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 Ethical Codes. Show all posts
Showing posts with label Ethical Codes. Show all posts

Thursday, January 5, 2023

The Supreme Court Needs Real Oversight

Glen Fine
The Atlantic
Originally posted 5 DEC 22

Here is an excerpt:

The lack of ethical rules that bind the Court is the first problem—and the easier one to address. The Code of Conduct for United States Judges, promulgated by the federal courts’ Judicial Conference, “prescribes ethical norms for federal judges as a means to preserve the actual and apparent integrity of the federal judiciary.” The code covers judicial conduct both on and off the bench, including requirements that judges act at all times to promote public confidence in the integrity and impartiality of the judiciary. But this code applies only to lower-level federal judges, not to the Supreme Court, which has not issued ethical rules that apply to its own conduct. The Court should explicitly adopt this code or a modified one.

Chief Justice Roberts has noted that Supreme Court justices voluntarily consult the Code of Conduct and other ethical rules for guidance. He has also pointed out that the justices can seek ethical advice from a variety of sources, including the Court’s Legal Office, the Judicial Conference’s Committee on Codes of Conduct, and their colleagues. But this is voluntary, and each justice decides independently whether and how ethical rules apply in any particular case. No one—including the chief justice—has the ability to alter a justice’s self-judgment.

Oversight of the judiciary is a more difficult issue, involving separation-of-powers concerns. I was the inspector general of the Department of Justice for 11 years and the acting inspector general of the Department of Defense for four years; I saw the importance and challenges of oversight in two of the most important government agencies. I also experienced the difficulties in conducting complex investigations of alleged misconduct, including leak investigations. But as I wrote in a Brookings Institution article this past May after the Dobbs leak, the Supreme Court does not have the internal capacity to effectively investigate such leaks, and it would benefit from a skilled internal investigator, like an inspector general, to help oversee the Court and the judiciary.

Another example of the Court’s ineffective self-policing and lack of transparency involves its recusal decisions. For example, Justice Thomas’s wife, Virginia Thomas, has argued that the 2020 presidential election was stolen, sent text messages to former White House Chief of Staff Mark Meadows urging him and the White House to seek to overturn the election, and expressed support for the pro-Trump January 6 rally on the Ellipse. Nevertheless, Justice Thomas has not recused himself in cases relating to the subsequent attack on the Capitol.

Notably, Thomas was the only justice to dissent from the Court’s decision not to block the release to the January 6 committee of White House records related to the attack, which included his wife’s texts. Some legal experts have argued that this is a clear instance where recusal should have occurred. Statute 28 U.S.C. 455 requires federal judges, including Supreme Court justices, to recuse themselves from a case when they know that their spouse has any interest that could be substantially affected by the outcome. In addition, the statute requires justices and judges to disqualify themselves in any proceeding in which their impartiality may reasonably be questioned.

Saturday, March 12, 2022

The Moral Injury of COVID: How Will Nurses Survive?

Diane M. Goodman
MedScape.com
Originally posted 11 FEB 22

Here are some excerpts:

According to recent statistics, 1 in 5 nurses have retired from active duty since the pandemic began. Far from feeling like heroes, nurses now feel exhausted, demoralized, underappreciated, and severely overworked. They are broken in ways that cannot be repaired.

Recently, an intensive care unit nurse abandoned his shift in the middle of the night and walked off into the unknown only to be found deceased 2 days later. What happened to this caregiver? Was his distress so severe he could not communicate pain? One can only wonder.

Nurses across the country are suffering from moral injury.

(cut)

This is what nurses feel prepared to do, but it violates their moral code.

Nurses may be unfamiliar with the process of rationing care, but the pandemic has changed that perspective. Nurses are now dealing with a form of rationing that leaves them miserable, in tears, and in persistent distress.

Providing care for 10 patients as opposed to a maximum of five forces nurses to make appalling decisions. Which patient needs my attention now? Will another patient die while I am in this room? How can I choose without suffering lasting trauma from my decisions?

Nurses have repeatedly been placed in impossible situations throughout the pandemic.

Remember the early days of PPE shortages? Nurses went without appropriate attire to protect their peers, at times with fatal results. 

(cut)

The profession prides itself on delivering the highest quality care it can. But when was the last time nurses felt that they were meeting this standard? How can they? They are working in a system where their own needs are minimized to meet the demands of an ongoing COVID patient population.

Moral injury, which can lead to moral trauma if unresolved, is different from burnout. 

Moral injury affects our sense of right and wrong. Moral injury is different because it represents a situation of witnessing care or offering care that conflicts with our internal compass. It is witnessing patients die without loved ones, repeatedly, or instituting a crisis standard of care that feels endless, although no earthquake, tornado, or bus accident has occurred. It is a feeling of running behind without the possibility of ever getting a break.

Moral injury is lasting distress that leads to feelings such as guilt, anger, and shame. There are true psychological implications for this type of angst. 

