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

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Cost Benefit Analysis. Show all posts
Showing posts with label Cost Benefit Analysis. Show all posts

Saturday, January 15, 2022

What Dilemma? Moral Evaluation Shapes Factual Belief

B. Lui, & P. Ditto
Social Psychological and Personality Science. 2013;4(3):316-323. doi:10.1177/1948550612456045

Abstract

Moral dilemmas—like the “trolley problem” or real-world examples like capital punishment—result from a conflict between consequentialist and deontological intuitions (i.e., whether ends justify means). The authors contend that people often resolve such moral conflict by aligning factual beliefs about consequences of acts with evaluations of the act’s inherent morality (i.e., morality independent of its consequences). In both artificial (Study 1) and real-world (Study 2) dilemmas, the more an act was deemed inherently immoral, the more it was seen as unlikely to produce beneficial consequences and likely to involve harmful costs. Coherence between moral evaluations and factual beliefs increased with greater moral conviction, self-proclaimed topical knowledge, and political conservatism (Study 2). Reading essays about the inherent morality or immorality of capital punishment (Study 3) changed beliefs about its costs and benefits, even though no information about consequences was supplied. Implications for moral reasoning and political conflict are discussed.

From the General Discussion

While individuals can and do appeal to principle in some cases to support their moral positions, we argue that this is a difficult stance psychologically because it conflicts with well-rehearsed economic intuitions urging that the most rational course of action is the one that produces the most favorable cost–benefit ratio. Our research suggests that people resolve such dilemmas by bringing cost–benefit beliefs into line with moral evaluations, such that the right course of action morally becomes the right course of action practically as well.Study 3 provides experimental confirmation of a pattern implied by both our own and others’ correlational research(e.g., Kahan, 2010): People shape their descriptive understand-ing of the world to fit their prescriptive understanding of it.

Saturday, October 21, 2017

Thinking about the social cost of technology

Natasha Lomas
Tech Crunch
Originally posted September 30, 2017

Here is an excerpt:

Meanwhile, ‘users’ like my mum are left with another cryptic puzzle of unfamiliar pieces to try to slot back together and — they hope — return the tool to the state of utility it was in before everything changed on them again.

These people will increasingly feel left behind and unplugged from a society where technology is playing an ever greater day-to-day role, and also playing an ever greater, yet largely unseen role in shaping day to day society by controlling so many things we see and do. AI is the silent decision maker that really scales.

The frustration and stress caused by complex technologies that can seem unknowable — not to mention the time and mindshare that gets wasted trying to make systems work as people want them to work — doesn’t tend to get talked about in the slick presentations of tech firms with their laser pointers fixed on the future and their intent locked on winning the game of the next big thing.

All too often the fact that human lives are increasingly enmeshed with and dependent on ever more complex, and ever more inscrutable, technologies is considered a good thing. Negatives don’t generally get dwelled on. And for the most part people are expected to move along, or be moved along by the tech.

That’s the price of progress, goes the short sharp shrug. Users are expected to use the tool — and take responsibility for not being confused by the tool.

But what if the user can’t properly use the system because they don’t know how to? Are they at fault? Or is it the designers failing to properly articulate what they’ve built and pushed out at such scale? And failing to layer complexity in a way that does not alienate and exclude?

And what happens when the tool becomes so all consuming of people’s attention and so capable of pushing individual buttons it becomes a mainstream source of public opinion? And does so without showing its workings. Without making it clear it’s actually presenting a filtered, algorithmically controlled view.

There’s no newspaper style masthead or TV news captions to signify the existence of Facebook’s algorithmic editors. But increasingly people are tuning in to social media to consume news.

This signifies a major, major shift.

The article is here.

Friday, September 18, 2015

Are Arguments about GMO Safety Really About Something Else?

By Gregory E. Kaebnick
The Hastings Center Blog
Originally published August 28, 2015

Here is an excerpt:

Saletan is trying to examine the impact of GMOs in more or less this objective way. Perhaps, however, the fiercer, dyed-in-the-wool opponents of GMOs are looking beyond health and safety, strictly construed in terms of quantifiable aspects of human well-being, to something else. One possibility is that they are indeed focused on health and safety but are put off by something about the particular form of the threat. Moral psychologists such as Paul Slovic and Daniel Kahneman have noted that the perception of a risk’s severity does not cleanly track the quantifiable outcomes. Different ways of dying may be perceived as better or worse, even though death is the measurable outcome in both cases. After September 11, 2001, air travel dropped significantly and many people who might have been expected to fly in planes, and safely reach their destinations, went by car instead and died in automobile accidents. Viewed strictly in terms of the quantifiable risk of death, the decision to go by car looks silly. But maybe, the risk assessor (and scholarly critic of risk assessment) Adam Finkel has proposed, what put people off flying was not the risk of death alone but the prospect of “death preceded by agonizing minutes of chaos and the awful opportunity of being able to contact loved ones before the grisly culmination of another’s suicide mission.”

