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 Professional Identity. Show all posts
Showing posts with label Professional Identity. Show all posts

Wednesday, March 13, 2019

Professional ethics takes a team approach

Richard Kyte
Lacrosse Tribune
Originally posted February 24, 2019

Here is an excerpt:

Why do some professions enjoy consistently high levels of trust while other professions rate low year after year?

Part of the answer may lie in the motivations of individuals within the professions. When I ask nursing students why they want to go into nursing, they invariably respond by saying they want to help others. Business students, by contrast, are more likely to be motivated by self-interest.

But motivation does not fully explain the reputational difference among professions. Most young people who go into ministry or politics also embark upon their careers with pro-social motivations. And my own experience of lawyers, bankers, real estate agents and car salespeople suggests that the individuals in those professions are just as trustworthy as anybody else.

If that is true, then what earns a profession a positive or negative reputation is not just the people in the profession but the way the profession is practiced. Especially important is the way different professions handle ethically problematic cases and circumstances.

The info is here.

Friday, August 31, 2018

Physicians aren’t ‘burning out.’ They’re suffering from moral injury

Simon G. Talbot and Wendy Dean
STAT News
Originally published July 26, 2018

Here is an excerpt:

The term “moral injury” was first used to describe soldiers’ responses to their actions in war. It represents “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Journalist Diane Silver describes it as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”

The moral injury of health care is not the offense of killing another human in the context of war. It is being unable to provide high-quality care and healing in the context of health care.

Most physicians enter medicine following a calling rather than a career path. They go into the field with a desire to help people. Many approach it with almost religious zeal, enduring lost sleep, lost years of young adulthood, huge opportunity costs, family strain, financial instability, disregard for personal health, and a multitude of other challenges. Each hurdle offers a lesson in endurance in the service of one’s goal which, starting in the third year of medical school, is sharply focused on ensuring the best care for one’s patients. Failing to consistently meet patients’ needs has a profound impact on physician wellbeing — this is the crux of consequent moral injury.

The information is here.

Thursday, March 30, 2017

Association Between Physician Burnout and Identification With Medicine as a Calling

Andrew J. Jager, MA, Michael A. Tutty, PhD, Audiey C. Kao, PhD Audiey C. Kao
Mayo Clinic Proceedings
DOI: http://dx.doi.org/10.1016/j.mayocp.2016.11.012

Objective

To evaluate the association between degree of professional burnout and physicians' sense of calling.

Participants and Methods

US physicians across all specialties were surveyed between October 24, 2014, and May 29, 2015. Professional burnout was assessed using a validated single-item measure. Sense of calling, defined as committing one's life to personally meaningful work that serves a prosocial purpose, was assessed using 6 validated true-false items. Associations between burnout and identification with calling items were assessed using multivariable logistic regressions.

Results

A total of 2263 physicians completed surveys (63.1% response rate). Among respondents, 28.5% (n=639) reported experiencing some degree of burnout. Compared with physicians who reported no burnout symptoms, those who were completely burned out had lower odds of finding their work rewarding (odds ratio [OR], 0.05; 95% CI, 0.02-0.10; P<.001), seeing their work as one of the most important things in their lives (OR, 0.38; 95% CI, 0.21-0.69; P<.001), or thinking their work makes the world a better place (OR, 0.38; 95% CI, 0.17-0.85; P=.02). Burnout was also associated with lower odds of enjoying talking about their work to others (OR, 0.23; 95% CI, 0.13-0.41; P<.001), choosing their work life again (OR, 0.11; 95% CI, 0.06-0.20; P<.001), or continuing with their current work even if they were no longer paid if they were financially stable (OR, 0.30; 95% CI, 0.15-0.59; P<.001).

Conclusion

Physicians who experience more burnout are less likely to identify with medicine as a calling. Erosion of the sense that medicine is a calling may have adverse consequences for physicians as well as those for whom they care.

Thursday, February 19, 2015

Batgirl's Psychologist

By applying characters' fictional psyches to real-life problems, a cosplay enthusiast turned a passion for comic books into a mental-health career.

Erika Hayasaki
The Atlantic
Originally published January 27, 2015

Here is an excerpt:

Despite her excellent credentials and high grades, she carried with her traces of imposter syndrome—the fear that colleagues would discover she wasn’t smart or talented enough to be in her position. It is an anxiety that many career-driven women who excel in their fields experience, as noted in a famous 1978 study in Psychotherapy Theory, Research, and Practice, in which observations of 150 highly successful women found that they often thought of themselves as frauds and did not “experience an internal sense of success.”

The entire article is here.

Friday, January 30, 2015

Socrates Untenured

By Robert Frodeman and Adam Briggle
Inside Higher Ed
Originally published January 13, 2015

Here is an excerpt:

While it is possible to point to philosophers who work with (rather than merely talk about) the concerns of non-philosophers, among the mass of philosophers societal irrelevance is often treated as a sign of intellectual seriousness.

