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 Legislation. Show all posts
Showing posts with label Legislation. Show all posts

Tuesday, January 16, 2024

Criminal Justice Reform Is Health Care Reform

Haber LA, Boudin C, Williams BA.
JAMA.
Published online December 14, 2023.

Here is an excerpt:

Health Care While Incarcerated

Federal law mandates provision of health care for incarcerated persons. In 1976, the US Supreme Court ruled in Estelle v Gamble that “deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain,’” prohibited under the Eighth Amendment. Subsequent cases established that incarcerated individuals must receive access to medical care, enactment of ordered care, and treatment without bias to their incarcerated status.

Such court decisions establish rights and responsibilities, but do not fund or oversee health care delivery. Community health care oversight, such as the Joint Commission, does not apply to prison health care. When access to quality care is inadequate, incarcerated patients must resort to lawsuits to advocate for change—a right curtailed by the Prison Litigation Reform Act of 1996, which limited prisoners’ ability to file suit in federal court.

Despite Eighth Amendment guarantees, simply entering the criminal-legal system carries profound personal health risks: violent living conditions result in traumatic injuries, housing in congregate settings predisposes to the spread of infectious diseases, and exceptions to physical comfort, health privacy, and informed decision-making occur during medical care delivery. These factors compound existing health disparities commonly found in the incarcerated population.

The First Step Act

Signed under then-president Trump, the First Step Act of 2018 (FSA) was a bipartisan criminal justice reform bill designed to reduce the federal prison population while also protecting public safety. The legislation aimed to decrease entry into prison, provide rehabilitation during incarceration, improve protections for medically vulnerable individuals, and expedite release.

To achieve these goals, the FSA included prospective and retroactive sentencing reforms, most notably expanded relief from mandatory minimum sentences for drug distribution offenses that disproportionately affect Black individuals in the US. The FSA additionally called for the use of evidence-based tools, such as the Prisoner Assessment Tool Targeting Estimated Risk and Needs, to facilitate release decisions.

The legislation also addressed medical scenarios commonly encountered by professionals providing care to incarcerated persons, including prohibitions on shackling pregnant patients, deescalation training for correctional officers when encountering people with psychiatric illness or cognitive deficits, easing access to compassionate release for those with advanced age or life-limiting illness, and mandatory reporting on the use of medication-assisted treatment for opioid use disorder. With opioid overdose being the leading cause of postrelease mortality, the latter requirement has been particularly important for those transitioning out of correctional settings.

During the recent COVID-19 pandemic, FSA amendments expanding incarcerated individuals’ access to the courts led to a marked increase in successful petitions for early release from prison. Decarcerating those individuals most medically at risk during the public health crisis reduced the spread of viral illness associated with prison overcrowding, protecting both incarcerated individuals and those working in carceral settings.

Monday, December 30, 2019

Privacy: Where Security and Ethics Miss the Mark

privacyJason Paul Kazarian
securityboulevard.com
Originally posted 29 Nov 19

Here is an excerpt:

Without question, we as a society have changed course. The unfettered internet has had its day. Going forward, more and more private companies will be subject to increasingly demanding privacy legislation.

Is this a bad thing? Something nefarious? Probably not. Just as we have always expected privacy in our physical lives, we now expect privacy in our digital lives as well. And businesses are adjusting toward our expectations.

One visible adjustment is more disclosure about exactly what private data a business collects and why. Privacy policies are easier to understand, as well as more comprehensive. Most websites warn visitors about the storage of private data in “cookies.” Many sites additionally grant visitors the ability to turn off such cookies except those technically necessary for the site’s operation.

Another visible adjustment is the widespread use of multi-factor authentication. Many sites, especially those involving credit, finance or shopping, validate login with a token sent by email, text or voice. These sites then verify the authorized user is logging in, which helps avoid leaking private data.

Perhaps the biggest adjustment is not visible: encryption of private data. More businesses now operate on otherwise meaningless cipher substitutes (the output of an encryption function) in place of sensitive data such as customer account numbers, birth dates, email or street addresses, member names and so on. This protects customers from breaches where private data is exploited via an all-too-common breach.

