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

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

Wednesday, February 28, 2018

Can scientists agree on a code of ethics?

David Ryan Polgar
BigThink.com
Originally published January 30, 2018

Here is an excerpt:

Regarding the motivation for developing this Code of Ethics, Hug mentioned the threat of reduced credibility of research if the standards seem to loose. She mentioned the pressure that many young scientists face in being prolific with research, insinuating the tension with quantity versus quality. "We want research to remain credible because we want it to have an impact on policymakers, research being turned into action." One of the goals of Hug presenting about the Code of Ethics, she said, was to start having various research institutions endorse the document, and have those institutions start distributing the Code of Ethics within their network.

“All these goals will conflict with each other," said Jodi Halpern, referring to the issues that may get in the way of adopting a code of ethics for scientists. "People need rigorous education in ethical reasoning, which is just as rigorous as science education...what I’d rather have as a requirement, if I’d like to put teeth anywhere. I’d like to have every doctoral student not just have one of those superficial IRB fake compliance courses, but I’d like to have them have to pass a rigorous exam showing how they would deal with certain ethical dilemmas. And everybody who will be the head of a lab someday will have really learned how to do that type of thinking.”

The article is here.

Why willpower is overrated

Brian Resnick
vox.com
Originally published January 15, 2018

Here is an excerpt:

What we can learn from people who are good at self-control

So who are these people who are rarely tested by temptations? They’re doing something right. Recent research suggests a few lessons we can draw from them.

1) People who are better at self-control actually enjoy the activities some of us resist — like eating healthy, studying, or exercising.

So engaging in these activities isn’t a chore for them. It’s fun.

“‘Want to’ goals are more likely to be obtained than ‘have to’ goals,” Milyavskaya said in an interview last year. “Want-to goals lead to experiences of fewer temptations. It’s easier to pursue those goals. It feels more effortless.”

If you’re running because you “have to” get in shape but find running to be a miserable activity, you’re probably not going to keep it up. An activity you like is more likely to be repeated than an activity you hate.

2) People who are good at self-control have learned better habits.

In 2015, psychologists Brian Galla and Angela Duckworth published a paper in the Journal of Personality and Social Psychology, finding across six studies and more than 2,000 participants that people who are good at self-control also tend to have good habits — like exercising regularly, eating healthy, sleeping well, and studying.

“People who are good at self-control … seem to be structuring their lives in a way to avoid having to make a self-control decision in the first place,” Galla tells me. And structuring your life is a skill. People who do the same activity, like running or meditating, at the same time each day have an easier time accomplishing their goals, he says — not because of their willpower, but because the routine makes it easier.

The article is here.

Tuesday, February 27, 2018

Artificial neurons compute faster than the human brain

Sara Reardon
Nature
Originally published January 26, 2018

Superconducting computing chips modelled after neurons can process information faster and more efficiently than the human brain. That achievement, described in Science Advances on 26 January, is a key benchmark in the development of advanced computing devices designed to mimic biological systems. And it could open the door to more natural machine-learning software, although many hurdles remain before it could be used commercially.

Artificial intelligence software has increasingly begun to imitate the brain. Algorithms such as Google’s automatic image-classification and language-learning programs use networks of artificial neurons to perform complex tasks. But because conventional computer hardware was not designed to run brain-like algorithms, these machine-learning tasks require orders of magnitude more computing power than the human brain does.

“There must be a better way to do this, because nature has figured out a better way to do this,” says Michael Schneider, a physicist at the US National Institute of Standards and Technology (NIST) in Boulder, Colorado, and a co-author of the study.

The article is here.

After long battle, mental health will be part of New York's school curriculum

Bethany Bump
Times Union
Originally published January 27, 2018

Here is an excerpt:

The idea of teaching young people about mental health is not a new one.

The mental hygiene movement of the early 1900s introduced society to the concept that mental wellness could be just as important as physical wellness.,

In 1928, a nationwide group of superintendents recommended that mental hygiene be included in the teaching of health education, but it was not.

"When you talk about mental health and mental illness, people are still, because of the stigma, in the closet about it," Liebman said. "People just don't talk about it like they talk about physical illness."

Social media has strengthened the movement to de-stigmatize mental illness, he said. "People are being more candid about their mental health issues and seeking support and using social media as kind of a fulcrum for gaining support, peers and friends in their recovery," Liebman said.

Making the case

Advocates of the law want people to know they are not pushing for students or schoolteachers to become diagnosticians. They say that is best left to professionals.

Adding mental health literacy to the curriculum will provide youth with the knowledge of how to prevent mental disorders, recognize when a disorder is developing, know how and where to seek help and treatment, strategies for dealing with milder issues, and strategies for supporting others who are struggling.

The information is here.

Monday, February 26, 2018

How Doctors Deal With Racist Patients

Sumathi Reddy
The Wall Street Journal
Originally published January 22, 2018

Her is an excerpt:

Patient discrimination against physicians and other health-care providers is an oft-ignored topic in a high-stress job where care always comes first. Experts say patients request another physician based on race, religion, gender, age and sexual orientation.

No government entity keeps track of such incidents. Neither do most hospitals. But more trainees and physicians are coming forward with stories and more hospitals and academic institutions are trying to address the issue with new guidelines and policies.

The examples span race and religion. A Korean-American doctor’s tweet about white nationalists refusing treatment in the emergency room went viral in August.

A trauma surgeon at a hospital in Charlotte, N.C., published a piece on KevinMD, a website for physicians, last year detailing his own experiences with discrimination given his Middle Eastern heritage.

Penn State College of Medicine adopted language into its patient rights policy in May that says patient requests for providers based on gender, race, ethnicity or sexual orientation won’t be honored. It adds that some requests based on gender will be evaluated on a case-by-case basis.

The article is here.

Business ethics: am I boring you?

Katherine Bradshaw
The Guardian
Originally published November 8, 2012

Here is an excerpt:

We need to bridge the gap between ethics programmes and daily worklife – and stories can help us do that.

No matter how sophisticated we are as a society, stories continue to be our preferred way of communicating and sharing our experiences of life. From a book at bedtime to the latest cliffhanger of our favourite soap, stories help us connect and communicate our emotions and values with each other.

Business ethics training at its worst can include material which seems distant to staff and how they do their day-to-day job. A set of compliance dictats communicated with slides animated with clip art, or an eLearning programme with easy multiple choice questions conducted in isolation, is unlikely to engage anyone with what really matters.

Ethical values need to be embedded into company culture so that they are reflected in the way that business is actually done. This requires an ethics programme with objectives beyond just imparting knowledge and raising awareness of expected standards – the challenge is to communicate their relevance and importance at all levels and locations in a way that impacts on understanding, decisions and behaviours.

The article is here.