This is a shame, since we are surrounded by phenomena crying out for philosophic reflection. Today we are constantly confronted by philosophic questions, in many cases created by advances in science and technology. Open your computer and you can find thoughtful exploration of issues as varied as the creation of autonomous killing machines, the loss of privacy in a digital age, the remaking of friendship via Facebook, and the refashioning of human nature via biotechnology. In this sense philosophy abounds. But professional philosophers have remained largely on the margins of this growing cultural conversation.

It needn’t be this way. Take the subject matter of metaphysics. Every philosophy department teaches courses in metaphysics. But how is the subject handled? As evidenced by a sample of university syllabuses posted online, metaphysics classes are overwhelmingly exercises in professional philosophy. Just as Dewey complained, classes begin from the concerns of philosophers rather than from contemporary problems. This can be seen in the leading textbooks.

The entire article is here.

Monday, January 12, 2015

Why there would have been no torture without the psychologists

By Steven Reisner
Slate
Originally published December 12, 2014

Here is an excerpt:

The psychologists were vital to the torture program for one additional reason: The Justice Department’s Office of Legal Counsel had determined that the presence of psychologists and physicians, monitoring the state and condition of the prisoner being tortured, afforded protection for the CIA leadership and the Bush administration from liability and potential prosecution for the torture. Later, the OLC applied the same rules to the Defense Department’s “enhanced interrogation program,” which, according to an investigation by the Senate Armed Services Committee, was created and overseen by a team led by a clinical psychologist, and eventually overseen exclusively by clinical psychologists.

The entire article is here.

Thursday, January 8, 2015

Tortured by Psychologists and Doctors

The New York Time Editorial Board
Originally published

Here is an excerpt:

The ghastly new revelation is that two psychologists, James Mitchell and Bruce Jessen, who devised a list of coercive techniques to be used in questioning prisoners also personally conducted interrogations in which they tortured some C.I.A. detainees. They earned tens of millions of dollars under contracts for those services.

The report also cites other health professionals who participated, including unidentified C.I.A. medical officers or doctors who cleared prisoners for interrogation and played a central role in deciding whether to continue or adjust procedures when a prisoner developed severe medical problems.

The entire article is here.

Wednesday, December 10, 2014

Business culture and dishonesty in the banking industry

By Alain Cohn, Ernst Fehr & Michel André Maréchal
Nature (2014) doi:10.1038/nature13977
Published online 19 November 2014

Abstract

Trust in others’ honesty is a key component of the long-term performance of firms, industries, and even whole countries. However, in recent years, numerous scandals involving fraud have undermined confidence in the financial industry. Contemporary commentators have attributed these scandals to the financial sector’s business culture, but no scientific evidence supports this claim. Here we show that employees of a large, international bank behave, on average, honestly in a control condition. However, when their professional identity as bank employees is rendered salient, a significant proportion of them become dishonest. This effect is specific to bank employees because control experiments with employees from other industries and with students show that they do not become more dishonest when their professional identity or bank-related items are rendered salient. Our results thus suggest that the prevailing business culture in the banking industry weakens and undermines the honesty norm, implying that measures to re-establish an honest culture are very important.

The article can be found here.

Thursday, November 6, 2014

Impressions of Misconduct: Graduate Students’ Perception of Faculty Ethical Violations in Scientist-Practitioner Clinical Psychology Programs.

January, Alicia M.; Meyerson, David A.; Reddy, L. Felice; Docherty, Anna R.; Klonoff, Elizabeth A.
Training and Education in Professional Psychology, Aug 25 , 2014

Abstract

Ethical conduct is a foundational element of professional competence, yet very little is known about how graduate student trainees perceive ethical violations committed by clinical faculty. Thus, the current study attempted to explore how perceived faculty ethical violations might affect graduate students and the training environment. Of the 374 graduate students in scientist-practitioner clinical psychology programs surveyed, nearly a third (n = 121, 32.4%) reported knowledge of unethical faculty behavior. Students perceived a wide range of faculty behaviors as unethical. Perception of unethical faculty behavior was associated with decreased confidence in department faculty and lower perceived program climate. Implications of these findings are discussed and recommendations offered.

The entire article is here, behind a paywall.

