OGE), the federal government’s ethics watchdog, clarified its policy on legal defense funds on Thursday, stating that anonymous contributions should not be accepted.

The announcement comes after a report that suggested the OGE was departing from internal policy regarding the donations, paving the way for federal officials to accept anonymous donations from otherwise prohibited groups — such as lobbyists — to offset their legal bills.

In 1993, the OGE issued an informal advisory opinion that allowed for such donations because the federal employee “does not know who the paymasters are.”

Immediately after, the office acknowledged the problems associated with allowing prohibited individuals to give to legal defense funds anonymously and instead advised lawyers not to accept those contributions.

Then-OGE Director Stephen Potts told a congressional panel in 1994 that the agency “recognized that donor anonymity may be difficult to enforce in practice because there is nothing to prevent a donor disclosing to the employee that he or she contributed to the employee’s legal defense fund,” the advisory published Thursday notes.

The article is here.

Friday, September 29, 2017

How Silicon Valley is erasing your individuality

Franklin Foer
Washington Post
Originally posted September 8, 2017

Here is an excerpt:

There’s an oft-used shorthand for the technologist’s view of the world. It is assumed that libertarianism dominates Silicon Valley, and that isn’t wholly wrong. High-profile devotees of Ayn Rand can be found there. But if you listen hard to the titans of tech, it’s clear that their worldview is something much closer to the opposite of a libertarian’s veneration of the heroic, solitary individual. The big tech companies think we’re fundamentally social beings, born to collective existence. They invest their faith in the network, the wisdom of crowds, collaboration. They harbor a deep desire for the atomistic world to be made whole. (“Facebook stands for bringing us closer together and building a global community,” Zuckerberg wrote in one of his many manifestos.) By stitching the world together, they can cure its ills.

Rhetorically, the tech companies gesture toward individuality — to the empowerment of the “user” — but their worldview rolls over it. Even the ubiquitous invocation of users is telling: a passive, bureaucratic description of us. The big tech companies (the Europeans have lumped them together as GAFA: Google, Apple, Facebook, Amazon) are shredding the principles that protect individuality. Their devices and sites have collapsed privacy; they disrespect the value of authorship, with their hostility toward intellectual property. In the realm of economics, they justify monopoly by suggesting that competition merely distracts from the important problems like erasing language barriers and building artificial brains. Companies should “transcend the daily brute struggle for survival,” as Facebook investor Peter Thiel has put it.

The article is here.

The Dark Side of Morality: Group Polarization and Moral-Belief Formation

Marcus Arvan
University of Tampa

Most of us are accustomed to thinking of morality in a positive light. Morality, we say, is a matter of “doing good” and treating ourselves and each other “rightly.” However, moral beliefs and discourse also plausibly play a role in group polarization, the tendency of social groups to divide into progressively more extreme factions, each of which regards other groups to be “wrong.” Group polarization often occurs along moral lines, and is known to have many disturbing effects, increasing racial prejudice among the already moderately prejudiced, leading group decisions to be more selfish, competitive, less trusting, and less altruistic than individual decisions, eroding public trust, leading juries to impose more severe punishments in trial, generating more extreme political decisions, and contributing to war, genocide, and other violent behavior.

This paper argues that three empirically-supported theories of group polarization predict that polarization is likely caused in substantial part by a conception of morality that I call the Discovery Model—a model which holds moral truths exist to be discovered through moral intuition, moral reasoning, or some other process.

The paper is here.

Thursday, September 28, 2017

How Much Do A Company's Ethics Matter In The Modern Professional Climate?

Larry Alton
Forbes
Originally posted September 12, 2017

More than ever, a company’s success depends on the talent it’s able to attract, but attracting the best talent is about more than just offering the best salary—or even the best benefits. Companies may have a lucrative offer for a prospective candidate, and a culture where they’ll feel at home, but how do corporate ethics stack up against those of its competition?

This may not seem like the most important question to ask when you’re trying to hire someone for a position—especially one that might not be directly affected by the actions of your corporation as a whole—but the modern workplace is changing, as are American professionals’ values, and if you want to keep up, you need to know just how significant those ethical values are.

What Qualifies as “Ethics”?

What do I mean by “ethics”? This is a broad category, and subjective in nature, but generally, I’m referring to these areas:
  • Fraud and manipulation. This should be obvious, but ethical companies don’t engage in shady or manipulative financial practices, such as fraud, bribery, or insider trading. The problem here is that individual actions are often associated with the company as a whole, so any individual within your company who behaves in an unethical way could compromise the reputation of your company. Setting strict no-tolerance policies and taking proper disciplinary action can mitigate these effects.

What’s Wrong With Voyeurism?

David Boonin
What's Wrong?
Originally posted August 31, 2017

The publication last year of The Voyeur’s Motel, Gay Talese’s controversial account of a Denver area motel owner who purportedly spent several decades secretly observing the intimate lives of his customers, raised a number of difficult ethical questions.  Here I want to focus on just one: does the peeping Tom who is never discovered harm his victims?

The peeping Tom profiled in Talese’s book certainly doesn’t think so.  In an excerpt that appeared in the New Yorker in advance of the book’s publication, Talese reports that Gerald Foos, the proprietor in question, repeatedly insisted that his behavior was “harmless” on the grounds that his “guests were unaware of it.”  Talese himself does not contradict the subject of his account on this point, and Foos’s assertion seems to be grounded in a widely accepted piece of conventional wisdom, one that often takes the form of the adage that “what you don’t know can’t hurt you”.  But there’s a problem with this view of harm, and thus a problem with the view that voyeurism, when done successfully, is a harmless vice.

The blog post is here.

Wednesday, September 27, 2017

New York’s Highest Court Rules Against Physician-Assisted Suicide

Jacob Gershman
The Wall Street Journal
Originally posted September 7, 2017

New York’s highest court on Thursday ruled that physician-assisted suicide isn’t a fundamental right, rejecting a legal effort by terminally ill patients to decriminalize doctor-assisted suicide through the courts.

The state Court of Appeals, though, said it wouldn’t stand in the way if New York’s legislature were to decide that assisted suicide could be “effectively regulated” and pass legislation allowing terminally ill and suffering patients to kill themselves.

Physician-assisted suicide is illegal in most of the country. But advocates who support loosening the laws have been making gains. Doctor-assisted dying has been legalized in several states, most recently in California and Colorado, the former by legislation and the latter by a ballot measure approved by voters in November. Oregon, Vermont and Washington have enacted similar “end-of-life” measures. Washington, D.C., also passed an “assisted-dying” law last year.

Montana’s highest court in 2009 ruled that physicians who provide “aid in dying” are shielded from liability.

No state court has recognized “aid in dying” as a fundamental right.

The article is here.

How to Recognize Burnout Before You’re Burned Out

Kenneth R. Rosen
The New York Times
Originally published September 5, 2017

Here is an excerpt:

In today’s era of workplace burnout, achieving a simpatico work-life relationship seems practically out of reach. Being tired, ambivalent, stressed, cynical and overextended has become a normal part of a working professional life. The General Social Survey of 2016, a nationwide survey that since 1972 has tracked the attitudes and behaviors of American society, found that 50 percent of respondents are consistently exhausted because of work, compared with 18 percent two decades ago.

Where once the term burnout was applied exclusively to health care workers, police officers, firefighters, paramedics or social workers who deal with trauma and human services — think Graham Greene’s novel “A Burnt-Out Case,” about a doctor in the Belgian Congo, a book that gave rise to the term colloquially — the term has since expanded to workers who are now part of a more connected, hyperactive and overcompensating work force.

But occupational burnout goes beyond needing a simple vacation or a family retreat, and many experts, psychologists and institutions, including the Centers for Disease Control and Prevention, highlight long-term and unresolvable burnout as not a symptom but rather a major health concern. (Though it does not appear in the Diagnostic and Statistical Manual of Mental Disorders, which outlines psychiatric disorders, it does appear in the International Statistical Classification of Diseases and Related Health Problems, a classification used by the World Health Organization.)