Sunday, February 25, 2018

The Moral Importance of Reflective Empathy

Ingmar Persson and Julian Savulescu
J. Neuroethics (2017). https://doi.org/10.1007/s12152-017-9350-7

Abstract

This is a reply to Jesse Prinz and Paul Bloom’s skepticism about the moral importance of empathy. It concedes that empathy is spontaneously biased to individuals who are spatio-temporally close, as well as discriminatory in other ways, and incapable of accommodating large numbers of individuals. But it is argued that we could partly correct these shortcomings of empathy by a guidance of reason because empathy for others consists in imagining what they feel, and, importantly, such acts of imagination can be voluntary – and, thus, under the influence of reflection – as well as automatic. Since empathizing with others motivates concern for their welfare, a reflectively justified empathy will lead to a likewise justified altruistic concern. In addition, we argue that such concern supports another central moral attitude, namely a sense of justice or fairness.

From the Conclusion

All in all, the picture that emerges is this. We have beliefs about how other individuals feel and how we can help them to feel better. There is both a set of properties such that: (1) if we believe individuals have any of these properties, this facilitates spontaneous empathy with these individuals, i.e. disposes us to imagine spontaneously how they feel, and (2) a set of properties such that if we believe that individuals have any of them, this hinders spontaneous empathy with them. In the former case, we will be spontaneously concerned about the well-being of these individuals; in the latter case, it will take voluntary reflection to empathize and be concerned about the individuals in question. We are also in possession of a sense of justice or fairness which not only animates us to benefit those whom justice requires to be benefited, but also to harm those whom justice requires be harmed.

The article can be accessed here.

Saturday, February 24, 2018

Evolution and Human Behavior: A Field Guide for Teaching Evolution in the Social Sciences

Cristine Legare John Opfer Justin Busch Andrew Shtulman
Published January 21, 2018

Abstract

The theory of evolution by natural selection has begun to revolutionize our understanding of perception, cognition, language, social behavior, and cultural practices. Despite the centrality of evolutionary theory to the social sciences, many students, teachers,and even scientists struggle to understand how natural selection works. Our goal is to provide a field guide for social scientists on teaching evolution, based on research in cognitive psychology, developmental psychology, and education. We synthesize what is known about the psychological obstacles to understanding evolution, methods for assessing evolution understanding, and pedagogical strategies for improving evolution understanding. We review what is known about teaching evolution about nonhuman species and then explore implications of these findings for the teaching of evolution about humans. By leveraging our knowledge of how to teach evolution in general, we hope to motivate and equip social scientists to begin teaching evolution in the context of their own field.

The field guide is here.

Friday, February 23, 2018

Apple vs. Ivanka Trump: Competing ethics collide in China

Erika Kinetz
Associated Press
Originally published January 25, 2018

Here is an excerpt:

Ivanka Trump's company, meanwhile, has called supply chain integrity a "top priority," but maintains that suppliers are the responsibility of its licensees — companies it contracts with to manufacture tons of Ivanka Trump handbags, shoes and clothes. The brand doesn't publish the identities of its manufacturers. In fact, its supply chains have only grown more opaque since the First Daughter took on her White House role, the Associated Press showed last year.

"That mode of thinking is the dominant mode of thinking," said Seth Gurgel, who has worked on Chinese legal and labor rights issues for more than a decade. "They'd be a textbook company that would want to hide behind licensee protections."

Big brands with dedicated suppliers tend to be more invested in workplace conditions than smaller brands like Ivanka Trump's. But the political and ethical calculus surrounding Ivanka Trump's name — and her namesake brand, which she still owns but no longer closely manages — shifted radically when she became an adviser to her father in the White House.

"If Ivanka could be pressured or convinced to become a global leader or speak out about abuses in the apparel industry, she could be a huge ally for labor NGOs and worker groups around the world," Gurgel said.

The article is here.

Forgiveness Therapy for the Promotion of Mental Well-Being

Sadaf Akhtar, Jane Barlow
Trauma, Violence & Abuse 2016 March 23

Abstract

Interpersonal hurts and violence against the individual have a high prevalence and are associated with a range of long-term problems in terms of psychological functioning. There is a growing body of research highlighting the role of forgiveness therapy in improving different aspects of psychological health in populations who have experienced diverse types of hurt, violence, or trauma. This article reports the findings of a systematic review and meta-analysis of the efficacy of process-based forgiveness interventions among samples of adolescents and adults who had experienced a range of sources of hurt or violence against them. Randomized controlled trials were retrieved using electronic databases and an examination of reference sections of previous reviews; each study was assessed for risk of bias. Standardized mean differences (SMDs) and confidence intervals (CIs) were used to assess treatment effects. The results suggest that forgiveness interventions are effective in reducing depression (SMD = −0.37, 95% CI [−0.68, −0.07]), anger and hostility (SMD = −0.49, 95% CI [−0.77, −0.22]), and stress and distress (SMD = −0.66, 95% CI [−0.91, −0.41]) and in promoting positive affect (SMD = −0.29, 95% CI [−0.52, −0.06]). There was also evidence of improvements in state (SMD = −0.55, 95% CI [−0.88, −0.21) and trait (SMD = −0.43, 95% CI [−0.67, −0.20]) forgiveness. The findings provide moderately strong evidence to suggest that forgiving a variety of real-life interpersonal offenses can be effective in promoting different dimensions of mental well-being. Further research is, however, needed.

The article is here.

Thursday, February 22, 2018

James Comey isn’t qualified for his new gig teaching ethics, experts explain

Olivia Goldhill
Quartz
Originally published January 27, 2018

Here is an excerpt:

“My entire professional life has been dedicated to ethics education. I’m disheartened by the fact that educational institutions hire people to teach ethics who really don’t have a background in ethics,” says Aine Donovan, director of the ethics institute at Dartmouth University.

Certainly, Comey’s own behavior as FBI director would make the basis of a strong case study, says Donovan. But Comey’s experience navigating a moral quandary is not sufficient qualification. “I’d rather have moral exemplars teaching an ethical leadership class than somebody who has even a whiff of controversy associated with them,” Donovan says. In addition, Donovan adds, it seems Comey did not make the right moral choice at every stage. For example, Comey leaked documents about his conversations with Trump. “I’m highly skeptical that that would ever pass ethical muster,” adds Donovan.

A “puzzling” choice

“There is much to be learned about [ethics from] studying Mr. Comey’s own conduct, but most of it is not positive,” Howard Prince II, who holds the Loyd Hackler Endowed Chair in Ethical Leadership at University of Texas-Austin, writes in an email. Overall, Comey is “a puzzling choice” to teach ethical leadership, he adds.

The article is here.

NIH adopts new rules on human research, worrying behavioral scientists

William Wan
The Washington Post
Originally posted January 24, 2018

Last year, the National Institutes of Health announced plans to tighten its rules for all research involving humans — including new requirements for scientists studying human behavior — and touched off a panic.