Sunday, October 5, 2014

Whistleblowing and the Bioethicist’s Public Obligations

By D. Robert MacDougall
Cambridge Quarterly of Healthcare Ethics / Volume 23 / Issue 04 / October 2014, pp 431-442

Abstract:

Bioethicists are sometimes thought to have heightened obligations by virtue of the fact that their professional role addresses ethics or morals. For this reason it has been argued that bioethicists ought to “whistleblow”—that is, publicly expose the wrongful or potentially harmful activities of their employer—more often than do other kinds of employees. This article argues that bioethicists do indeed have a heightened obligation to whistleblow, but not because bioethicists have heightened moral obligations in general. Rather, the special duties of bioethicists to act as whistleblowers are best understood by examining the nature of the ethical dilemma typically encountered by private employees and showing why bioethicists do not encounter this dilemma in the same way. Whistleblowing is usually understood as a moral dilemma involving conflicting duties to two parties: the public and a private employer. However, this article argues that this way of understanding whistleblowing has the implication that professions whose members identify their employer as the public—such as government employees or public servants—cannot consider whistleblowing a moral dilemma, because obligations are ultimately owed to only one party: the public. The article contends that bioethicists—even when privately employed—are similar to government employees in the sense that they do not have obligations to defer to the judgments of those with private interests. Consequently, bioethicists may be considered to have a special duty to whistleblow, although for different reasons than those usually cited.

The entire article is here, behind a paywall.

Thursday, September 4, 2014

Moral Distress in Medical Education and Training

by Berger, Jeffrey T
Journal of General Internal Medicine, Volume 29, Issue 2
doi: 10.1007/s11606-013-2665-0

Abstract

Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one’s moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators’ efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.

Introduction

Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress is common in clinical practice, because caring for the ill is an inherently moral activity. Medical students and junior practitioners may be particularly challenged by morally distressing situations. Their development into attending physicians involves a process that is complex intellectually, sociologically, and culturally, and is no less complex in its moral dimensions.

(cut)

Academic health institutions whose leadership presupposes that moral distress affects all of its clinicians will be best positioned to mitigate this stress and to promote moral wellness and professionalism. Programs should expect that their trainees will experience moral distress and trainees should be aware of this expectation.

The entire article is here.

Saturday, August 2, 2014

Parole board psychologist admits he made up story

Frank Colistro had told KOIN 6 News he was shot during two different hostage negotiation operations

By Dan Tilkin
KOIN 6
Published: July 14, 2014

Frank Colistro, an influential Portland psychologist, told KOIN 6 News he was shot twice in the line of duty.

He now admits that was a lie.

Colistro is one of only five psychologists the Oregon Parole Board uses to evaluate inmates to help determine if they’re ready to be released from prison. He’s weighed in on countless cases, including very high-profile murders and rapes.

The entire story is here.



Monday, July 14, 2014

Episode 11: Why Marketing is our Ethical Duty (and why Public Education is an ideal way to do it)

In this episode, John talks with Pauline Wallin, PhD, expert in marketing, public education, and media as well as a cofounder of The Practice Institute, where she helps clinicians build their practices.  It is important for psychologists to understand why marketing a psychological practice helps protect the public and raise awareness of how psychotherapy can improve people's lives.  Pauline makes the distinction between marketing and selling.  We also discuss four ethical ways to market psychological services via public education.

The end of this podcast, the listener will be able to:

1. Describe two ways that marketing your practice benefits the public.
2. List four ways to use public education to market your practice.
3. Describe two potential ethical pitfalls in marketing via public education, and how to avoid them.

Find this podcast on iTunes

For 1 APA-approved credit, click here.

Listen directly on this site here.



Resources

Dr. Pauline Wallin's website  @DoctorWallin

The Practice Institute  @PracticeHelp

APA Code of Conduct: Standard 5 - Advertising and Other Public Statements

National Institute of Health Information on Mental Health

American Psychological Association Media Referral Service

"Psychology Works" Facts Sheets - Canadian Psychological Association

Help a Reporter Out

Saturday, June 28, 2014

A Seattle doctor is suspended for sexting during surgery

By Lindsey Bever
The Washington Post
Originally published June 10, 2014

Here is an excerpt:

Medical authorities have suspended the license of a Seattle anesthesiologist for allegedly sending explicit “selfies” and exchanging sexy text messages during surgeries.

The findings against 47-year-old Arthur K. Zilberstein, released Monday by the Washington state Department of Health, detail nearly 250 text messages with sexual innuendo he exchanged during procedures — all kinds of procedures, including Cesarean deliveries, pediatric appendectomies, epidurals, tubal ligations, cardiac-probe insertions.

The entire article is here.

Tuesday, June 17, 2014

Trial of alleged Fort Hood shooter renews call for restraint

By Art Caplan
Clinical Psychiatry News
Originally posted August 2, 2013

One year ago this month, after the theater shooting in Aurora, Colo., I wrote a column for this newspaper headlined, “The Aurora Shootings: Why the Mental Health Community Must Show Restraint.” In this column, I talked about the risks inherent in offering public comments about a defendant’s mental state and about Section 7.3 of the American Psychiatric Association’s Principles of Medical Ethics, which state:
On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself or herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general.
However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

The entire article is here.