The info is here.

Wednesday, February 20, 2019

Why Won’t John Roberts Accept an Ethics Code for Supreme Court Justices?

Steven Lubet
Slate.com
Originally posted January 16, 2019

Here is an excerpt:

Chief Justice John Roberts addressed the anomaly of the missing ethics code in his 2011 Year-End Report on the Federal Judiciary, acknowledging that the lower courts’ code is a good “starting point” for ethics inquiries. Nonetheless, he asserted that there is “no reason” to adopt a SCOTUS code because members of his court consult a wide variety of other sources for guidance. In addition, Roberts noted that current iterations of the judicial code do “not adequately answer some of the ethical considerations unique to the Supreme Court,” and that “no compilation of ethical rules can guarantee integrity.”

The chief justice’s observations are all reasonable, but they do not begin to justify the absence of a Supreme Court code. Nearly all of his explanations apply with equal force to every other court in the U.S., and yet those courts have, without exception, adopted written codes. It is true, of course, that no “compilation” of rules can guarantee compliance, but the same could be said for all other codes, ranging from the Bill of Rights to the Ten Commandments. He is right that existing judicial codes do not address issues “unique to the Supreme Court,” but that is why the proposed legislation allows “provisions that are applicable only” to SCOTUS justices.

The info is here.

Tuesday, July 10, 2018

The Artificial Intelligence Ethics Committee

Zara Stone
Forbes.com
Originally published June 11, 2018

Here is an excerpt:

Back to the ethics problem: Some sort of bias is sadly inevitable in programming. “We humans all have a bias,” said computer scientist Ehsan Hoque, who leads the Human-Computer Interaction Lab at Rochester University. “There’s a study where judges make more favorable decisions after a lunch break. Machines have an inherent bias (as they are built by humans) so we need to empower users in ways to make decisions.”

For instance, Walworth's way of empowering his choices is by being conscious about what AI algorithms show him. “I recommend you do things that are counterintuitive,” he said. “For instance, read a spectrum of news, everything from Fox to CNN and The New York Times to combat the algorithm that decides what you see.” Use the Cambridge Analytica election scandal as an example here. Algorithms dictated what you’d see, how you’d see it and if more of the same got shown to you, and were manipulated by Cambridge Analytica to sway voters.

The move to a consciousness of ethical AI  is both a top-down and bottoms up approach. “There’s a rising field of impact investing,” explained Walworth. “Investors and shareholders are demanding something higher than the bottom line, some accountability with the way they spend and invest money.”

The article is here.

Monday, July 17, 2017

The ethics of brain implants and ‘brainjacking’

Chelsey Ballarte
Geek Wire
Originally published June 29, 2017

Here is an excerpt:

Fetz and the report’s other authors say we should regard advancements in machine learning and artificial intelligence with the same measure of caution we use when we consider accountability for self-driving cars and privacy for smartphones.

Fetz recalled the time security researchers proved they could hack into a Jeep Cherokee over the internet and disable it as it drove on the freeway. He said that in the world of prosthetics, a hacker could conceivably take over someone’s arm.

“The hack could override the signals,” he said. It could even override a veto, and that’s the danger. The strategy to head off that scenario would have to be to make sure the system can’t be influenced from the outside.

Study co-author John Donoghue, a director of the Wyss Center for Bio and Neuroengineering in Geneva, said these are just a few things we would have to think about if these mechanisms became the norm.

“We must carefully consider the consequences of living alongside semi-intelligent, brain-controlled machines, and we should be ready with mechanisms to ensure their safe and ethical use,” he said in a news release.

Donoghue said that as technology advances, we need to be ready to think about how our current laws would apply. “Our aim is to ensure that appropriate legislation keeps pace with this rapidly progressing field,” he said.

The article is here.

Tuesday, March 21, 2017

Why can 12-year-olds still get married in the United States?