The entire article is here.

Wednesday, September 9, 2015

Can generosity go too far?

By Julian Baggini
The New Statesman
Originally published on August 21, 2015

Here is an excerpt:

We have heard so many stories of misguided projects and misspent money over the years that surely the time has come to demand evidence that the charities we ­support are effective. But how do you measure whether a charity is effective? One answer would be to apply two tests: does it achieve its stated goal and does it do so as cost-efficiently as it can? A charity such as Guide Dogs might pass this test. But for effective altruists, in deciding whether to give to Guide Dogs, you ought to ask another question: could you get more altruistic bang for your buck by giving to something completely different instead?

They say you can. Guide Dogs UK says it costs £32,400 to train a guide dog and its owner and then another £12,800 “to support the working partnership”. In contrast, Singer says you can save someone from going blind in the developing world for between $20 and $100. “If you do the maths,” he writes, “you will see that the choice we face is to provide one person with a guide dog or prevent anywhere between 400 and 2,000 cases of blindness.”

The entire article is here.

Sunday, November 30, 2014

Brain stimulation for ‘enhancement’ in children: An ethical analysis

By Hannah Maslen, Brian D Earp, Roi Cohen-Kadosh and Julian Savulescu
Frontiers in Human Neuroscience
Revised on November 6, 2014

Abstract

Davis (2014) called for "extreme caution" in the use of non-invasive brain stimulation (NIBS) to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child's future options. The distinction between treatment and enhancement has some normative force here. As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests (as judged by the parents) diminish, and the need to protect the child's (future) autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are (themselves) justified on a best interests standard.

The entire article is here.

Saturday, November 29, 2014

Is parenthood morally respectable?

By Thomas Rodham Wells
The Philosopher's Beard
Originally published November 5, 2014

Parents' private choices to procreate impose public costs without public accountability. Society is presented with expensive obligations to ensure every child a decent quality of life and their development into successful adults and citizens, and that means massive tax-subsidies for their health, education, parental income, and so forth. In addition, children have a demographic impact on public goods like the environment which creates additional costs for society and perhaps humanity as a whole.

So, is parenthood an irresponsible and selfish lifestyle choice?

The entire article is here.

Thursday, August 14, 2014

Bostrom on Superintelligence

By John Danaher
Philosophical Disquisitions
Originally published July 27, 2014

Nick Bostrom’s magnum opus on the topic of AI risk — Superintelligence: Paths, Dangers and Strategies — was recently published by Oxford University Press. The book is a comprehensive overview and analysis of the risks arising from an intelligence explosion. As you may know, some people are concerned that the creation of superintelligent machines will precipitate an existential catastrophe for the human race. For better or worse, the debate about this issue has largely taken place online, via various internet fora. Now, while I’m certainly not one to disparage such fora — this blog, after all, would count as one — I have to admit that Bostrom’s book is something of a relief. At last, we have a detailed, reasonably sober, academic analysis of the issue, one that is clearly the product of many years of research, reflection and discussion.

The rest of the review and content analysis is here.

Monday, May 5, 2014

Cost of Treatment May Influence Doctors

By Andrew Pollack
The New York Times
Originally published April 17, 2014

Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.

The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.

The entire article is here.

Tuesday, August 20, 2013

The Woman Who Ate Cutlery

By CHRISTINE MONTROSS
The New York Times - Opinion
Published: August 3, 2013

Here are some excerpts:

The costs of M’s repeated hospitalizations are staggering. Her ingestions and insertions incur the already high costs of hospital admission and the medical procedures and surgeries she requires. In addition, once M is hospitalized as a psychiatric patient, a staff member must stay with her at all times to make sure she doesn’t ingest utensils from her meal trays, insert tools from group craft activities into her body or drink Purell from the dispensers on the unit walls.

(cut)

In one of the ironies in a country with health care discrepancies, a single hospital admission for M — paid for by the taxpayer-financed state medical-assistance program — costs more than a year of private outpatient care would.

The entire article is here.

Thanks to Tom Fink for the story.

Monday, June 17, 2013

Treatment of Mental Illness Lowers Arrest Rates, Saves Money

Science Daily
Originally published June 10, 2013

Research from North Carolina State University, the Research Triangle Institute (RTI) and the University of South Florida shows that outpatient treatment of mental illness significantly reduces arrest rates for people with mental health problems and saves taxpayers money.