Some of the country’s biggest scientific associations, including the American Psychological Association and Federation of Associations in Behavioral and Brain Sciences, penned impassioned letters over the summer warning that the new policies could slow scientific progress, increase red tape and present obstacles for researchers working in smaller labs with less financial and administrative resources to deal with the added requirements. More than 3,500 scientists signed an open letter to NIH director Francis Collins.

The new rules are scheduled to take effect Thursday. They will have a big impact on how research is conducted, especially in fields like psychology and neuroscience. NIH distributes more than $32 billion each year, making it the largest public funder of biomedical and health research in the world, and the rules apply to any NIH-supported work that studies human subjects and is evaluating the effects of interventions on health or behavior.

The article is here.

Wednesday, February 21, 2018

The Federal Right to Try Act of 2017—A Wrong Turn for Access to Investigational Drugs and the Path Forward

Alison Bateman-House and Christopher T. Robertson
JAMA Intern Med. Published online January 22, 2018.

In 2017, President Trump said that “one thing that’s always disturbed”1 him is that the US Food and Drug Administration (FDA) denies access to experimental drugs even “for a patient who’s terminal…[who] is not going to live more than four weeks [anyway.]”  Fueled by emotionally charged anecdotes recirculated by libertarian political activists, 38 states have passed Right to Try laws. In 2017, the US Senate approved a bill that would create a national law (Box). As of December 2017, the US House of Representatives was considering the bill.

The article is here.

Don’t look to the president for moral leadership

Julia Azari
vox.com
Originally posted February 19, 2018

President Trump’s reaction to last week’s school shooting in Parkland, Florida, has drawn heavy criticism.

His initial round of tweets, reminding the country that the Florida shooter had been known to display “bad and erratic behavior,” and that such behavior should be “reported to the authorities” were not well-received. Critics called the response “victim-blaming.” Survivors of the shooting were neither comforted nor inspired.

Of course, we live in a time of partisan polarization, and it’s easy to suggest that there are many Americans who are unlikely to respond positively to any message from President Trump. That’s probably true. But none other than liberal snowflake Ari Fleischer — press secretary to George W. Bush — offered a broader indictment: “Some of the biggest errors Pres. Trump has made are what he did NOT say. He did not immediately condemn the KKK after Charlottesville. He did not immediately condemn domestic violence or offer sympathy for Rob Porter’s ex-wives. He should speak today about the school shooting.” Trump did address the incident in a speech on Thursday.

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Anti-Trump Republican Rick Wilson tweeted on Sunday that Trump isn’t a president but a “moral stress test.” His speech on Thursday and his visit to Florida over the weekend appeared to impress very few people. At the time of this writing, the president’s response appears to have culminated in a series of tweets chastising the FBI for not pursuing reports about the Florida shooter and linking the FBI’s failure to its Russia investigation.

The article is here.

Tuesday, February 20, 2018

This Cat Sensed Death. What if Computers Could, Too?

Siddhartha Mukherjee
The New York Times
Originally published January 3, 2017

Here are two excerpts:

But what if an algorithm could predict death? In late 2016 a graduate student named Anand Avati at Stanford’s computer-science department, along with a small team from the medical school, tried to “teach” an algorithm to identify patients who were very likely to die within a defined time window. “The palliative-care team at the hospital had a challenge,” Avati told me. “How could we find patients who are within three to 12 months of dying?” This window was “the sweet spot of palliative care.” A lead time longer than 12 months can strain limited resources unnecessarily, providing too much, too soon; in contrast, if death came less than three months after the prediction, there would be no real preparatory time for dying — too little, too late. Identifying patients in the narrow, optimal time period, Avati knew, would allow doctors to use medical interventions more appropriately and more humanely. And if the algorithm worked, palliative-care teams would be relieved from having to manually scour charts, hunting for those most likely to benefit.

(cut)

So what, exactly, did the algorithm “learn” about the process of dying? And what, in turn, can it teach oncologists? Here is the strange rub of such a deep learning system: It learns, but it cannot tell us why it has learned; it assigns probabilities, but it cannot easily express the reasoning behind the assignment. Like a child who learns to ride a bicycle by trial and error and, asked to articulate the rules that enable bicycle riding, simply shrugs her shoulders and sails away, the algorithm looks vacantly at us when we ask, “Why?” It is, like death, another black box.

The article is here.

Death and the Self

Shaun Nichols, Nina Strohminger, Arun Rai, Jay Garfield
Cognitive Science (2018) 1–19

Abstract

It is an old philosophical idea that if the future self is literally different from the current self,
one should be less concerned with the death of the future self (Parfit, 1984). This paper examines
the relation between attitudes about death and the self among Hindus, Westerners, and three Buddhist
populations (Lay Tibetan, Lay Bhutanese, and monastic Tibetans). Compared with other
groups, monastic Tibetans gave particularly strong denials of the continuity of self, across several
measures. We predicted that the denial of self would be associated with a lower fear of death and
greater generosity toward others. To our surprise, we found the opposite. Monastic Tibetan Buddhists
showed significantly greater fear of death than any other group. The monastics were also
less generous than any other group about the prospect of giving up a slightly longer life in order
to extend the life of another.

The article is here.

Monday, February 19, 2018

Culture and Moral Distress: What’s the Connection and Why Does It Matter?

Nancy Berlinger and Annalise Berlinger
AMA Journal of Ethics. June 2017, Volume 19, Number 6: 608-616.

Abstract

Culture is learned behavior shared among members of a group and from generation to generation within that group. In health care work, references to “culture” may also function as code for ethical uncertainty or moral distress concerning patients, families, or populations. This paper analyzes how culture can be a factor in patient-care situations that produce moral distress. It discusses three common, problematic situations in which assumptions about culture may mask more complex problems concerning family dynamics, structural barriers to health care access, or implicit bias. We offer sets of practical recommendations to encourage learning, critical thinking, and professional reflection among students, clinicians, and clinical educators.

Here is an excerpt:

Clinicians’ shortcuts for identifying “problem” patients or “difficult” families might also reveal implicit biases concerning groups. Health care professionals should understand the difference between cultural understanding that helps them respond to patients’ needs and concerns and implicit bias expressed in “cultural” terms that can perpetuate stereotypes or obscure understanding. A way to identify biased thinking that may reflect institutional culture is to consider these questions about advocacy:

  1. Which patients or families does our system expect to advocate for themselves?
  2. Which patients or families would we perceive or characterize as “angry” or “demanding” if they attempted to advocate for themselves?
  3. Which patients or families do we choose to advocate for, and on what grounds?
  4. What is our basis for each of these judgments?

Antecedents and Consequences of Medical Students’ Moral Decision Making during Professionalism Dilemmas

Lynn Monrouxe, Malissa Shaw, and Charlotte Rees
AMA Journal of Ethics. June 2017, Volume 19, Number 6: 568-577.

Abstract

Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students’ action (or inaction) runs counter to their perceived moral values—often due to organizational constraints or power hierarchies—they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance). We suggest how medical educators can support students’ understandings of ethical dilemmas and facilitate their habits of enacting professionalism: by modeling appropriate resistance behaviors.