Monday, August 5, 2019

Ethical considerations in assessment and behavioral treatment of obesity: Issues and practice implications for clinical health psychologists

Williamson, T. M., Rash, J. A., Campbell, T. S., & Mothersill, K. (2019).
Professional Psychology: Research and Practice. Advance online publication.
http://dx.doi.org/10.1037/pro0000249

Abstract

The obesity epidemic in the United States and Canada has been accompanied by an increased demand on behavioral health specialists to provide comprehensive behavior therapy for weight loss (BTWL) to individuals with obesity. Clinical health psychologists are optimally positioned to deliver BTWL because of their advanced competencies in multimodal assessment, training in evidence-based methods of behavior change, and proficiencies in interdisciplinary collaboration. Although published guidelines provide recommendations for optimal design and delivery of BTWL (e.g., behavior modification, cognitive restructuring, and mindfulness practice; group-based vs. individual therapy), guidelines on ethical issues that may arise during assessment and treatment remain conspicuously absent. This article reviews clinical practice guidelines, ethical codes (i.e., the Canadian Code of Ethics for Psychologists and the American Psychological Association Ethical Principles of Psychologists), and the extant literature to highlight obesity-specific ethical considerations for psychologists who provide assessment and BTWL in health care settings. Five key themes emerge from the literature: (a) informed consent (instilling realistic treatment expectations; reasonable alternatives to BTWL; privacy and confidentiality); (b) assessment (using a biopsychosocial approach; selecting psychological tests); (c) competence and scope of practice (self-assessment; collaborative care); (d) recognition of personal bias and discrimination (self-examination, diversity); and (e) maximizing treatment benefit while minimizing harm. Practical recommendations grounded in the American Psychological Association’s competency training model for clinical health psychologists are discussed to assist practitioners in addressing and mitigating ethical issues in practice.

Thursday, July 19, 2018

Ethics Policies Don't Build Ethical Cultures

Dori Meinert
www.shrm.org
Originally posted June 19, 2018

Here is an excerpt:

Most people think they would never voluntarily commit an unethical or illegal act. But when Gallagher asked how many people in the audience had ever received a speeding ticket, numerous hands were raised. Similarly, employees rationalize their misuse of company supplies all the time, such as shopping online on their company-issued computer during work hours.

"It's easy to make unethical choices when they are socially acceptable," he said.

But those seemingly small choices can start people down a slippery slope.

Be on the Lookout for Triggers

No one plans to destroy their career by breaking the law or violating their company's ethics policy. There are usually personal stressors that push them over the edge, triggering a "fight or flight" response. At that point, they're not thinking rationally, Gallagher said.

Financial problems, relationship problems or health issues are the most common emotional stressors, he said.

"If you're going to be an ethical leader, are you paying attention to your employees' emotional triggers?"

The information is here.

Monday, July 9, 2018

Technology and culture: Differences between the APA and ACA ethical codes

Firmin, M.W., DeWitt, K., Shell, A.L. et al.
Curr Psychol (2018). https://doi.org/10.1007/s12144-018-9874-y

Abstract

We conducted a section-by-section and line-by-line comparison of the ethical codes published by the American Psychological Association (APA) and the American Counseling Association (ACA). Overall, 144 differences exist between the two codes and, here we focus on two constructs where 36 significant differences exist: technology and culture. Of this number, three differences were direct conflicts between the APA and ACA ethical codes’ expectations for technology and cultural behavior. The other 33 differences were omissions in the APA code, meaning that specific elements in the ACA code were explicitly absent from the APA code altogether. Of the 36 total differences pertaining to technology and culture in the two codes, 27 differences relate to technology and APA does not address 25 of these 27 technology differences. Of the 36 total differences pertaining to technology and culture, nine differences relate to culture and APA does not address eight of these issues.

The information is here.

Thursday, October 26, 2017

DeepMind launches new research team to investigate AI ethics

James Vincent
The Verge
Originally posted October 4, 2017

Google’s AI subsidiary DeepMind is getting serious about ethics. The UK-based company, which Google bought in 2014, today announced the formation of a new research group dedicated to the thorniest issues in artificial intelligence. These include the problems of managing AI bias; the coming economic impact of automation; and the need to ensure that any intelligent systems we develop share our ethical and moral values.

DeepMind Ethics & Society (or DMES, as the new team has been christened) will publish research on these topics and others starting early 2018. The group has eight full-time staffers at the moment, but DeepMind wants to grow this to around 25 in a year’s time. The team has six unpaid external “fellows” (including Oxford philosopher Nick Bostrom, who literally wrote the book on AI existential risk) and will partner with academic groups conducting similar research, including The AI Now Institute at NYU, and the Leverhulme Centre for the Future of Intelligence.

The article is here.

Sunday, August 13, 2017

Ethical and legal considerations in psychobiography

Jason D Reynolds and Taewon Choi
American Psychologist 2017 Jul-Aug;72(5):446-458

Abstract

Despite psychobiography's long-standing history in the field of psychology, there has been relatively little discussion of ethical issues and guidelines in psychobiographical research. The Ethics Code of the American Psychological Association (APA) does not address psychobiography. The present article highlights the value of psychobiography to psychology, reviews the history and current status of psychobiography in the field, examines the relevance of existing APA General Principles and Ethical Standards to psychobiographical research, and introduces a best practice ethical decision-making model to assist psychologists working in psychobiography. Given the potential impact of psychologists' evaluative judgments on other professionals and the lay public, it is emphasized that psychologists and other mental health professionals have a high standard of ethical vigilance in conducting and reporting psychobiography.

The article is here.