“We’re shooting ourselves in the foot,” Ms. Seppala told me. “Biologically we are not meant to be in that high-stress mode all the time. We got lost in this idea that the only way to be productive is to be on the go-go-go mode.”

The article is here.

Tuesday, September 26, 2017

The Influence of War on Moral Judgments about Harm

Hanne M Watkins and Simon M Laham
Preprint

Abstract

How does war influence moral judgments about harm? While the general rule is “thou shalt not kill,” war appears to provide an unfortunately common exception to the moral prohibition on intentional harm. In three studies (N = 263, N = 557, N = 793), we quantify the difference in moral judgments across peace and war contexts, and explore two possible explanations for the difference. Taken together, the findings of the present studies have implications for moral psychology researchers who use war based scenarios to study broader cognitive or affective processes. If the war context changes judgments of moral scenarios by triggering group-based reasoning or altering the perceived structure of the moral event, using such scenarios to make “decontextualized” claims about moral judgment may not be warranted.

Here is part of the discussion.

A number of researchers have begun to investigate how social contexts may influence moral judgment, whether those social contexts are grounded in groups (Carnes et al, 2015; Ellemers & van den Bos, 2009) or relationships (Fiske & Rai, 2014; Simpson, Laham, & Fiske, 2015). The war context is another specific context which influences moral judgments: in the present study we found that the intergroup nature of war influenced people’s moral judgments about harm in war – even if they belonged to neither of the two groups actually at war – and that the usually robust difference between switch and footbridge scenarios was attenuated in the war context. One implication of these findings is that some caution may be warranted when using war-based scenarios for studying morality in general. As mentioned in the introduction, scenarios set in war are often used in the study of broad domains or general processes of judgment (e.g. Graham et al., 2009; Phillips & Young, 2011; Piazza et al., 2013). Given the interaction of war context with intergroup considerations and with the construed structure of the moral event in the present studies, researchers are well advised to avoid making generalizations to morality writ large on the basis of war-related scenarios (see also Bauman, McGraw, Bartels, & Warren, 2014; Bloom, 2011).

The preprint is here.

Drug company faked cancer patients to sell drug

Aaron M. Kessler
CNN.com
Originally published September 6, 2017

When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.

To boost sales, the company allegedly took patients who didn't have cancer and made it look like they did.

The drug maker used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company, according to a federal indictment and ongoing congressional investigation by Sen. Claire McCaskill, a Democrat from Missouri.

The new report by McCaskill's office released Wednesday includes allegations about just how far the company went to push prescriptions of its sprayable form of fentanyl, Subsys.

Because of the high cost associated with Subsys, most insurers wouldn't pay for it unless it was approved in advance. That process, likely familiar to anyone who's taken an expensive medication, is called "prior-authorization."

The article is here.

Monday, September 25, 2017

Science debate: Should we embrace an enhanced future?

Alexander Lees
BBC.com
Originally posted September 9, 2017

Here is an excerpt:

Are we all enhanced?

Most humans are now enhanced to be resistant to many infectious diseases. Vaccination is human enhancement. Apart from "anti-vaxxers" - as those who lobby against childhood inoculations are often dubbed - most of us are content to participate. And society as a whole benefits from being free of those diseases.

So what if we took that a pharmaceutical step further. What if, as well as vaccines against polio, mumps, measles, rubella and TB, everyone also "upgraded" by taking drugs to modify their behaviour? Calming beta-blocker drugs could reduce aggression - perhaps even helping to diffuse racial tension. Or what if we were all prescribed the hormone oxytocin, a substance known to enhance social and family bonds - to just help us all just get along a little better.

Would society function better with these chemical tweaks? And might those who opt out become pariahs for not helping to build a better world - for not wanting to be "vaccinated" against anti-social behaviours?

And what if such chemical upgrades could not be made available to everyone, because of cost or scarcity? Should they be available to no one? An enhanced sense of smell might be useful for a career in wine tasting but not perhaps in rubbish disposal.

A case in point is military research - an arm of which is already an ongoing transhumanism experiment.

Many soldiers on the battlefield routinely take pharmaceuticals as cognitive enhancers to reduce the need to sleep and increase the ability to operate under stress. High tech exoskeletons, increasing strength and endurance, are no longer the realms of science fiction and could soon be in routine military use.

The article is here.

New class of drugs targets aging to help keep you healthy

Jacqueline Howard
CNN.com
Originally published September 5, 2017

Here is an excerpt:

"In the coming decades, I believe that health care will be transformed by this class of medicine and a whole set of diseases that your parents and grandparents have will be things you only see in movies or read in books, things like age-associated arthritis," said David, whose company was not involved in the new paper.

Yet he cautioned that, while many more studies may be on the horizon for senolytic drugs, some might not be successful.

"One thing that people tend to do is, they tend to overestimate things in the short run but then underestimate things in the long run, and I think that, like many fields, this suffers from that as well," David said.

"It will take a while," he said. "I think it's important to recognize that a drug discovery is among the most important of all human activities ... but it takes time, and there must be a recognition of that, and it takes patience."

The article is here.

Sunday, September 24, 2017

Ethics experts say Trump administration far from normal

Rachael Seeley Flores
The Center for Public Integrity
Originally published September 23, 2017

President Donald Trump’s young administration has already sharply diverged from the ethical norms that typically govern the executive branch, exposing vulnerabilities in the system, a small group of ethics experts and former government officials agreed Saturday.

The consensus emerged at a panel titled “Trump, Ethics and the Law” at the Texas Tribune Festival in Austin, Texas. The panel was moderated by Dave Levinthal, a senior reporter at the Center for Public Integrity.

“There have been untidy administrations in the past, but usually it takes a while to see these things develop,” said Ken Starr, a lawyer and judge who served as solicitor general under President George H.W. Bush and is best known for heading the investigation that led to the impeachment of President Bill Clinton.

Ethics laws are based on the idea that norms will be followed, said Walter Shaub, former director of the U.S. Office of Government Ethics (OGE).

“When they’re not followed, we suddenly discover how completely vulnerable our system is,” Shaub said.

The article is here.

The Bush Torture Scandal Isn’t Over

Daniel Engber
Slate.com
Originally published September 5, 2017

In June, a little-known academic journal called Teaching of Psychology published an article about the American Psychological Association’s role in the U.S. government’s war on terror and the interrogation of military detainees. Mitchell Handelsman’s seven-page paper, called “A Teachable Ethics Scandal,” suggested that the seemingly cozy relationship between APA officials and the Department of Defense might be used to illustrate numerous psychological concepts for students including obedience, groupthink, terror management theory, group influence, and motivation.

By mid-July, Teaching of Psychology had taken steps to retract the paper. The thinking that went into that decision reveals a disturbing under-covered coda to a scandal that, for a time, was front-page news. In July 2015, then–APA President Nadine Kaslow apologized for the organization’s involvement in Bush-era enhanced interrogations. “This bleak chapter in our history,” she said, speaking for a group with more than 100,000 members and a nine-figure budget, “occurred over a period of years and will not be resolved in a matter of months.” Two years later, the APA’s attempt to turn the page has devolved into a vicious internecine battle in which former association presidents have taken aim at one another. At issue is the question of who (if anyone) should be blamed for giving the Bush administration what’s been called a “green light” to torture detainees—and when the APA will ever truly get past this scandal.

The article is here.

Saturday, September 23, 2017

Why Buddhism is True with Robert Wright

Scott Barry Kaufman
The Psychology Podcast
August 13, 2017

This week we’re excited to have Robert Wright on The Psychology Podcast. Robert is the New York Times best-selling author of Nonzero, The Moral Animal, The Evolution of God, and most recently Why Buddhism is True. He has also written for The New Yorker, The Atlantic, The New York Times, Time, Slate, and The New Republic, and has taught at The University of Pennsylvania and Princeton University, where he also created the online course Buddhism and Modern Psychology. Robert draws on his wide-ranging knowledge of science, religion, psychology, history and politics to figure out what makes humanity tick.




Note from John: If you are a psychologist and cannot read Why Buddhism is True, then this is your next best option.  This book is really good and I highly recommend it.