Here is an excerpt:

Rather than being a straightforward matter of doing the right thing, medical students’ understandings of morally correct behavior differ from one individual to another. This is partly because moral judgments frequently concern decisions about behaviors that might entail some form of harm to another, and different individuals hold different perspectives about moral trade-offs (i.e., how to decide between two courses of action when the consequences of both have morally undesirable effects). It is partly because the majority of human behavior arises within a person-situation interaction. Indeed, moral “flexibility” suggests that though we are motivated to do the right thing, any moral principle can bring forth a variety of context-dependent moral judgments and decisions. Moral rules and principles are abstract ideas—rather than facts—and these ideas need to be operationalized and applied to specific situations. Each situation will have different affordances highlighting one facet or another of any given moral value. Thus, when faced with morally dubious situations—such as being asked to participate in lapses of patient consent by senior clinicians during workplace learning events—medical students’ subsequent actions (compliance or resistance) differ.

The article is here.

Sunday, February 18, 2018

Responsibility and Consciousness

Matt King and Peter Carruthers

1. Introduction

Intuitively, consciousness matters for responsibility. A lack of awareness generally provides the
basis for an excuse, or at least for blameworthiness to be mitigated. If you are aware that what
you are doing will unjustifiably harm someone, it seems you are more blameworthy for doing so
than if you harm them without awareness. There is thus a strong presumption that consciousness
is important for responsibility. The position we stake out below, however, is that consciousness,
while relevant to moral responsibility, isn’t necessary.

The background for our discussion is an emerging consensus in the cognitive sciences
that a significant portion, perhaps even a substantial majority, of our mental lives takes place
unconsciously. For example, routine and habitual actions are generally guided by the so-called
“dorsal stream” of the visual system, whose outputs are inaccessible to consciousness (Milner &
Goodale 1995; Goodale 2014). And there has been extensive investigation of the processes that
accompany conscious as opposed to unconscious forms of experience (Dehaene 2014). While
there is room for disagreement at the margins, there is little doubt that our actions are much more
influenced by unconscious factors than might intuitively seem to be the case. At a minimum,
therefore, theories of responsibility that ignore the role of unconscious factors supported by the
empirical data proceed at their own peril (King & Carruthers 2012). The crucial area of inquiry
for those interested in the relationship between consciousness and responsibility concerns the
relative strength of that relationship and the extent to which it should be impacted by findings in
the empirical sciences.

The paper is here.

Saturday, February 17, 2018

Fantasy and Dread: The Demand for Information and the Consumption Utility of the Future

Ananda R. Ganguly and Joshua Tasoff
Management Science
Last revised: 1 Jun 2016

Abstract

We present evidence that intrinsic demand for information about the future is increasing in expected future consumption utility. In the first experiment, subjects may resolve a lottery now or later. The information is useless for decision making but the larger the reward, the more likely subjects are to pay to resolve the lottery early. In the second experiment subjects may pay to avoid being tested for HSV-1 and the more highly feared HSV-2. Subjects are three times more likely to avoid testing for HSV-2, suggesting that more aversive outcomes lead to more information avoidance. In a third experiment, subjects make choices about when to get tested for a fictional disease. Some subjects behave in a way consistent with expected utility theory and others exhibit greater delay of information for more severe diseases. We also find that information choice is correlated with positive affect, ambiguity aversion, and time preference as some theories predict.

The research is here.

Friday, February 16, 2018

The Scientism of Psychiatry

Sami Timimi
Mad in America
Originally posted January 10, 2018

Here is an excerpt:

Mainstream psychiatry has been afflicted by at least two types of scientism. Firstly, it parodies science as ideology, liking to talk in scientific language, using the language of EBM, and carrying out research that ‘looks’ scientific (such as brain scanning). Psychiatry wants to be seen as residing in the same scientific cosmology as the rest of medicine. Yet the cupboard of actual clinically relevant findings remains pretty empty. Secondly, it ignores much of the genuine science there is and goes on supporting and perpetuating concepts and treatments that have little scientific support. This is a more harmful and deceptive form of scientism; it means that psychiatry likes to talk in the language of science and treats this as more important than the actual science.

I have had debates with fellow psychiatrists on many aspects of the actual evidence base. Two ‘defences’ have become familiar to me. The first is use of anecdote — such and such a patient got better with such and such a treatment, therefore, this treatment ‘works.’ Anecdote is precisely what EBM was trying to get away from. The second is an appeal for me to take a ‘balanced’ perspective. Of course each person’s idea of what is a ‘balanced’ position depends on where they are sitting. We get our ideas on what is ‘balanced’ from what is culturally dominant, not from what the science is telling us. At one point, to many people, Nelson Mandala was a violent terrorist; later to many more people, he becomes the embodiment of peaceful reconciliation and forgiveness. What were considered ‘balanced’ views on him were almost polar opposites, depending on where and when you were examining him from. Furthermore, in science facts are simply that. Our interpretations are of course based on our reading of these facts. Providing an interpretation consistent with the facts is more important than any one person’s notion of what a ‘balanced’ position should look like.

The article is here.

Health Care Workers & Moral Objections I: Procedures

Mike LaBossiere
Talking Philosophy
Originally published on January 18, 2018

Here is an excerpt:

But, this moral coin has another side—entering a profession, especially in the field of health, also comes with moral and professional responsibilities. These responsibilities can, like all responsibilities, can justly impose burdens. For example, doctors are not permitted to instantly abandon patients they dislike or because they want to move to a better paying position. As such, ethics of a health worker refusing to perform a procedure based on their moral or religious views requires that each procedure be reviewed to determine whether it is one that a health care worker can justly refuse or one that is a justly imposed burden.

To illustrate, consider a doctor who is asked to keep prisoners conscious and alive during torture performed by agents of the state. Most doctors, like most people, would have moral objections to being involved in torture. However, there is the question of whether this would be something they should be morally expected to do as part of their profession. On the face of it, since the purpose of the medical profession is to heal and alleviate suffering (a professional ethics that goes back to the origin of western medicine) this is not something that a doctor is obligated to do even in the face of moral objections. In fact, the ethics of the profession would dictate against engaging in this behavior.

Now, imagine a health care worker who has sincere religious or moral beliefs that when a person can no longer sustain their life on their own, they must be released to God. As such, the worker refuses to engage in procedures that violate their principles, such as keeping a patient on life support. While this could be a sincerely held belief, it seems to run counter to the ethics of the profession. As such, such a health care worker would seem to not have the right to refuse such services.

The article is here.

Thursday, February 15, 2018

Declining Trust in Facts, Institutions Imposes Real-World Costs on U.S. Society

Rand Corporation
Pressor
Released on January 16, 2018

Americans' reliance on facts to discuss public issues has declined significantly in the past two decades, leading to political paralysis and collapse of civil discourse, according to a RAND Corporation report.