"This study shows that providing mental health care is not only in the best interest of people with mental illness, but in the best interests of society," says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and co-author of a paper describing the research.

The researchers wanted to determine the extent to which treating mental illness can keep people with mental health problems out of trouble with the law. It is well established that people with mental health problems, such as schizophrenia or bipolar disorder, make up a disproportionate percentage of defendants, inmates and others who come into contact with the criminal justice system.

The entire story is here.

Tuesday, October 2, 2012

Is A Competitive Health Care Model All It’s Cracked Up To Be?

By Julie Appleby and Marilyn Werber Serafini
Kaiser Health News, in conjunction with The Atlantic
Originally published on September 20, 2012


Republican vice presidential nominee Paul Ryan says his proposal to overhaul Medicare would use market competition to tame costs in the government health program relied on by almost 50 million people.

As models, he often cites the health program for federal employees – including members of Congress -- and Medicare’s prescription drug program. "It works with federal employees, it works with the prescription drug benefit, and more to the point, it saves Medicare," Ryan said on "Meet the Press" in April.

Both of those programs get high marks from beneficiaries for the choices they offer. But their track record on cost control is more complicated, raising questions about whether the competitive model is in fact the silver bullet that backers have suggested. 

The federal employee health insurance program is often touted as holding down the increase in premium prices more successfully than private workplace plans or government-run programs. But a data analysis done for Kaiser Health News (KHN) and interviews with experts shows it has not held down costs per enrollee as efficiently as Medicare during the past decade.

Average spending in the federal workers’ program grew at 7.1 percent annually per enrollee, higher than the 5.8 percent growth rate for traditional Medicare – excluding the drug program -- over the decade ending in 2010, according to data analyzed at KHN’s request.  The analysis, based on 10-year averages, was done by Walton Francis, a consultant and principal author for 30 years of the Consumers’ Checkbook Guide to Health Plans for Federal Employees.

Sunday, October 9, 2011

Mental-health cuts: Experts fear long-term costs

By Mary Reinhart
The Arizona Republic
azcentral.com

Arizona taxpayers are providing fewer services to fewer people with serious mental illnesses than they were last year, for annual savings of roughly $50 million.

But the short-term savings from state budget cuts threaten to have long-term consequences for patients, providers and the community, mental-health experts say.

The budget reductions eliminated services for about 12,000 Arizonans who don't qualify for Medicaid, removing the foundation of a system intended to keep the seriously mentally ill healthy and out of emergency rooms, hospitals, jails and prisons.

State lawmakers instead provided money for generic medication and additional funding to beef up a statewide crisis-response system to help prevent people from falling through the cracks. But in the 15 months since this population lost case management, brand-name prescription drugs, therapy, transportation and other benefits, more than 2,000 people have stopped receiving any state-funded services and are unaccounted for.

Local and county jails, emergency responders and hospitals often shoulder the costs when people with untreated serious mental illness, such as schizophrenia and bipolar disorder, fall into crisis.

The precise financial costs to those entities are unknown, but health professionals do know that it's far more expensive to treat people who have spiraled into crisis than to keep them stable. And once in crisis, health professionals say, it's more difficult for people to rebound, which means those higher costs continue to recur.

"It's a penny-wise and pound-foolish approach," said Bill Kennard, former executive director of the National Alliance on Mental Illness' office in Phoenix. "More people in jail and prison with mental illness, more time that law enforcement spends dealing with a health issue as opposed to a public-safety issue."

The costs

The state has not conducted an analysis that compares ongoing treatment with crisis costs.

But a March 2011 study that examined proposed mental-health cuts in Texas put the average daily cost of services at $12 for adults, compared with $401 a day in the state's mental hospital, $137 a day for a jail inmate with mental illness and $986 for an emergency-room visit.

The study, by Health Management Associates for the Texas Conference of Urban Counties, also showed that gaps in services put those discharged from psychiatric hospitals and jail at greater risk of relapse, readmission and recidivism.

Janey Durham, who is in charge of a workshop program at Mesa's Marc Center, said she lost 120 people to the budget cuts, including a man diagnosed with schizophrenia who deteriorated almost before her eyes. The non-profit agency center provides job training and other services to the mentally ill and developmentally disabled.

Durham said the man, a former alcoholic in his 50s, worked hard at his job in the manufacturing warehouse, at maintaining his sobriety and in treating his mental illness. But soon after the budget cuts forced him to switch to a generic medication, Durham said, he stopped taking his medication, started drinking again and grew increasingly paranoid, plagued by voices in his head.

Over the past year his erratic, disruptive behavior led Marc Center employees to call Mesa police at least once. He is believed to be homeless, she said, but contact with him has been sporadic since last winter.

Read the entire story here.