Tom Price Flies Blind on Ethics

Editors
Bloomberg View
Originally published September 21, 2017

Under the lax ethical standards President Donald Trump brought to the White House, rampant conflicts of interest are treated with casual indifference. This disregard has sent a message to his entire administration that blurring lines -- between public and private, right and wrong -- will be not just tolerated but defended. At least one cabinet member appears to have taken the message to heart.

Health and Human Services Secretary Tom Price took five chartered flights last week, including one to a conference at a resort in Maine. Two of the flights -- round-trip from Washington to Philadelphia -- probably cost about $25,000, or roughly $24,750 more than the cost of an Amtrak ticket, for a trip that would have taken roughly the same amount of time. Total costs for the five flights are estimated to be at least $60,000.

The department has yet to reveal how many times Price has flown by charter since being sworn into office. There would be no problem were he picking up the tab himself, as Education Secretary Betsy DeVos reportedly does. But cabinet secretaries -- other than for the Defense and State departments, who often ride in military planes -- typically fly commercial. Taxpayers should not have to foot the bill for charters except in emergency situations.

The article is here.

Friday, September 22, 2017

I Lie? We Lie! Why? Experimental Evidence on a Dishonesty Shift in Groups

Kocher, Martin G. and Schudy, Simeon and Spantig, Lisa
CESifo Working Paper Series No. 6008.

Abstract

Unethical behavior such as dishonesty, cheating and corruption occurs frequently in organizations or groups. Recent experimental evidence suggests that there is a stronger inclination to behave immorally in groups than individually. We ask if this is the case, and if so, why. Using a parsimonious laboratory setup, we study how individual behavior changes when deciding as a group member. We observe a strong dishonesty shift. This shift is mainly driven by communication within groups and turns out to be independent of whether group members face payoff commonality or not (i.e., whether other group members benefit from one’s lie). Group members come up with and exchange more arguments for being dishonest than for complying with the norm of honesty. Thereby, group membership shifts the perception of the validity of the honesty norm and of its distribution in the population.

The article is here.

3D bioprint me: a socioethical view of bioprinting human organs and tissues

Vermeulen N, Haddow G, Seymour T, et al
Journal of Medical Ethics 2017;43:618-624.

Abstract

In this article, we review the extant social science and ethical literature on three-dimensional (3D) bioprinting. 3D bioprinting has the potential to be a ‘game-changer’, printing human organs on demand, no longer necessitating the need for living or deceased human donation or animal transplantation. Although the technology is not yet at the level required to bioprint an entire organ, 3D bioprinting may have a variety of other mid-term and short-term benefits that also have positive ethical consequences, for example, creating alternatives to animal testing, filling a therapeutic need for minors and avoiding species boundary crossing. Despite a lack of current socioethical engagement with the consequences of the technology, we outline what we see as some preliminary practical, ethical and regulatory issues that need tackling. These relate to managing public expectations and the continuing reliance on technoscientific solutions to diseases that affect high-income countries. Avoiding prescribing a course of action for the way forward in terms of research agendas, we do briefly outline one possible ethical framework ‘Responsible Research Innovation’ as an oversight model should 3D bioprinting promises are ever realised. 3D bioprinting has a lot to offer in the course of time should it move beyond a conceptual therapy, but is an area that requires ethical oversight and regulation and debate, in the here and now. The purpose of this article is to begin that discussion.

The article is here.

Thursday, September 21, 2017

Jimmy Kimmel Monologues on Health Care Legislation



Jimmy Kimmel keeps it simple on Graham-Cassidy healthcare legislation.

When is a lie acceptable? Work and private life lying acceptance depends on its beneficiary

Katarzyna Cantarero, Piotr Szarota, E. Stamkou, M. Navas & A. del Carmen Dominguez Espinosa
The Journal of Social Psychology 
Pages 1-16 | Received 02 Jan 2017, Accepted 25 Apr 2017, Published online: 14 Aug 2017

ABSTRACT

In this article we show that when analyzing attitude towards lying in a cross-cultural setting, both the beneficiary of the lie (self vs other) and the context (private life vs. professional domain) should be considered. In a study conducted in Estonia, Ireland, Mexico, The Netherlands, Poland, Spain, and Sweden (N = 1345), in which participants evaluated stories presenting various types of lies, we found usefulness of relying on the dimensions. Results showed that in the joint sample the most acceptable were other-oriented lies concerning private life, then other-oriented lies in the professional domain, followed by egoistic lies in the professional domain; and the least acceptance was shown for egoistic lies regarding one’s private life. We found a negative correlation between acceptance of a behavior and the evaluation of its deceitfulness.

Here is an excerpt:

Research shows differences in reactions to moral transgressions depending on the culture of the respondent as culture influences our moral judgments (e.g., Gold, Colman, & Pulford, 2014; Graham, Meindl, Beall, Johnson, & Zhang, 2016). For example, when analyzing transgressions of community (e.g., hearing children talking with their teacher the same way as they do towards their peers) Indian participants showed more moral outrage than British participants (Laham, Chopra, Lalljee, & Parkinson, 2010). Importantly, one of the main reasons why we can observe cross-cultural differences in reactions to moral transgressions is that culture influences our perception of whether an act itself constitutes a moral transgression at all (Haidt, 2001; Haidt & Joseph, 2004; Shweder, Mahapatra, & Miller, 1987; Shweder, Much, Mahapatra, & Park, 1997). Haidt, Koller and Dias (1993) showed that Brazilian participants would perceive some acts of victimless yet offensive actions more negatively than did Americans. The authors argue that for American students some of the acts that were being evaluated (e.g., using an old flag of ones’ country to clean the bathroom) fall outside the moral domain and are only a matter of social convention, whereas Brazilians would perceive them as morally wrong.

The paper is here.

Wednesday, September 20, 2017

What is moral injury, and how does it affect journalists covering bad stuff?

Thomas Ricks
Foreign Policy
Originally published September 5, 2017

Here is an excerpt:

They noted that moral injury is the damage done to a “person’s conscience or moral compass by perpetrating, witnessing, or failing to prevent acts that transgress personal moral and ethical values or codes of conduct.”

While not all journalists were affected the same way, the most common reactions were feelings of guilt at not having done enough personally to help refugees and shame at the behavior of others, such as local authorities, they wrote.

Journalists with children had more moral injury-related distress while those working alone said they were more likely to have acted in ways that violated their own moral code. Those who said they had not received enough support from their organization were more likely to admit seeing things they perceived as morally wrong. Less control over resources to report on the crisis also correlated significantly with moral injury. And moral injury scores correlated significantly with guilt. Greater guilt, in turn, was noted by journalists covering the story close to home and by those who had assisted refugees, the report added.

Feinstein and Storm wrote that moral injury can cause “considerable emotional upset.” They noted that journalists reported symptoms of intrusion. While they didn’t go into detail, intrusion can mean flashbacks, nightmares and unwanted memories. These can disrupt normal functioning. In my view, guilt and shame can also be debilitating.

The article is here.

Companies should treat cybersecurity as a matter of ethics

Thomas Lee
The San Francisco Chronicle
Originally posted September 2, 2017

Here is an excerpt:

An ethical code will force companies to rethink how they approach research and development. Instead of making stuff first and then worrying about data security later, companies will start from the premise that they need to protect consumer privacy before they start designing new products and services, Harkins said.

There is precedent for this. Many professional organizations like the American Medical Association and American Bar Association require members to follow a code of ethics. For example, doctors must pledge above all else not to harm a patient.

A code of ethics for cybersecurity will no doubt slow the pace of innovation, said Maurice Schweitzer, a professor of operations, information and decisions at the University of Pennsylvania’s Wharton School.

Ultimately, though, following such a code could boost companies’ reputations, Schweitzer said. Given the increasing number and severity of hacks, consumers will pay a premium for companies dedicated to security and privacy from the get-go, he said.

In any case, what’s wrong with taking a pause so we can catch our breath? The ethical quandaries technology poses to mankind are only going to get more complex as we increasingly outsource our lives to thinking machines.