Fraidy Reiss
The Washington Post
Originally published February 10, 2017

Here is an excerpt:

Unchained At Last, a nonprofit I founded to help women resist or escape forced marriage in the United States, spent the past year collecting marriage license data from 2000 to 2010, the most recent year for which most states were able to provide information. We learned that in 38 states, more than 167,000 children — almost all of them girls, some as young 12 — were married during that period, mostly to men 18 or older. Twelve states and the District of Columbia were unable to provide information on how many children had married there in that decade. Based on the correlation we identified between state population and child marriage, we estimated that the total number of children wed in America between 2000 and 2010 was nearly 248,000.

Despite these alarming numbers, and despite the documented consequences of early marriages, including negative effects on health and education and an increased likelihood of domestic violence, some state lawmakers have resisted passing legislation to end child marriage — because they wrongly fear that such measures might unlawfully stifle religious freedom or because they cling to the notion that marriage is the best solution for a teen pregnancy.

The article is here.

Monday, January 2, 2017

Senator Johnson wants to re-think Tennessee's counselor ethics

by Emily West
Nolensville Home Page
Originally posted December 6, 2016

Here is an excerpt:

“I don’t think it’s appropriate that we delegate that responsibility to a special interest group from Washington,” Johnson said. “There are other organizations that represent them. I think it’s worth having our own conversation … Tennesseans are best suited to determine what our state licensure requirements for our professional counselors should be rather than subrogating that right to a private organization.

“I believe our State Board of Professional Counselors is capable of this responsibility and that all Tennesseans seeking counseling will benefit as a result.”

Having the conversation could come come at a price, at least from the American Counseling Association’s perspective.

Right now, the ACA sees the potential for this type of legislation to become dangerous.

“I think what you do is run the risk of a couple of things,” ACA’s‎ Director of Government Affairs Art Terrazas said. “The insurance companies – who underwrite the liability – are going to take a second look if they want to insure the counselor outside of the code of ethics. There could be an impact if they stay or remained employed in the state of Tennessee.

“If they are meeting the industry standard, they may not want to practice there. Those who need to seek mental health clinicians could find there will be less of them. We are talking about folks suffering from depression, to those under 18, military families and also our veterans.”

The article is here.

Wednesday, March 23, 2016

Colorado Looks to Broaden Therapists' Power to Prevent School Shootings

by Dan Frosch
The Wall Street Journal
Originally published March 6, 2016

In a state that has been battered by mass shootings, Colorado lawmakers are trying a new, focused approach to stopping bloodshed in schools.

A proposed bill would broaden the circumstances under which mental-health professionals can report a student that they believe poses a threat, an issue that has drawn increasing attention around the country

Colorado law requires mental-health workers to alert authorities if a patient expresses a specific, imminent threat, and mandates that they warn those being threatened.

The proposal would permit therapists to alert school administrators about a potentially dangerous student even if that danger isn't immediate. It would apply to all public and private schools, as well as institutes of postsecondary education. Counselors who are school district employees are already permitted such latitude under federal law, but many schools contract with outside mental health workers to treat students, and some students are in private therapy as well, experts said.

The bill, which has bipartisan support, sailed through Colorado's House of Representatives last month by a vote of 51-12. It now heads to the Senate, where it is expected to have the backing of members of both parties.

The article is here.

Wednesday, March 16, 2016

Bill would allow therapists to refuse clients over religious beliefs

Holly Meyer
The Tennessean
Originally published March 2, 2016

A bill that would allow counselors and therapists to refuse to see clients whose cases violate their religious beliefs has taken a step forward in the Tennessee state House.

The bill, sponsored by Rep. Dan Howell, R-Georgetown, would let counselors and therapists refer clients without risking repercussions, such as a civil lawsuit or criminal action. The state House Health Subcommittee advanced the legislation Tuesday to the full committee.

The subcommittee recommended passage of the legislation with an amendment that changes the bill's language from "sincerely held religious beliefs" to "sincerely held principles."

The article is here.

