By M.A. de Vos, A.A. Seeber, S.K.M. Gevers, A.P. Bos, F. Gevers, and D.L. Williams
J Med Ethics 2015;41:195-200 doi:10.1136/medethics-2013-101395
Abstract
Background
In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents.
Objective
To discuss who can best protect a child's interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership.
Methods
We describe the case of a 3-year-old boy with acquired brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians.
Conclusions
Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team.
The entire article is here.
Monday, February 23, 2015
On making the right choice: A meta-analysis and large-scale replication attempt of the unconscious thought advantage
M.R. Nieuwenstein, T. Wirenga, R.D. Morey, J.M. Wichers, T.N. Blom, E. Wagenmakers, and H. vanRijn
Judgment and Decision Making, Vol. 10, No. 1, January 2015, pp. 1-17
Abstract
Are difficult decisions best made after a momentary diversion of thought? Previous research addressing this important question has yielded dozens of experiments in which participants were asked to choose the best of several options (e.g., cars or apartments) either after conscious deliberation, or after a momentary diversion of thought induced by an unrelated task. The results of these studies were mixed. Some found that participants who had first performed the unrelated task were more likely to choose the best option, whereas others found no evidence for this so-called unconscious thought advantage (UTA). The current study examined two accounts of this inconsistency in previous findings. According to the reliability account, the UTA does not exist and previous reports of this effect concern nothing but spurious effects obtained with an unreliable paradigm. In contrast, the moderator account proposes that the UTA is a real effect that occurs only when certain conditions are met in the choice task. To test these accounts, we conducted a meta-analysis and a large-scale replication study (N = 399) that met the conditions deemed optimal for replicating the UTA. Consistent with the reliability account, the large-scale replication study yielded no evidence for the UTA, and the meta-analysis showed that previous reports of the UTA were confined to underpowered studies that used relatively small sample sizes. Furthermore, the results of the large-scale study also dispelled the recent suggestion that the UTA might be gender-specific. Accordingly, we conclude that there exists no reliable support for the claim that a momentary diversion of thought leads to better decision making than a period of deliberation.
The entire article is here.
Judgment and Decision Making, Vol. 10, No. 1, January 2015, pp. 1-17
Abstract
Are difficult decisions best made after a momentary diversion of thought? Previous research addressing this important question has yielded dozens of experiments in which participants were asked to choose the best of several options (e.g., cars or apartments) either after conscious deliberation, or after a momentary diversion of thought induced by an unrelated task. The results of these studies were mixed. Some found that participants who had first performed the unrelated task were more likely to choose the best option, whereas others found no evidence for this so-called unconscious thought advantage (UTA). The current study examined two accounts of this inconsistency in previous findings. According to the reliability account, the UTA does not exist and previous reports of this effect concern nothing but spurious effects obtained with an unreliable paradigm. In contrast, the moderator account proposes that the UTA is a real effect that occurs only when certain conditions are met in the choice task. To test these accounts, we conducted a meta-analysis and a large-scale replication study (N = 399) that met the conditions deemed optimal for replicating the UTA. Consistent with the reliability account, the large-scale replication study yielded no evidence for the UTA, and the meta-analysis showed that previous reports of the UTA were confined to underpowered studies that used relatively small sample sizes. Furthermore, the results of the large-scale study also dispelled the recent suggestion that the UTA might be gender-specific. Accordingly, we conclude that there exists no reliable support for the claim that a momentary diversion of thought leads to better decision making than a period of deliberation.
The entire article is here.
Sunday, February 22, 2015
A fault in our design
We tend to think that technological progress is making us more resilient, but it might be making us more vulnerable
By Colin Dickey
Aeon Magazine
Originally published January 23, 2015
Here is an excerpt:
Freed from the constant worry of danger, we tend to forget that there ever was a danger in the first place. We’ve immunised ourselves from the fear of diseases that once plagued us, to the point where they’re now killing us once more. Fuelled by the viral spread of misinformation and paranoia, vaccine use has plummeted in parts of the Western world, leading to a resurgence in viruses. In the US, mortality rates for pertussis (whooping cough) dropped from 1,100 in 1950 to six in 1995, yet in the past decade outbreaks have once again spiked – more than 48,000 cases were reported in 2013, significantly outnumbering the 5137 cases that were reported back in 1995.
The entire article is here.
By Colin Dickey
Aeon Magazine
Originally published January 23, 2015
Here is an excerpt:
Freed from the constant worry of danger, we tend to forget that there ever was a danger in the first place. We’ve immunised ourselves from the fear of diseases that once plagued us, to the point where they’re now killing us once more. Fuelled by the viral spread of misinformation and paranoia, vaccine use has plummeted in parts of the Western world, leading to a resurgence in viruses. In the US, mortality rates for pertussis (whooping cough) dropped from 1,100 in 1950 to six in 1995, yet in the past decade outbreaks have once again spiked – more than 48,000 cases were reported in 2013, significantly outnumbering the 5137 cases that were reported back in 1995.
The entire article is here.
Saturday, February 21, 2015
Clinical supervision of psychotherapy: essential ethics issues for supervisors and supervisees
By Jeffrey E. Barnett and Corey H. Molzon
J Clin Psychol 2014 Nov 14;70(11):1051-61. Epub 2014 Sep 14.