That’s why a code of ethics is so important. Technology may come and go, but right and wrong never changes.

The article is here.

Tuesday, September 19, 2017

Massive genetic study shows how humans are evolving

Bruno Martin
Nature
Originally published 06 September 2017

Here is an excerpt:

Why these late-acting mutations might lower a person’s genetic fitness — their ability to reproduce and spread their genes — remains an open question.

The authors suggest that for men, it could be that those who live longer can have more children, but this is unlikely to be the whole story. So scientists are considering two other explanations for why longevity is important. First, parents surviving into old age in good health can care for their children and grandchildren, increasing the later generations’ chances of surviving and reproducing. This is sometimes known as the ‘grandmother hypothesis’, and may explain why humans tend to live long after menopause.

Second, it’s possible that genetic variants that are explicitly bad in old age are also harmful — but more subtly — earlier in life. “You would need extremely large samples to see these small effects,” says Iain Mathieson, a population geneticist at the University of Pennsylvania in Philadelphia, so that’s why it’s not yet possible to tell whether this is the case.

The researchers also found that certain groups of genetic mutations, which individually would not have a measurable effect but together accounted for health threats, appeared less often in people who were expected to have long lifespans than in those who weren't. These included predispositions to asthma, high body mass index and high cholesterol. Most surprising, however, was the finding that sets of mutations that delay puberty and childbearing are more prevalent in long-lived people.

The article is here.

Note: This article is posted, in part, because evolution is not emphasized in the field of psychology. There are psychologists who believe that humans did not evolve in the way other plants and animals evolved.  I have argued in lectures and workshops that we humans are not in our final form.

The strategic moral self: Self-presentation shapes moral dilemma judgments

Sarah C. Roma and Paul Conway
Journal of Experimental Social Psychology
Volume 74, January 2018, Pages 24–37

Abstract

Research has focused on the cognitive and affective processes underpinning dilemma judgments where causing harm maximizes outcomes. Yet, recent work indicates that lay perceivers infer the processes behind others' judgments, raising two new questions: whether decision-makers accurately anticipate the inferences perceivers draw from their judgments (i.e., meta-insight), and, whether decision-makers strategically modify judgments to present themselves favorably. Across seven studies, a) people correctly anticipated how their dilemma judgments would influence perceivers' ratings of their warmth and competence, though self-ratings differed (Studies 1–3), b) people strategically shifted public (but not private) dilemma judgments to present themselves as warm or competent depending on which traits the situation favored (Studies 4–6), and, c) self-presentation strategies augmented perceptions of the weaker trait implied by their judgment (Study 7). These results suggest that moral dilemma judgments arise out of more than just basic cognitive and affective processes; complex social considerations causally contribute to dilemma decision-making.

The article is here.

Monday, September 18, 2017

Hindsight Bias in Depression

Julia Groß, Hartmut Blank, Ute J. Bayen
Clinical Psychological Science 
First published date: August-07-2017

Abstract

People tend to be biased by outcome knowledge when looking back on events. This phenomenon is known as hindsight bias. Clinical intuition and theoretical accounts of affect-regulatory functions of hindsight bias suggest a link between hindsight bias and depression, but empirical evidence is scarce. In two experiments, participants with varying levels of depressive symptoms imagined themselves in everyday scenarios that ended positively or negatively and completed hindsight and affect measures. Participants with higher levels of depression judged negative outcomes, but not positive outcomes, as more foreseeable and more inevitable in hindsight. For negative outcomes, they also misremembered prior expectations as more negative than they initially were. This memory hindsight bias was accompanied by disappointment, suggesting a relation to affect-regulatory malfunction. We propose that “depressive hindsight bias” indicates a negative schema of the past and that it sustains negative biases in depression.

The research is here.

Artificial wombs could soon be a reality. What will this mean for women?

Helen Sedgwick
The Guardian
Originally posted Monday 4 September 2017

Here is an excerpt:

There is a danger that whoever pays for the technology behind ectogenesis would have the power to decide how, when and for whose benefit it is used. It could be the state or private insurance companies trying to avoid the unpredictable costs of traditional childbirth. Or, it could become yet another advantage available only to the privileged, with traditional pregnancies becoming associated with poverty, or with a particular class or race. Would babies gestated externally have advantages over those born via the human body? Or, if artificial gestation turns out to be cheaper than ordinary pregnancy, could it become an economic necessity forced on some?

But an external womb could also lead to a new equality in parenthood and consequently change the structure of our working and private lives. Given time, it could dismantle the gender hierarchies within our society. Given more time, it could eliminate the differences between the sexes in our biology. Once parental roles are equal, there will be no excuse for male-dominated boardrooms or political parties, or much of the other blatant inequality we see today.

Women’s rights are never more emotive than when it comes to a woman’s right to choose. While pregnancy occurs inside a woman’s body, women have some control over it, at least. But what happens when a foetus can survive entirely outside the body? How will our legislation stand up when viability begins at conception? There are fundamental questions about what rights we give to embryos outside the body (think of the potential for harvesting “spare parts” from unwanted foetuses). There is also the possibility of pro-life activists welcoming this process as an alternative to abortion – with, in the worst case, women being forced to have their foetuses extracted and gestated outside their bodies.

The article is here.

Sunday, September 17, 2017

Genitals photographed, shared by UPMC hospital employees: a common violation in health care industry

David Wenner
The Patriot News/PennLive.com
Updated September 16, 2017

You might assume anyone in healthcare would know better. Smart phones aren't new. Health care providers have long wrestled with the patient privacy- and medical ethics-related ramifications. Yet once again, smart phones have contributed to a very public black eye for a health care provider.

UPMC Bedford in Everett, Pa. has been cited by the Pennsylvania Department of Health after employees snapped and shared photos and video of an unconscious patient who needed surgery to remove an object from a genital. Numerous employees, including two doctors, were disciplined for being present.

It's not the first time unauthorized photos were taken of a hospital patient and shared or posted on social media.

  • Last year, a nurse in New York lost her license after taking a smart phone photo of an unconscious patient's penis and sending it to some of her co-workers. She also pleaded guilty to misdemeanor criminal charges.
  • The Los Angeles Times in 2013 wrote about an anesthesiologist in California who put a sticker of a mustache on the face of an unconscious female patient, with a nurse's aid then taking a picture. That article also reported allegations of a medical device salesman taking photos of a naked woman without her knowledge.
  • In 2010, employees at a hospital in Florida were disciplined after taking and posting online photos of a shark attack victim who didn't survive. No one was fired, with the hospital concluding the incident was the "result of poor judgement rather than malicious intent," according to an article in Radiology Today. 
  • Many such incidents have involved nursing homes. An article published by the American Association of Nurse Assessment Coordination in 2016 stated, "In the shadow of the social media revolution, a disturbing trend has begun to emerge of [nursing home] employees posting and sharing degrading images of their residents on social media." An investigation published by ProPublica in 2015 detailed 47 cases since 2012 of workers at nursing homes and assisted living facilities sharing photos or videos of residents on Facebook. 

The behavioural ecology of irrational behaviours

Philippe Huneman Johannes Martens
History and Philosophy of the Life Sciences
September 2017, 39:23

Abstract

Natural selection is often envisaged as the ultimate cause of the apparent rationality exhibited by organisms in their specific habitat. Given the equivalence between selection and rationality as maximizing processes, one would indeed expect organisms to implement rational decision-makers. Yet, many violations of the clauses of rationality have been witnessed in various species such as starlings, hummingbirds, amoebas and honeybees. This paper attempts to interpret such discrepancies between economic rationality (defined by the main axioms of rational choice theory) and biological rationality (defined by natural selection). After having distinguished two kinds of rationality we introduce irrationality as a negation of economic rationality by biologically rational decision-makers. Focusing mainly on those instances of irrationalities that can be understood as exhibiting inconsistency in making choices, i.e. as non-conformity of a given behaviour to axioms such as transitivity or independence of irrelevant alternatives, we propose two possible families of Darwinian explanations that may account for these apparent irrationalities. First, we consider cases where natural selection may have been an indirect cause of irrationality. Second, we consider putative cases where violations of rationality axioms may have been directly favored by natural selection. Though the latter cases (prima facie) seem to clearly contradict our intuitive representation of natural selection as a process that maximizes fitness, we argue that they are actually unproblematic; for often, they can be redescribed as cases where no rationality axiom is violated, or as situations where no adaptive solution exists in the first place.