Sunday, March 13, 2016

Right-to-die report will call for prior consent in dementia cases

By Robert Fife and Laura Stone
The Globe and Mail - Ottawa
Originally published February 24, 2016

A special parliamentary committee will propose Parliament adopt a new physician-assisted dying law that includes advance consent for people in early stages of dementia, sources say.

In a report to be tabled in Parliament Thursday, sources say the joint Commons-Senate committee will also address how doctors should deal with people with debilitating mental disorders and young people enduring painful and terminal illnesses.

The report recommends the government should first see how medically assisted dying works with adults before allowing it for children or people with mental illnesses.

The article is here.

Tuesday, December 29, 2015

Is Anyone Competent to Regulate Artificial Intelligence?

By John Danaher
Philosophical Disquisitions
Posted November 21, 2015

Artificial intelligence is a classic risk/reward technology. If developed safely and properly, it could be a great boon. If developed recklessly and improperly, it could pose a significant risk. Typically, we try to manage this risk/reward ratio through various regulatory mechanisms. But AI poses significant regulatory challenges. In a previous post, I outlined eight of these challenges. They were arranged into three main groups. The first consisted of definitional problems: what is AI anyway? The second consisted of ex ante problems: how could you safely guide the development of AI technology? And the third consisted of ex post problems: what happens once the technology is unleashed into the world? They are depicted in the diagram above.

The entire blog post is here.

Monday, July 28, 2014

Episode 12: Prescriptive Authority Illinois Style

Dr. Beth Rom-Rymer from Illinois speaks with John about  the recent RxP success in Illinois. Psychologists advocated passing a law to permit appropriately trained psychologist to prescribe psychotropic agents.  Beth shares many words of wisdom, including reasons for psychologists obtaining prescriptive authority, keys to advocacy, and the details of the prescriptive authority law in Illinois.  While John laments that Pennsylvania may be in the Precontemplative stage of change, Beth offers numerous suggestions to any state moving in a forward direction on RxP legislation.

The Skype connection was not the best, so apologies in advance for any technical flaws.

In terms of learning objectives, at the end of the podcast, the listener will be able to:

1.      Describe two reasons why psychologists are seeking prescriptive authority;
2.      Explain the educational requirements of becoming a prescribing psychologist in Illinois; and,
3.      Describe two important components to passing legislation on prescriptive authority.

Find this podcast on iTunes

To earn 1-APA approved Continuing Education Credit, click here.

Click to listen directly below




Resources

Updated Prescriptive Authority Law Enacted
American Psychological Association

Ethics and Psychology Resources on Prescribing Psychologists/Medical Psychologists

APA Resources on the RxP movement

Monday, March 4, 2013

Anti-human-trafficking efforts gain momentum

New policies and new laws on human trafficking are spreading across several states

By Yamiche Alcindor
USA TODAY
Originally posted on February 16, 2013


A growing wave of efforts to stop human trafficking has spread across the country as lawmakers and others look to combat the problem through law, policy, and grass-roots activism.

While approaches vary, advocates say more must be done to stop the crime, dubbed "modern day slavery" and defined by the U.S. State Department as the recruitment, transportation or harboring of people by means of deception or coercion. Victims, often mentally and physically abused, can be forced into prostitution, unfair working conditions, or other exploitative situations.

"Consciousness and outrage have reached a different level because of the perverseness but also the impact of human trafficking," said Sen. Richard Blumenthal, D-Conn. "People understand that everyone has a responsibility to fight human trafficking and every individual can have an impact."

The entire story is here.

Wednesday, February 27, 2013

House Republican aims to repeal Medicare doctor pay cuts

Reuters
Originally published on February 13, 2013

Republicans in the House of Representatives will seek a permanent solution to scheduled steep cuts in physician payments from the federal Medicare health insurance plan for retirees and disabled people, a House committee chairman said on Wednesday.

Rep. Fred Upton, chairman of the House Energy and Commerce Committee, told doctors he hopes to send so-called "Doc Fix" legislation to the House floor this summer that would repeal payment reductions enacted in 1997 as part of a law to balance the federal budget.

The 16-year-old "sustainable growth rate" (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.


The entire article is here.