This phenomenon, referred to as “Truth Decay,” is defined by increasing disagreement about facts, a blurring between opinion and fact, an increase in the relative volume of opinion and personal experience over fact, and declining trust in formerly respected sources of factual information.

While there is evidence of similar phenomena in earlier eras in U.S. history, the current manifestation of Truth Decay is exacerbated by changes in the ways Americans consume information—particularly via social media and cable news. Other influences that may make Truth Decay more intense today include political, economic and social polarization that segment and divide the citizenry, the study finds.

These factors lead to Truth Decay's damaging consequences, such as political paralysis and uncertainty in national policy, which incur real costs. The government shutdown of 2013, which lasted 16 days, resulted in a $20 billion loss to the U.S. economy, according to estimates cited in the study.

The pressor is here.

Engineers, philosophers and sociologists release ethical design guidelines for future technology

Rafael A Calvo and Dorian Peters
The Conversation
Originally posted December 12, 2017

Here is an excerpt:

The big questions posed by our digital future sit at the intersection of technology and ethics. This is complex territory that requires input from experts in many different fields if we are to navigate it successfully.

To prepare the report, economists and sociologists researched the effect of technology on disempowered groups. Lawyers considered the future of privacy and justice. Doctors and psychologists examined impacts on physical and mental health. Philosophers unpacked hidden biases and moral questions.

The report suggests all technologies should be guided by five general principles:

  • protecting human rights
  • prioritising and employing established metrics for measuring wellbeing
  • ensuring designers and operators of new technologies are accountable
  • making processes transparent
  • minimizing the risks of misuse.

Sticky questions

The report runs the spectrum from practical to more abstract concerns, touching on personal data ownership, autonomous weapons, job displacement and questions like “can decisions made by amoral systems have moral consequences?”

One section deals with a “lack of ownership or responsibility from the tech community”. It points to a divide between how the technology community sees its ethical responsibilities and the broader social concerns raised by public, legal, and professional communities.

The article is here.

Wednesday, February 14, 2018

Alone Together: Who's Lonely and How Do We Measure It?

Tom Harrison
The RSA.org
Originally published January 18, 2018

Here is an excerpt:

What affect does loneliness have on our health?

Neuroscientist John Cacioppo’s seminal work published in ‘Loneliness: Human Nature and Need for Social Connection’ was one of the first to study the health impacts of loneliness. He found that lonely people have a 20 per cent higher premature mortality rate and called for a culture shift that would see loneliness as important a public health issue as obesity. The Campaign to End Loneliness acknowledges this; reporting that 3 out of 4 GPs say they see between 1 and 5 people a day who have come in mainly because they are lonely.

Indeed, research tells us that this phenomenon goes far beyond the familiar stereotype of an isolated grandmother. A recent British Red Cross report found that 32 per cent of those aged 16-24 reported that in the past 2 weeks they had often or always felt lonely. Are 1/3 of young people just snowflakes? It seems unlikely.

This has contributed to pressure for government to respond. But how do we measure the problem and what are responses required to tackle it?

The article is here.

Note to Reader: Psychotherapy can help with loneliness.

Tuesday, February 13, 2018

How Should Physicians Make Decisions about Mandatory Reporting When a Patient Might Become Violent?

Amy Barnhorst, Garen Wintemute, and Marian Betz
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 29-35.

Abstract

Mandatory reporting of persons believed to be at imminent risk for committing violence or attempting suicide can pose an ethical dilemma for physicians, who might find themselves struggling to balance various conflicting interests. Legal statutes dictate general scenarios that require mandatory reporting to supersede confidentiality requirements, but physicians must use clinical judgment to determine whether and when a particular case meets the requirement. In situations in which it is not clear whether reporting is legally required, the situation should be analyzed for its benefit to the patient and to public safety. Access to firearms can complicate these situations, as firearms are a well-established risk factor for violence and suicide yet also a sensitive topic about which physicians and patients might have strong personal beliefs.

The commentary is here.

Does Volk v. DeMeerleer Conflict with the AMA Code of Medical Ethics?

Jennifer L. Piel and Rejoice Opara
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 10-18.

Abstract

A recent Washington State case revisits the obligation of mental health clinicians to protect third parties from the violent acts of their patients. Although the case of Volk v DeMeerleer raises multiple legal, ethical, and policy issues, this article will focus on a potential ethical conflict between the case law and professional guidelines, namely the American Medical Association’s Code of Medical Ethics.

Here is a portion of the conclusion:

The Volk case established legal precedent for outpatient mental health clinicians in Washington State. Future cases against clinicians for their patients’ harm to third parties (e.g., medical negligence, wrongful death) will be tried under the Volk standard. It will be up to the trier of fact to determine whether the victims of a patient’s violence were foreseeable and, if so, whether the clinician acted reasonably to protect them.

Without changes to this law, there is increased likelihood that future clinicians and employers in similar situations, fearful of being in Dr. Ashby’s position, will more willingly (and likely unhelpfully) breach patient confidentiality. This creates a dilemma for clinicians in Washington State, who could find themselves caught between trying to meet the requirements of the legal case and also adhering to their professional ethical guidelines.

The article is here.

Monday, February 12, 2018

Prison for psychologist had sex with patients

Perrin Stein
Gillette News Record
Originally published January 12, 2018

It was standing room only in the courtroom as dozens of people gathered Thursday afternoon to see a former Gillette psychologist sentenced to prison for sexually assaulting two patients.

“During my brief time as a therapist, I did more harm than good and acted in ways that will reverberate in these women’s lives for years to come,” Joshua Popkin, 33, said before being taken into custody to serve two consecutive three- to five-year prison sentences for two counts of second-degree sexual assault.

Popkin met the two patients while interning at Campbell County Health in 2015.

One of the patients was seeking treatment for mental health issues related to a previous rape by an assailant elsewhere, according to court documents. After treating her at CCH, he saw her at his private practice, where he made increasingly sexual advances toward her. In June 2016, he had forced sex with her, according to court documents.

The article is here.

Can we please discuss ethics in the future of work?

Sylvia Vorhauser-Smith
Forbes
Originally published

Here is an excerpt:

Our brains have a very distinct and subliminal way of normalizing just about anything we are exposed to if we experience it long enough – even if we don’t like it. Look at how social norms have evolved over the past fifty years: back then a teenager would instinctively forego a seat on a bus for the elderly, men in suits wore ties, women never touched up their makeup in public and no one swore at policemen. Today, these aspects of social etiquette have changed significantly. Some for better, some for worse. New norms apply.

Equally, the workplace is a very different environment to what it used to be. Much of it better – safer, more engaging, more stimulating, more collaborative. But there have been trade-offs. Our working days are longer, technology has dissolved many of the boundaries between home and work and we are expected to be more self-sufficient and productive than ever before. And that’s before the next wave of innovations.

The information is here.