The article is here.

Saturday, September 16, 2017

How to Distinguish Between Antifa, White Supremacists, and Black Lives Matter

Conor Friedersdorf
The Atlantic
Originally published August 31, 2017

Here are two excerpts:

One can condemn the means of extralegal violence, and observe that the alt-right, Antifa, and the far-left have all engaged in it on different occasions, without asserting that all extralegal violence is equivalent––murdering someone with a car or shooting a representative is more objectionable than punching with the intent to mildly injure. What’s more, different groups can choose equally objectionable means without becoming equivalent, because assessing any group requires analyzing their ends, not just their means.

For neo-Nazis and Klansmen in Charlottesville, one means, a torch-lit parade meant to intimidate by evoking bygone days of racial terrorism, was deeply objectionable; more importantly, their end, spreading white-supremacist ideology in service of a future where racists can lord power over Jews and people of color, is abhorrent.

Antifa is more complicated.

Some of its members employ the objectionable means of initiating extralegal street violence; but its stated end of resisting fascism is laudable, while its actual end is contested. Is it really just about resisting fascists or does it have a greater, less defensible agenda? Many debates about Antifa that play out on social media would prove less divisive if the parties understood themselves to be agreeing that opposing fascism is laudable while disagreeing about Antifa’s means, or whether its end is really that limited.

(cut)

A dearth of distinctions has a lot of complicated consequences, but in aggregate, it helps to empower the worst elements in a society, because those elements are unable to attract broad support except by muddying distinctions between themselves and others whose means or ends are defensible to a broader swath of the public. So come to whatever conclusions accord with your reason and conscience. But when expressing them, consider drawing as many distinctions as possible.

The article is here.

Friday, September 15, 2017

Robots and morality

The Big Read (which is actually in podcast form)
The Financial Times
Originally posted August 2017

Now our mechanical creations can act independently, what happens when AI goes wrong? Where does moral, ethical and legal responsibility for robots lie — with the manufacturers, the programmers, the users or the robots themselves, asks John Thornhill. And who owns their rights?

Click on the link below to access the 13 minutes podcast.

Podcast is here.

Trump ethics watchdog moves to allow anonymous gifts to legal defense funds

Darren Samuelsohn
Politico
Originally published September 13, 2017

The U.S. Office of Government Ethics has quietly reversed its own internal policy prohibiting anonymous donations from lobbyists to White House staffers who have legal defense funds.

The little-noticed change could help President Donald Trump’s aides raise the money they need to pay attorneys as the Russia probe expands — but raises the potential for hidden conflicts of interest or other ethics trouble.

“You can picture a whole army of people with business before the government willing to step in here and make [the debt] go away,” said Marilyn Glynn, a former George W. Bush-era acting OGE director who worked in the office for 17 years.

Lawyer fees have long been the source of controversy for presidents under fire. Richard Nixon’s White House took covert steps to pay the Watergate burglars, and a trust set up during Bill Clinton’s first term to deal with Whitewater and other controversies had to return hundreds of thousands of dollars in donations from a controversial Arkansas friend who was later indicted for campaign finance abuses.

At issue for the Trump staffers is a 1993 OGE guidance document that gave a green light to organizers of legal defense funds for government employees to solicit anonymous donations from otherwise prohibited sources — like lobbyists or others with business before the government. That Clinton-era opinion reasoned that if such donors were anonymous, such donations could be legal because the employee “does not know who the paymasters are.”

The article is here.

Thursday, September 14, 2017

Over half of doctors have symptoms of burn-out: survey

Lynn Desjardins
Radio Canada International
Originally published August 28, 2017

A recent survey suggests that 54 per cent of Canadian doctors have symptoms of burn-out and it’s a problem that physicians themselves don’t like to talk about. This was a topic much discussed at the annual meeting of the Canadian Medical Association which represents more than 80,000 doctors.

‘Very frustrating and annoying’ interventions required

“First and foremost, it’s about the inability that physicians have sometimes to get what the patient actually needs in a timely way,” says Dr. Granger Avery, immediate past president of the Canadian Medical Association.

“So, that’s whether looking for a consultation, following up on an operation, whether it’s transferring a patient from one level of service to another, these things often require the doctor to make repeated phone calls, repeated interventions to get what should be a relatively simple piece of work done. So, that’s very frustrating and annoying for a physician who’s been brought up and trained and focused on helping people, not doing that administrative work.”

The article and the podcast are here.

Bioethics and multiculturalism: nuancing the discussion

Chris Durante
Journal of Medical Ethics 
Published Online First: 11 August 2017

Abstract

In his recent analysis of multiculturalism, Tom Beauchamp has argued that those who implement multicultural reasoning in their arguments against common morality theories, such as his own, have failed to understand that multiculturalism is neither a form of moral pluralism nor ethical relativism but is rather a universalistic moral theory in its own right. Beauchamp’s position is indeed on the right track in that multiculturalists do not consider themselves ethical relativists. Yet, Beauchamp tends to miss the mark when he argues that multiculturalism is in effect a school of thought that endorses a form of moral universalism that is akin to his own vision of a common morality. As a supporter of multiculturalism, I would like to discuss some aspects of Beauchamp’s comments on multiculturalism and clarify what a multicultural account of public bioethics might look like. Ultimately, multiculturalism is purported as a means of managing diversity in the public arena and should not be thought of as endorsing either a version of moral relativism or a universal morality. By simultaneously refraining from the promotion of a comprehensive common moral system while it attempts to avoid a collapse into relativism, multiculturalism can serve as the ethico-political framework in which diverse moralities can be managed and in which opportunities for ethical dialogue, debate and deliberation on the prospects of common bioethical norms are made possible.

The article is here.

Wednesday, September 13, 2017

Economics: Society Cannot Function Without Moral Bonds

Geoffrey Hodgson
Evonomics
Originally posted June 29, 2016

Here is an excerpt:

When mainstream economists began to question that individuals are entirely self-interested, their approach was to retain utility-maximization and preference functions, but to make them “other-regarding” so that some notion of altruism could be maintained. But such an individual is still self-serving, rather than being genuinely altruistic in a wider and more adequate sense. While “other regarding” he or she is still egotistically maximizing his or her own utility. As Deirdre McCloskey  put it, the economic agent is still Max U.

There is now an enormous body of empirical research confirming that humans have cooperative as well as self-interested dispositions. But many accounts conflate morality with altruism or cooperation. By contrast, Darwin established a distinctive and vital additional role for morality. Darwin’s argument counters the idea of unalloyed self-interest and the notion that morality can be reduced to a matter of utility or preference.

A widespread view among moral philosophers is that moral judgments cannot be treated as matters of mere preference or utility maximization. Morality means “doing the right thing.” It entails notions of justice that can over-ride our preferences or interests. Moral judgments are by their nature inescapable. They are buttressed by emotional feelings and reasoned argument. Morality differs fundamentally from matters of mere convenience, convention or conformism. Moral feelings are enhanced by learned cultural norms and rules. Morality is a group phenomenon involving deliberative, emotionally-driven and purportedly inescapable rules that apply to a community.

The article is here.

Peter Thiel sponsors offshore testing of herpes vaccine, sidestepping U.S. safety rules

Marisa Taylor
Kaiser News
Originally posted August 28, 2017

Here is an excerpt:

“What they’re doing is patently unethical,” said Jonathan Zenilman, chief of Johns Hopkins Bayview Medical Center’s Infectious Diseases Division. “There’s a reason why researchers rely on these protections. People can die.”

The risks are real. Experimental trials with live viruses could lead to infection if not handled properly or produce side effects in those already infected. Genital herpes is caused by two viruses that can trigger outbreaks of painful sores. Many patients have no symptoms, though a small number suffer greatly. The virus is primarily spread through sexual contact, but also can be released through skin.

