Your Brain Creates Your Emotions

Lisa Feldman Barrett
TED Talk
Published December 2017

Can you look at someone's face and know what they're feeling? Does everyone experience happiness, sadness and anxiety the same way? What are emotions anyway? For the past 25 years, psychology professor Lisa Feldman Barrett has mapped facial expressions, scanned brains and analyzed hundreds of physiology studies to understand what emotions really are. She shares the results of her exhaustive research -- and explains how we may have more control over our emotions than we think.

Lessons in End-of-Life Care From the V.A.

By David Casarett
The New York Times
November 11, 2015

Here are two excerpts:

Sheila had just received a “patient experience” survey that asked for her opinions about her recent stay in one of our hospitals. He read off some of the questions, in a voice that was tinged with a mix of anger and amusement. Those questions were about the quality of the food (“unimpressive”), the availability of parking (“O.K.”), and the cleanliness of the rooms (“perfect”).

But, he said, “You didn’t ask us about what really matters.”

What he meant, he explained, was that these questions didn’t reflect what was important to a 73-year-old woman with incurable breast cancer who knows she’s going to die in the next six months. And they didn’t assess how well we were supporting her husband, who was overwhelmed with being a caregiver and advocate, a father and grandfather. We asked for their opinions, but we didn’t ask the right questions.

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We need to be asking these questions. National surveys could easily be modified to include questions that are important to patients like Sheila. We could include questions about emotional and spiritual support, control over decisions, adequacy of information and respect for dignity. Those sorts of questions are arguably important for all of us, but they’re particularly relevant to those who are facing advanced, incurable illnesses.

The entire article is here.

Treatment-resistant depression and physician-assisted death

By Franklin G Miller
J Med Ethics doi:10.1136/medethics-2015-103060

Abstract

In a recent article, Udo Schuklenk and Suzanne van de Vathorst argued in favour of a legal option of physician-assisted death for patients with ‘treatment-resistant’ depression. In this commentary, I contend that their argument neglects the important consideration of the professional integrity of physicians. In light of this consideration, coupled with uncertainty about whether additional interventions with the patient can improve quality of life and restore the will to live, it is not appropriate to include patients with ‘treatment-resistant’ depression within a legal option of physician-assisted death.

The entire article is here.

Healing a Wounded Sense of Morality

Many veterans are suffering from a condition similar to, but distinct from, PTSD: moral injury, in which the ethical transgressions of war can leave service members traumatized.

By Maggie Puniewska
The Atlantic
Originally published July 3, 2015

Here are two excerpts:

Identifying moral injury can be tricky for two reasons: First, it’s easily mistaken for PTSD, which shares many of the same symptoms. And second, because veterans may feel too ashamed to talk about their moral infractions, therapists might not even know to look for the signs of moral injury at all, says Joseph Currier, an assistant professor of psychology at the University of South Alabama. To help therapists better understand how to diagnose the condition, he and several colleagues have developed a 20-item questionnaire that screens patients for moral injury, asking patients to rate their agreement with statements like “I did things in war that betrayed my personal values” and “I made mistakes in the war zone that led to injury and death.”

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But healing isn’t just confined to the individual. Emotions that guide morality, Currier explains, are rooted in social relationships:  “The function of guilt is to reconcile a potentially damaged social bond, whereas with shame, the reaction is to withdraw so the social group can preserve its identity,” he says.   For many veterans, therefore, recovery from moral injury depends in part on the civilian communities to which they return. “A part of feeling betrayed or distrusted or guilty by the practices of war is feeling alienated. It’s feeling like you can’t share your experiences because people will judge you or won’t understand,” Sherman says.

The entire article is here.

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

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

Here is an excerpt:

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

The entire article is here.

The article in the Journal of Medical Ethics is here.