Sunday, February 11, 2018

Trump shifts meaning of 'Drain the Swamp' from ethics to anything he objects to

Noah Bierman
The Los Angeles Times
Originally posted February 9, 2018

Donald Trump long thought the phrase "Drain the Swamp" was a little hokey, he has confessed to crowds. Yet it stayed. If Frank Sinatra had to croon "My Way," even when he tired of it, Trump reasoned aloud, Trump could belt out his crowd-pleasing catchphrase.

More than a year into his presidency, Trump mouths the words a little less often. But rather than completely kill off a slogan that once rivaled "Build the Wall" in the Trump repertoire, he has done something more subversive: He has drained it of its meaning.

The motto no longer refers to Trump's promises of ethics and lobbying reforms — many of which have dropped by the wayside or been watered down — or to vows about stopping members of his administration from profiting from their service.

In recent months, Trump has rebranded the "swamp" to mean almost anything he objects to: reporters, opponents of his immigration plan, free traders, phonies, bureaucrats, politicians who vote against tax cuts.

The article is here.

Saturday, February 10, 2018

Could Biologically Enhancing Our Morality Save Our Species?

Julian Savulescu
Leapsmag.com
Originally published January 12, 2017

Here is an excerpt:

Our limitations have also become apparent in another form of existential threat: resource depletion. Despite our best efforts at educating, nudging, and legislating on climate change, carbon dioxide emissions in 2017 are expected to come in at the highest ever following a predicted rise of 2 percent. Why? We aren’t good at cooperating in larger groups where freeriding is not easily spotted. We also deal with problems in order of urgency. A problem close by is much more significant to us than a problem in the future. That’s why even if we accept there is a choice between economic recession now or natural disasters and potential famine in the future, we choose to carry on drilling for oil. And if the disasters and famine are present day, but geographically distant, we still choose to carry on drilling.

So what is our radical solution? We propose that there is a need for what we call moral bioenhancement. That is, for seeking a biological intervention that can help us overcome our evolved moral limitations. For example, adapting our biology so that we can appreciate the suffering of foreign or future people in the same instinctive way we do our friends and neighbors. Or, in the case of individuals, in addressing the problem of psychopathy from a biological perspective.

The information is here.

Friday, February 9, 2018

Robots, Law and the Retribution Gap

John Danaher
Ethics and Information Technology
December 2016, Volume 18, Issue 4, pp 299–309

We are living through an era of increased robotisation. Some authors have already begun to explore the impact of this robotisation on legal rules and practice. In doing so, many highlight potential liability gaps that might arise through robot misbehaviour. Although these gaps are interesting and socially significant, they do not exhaust the possible gaps that might be created by increased robotisation. In this article, I make the case for one of those alternative gaps: the retribution gap. This gap arises from a mismatch between the human desire for retribution and the absence of appropriate subjects of retributive blame. I argue for the potential existence of this gap in an era of increased robotisation; suggest that it is much harder to plug this gap than it is to plug those thus far explored in the literature; and then highlight three important social implications of this gap.

From the Discussion Section

Third, and finally, I have argued that this retributive gap has three potentially significant social implications: (i) it could lead to an increased risk of moral scapegoating; (ii) it could erode confidence in the rule of law; and (iii) it could present a strategic opening for those who favour nonretributive approaches to crime and punishment.

The paper is here.

Benjamin Franklin built his character around 13 virtues

Trent Hamm
The Simple Dollar - Business Insider
Originally published January 13, 2018

Here are two excerpts:

One of the things that has really stood out to me each time I've read his autobiography is the fact that he attributed most of his success (beyond that of luck) to practicing 13 core life virtues, to the best of his ability. He believed that by living those virtues, he had done everything he could to put himself in a position to be on the good side of the unexpected events of life.

(cut)

Once you've defined a set of virtues or specific skills that you want to work on in your life and integrate into your normal behaviors, take it a step further and copy Franklin's entire system, using your desired virtues and skills as the basis for your practice.

You can start by making a set of cards for the virtues you want to practice. It's pretty simple to design a small table, with rows for each thing you want to improve and columns for each day of the week, in your preferred word processing program. Just design a size that prints easily on a blank 4″ by 6″ index card and print them yourself. If you prefer, you can also design them by hand using a ruler and a pen.

On each card, simply write the days of the week at the top of each column and an abbreviation of the skill or virtue you want to practice to the left of each row.

Consider designing a set of these cards, one with each virtue or skill you want to practice at the top with a brief description, so that you have a particular virtue or skill to focus on that week. Print off (or make) the entire set at once, cycle through all of them, and then make a new set and start from scratch.

The article is here.

Thursday, February 8, 2018

What I’ve learned from my tally of 757 doctor suicides

Pamela Wible
The Washington Post
Originally published January 13, 2018

Here are two excerpts:

Physician suicide is a public health crisis. One million Americans lose their doctors to suicide each year.

Many doctors have lost a colleague to suicide. Some have lost up to eight during their career — with no opportunity to grieve.

We lose way more men than women. For every female physician on my suicide registry, there are seven men. Suicide methods vary by region and gender. Women prefer to overdose and men choose firearms. Gunshot wounds prevail out West. Jumping is popular in New York City. In India, doctors have been found hanging from ceiling fans.

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Patient deaths hurt doctors. A lot. Even when there’s no medical error, doctors may never forgive themselves for losing a patient. Suicide is the ultimate ­self-punishment. In several cases, the death of a patient seemed to be the key factor in pushing them over the edge.

Malpractice suits can be devastating. Humans make mistakes. Yet when doctors make mistakes, they’re publicly shamed in court, on TV and in newspapers (that live online forever). Many continue to suffer the agony of harming someone else — unintentionally — for the rest of our lives.

Academic distress kills medical students’ dreams. Failing medical-board exams and not getting a post-medical-school assignment in a specialty of choice has led to suicides. Doctors can be shattered if they fail to gain a residency: Before his suicide, Robert Chu, unmatched to residency, wrote a letter to medical officials and government leaders calling out a system that he said ruined his career.

The information is here.

How can groups make good decisions? Deliberation & Diversity

Mariano Sigman and Dan Ariely
TED Talk
Originally recorded April 2017

We all know that when we make decisions in groups, they don't always go right -- and sometimes they go very wrong. How can groups make good decisions? With his colleague Dan Ariely, neuroscientist Mariano Sigman has been inquiring into how we interact to reach decisions by performing experiments with live crowds around the world. In this fun, fact-filled explainer, he shares some intriguing results -- as well as some implications for how it might impact our political system. In a time when people seem to be more polarized than ever, Sigman says, better understanding how groups interact and reach conclusions might spark interesting new ways to construct a healthier democracy.

Wednesday, February 7, 2018

America is spiritually bankrupt.

Cornel West
The Guardian
Originally published January 14, 2018

Here are two excerpts:

The distinctive features of our spiritual blackout are threefold.