The push behind the vaccine is as much political as medical. President Trump has vowed to speed up the FDA’s approval of some medicines. FDA Commissioner Scott Gottlieb, who had deep financial ties to the pharmaceutical industry, slammed the FDA before his confirmation for over-prioritizing consumer protection to the detriment of medical innovations.

“This is a test case,” said Bartley Madden, a retired Credit Suisse banker and policy adviser to the conservative Heartland Institute, who is another investor in the vaccine. “The FDA is standing in the way, and Americans are going to hear about this and demand action.”

American researchers are increasingly going offshore to developing countries to conduct clinical trials, citing rising domestic costs. But in order to approve the drug for the U.S. market, the FDA requires that clinical trials involving human participants be reviewed and approved by an IRB or an international equivalent. The IRB can reject research based on safety concerns.

The article is here.

Tuesday, September 12, 2017

The consent dilemma

Elyn Saks
Politico - The Agenda
Originally published August 9, 2017

Patient consent is an important principle in medicine, but when it comes to mental illness, things get complicated. Other diseases don’t affect a patient’s cognition the way a mental illness can. When the organ with the disease is a patient’s brain, how can it be trusted to make decisions?

That’s one reason that, historically, psychiatric patients were given very little authority to make decisions about their own care. Mental illness and incompetence were considered the same thing. People could be hospitalized and treated against their will if they were considered mentally ill and “in need of treatment.” The presumption was that people with mental illness—essentially by definition—lacked the ability to appreciate their own need for treatment.

In the 1970s, the situation began to change. First, the U.S. Supreme Court ruled that a patient could be hospitalized against his will only if he were dangerous to himself or others, or “gravely disabled,” a decision that led to the de-institutionalization of most mental health care. Second, anti-psychotic medications came into wide use, effectively handing patients the power—on a daily basis—to decide whether to consent to treatment or not, simply by deciding whether or not to take their pills.

The article is here.

Personal values in human life

Lilach Sagiv, Sonia Roccas, Jan Cieciuch & Shalom H. Schwartz
Nature Human Behaviour (2017)
doi:10.1038/s41562-017-0185-3

Abstract

The construct of values is central to many fields in the social sciences and humanities. The last two decades have seen a growing body of psychological research that investigates the content, structure and consequences of personal values in many cultures. Taking a cross-cultural perspective we review, organize and integrate research on personal values, and point to some of the main findings that this research has yielded. Personal values are subjective in nature, and reflect what people think and state about themselves. Consequently, both researchers and laymen sometimes question the usefulness of personal values in influencing action. Yet, self-reported values predict a large variety of attitudes, preferences and overt behaviours. Individuals act in ways that allow them to express their important values and attain the goals underlying them. Thus, understanding personal values means understanding human behaviour.

Monday, September 11, 2017

Do’s and Don’ts for Media Reporting on Suicide

David Susman
The Mental Health and Wellness Blog
Originally published June 15, 2017

Here is an excerpt:

I was reminded recently of the excellent resources which provide guidelines for the responsible reporting and discussion of suicide in the media. In the guideline document, “Recommendations for Reporting on Suicide,” several useful and concrete guidelines are offered for how to talk about suicide in the media. Most of the material in this article comes from this source. Let’s first review and summarize the list of do’s and don’ts.

1) Don’t use big or sensationalistic headlines with specific details about the method of suicide. Do inform without sensationalizing the suicide and without providing details in the headline.

2) Don’t include photos or videos of the location or method of death, grieving family or friends, funerals. Do use a school or work photo; include suicide hotline numbers or local crisis contacts.

3) Don’t describe suicide as “an epidemic,” “skyrocketing,” or other exaggerated terms. Do use accurate words such as “higher rates” or “rising.”

4) Don’t describe a suicide as “without warning” or “inexplicable.” Do convey that people exhibit warning signs of suicide and include a list of common warning signs and ways to intervene when someone is suicidal (see section below).

5) Don’t say “she left a suicide note saying…” Do say “a note from the deceased was found.”

6) Don’t investigate and report on suicide as though it is a crime. Do report on suicide as a public health issue.

7) Don’t quote police or first responders about the causes of suicide. Do seek advice and information from suicide prevention experts.

8) Don’t refer to suicide as “successful,” “unsuccessful,” or a “failed attempt.” Avoid the use of “committed suicide,” which is an antiquated reference to when suicidal acts or attempts were punished as crimes. Do say “died by suicide,” “completed” or “killed him/herself.”

The article is here.

Nonvoluntary Psychiatric Treatment Is Distinct From Involuntary Psychiatric Treatment

Dominic A. Sisti
JAMA. Published online August 24, 2017

Some of the most ethically challenging cases in mental health care involve providing treatment to individuals who refuse that treatment. Sometimes when persons with mental illness become unsafe to themselves or others, they must be taken, despite their outward and often vigorous refusal, to an emergency department or psychiatric hospital to receive treatment, such as stabilizing psychotropic medication. On occasion, to provide medical care over objection, a patient must be physically restrained.

The modifier “involuntary” is generally used to describe these cases. For example, it is said that a patient has been involuntarily hospitalized or is receiving involuntary medication ostensibly because the patient did not consent and was forced or strongly coerced into treatment. Importantly, a person may be involuntarily hospitalized but retain the right to refuse treatment. “Involuntary” is also used to describe instances when an individual is committed to outpatient treatment by a court. The fact that a person is being treated involuntarily raises numerous challenges; it raises concerns about protecting individual liberty, respect for patient autonomy, and the specter of past abuses of patients in psychiatric institutions.

Although it has become both a clinical colloquialism and legal touchstone, the concept of involuntary treatment is used imprecisely to describe all instances in which a patient has refused the treatment he or she subsequently receives. In some cases, a patient outwardly refuses treatment but may have previously expressed a desire to be treated in crisis or, according to a reasonable evaluator, he or she would have agreed to accept stabilizing treatment, such as antipsychotic medication. A similar scenario occurs in the treatment of individuals who experience a first episode of psychosis and who outwardly refuse treatment. With no prior experience of what it is like to have psychosis, these patients are unable to develop informed preferences about treatment in advance of their first crisis. In these cases, some believe it is reasonable to provide treatment despite the opposition of the patient, although this could be debated.

The article is here.

Sunday, September 10, 2017

Google has created a tool that tests for clinical depression

Katherine Ellen Foley
Quartz
Originally posted August 24, 2017

People often delay seeking treatment for mental health conditions like depression. The longer they wait to see their doctors, the worse the condition becomes, making it harder to treat in the future.

In an effort to encourage more patients to seek treatment sooner, Google announced Aug. 23 that it has teamed up with National Alliance on Mental Illness (NAMI), an advocacy group, to create a simple tool for users to assess if they may be depressed. Now, when people in the US search for “clinical depression” on their phones, the typical “knowledge panel”—a container that displays company-vetted information on Google’s search results page—will come with an option to take a quiz that can assess the severity of symptoms. (Google says the quiz results will not be seen by anyone but the quiz-taker.)

Google’s quiz isn’t new. It’s a reskinned version of the 18-year-old PQH-9 (pdf), used by physicians to help diagnose patients with mental illnesses like depression and anxiety. It asks about general interest in activities, eating and sleeping habits, and overall mood. Alone, the PQH-9 won’t give a definitive diagnosis. Doctors use it in conjunction with physical exams to rule out other causes for patients’ symptoms, like a thyroid problem. Google says its incorporation of the PQH-9 test in its search results is not meant as a final diagnosis, but as a tool to inspire people to have conversations with their healthcare providers if they were hesitant before.

The article is here.

Saturday, September 9, 2017

Will Technology Help Us Transcend the Human Condition?

Michael Hauskeller & Kyle McNease

Transcendence used to be the end of a spiritual quest and endeavour. Not anymore. Today we are more likely to believe that if anything can help us transcend the human condition it is not God or some kind of religious communion, but science and technology. Confidence is high that, if we do things right, and boldly and without fear embrace the new opportunities that technological progress grants us, we will soon be able to accomplish things that no human has ever done, or even imagined doing, before. With luck, we will be unimaginably smart and powerful, and virtually immortal, all thanks to a development that seems unstoppable and that has already surpassed all reasonable expectations.