Tuesday, June 10, 2014

When Doctors Treat Patients Like Themselves

By Abigail Zuger
The New York Times
Originally posted May 19, 2014

Here is an excerpt:

Professional training may not remove the interpersonal chemistry that binds us to some and estranges us from others, but it can neutralize these forces somewhat, enough to enable civilized and productive dialogue among all comers. Yet until the day when we deal only in cells, organs and genes and not their human containers, we will, for better or worse, always see ourselves in some patients, our friends and relatives in others, and our patients will likewise instinctively experience doctor as mother or father, buddy or virtual stranger.

Are the ties that bind us for better, medically, or are they for worse? Is health care more effective when patient and doctor are the same — the same sex, class, race, tax bracket, sore feet and cholesterol level? Or does essential objectivity require some differences? When your doctor looks at you and sees a mirrored reflection, is that good for you, or bad?

The entire article is here.

Monday, June 9, 2014

Episode 10: Social Media for Psychologists

In this episode, John talks with Dr. David Palmiter about the basics of social media.  They discuss why it is important for psychologists to understand social media as their patients are likely using various forms of social media.  Psychologists also need to know what social media is before they participate. They discuss their use of social media as part of professional development.  Psychologists need to know at least the basics about social media to practice psychotherapy effectively.

At the end of this podcast, the listener will be able to:

1. Explain the concept of social media.
2. List two reasons every psychologist should be on Twitter.
3. Define the concept of branding.

Please read David Palmiter's article: To Tweet or Not to Tweet for an understanding of Twitter.

Find this podcast on iTunes

Click here to purchase 1 APA-approved credit for this podcast

Listen directly here.




David Palmiter, PhD sites and contact information

Helping Parents.net

Hectic Parents Blog

Follow Dave on Twitter @HelpingParents

Resources

Palmiter, David. (2012). Positive Ethics Applied to Public Education Through Traditional Media and the Internet. In the APA Handbook of Ethics in Psychology, Volume 2: Practice, Teaching and Research.  Edited by Knapp, Gottlieb, Handelsman, and VandeCreek. Washington DC: The American Psychological Association.

10 Ways That Blogging Transformed My Private Practice
Julie Hanks

1 in 4 Americans now consults Google before booking an appointment with a doctor
Mark Sullivan

Social media: how does it really affect our mental health and well-being?
Medical News Today

Robi Ludwig: Fox News ‘homosexual impulses’ guest: My words were ‘twisted’

Thursday, May 22, 2014

Second VA doctor blows whistle on patient-care failures

By Dennis Wagner
The Republic
Originally published May 2, 2014

Here is an excerpt:

Both physicians, as well as other VA employees who asked not to be named for fear of retribution, said the Phoenix VA leadership disdains internal criticism and retaliates against those who speak out. In interviews and a written statement, Mitchell told The Republic she can no longer remain silent.

"I am violating the VA 'gag' order for ethical reasons," she wrote. "I am cognizant of the consequences. As a VA employee I have seen what happens to employees who speak up for patient safety and welfare within the system. The devastation of professional careers is usually the end result, and likely is the only transparent process that actually exists within the Phoenix VA Medical Center today."

The entire story is here.

Monday, May 19, 2014

Moral luck, agent regret and the doctor as drug

By Jonathon Tomlinson
BMJ Blogs
Originally posted April 3, 2014

Here is an excerpt:

Professional identity is particularly strong in doctors and medical students, and perhaps more than our non-medical peers we assimilate this into our personal identity. With this, comes an enhanced sense of moral responsibility; we cannot avoid thinking that we are morally responsible for what happens to our patients.

This spectrum of moral responsibility is intrinsic to our underlying constitution and moral predispositions. The efforts of lawyers, ethicists and moral philosphers to impose definitions seem far removed from experiences like those described above and our self-imposed moral standards. It is not only our attachment to our professional identity, but the nature of our work that makes us vulnerable to moral luck and agent regret. 

 The entire article is here.

Tuesday, May 13, 2014

Social media can cause problems for lawyers when it comes to ethics, professional responsibility

Bodies are trying to come up with guidelines for the legal profession when it comes to the use of social media

By Ed Silverstein
Inside Counsel
Originally published April 29, 2014

It is becoming increasingly confusing what lawyers, judges and courthouse employees can post on social media sites. For instance, can a judge “friend” someone who is an attorney on Facebook and then have the attorney appear before them in court?

Attorneys who post on sites like Facebook also have to worry about violating attorney-client confidentiality, disciplinary action, losing jobs, or engaging in the unauthorized or inadvertent practice of law, according to an article in the Touro Law Review. In addition, attorneys could “face sanctions for revealing misconduct or disparaging judges on social media sites,” the article adds.

The entire article is here.