Thursday, February 21, 2013

Assisted Suicide on Legal Agenda in Several States

By Susan Haigh
Associated Press
Originally posted February 8, 2013

A push for the legalization of physician-assisted suicide is under way in a half-dozen states where proponents say they see strong support for allowing doctors to prescribe mentally competent, dying individuals with the medications needed to end their own lives.

The large number of baby boomers facing end-of-life issues themselves is seen to have made the issue more prominent in recent years. Groups such as Compassion & Choices, a national end-of-life advocacy organization, have been working to advance the cause.

Advocates received a boost from last year's ballot question in Massachusetts on whether to allow physicians to help the terminally ill die. Although the vote failed, it helped to spark a national discussion, said Mickey MacIntyre, chief program officer for Compassion & Choices.

"The Massachusetts initiative lifted the consciousness of the nation and in particular the Northeast region to this issue that there are other alternatives patients and their families should have an opportunity to access," MacIntyre said.

Bills legalizing assisted suicide are being considered in Connecticut, Vermont, New Jersey, Kansas and Hawaii — and in Massachusetts, where proponents decided to resume their efforts after the public vote, according to the National Conference of State Legislatures, which tracks legislative trends. There are also bills related to the issue under consideration in New Hampshire, New York, Arizona and Montana.

In Connecticut, which has banned the practice since 1969, a group of lawmakers said Tuesday that the legislature's first public hearing on the subject would probably be held this month. At least two bills on the issue have so far been proposed in this year's session of the Connecticut legislature.

The entire story is here.

Sunday, February 17, 2013

Focus on Mental Health Laws to Curb Violence Is Unfair, Some Say

By ERICA GOODE and JACK HEALY
The New York Times
Published: January 31, 2013

In their fervor to take action against gun violence after the shooting in Newtown, Conn., a growing number of state and national politicians are promoting a focus on mental illness as a way to help prevent further killings.

Legislation to revise existing mental health laws is under consideration in at least a half-dozen states, including Colorado, Oregon and Ohio. A New York bill requiring mental health practitioners to warn the authorities about potentially dangerous patients was signed into law on Jan. 15. In Washington, President Obama has ordered “a national dialogue” on mental health, and a variety of bills addressing mental health issues are percolating on Capitol Hill.

But critics say that this focus unfairly singles out people with serious mental illness, who studies indicate are involved in only about 4 percent of violent crimes and are 11 or more times as likely than the general population to be the victims of violent crime.

And many proposals — they include strengthening mental health services, lowering the threshold for involuntary commitment and increasing requirements for reporting worrisome patients to the authorities — are rushed in execution and unlikely to repair a broken mental health system, some experts say.

“Good intentions without thought make for bad laws, and I think we have a risk of that,” said J. Reid Meloy, a forensic psychologist and clinical professor at the University of California, San Diego, who has studied rampage killers.

The entire story is here.

Tuesday, February 12, 2013

Measure would strengthen mental health-care system

By Brady Dennis and Paul Kane,
The bill would put in place standards for about 2,000 “federally qualified” community behavioral health centers, requiring them to provide such services as substance abuse treatment and 24-hour crisis care.

In return, facilities meeting criteria would be able to bill Medicaid for their services — a change intended to open the door to treatment for many more people and one that is estimated to cost about $1 billion over the next decade.

“There is an important gap here,” said Sen. Debbie Stabenow (D-Mich.), one of the bill’s main sponsors. She warned that too many people receive inadequate or no treatment and are at risk of their problems becoming more dangerous.

Sen. Roy Blunt (Mo.), the lead GOP sponsor of the measure, cited his state’s work in providing community health centers but also said that the recent shootings in Newtown, Conn., spotlighted shortcomings in mental health care that demand attention.

“We have a moment that works, and we have a model that works,” he said.

Additional Republican co-sponsors include Sens. Marco Rubio (Fla.) and Susan Collins (Maine). Other Democrats backing the legislation include Sens. Jack Reed (R.I.), Patrick J. Leahy (Vt.) and Barbara Boxer (Calif.).

The entire article is here.