Once upon a time, not so long ago, we used maps and atlases to find our way around. Occasionally we even had to stop and ask someone not named Siri or Cortana if we were indeed on the correct route. Today, our cars are navigated by satellites that triangulate our location in real time while circling the earth at thousands of miles per hour, and self-driving cars for everyone are just around the corner. Soon we may not even need cars anymore. Why go somewhere if technology can bring the world to us? Already we are in a position to do most of what we have to or want to do from home: get an education, work, do our shopping, our banking, our communication, all thanks to the internet, which 30 years ago did not exist and is now, to many of us, indispensable. Those who are coming of age today find it difficult to imagine a world without it. Currently, there are over 3.2 billion people connected to the World Wide Web, 2 billion of which live in developing countries. Most of them connect to the Web via increasingly versatile and powerful mobile devices few people would have thought possible a couple of generations ago. Soon we may be able to dispense even with mobile devices and do all of it in our bio-upgraded heads. In terms of the technology we are using every day without a second thought, the world has changed dramatically, and it continues to do so. Computation is now nearly ubiquitous, people seem constantly attached to their cellular phones, iPads, and laptops, enthusiastically endorsing their own progressive cyborgization. And connectivity does not stop at the level of human beings: even our household objects and devices are connected to the internet and communicate with each other, using their own secret language and taking care of things largely without the need for human intervention and control. The world we have built for ourselves thrives on a steady diet of zeroes and ones that have now become our co-creators, continuing the world-building in often unexpected ways.

The paper is here.

Friday, September 8, 2017

Study questions why thousands with developmental disabilities are prescribed antipsychotics

Peter Goffin
The Toronto Star
Originally published August 23, 2017

Researchers with the Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences have called for “guidelines and training around antipsychotic prescribing and monitoring” for doctors, pharmacists and care home staff after finding that nearly 40 per cent of people with developmental disabilities were prescribed antipsychotic drugs at some point over a six-year period.

One-third of the patients prescribed antipsychotics had no documented diagnosis of mental illness, according to the study, which tracked more than 51,000 people with developmental disabilities who are eligible for provincial drug benefits.

“We don’t know, with the data, why this one person was prescribed or this (other) person was prescribed so we’re trying to almost guess at why,” said psychologist Yona Lunsky, lead author of the study.

“It could be behaviour, aggression, self-injury, agitation.”

For people with developmental disabilities who live in group homes, the rate of antipsychotic prescriptions was even higher.

About 56 percent of developmentally disabled group home residents were prescribed antipsychotics. Of those, around 43 percent had no documented mental health issues.

The article is here.

Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says

Dominguez, S. and Lee, C.
Front. Psychol., 22 August 2017

Abstract

The American Psychological Association (APA) Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) concluded that there was strong evidence for cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and exposure therapy yet weak evidence for eye movement desensitization and reprocessing (EMDR). This is despite the findings from an associated systematic review which concluded that EMDR leads to loss of PTSD diagnosis and symptom reduction. Depression symptoms were also found to improve more with EMDR than control conditions. In that review, EMDR was marked down on strength of evidence (SOE) for symptom reduction for PTSD. However, there were several problems with the conclusions of that review. Firstly, in assessing the evidence in one of the studies, the reviewers chose an incorrect measure that skewed the data. We recalculated a meta-analysis with a more appropriate measure and found the SOE improved. The resulting effect size for EMDR on PTSD symptom reduction compared to a control condition was large for studies that meet the APA inclusion criteria (SMD = 1.28) and the heterogeneity was low (I2 = 43%). Secondly, even if the original measure was chosen, we highlight inconsistencies with the way SOE was assessed for EMDR, CT, and CPT. Thirdly, we highlight two papers that were omitted from the analysis. One of these was omitted without any apparent reason. It found EMDR superior to a placebo control. The other study was published in 2015 and should have been part of APA guidelines since they were published in 2017. The inclusion of either study would have resulted in an improvement in SOE. Including both studies results in standard mean difference and confidence intervals that were better for EMDR than for CPT or CT. Therefore, the SOE should have been rated as moderate and EMDR assessed as at least equivalent to these CBT approaches in the APA guidelines. This would bring the APA guidelines in line with other recent practice guidelines from other countries. Less critical but also important, were several inaccuracies in assessing the risk of bias and the failure to consider studies supporting strong gains of EMDR at follow-up.

The article is here.

Thursday, September 7, 2017

Harm to self outweighs benefit to others in moral decision making

Lukas J. Volz, B. Locke Welborn, Matthias S. Gobel, Michael S. Gazzaniga, and Scott T. Grafton
PNAS 2017 ; published ahead of print July 10, 2017

Abstract

How we make decisions that have direct consequences for ourselves and others forms the moral foundation of our society. Whereas economic theory contends that humans aim at maximizing their own gains, recent seminal psychological work suggests that our behavior is instead hyperaltruistic: We are more willing to sacrifice gains to spare others from harm than to spare ourselves from harm. To investigate how such egoistic and hyperaltruistic tendencies influence moral decision making, we investigated trade-off decisions combining monetary rewards and painful electric shocks, administered to the participants themselves or an anonymous other. Whereas we replicated the notion of hyperaltruism (i.e., the willingness to forego reward to spare others from harm), we observed strongly egoistic tendencies in participants’ unwillingness to harm themselves for others’ benefit. The moral principle guiding intersubject trade-off decision making observed in our study is best described as egoistically biased altruism, with important implications for our understanding of economic and social interactions in our society.

Significance

Principles guiding decisions that affect both ourselves and others are of prominent importance for human societies. Previous accounts in economics and psychological science have often described decision making as either categorically egoistic or altruistic. Instead, the present work shows that genuine altruism is embedded in context-specific egoistic bias. Participants were willing to both forgo monetary reward to spare the other from painful electric shocks and also to suffer painful electric shocks to secure monetary reward for the other. However, across all trials and conditions, participants accrued more reward and less harm for the self than for the other person. These results characterize human decision makers as egoistically biased altruists, with important implications for psychology, economics, and public policy.

The article is here.

Are morally good actions ever free?

Cory J. Clark, Adam Shniderman, Jamie Luguri, Roy Baumeister, and Peter Ditto
SSRN Electronic Journal, August 2017

Abstract

A large body of work has demonstrated that people ascribe more responsibility to morally bad actions than both morally good and morally neutral ones, creating the impression that people do not attribute responsibility to morally good actions. The present work demonstrates that this is not so: People attributed more free will to morally good actions than morally neutral ones (Studies 1a-1b). Studies 2a-2b distinguished the underlying motives for ascribing responsibility to morally good and bad actions. Free will ascriptions for morally bad actions were driven predominantly by affective punitive responses. Free will judgments for morally good actions were similarly driven by affective reward responses, but also less affectively-charged and more pragmatic considerations (the perceived utility of reward, normativity of the action, and willpower required to perform the action). Responsibility ascriptions to morally good actions may be more carefully considered, leading to generally weaker, but more contextually-sensitive free will judgments.

The research is here.

Wednesday, September 6, 2017

The importance of building ethics into artificial intelligence

Kriti Sharma
Mashable
Originally published August 18, 2017

Here is an excerpt:

Humans possess inherent social, economic and cultural biases. It’s unfortunately core to social fabrics around the world. Therefore, AI offers a chance for the business community to eliminate such biases from their global operations.

The onus is on the tech community to build technology that utilizes data from relevant, trusted sources to embrace a diversity of culture, knowledge, opinions, skills and interactions.

Indeed, AI operating in the business world today performs repetitive tasks well, learns on the job and even incorporates human social norms into its work. However, AI also spends a significant amount of time scouring the web and its own conversational history for additional context that will inform future interactions with human counterparts.

This prevalence of well-trodden data sets and partial information on the internet presents a challenge and an opportunity for AI developers. When built with responsible business and social practices in mind, AI technology has the potential to consistently – and ethically – deliver products and services to people who need them. And do so without the omnipresent human threat of bias.