First, we normalize mendacity and naturalize criminality. We make our lies look like the normal order of things. And we make our crimes look like the natural order of things. We too often say Wall Street is a good servant – rather than a bad master – of the common good. Then we look away from the criminal behavior of big banks because they are too indispensable to prosecute.

(cut)

Second, we encourage callousness and reward indifference. We make mean-spiritedness look manly and mature. And we make cold-heartedness look triumphant and victorious. In our world of the survival of the slickest and the smartest, we pave the way for raw greed and self-promotion. We make cowardice and avarice fashionable and compassion an option for losers. We prefer market-driven celebrities who thrive on glitzy spectacles and seductive brands over moral-driven exemplars who strive on with their gritty convictions and stouthearted causes.

Third, we trump the moral and spiritual dimensions of our lives and world by applauding our short-term gains and superficial successes. This immoral and brutal disposition reinforces – and, in part, is a result of – the all-encompassing commodification of a predatory capitalism, running out of control in our psyches and societies.

The opinion is here.

Ben Carson’s family ethics drama, explained

Emily Stewart
Vox.com
Originally posted February 3, 2018

Here is an excerpt:

Still, questions persist. Secretary Carson’s family has had more involvement in official business than is par for the course — executive branch officials aren’t supposed to use their offices to advance private or commercial interests, and anti-nepotism laws bar officials from employing or promoting the interests of their relatives. Documents obtained by Democratic-leaning nonprofit American Oversight and shared with CNN this week show multiple HUD-organized meetings for Carson Jr. and “friends.” Emails also suggest Ben Carson’s wife, Candy Carson, pushed for her son to get a meeting with Transportation Secretary Elaine Chao.

In a statement on Thursday, Carson asked his agency’s inspector general to look into his listening tour. “In my role as HUD secretary, I try to be as inclusive as possible and talk with a wide variety of people because when it comes to increasing access to affordable housing, no rock should remain unturned,” he said.

Carson just can’t seem to stay out of hot water, ethically speaking

This isn’t the first time Carson has been the subject of ethics scrutiny. Carson’s appearance at a campaign-style rally alongside President Trump in August raised questions about whether he had violated the Hatch Act, which bars executive branch officials from using their government positions to influence elections. Ethics watchdogs eventually agreed it was probably not a violation.

The article is here.

Tuesday, February 6, 2018

State Supreme Court Establishes Right To Sue Over Medical Record Breaches

Edmund H. Mahony
Hartford Courant
Originally published January 10, 2018

The state Supreme Court established Thursday that patients in Connecticut have the right to sue doctors and other health care providers for the unauthorized and negligent disclosure of their confidential medical records.

The majority decision creates new state law and adds Connecticut to a growing number of states that allow patients to sue for damages over the release of private records by their physicians. Courts in Connecticut have held previously — as have courts elsewhere — that private suits were blocked by federal law under the 1996 Health Insurance Portability and Accountability Act or HIPAA law.

HIPAA laws establish procedures to protect medical records and empower government to impose civil and criminal penalties for violation. But HIPAA does not permit private suits to collect damages for unauthorized disclosures.

“Finally we have a remedy in Connecticut that recognizes that there is a duty of confidentiality, the breach of which can lead to compensation for damages,” said attorney Bruce L. Elstein of Trumbull, whose client, Emily Byrne, sued over an unauthorized release of her medical history.

The article is here.

Do the Right Thing: Experimental Evidence that Preferences for Moral Behavior, Rather Than Equity or Efficiency per se, Drive Human Prosociality

Capraro, Valerio and Rand, David G.
(January 11, 2018). Judgment and Decision Making.

Abstract

Decades of experimental research show that some people forgo personal gains to benefit others in unilateral anonymous interactions. To explain these results, behavioral economists typically assume that people have social preferences for minimizing inequality and/or maximizing efficiency (social welfare). Here we present data that are incompatible with these standard social preference models. We use a “Trade-Off Game” (TOG), where players unilaterally choose between an equitable option and an efficient option. We show that simply changing the labelling of the options to describe the equitable versus efficient option as morally right completely reverses the correlation between behavior in the TOG and play in a separate Dictator Game (DG) or Prisoner’s Dilemma (PD): people who take the action framed as moral in the TOG, be it equitable or efficient, are much more prosocial in the DG and PD. Rather than preferences for equity and/or efficiency per se, our results suggest that prosociality in games such as the DG and PD are driven by a generalized morality preference that motivates people to do what they think is morally right.

Download the paper here.

Monday, February 5, 2018

The Effects of Internet Use on Religious Belief, Behavior, and Belonging

Paul K. McClure
Journal for the Scientific Study of Religion.

Abstract

Internet technology presents a new conceptual reality, one that could potentially challenge religion in subtle but distinct ways. Few sociologists of religion, however, have attempted to evaluate whether using the Internet impacts the way people think about and practice religion. This article elaborates on the concept of “tinkering” discussed by Berger, Berger, and Kellner (1974), Turkle (1997), and Wuthnow (2010) to argue that Internet use affects how people think about and affiliate with religious traditions. Using data from Wave III of the Baylor Religion Survey (2010), I find that Internet use is associated with increases in being religiously unaffiliated and decreases in religious exclusivism. At the same time, I find that television viewing is linked to decreases in religious attendance and other time-related religious activities, but these outcomes are not impacted by Internet use. To explain these disparate findings, I argue that the Internet is fundamentally different from previous technologies like television and thus impacts religious beliefs and belonging but not time-related religious activities.

The research is here.

A Robot Goes to College

Lindsay McKenzie
Inside Higher Ed
Originally published December 21, 2017

A robot called Bina48 has successfully taken a course in the philosophy of love at Notre Dame de Namur University, in California.

According to course instructor William Barry, associate professor of philosophy and director of the Mixed Reality Immersive Learning and Research Lab at NDNU, Bina48 is the world’s first socially advanced robot to complete a college course, a feat he described as “remarkable.” The robot took part in class discussions, gave a presentation with a student partner and participated in a debate with students from another institution.

(cut)

Barry said that working with Bina48 had been a valuable experience for him and his students. “We need to get over our existential fear about robots and see them as an opportunity,” he said. “If we approach artificial intelligence with a sense of the dignity and sacredness of all life, then we will produce robots with those same values,” he said.

The information is here.

Sunday, February 4, 2018

Goldwater Rule: Red Line or Guideline?

Scott O. Lilienfeld, , Joshua D. Miller, Donald R. Lynam
Perspectives on Psychological Science 
Vol 13, Issue 1, pp. 33 - 35
First Published October 13, 2017

The decades following Miller’s (1969) call for psychological scientists to “give psychology away” have witnessed a growing recognition that we need to do more to communicate our knowledge to the general public (Kaslow, 2015; Lilienfeld, 2012). But should there be limits on the nature of this communication? The Goldwater Rule, which expressly forbids psychiatrists from commenting on the mental health of public figures whom they have not directly examined, answers this query in the affirmative; as we observed in our article (Lilienfeld, Miller, & Lynam, 2017), this rule has been de facto adopted by psychology.