Ultimately, we need to create innately diverse AI. As an industry-focused tech community, we must develop effective mechanisms to filter out biases, as well as any negative sentiment in the data that AI learns from to ensure the technology does not perpetuate stereotypes. Unless we build AI using diverse teams, datasets and design, we risk repeating the fundamental inequality of previous industrial revolutions.

The article is here.

The Nuremberg Code 70 Years Later

Jonathan D. Moreno, Ulf Schmidt, and Steve Joffe
JAMA. Published online August 17, 2017.

Seventy years ago, on August 20, 1947, the International Medical Tribunal in Nuremberg, Germany, delivered its verdict in the trial of 23 doctors and bureaucrats accused of war crimes and crimes against humanity for their roles in cruel and often lethal concentration camp medical experiments. As part of its judgment, the court articulated a 10-point set of rules for the conduct of human experiments that has come to be known as the Nuremberg Code. Among other requirements, the code called for the “voluntary consent” of the human research subject, an assessment of risks and benefits, and assurances of competent investigators. These concepts have become an important reference point for the ethical conduct of medical research. Yet, there has in the past been considerable debate among scholars about the code’s authorship, scope, and legal standing in both civilian and military science. Nonetheless, the Nuremberg Code has undoubtedly been a milestone in the history of biomedical research ethics.1- 3

Writings on medical ethics, laws, and regulations in a number of jurisdictions and countries, including a detailed and sophisticated set of guidelines from the Reich Ministry of the Interior in 1931, set the stage for the code. The same focus on voluntariness and risk that characterizes the code also suffuses these guidelines. What distinguishes the code is its context. As lead prosecutor Telford Taylor emphasized, although the Doctors’ Trial was at its heart a murder trial, it clearly implicated the ethical practices of medical experimenters and, by extension, the medical profession’s relationship to the state understood as an organized community living under a particular political structure. The embrace of Nazi ideology by German physicians, and the subsequent participation of some of their most distinguished leaders in the camp experiments, demonstrates the importance of professional independence from and resistance to the ideological and geopolitical ambitions of the authoritarian state.

The article is here.

Tuesday, September 5, 2017

Ethical behaviour of physicians and psychologists: similarities and differences

Ferencz Kaddari M, Koslowsky M, Weingarten MA
Journal of Medical Ethics Published Online First: 18 August 2017.

Abstract

Objective 

To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas.

Population 88 clinical psychologists and 149 family physicians in Israel.

Method 

Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists.

Results 

Psychologists’ aggregated mean ethical intention score, as compared with the physicians, was found to be significantly higher (F(6, 232)=22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment (they would continue treating a non-paying patient while physicians would not) and dual relationships (they would avoid treating the son of a colleague). In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague's inappropriate practice due to personal problems.

Conclusions 

Responses to the dilemmas by physicians and psychologists can be categorised into two groups: (1) similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and (2) different behaviours when confronting either payment issues or dual relationships.

The research is here.

Monday, September 4, 2017

Teaching A.I. Systems to Behave Themselves

Cade Metz
The New York Times
Originally published August 13, 2017

Here is an excerpt:

Many specialists in the A.I. field believe a technique called reinforcement learning — a way for machines to learn specific tasks through extreme trial and error — could be a primary path to artificial intelligence. Researchers specify a particular reward the machine should strive for, and as it navigates a task at random, the machine keeps close track of what brings the reward and what doesn’t. When OpenAI trained its bot to play Coast Runners, the reward was more points.

This video game training has real-world implications.

If a machine can learn to navigate a racing game like Grand Theft Auto, researchers believe, it can learn to drive a real car. If it can learn to use a web browser and other common software apps, it can learn to understand natural language and maybe even carry on a conversation. At places like Google and the University of California, Berkeley, robots have already used the technique to learn simple tasks like picking things up or opening a door.

All this is why Mr. Amodei and Mr. Christiano are working to build reinforcement learning algorithms that accept human guidance along the way. This can ensure systems don’t stray from the task at hand.

Together with others at the London-based DeepMind, a lab owned by Google, the two OpenAI researchers recently published some of their research in this area. Spanning two of the world’s top A.I. labs — and two that hadn’t really worked together in the past — these algorithms are considered a notable step forward in A.I. safety research.

The article is here.

Sunday, September 3, 2017

The bold new fight to eradicate suicide

Simon Usborne
The Guardian
Originally published August 1, 2017

Here is an excerpt:

They call it “Zero Suicide”, a bold ambition and slogan that emerged from a Detroit hospital more than a decade ago, and which is now being incorporated into several NHS trusts. Since our first meeting, Steve has himself embraced the idea, and in May of this year held talks with Mersey Care, one of the specialist mental health trusts already applying a zero strategy. His plans are at an early stage, but he is setting out to create a Zero Suicide foundation. He wants it to identify good practices across the 55 mental health trusts in England and create a new strategy to be applied everywhere.

The zero approach is a proactive strategy that aims to identify and care for all those who may be at risk of suicide, rather than reacting once patients have reached crisis point. It emphasises strong leadership, improved training, better patient-screening and the use of the latest data and research to make changes without fear or delay. It is a joined-up strategy that challenges old ideas about the inevitability of suicide, the stigma that surrounds it, and the idea that if a reduction target is achieved, the deaths on the way to it are somehow acceptable. “Even if you believe we are never going to eradicate suicide, we must strive towards that,” Steve said to me. “If zero isn’t the right target, then what is?”

Zero Suicide is not radical, incorporating as it does several existing prevention strategies. But that it should be seen as new and daringly ambitious reveals much about how slowly attitudes have changed. In the 1957 book The Uses of Literacy: Aspects of Working-Class Life, a semi-autobiographical examination of the cultural upheavals of the 1950s, Richard Hoggart recalled his upbringing in Leeds. “Every so often one heard that so-and-so had ‘done ’erself in’ … or ‘put ’er ’ead in the gas-oven’,” he wrote. “It did not happen monthly or even every season, and not all attempts succeeded; but it happened sufficiently often to be part of the pattern of life.” He wondered how “suicide could be accepted – pitifully but with little suggestion of blame – as part of the order of existence”.

The article is here.

Friday, September 1, 2017

A Plutocratic Proposal: an ethical way for rich patients to pay for a place on a clinical trial

Alexander Masters and Dominic Nutt
Journal of Medical Ethics 
Published Online First: 06 June 2017.

Abstract

Many potential therapeutic agents are discarded before they are tested in humans. These are not quack medications. They are drugs and other interventions that have been developed by responsible scientists in respectable companies or universities and are often backed up by publications in peer-reviewed journals. These possible treatments might ease suffering and prolong the lives of innumerable patients, yet they have been put aside. In this paper, we outline a novel mechanism—the Plutocratic Proposal—to revive such neglected research and fund early phase clinical trials. The central idea of the Proposal is that any patient who rescues a potential therapeutic agent from neglect by funding early phase clinical trials (either entirely or in large part) should be offered a place on the trial.

The article is here.

Political differences in free will belief are driven by differences in moralization

Clark, C. J., Everett, J. A. C., Luguri, J. B., Earp, B. D., Ditto, P., & Shariff, A.
PsyArXiv. (2017, August 1).

Abstract

Five studies tested whether political conservatives’ stronger free will beliefs are driven by their broader view of morality, and thus a broader motivation to assign responsibility. On an individual difference level, Study 1 found that political conservatives’ higher moral wrongness judgments accounted for their higher belief in free will.In Study 2, conservatives ascribed more free will for negative events than liberals,while no differences emerged for positive events. For actions ideologically equivalent in perceived moral wrongness, free will judgments also did not differ (Study 3), and actions that liberals perceived as more wrong, liberals judged as more free(Study 4). Finally, higher wrongness judgments mediated the effect of conservatism on free will beliefs(Study 5). Higher free will beliefs among conservatives may be explained by conservatives’ tendency to moralize, which strengthens motivation to justify blame with stronger belief in free will and personal accountability.

The preprint research article is here.