We appreciate the opportunity to respond to two commentators who raise thoughtful qualifications and objections to our thesis, which holds that the Goldwater Rule is antiquated and premised on dubious scientific assumptions.  We are pleased that both scholars concur with us that the direct interview assumption—the principal empirical linchpin of the Goldwater Rule—is contradicted by large bodies of psychological research.

(cut to the conclusion)

Psychologists should typically refrain from proffering diagnostic judgments regarding public figures. Such judgments boost the risk of inaccurate ‘arm chair' diagnoses and of damaging the reputation of public figures and the profession at large.  At the same time, there is scant justification for a categorical ban on this practice, especially because psychologists can at times offer diagnostic information that bears to some degree on the question of individuals’ suitability for high public office.  We therefore recommend reformulating the 'Goldwater Rule” as the 'Goldwater Guideline.’  Such a change would underscore the wisdom of discretion with respect to statements concerning the diagnostic status of public figures but remind psychologists that such statements can be useful and even advisable within limits.

The article is here.

Vignette 37: The Fabricated Letter

Dr. Krista Gordon received an email from E Corp, the employer of a current patient Mr. Elliot Alderson (someone she provided psychotherapy for over a year, but has cancelled multiple appointments recently due to some family issues).  Dr. Gordon has not seen him for over a month, and he is not scheduled until the following month.

The email from E Corp was for the purposes of letting Dr. Gordon know that her patient had submitted documentation to E Corp (supposedly from Dr. Gordon), and they wanted to confirm that these documents were legitimate and unaltered.

To Dr. Gordon’s disappointment, she saw one legitimate letter (an older letter she wrote for Alderson to submit to his boss, confirming regular 4:30 pm appointment times, which allowed Alderson to leave 30 minutes early on those days), and one entirely questionable, clearly altered letter.

Apparently, Mr. Alderson copied Dr. Gordon’s letterhead and pasted it as an image for the false documentation.  The body of the letter is something Gordon never wrote (saying that Dr. Gordon assessed Alderson and determined he is unfit to return to work for an indefinite period).  Dr. Gordon’s signature is also copied and pasted on the fake letter.  The fake letter was shoddily done, the footer is cut-off, some of the text is cut-off, and most of the text appears to be slightly at an angle.  The letter clearly did not come from Dr. Gordon.

Of course, this a huge breach of trust and Dr. Gordon struggling to organize her thinking as she feels incredibly violated by Mr. Alderson.  Dr. Gordon calls you for a consultation.

What are the clinical issues involved in this situation?

What are the ethical issues involved in this scenario?

What are the ramifications about the therapeutic relationship?

How does Dr. Gordon respond or not respond to E Corp?

Are there any other legal issues that may be in play?

What course of action would you suggest to Dr. Gordon?

Saturday, February 3, 2018

Can We Reimagine Our Approach To Treating Disease?

Siddhartha Mukherjee
TED Talk
Posted December 22, 2017

When it comes to medicine, one rule of thinking has generally prevailed: Have disease, take pill, kill something. But physician Siddhartha Mukherjee says treatment should take a broader approach.


Friday, February 2, 2018

Has Technology Lost Society's Trust?

Mustafa Suleyman
The RSA.org
Originally published January 8, 2018

Has technology lost society's trust? Mustafa Suleyman, co-founder and Head of Applied AI at DeepMind, considers what tech companies have got wrong, how to fix it and how technology companies can change the world for the better. (7 minute video)


Confidential deals can obscure sexual misconduct allegations against doctors

Jayne O'Donnell
USA TODAY
Originally published January 5, 2018

Here are two excerpts:

Hospitals will often take over doctors' liability in confidential settlements, which Washington plaintiffs' attorney Patrick Malone calls a "frequent dodge" to keep medical negligence claims out of the National Practitioners Data Bank. Before they hire doctors, hospitals check the data bank, which also includes disciplinary actions by hospitals, medical societies and boards, which also have access to it.

Duncan's case, however, was a "miscellaneous tort claim," filed after Ohio's one-year statute of limitations for medical malpractice claims had passed.

That's just one of the many laws working in the favor of the Cleveland Clinic and the health care industry in Ohio. Plaintiff lawyer Michael Shroge, a former Cleveland Clinic associate general counsel, says major health care systems are "very often more interested in protecting their brand than protecting the health of patients."

(cut)

Critics of settlement deals' gag clauses say they compromise patients' health and safety and are unethical.

Confidential settlements are particularly problematic when it comes to health care, as "we take off our clothes in front of doctors," said Malone, who specializes in medical malpractice cases. "For a doctor to violate that in a sexual way is the ultimate wrong," he said, adding that he only agrees to confidential settlements if his client insists and only of the settlement amount.

The information is here.

Thursday, February 1, 2018

How to Counter the Circus of Pseudoscience

Lisa Pryor
The New York Times
Originally published January 5, 2018

Here are two excerpts:

In the face of such doubt, it is not surprising that some individuals, even those who are intelligent and well educated, are swept away by the breezy confidence of health gurus, who are full of passionate intensity while the qualified lack all conviction, to borrow from Yeats.

It is a cognitive bias known in psychology as the Dunning-Kruger Effect. In short, the less you know, the less able you are to recognize how little you know, so the less likely you are to recognize your errors and shortcomings. For the highly skilled, like trained scientists, the opposite is true: The more you know, the more likely you are to see how little you know. This is truly a cognitive bias for our time.

(cut)

Engaging is difficult when the alternative-health proponents are on such a different astral plane that it is a challenge even to find common language for a conversation, especially when they promote spurious concepts such as “pyrrole disease,” which they can speak about in great, false detail, drawing the well-informed physician, dietitian or scientist into a vortex of personal anecdote and ancient wisdom, with quips about big pharma thrown in for good measure.

The information is here.

Ethics for healthcare data is obsessed with risk – not public benefits

Tim Spector and Barbara Prainsack
The Conversation
Originally published January 5, 2018

Here is an excerpt:

Health researchers working with human participants – or their identifiable information – need to jump through lots of ethical and bureaucratic hoops. The underlying rationale is that health research poses particularly high risks to people, and that these risks need to be minimised. But does the same rationale apply to non-invasive research using digital health data? Setting aside physically invasive research, which absolutely should maintain the most stringent of safeguards, is data-based health research really riskier than other research that analyses people's information?

Many corporations can use data from their customers for a wide range of purposes without needing research ethics approval, because their users have already "agreed" to this (by ticking a box), or the activity itself isn't qualified as health research. But is the assumptions that it is less risky justified?

Facebook and Google hold voluminous and fine-grained datasets on people. They analyse pictures and text posted by users. But they also study behavioural information, such as whether or not users "like" something or support political causes. They do this to profile users and discern new patterns connecting previously unconnected traits and behaviours. These findings are used for marketing; but they also contribute to knowledge about human behaviour.

The information is here.