Abstract
Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront.
The entire article is here.
J Clin Psychol 2014 Nov 14;70(11):1051-61. Epub 2014 Sep 14.
Abstract
Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront.
The entire article is here.
Friday, February 20, 2015
Cognitive enhancement kept within contexts: neuroethics and informed public policy
By John R. Shook, Lucia Galvagni, and James Giordano
Front Syst Neurosci. 2014; 8: 228.
Published online Dec 5, 2014. doi: 10.3389/fnsys.2014.00228
Abstract
Neurothics has far greater responsibilities than merely noting potential human enhancements arriving from novel brain-centered biotechnologies and tracking their implications for ethics and civic life. Neuroethics must utilize the best cognitive and neuroscientific knowledge to shape incisive discussions about what could possibly count as enhancement in the first place, and what should count as genuinely “cognitive” enhancement. Where cognitive processing and the mental life is concerned, the lived context of psychological performance is paramount. Starting with an enhancement to the mental abilities of an individual, only performances on real-world exercises can determine what has actually been cognitively improved. And what can concretely counts as some specific sort of cognitive improvement is largely determined by the classificatory frameworks of cultures, not brain scans or laboratory experiments. Additionally, where the public must ultimately evaluate and judge the worthiness of individual performance enhancements, we mustn’t presume that public approval towards enhancers will somehow automatically arrive without due regard to civic ideals such as the common good or social justice. In the absence of any nuanced appreciation for the control which performance contexts and public contexts exert over what “cognitive” enhancements could actually be, enthusiastic promoters of cognitive enhancement can all too easily depict safe and effective brain modifications as surely good for us and for society. These enthusiasts are not unaware of oft-heard observations about serious hurdles for reliable enhancement from neurophysiological modifications. Yet those observations are far more common than penetrating investigations into the implications to those hurdles for a sound public understanding of cognitive enhancement, and a wise policy review over cognitive enhancement. We offer some crucial recommendations for undertaking such investigations, so that cognitive enhancers that truly deserve public approval can be better identified.
The entire article is here.
Front Syst Neurosci. 2014; 8: 228.
Published online Dec 5, 2014. doi: 10.3389/fnsys.2014.00228
Abstract
Neurothics has far greater responsibilities than merely noting potential human enhancements arriving from novel brain-centered biotechnologies and tracking their implications for ethics and civic life. Neuroethics must utilize the best cognitive and neuroscientific knowledge to shape incisive discussions about what could possibly count as enhancement in the first place, and what should count as genuinely “cognitive” enhancement. Where cognitive processing and the mental life is concerned, the lived context of psychological performance is paramount. Starting with an enhancement to the mental abilities of an individual, only performances on real-world exercises can determine what has actually been cognitively improved. And what can concretely counts as some specific sort of cognitive improvement is largely determined by the classificatory frameworks of cultures, not brain scans or laboratory experiments. Additionally, where the public must ultimately evaluate and judge the worthiness of individual performance enhancements, we mustn’t presume that public approval towards enhancers will somehow automatically arrive without due regard to civic ideals such as the common good or social justice. In the absence of any nuanced appreciation for the control which performance contexts and public contexts exert over what “cognitive” enhancements could actually be, enthusiastic promoters of cognitive enhancement can all too easily depict safe and effective brain modifications as surely good for us and for society. These enthusiasts are not unaware of oft-heard observations about serious hurdles for reliable enhancement from neurophysiological modifications. Yet those observations are far more common than penetrating investigations into the implications to those hurdles for a sound public understanding of cognitive enhancement, and a wise policy review over cognitive enhancement. We offer some crucial recommendations for undertaking such investigations, so that cognitive enhancers that truly deserve public approval can be better identified.
The entire article is here.
The Virtue of Scientific Thinking
By Steven Shapin
The Boston Review
Originally published January 20, 2015
Here is an excerpt:
So natural science without the capacity of moral uplift, and grown-up scientists, so to speak, without moral authority, are—in historical terms—recent creations. Both the disenchantment of the world and the supposed invalidity of inferring ought from is derive from the historical development of a conception of nature stripped of the moral powers it once possessed. That development reached its culmination in the science and metaphysics of Darwin and the scientific naturalists of the late nineteenth century. Their modern conception of nature could not make those who studied it more moral than anyone else because no sermons in stones were to be discerned. Nature, said the great nineteenth-century biologist T. H. Huxley, “is no school of virtue.”
The insistence that science cannot make you good, or make the scientist into a moral authority, flowed from a natural philosophical position: there are no spiritual forces operating in nature and there is no divine meaning to be discerned in nature. That is to say, Weber was making a sociological statement about what belongs to certain social roles, but he was doing so by way of historical changes in science and metaphysics.
The entire article is here.
The Boston Review
Originally published January 20, 2015
Here is an excerpt:
So natural science without the capacity of moral uplift, and grown-up scientists, so to speak, without moral authority, are—in historical terms—recent creations. Both the disenchantment of the world and the supposed invalidity of inferring ought from is derive from the historical development of a conception of nature stripped of the moral powers it once possessed. That development reached its culmination in the science and metaphysics of Darwin and the scientific naturalists of the late nineteenth century. Their modern conception of nature could not make those who studied it more moral than anyone else because no sermons in stones were to be discerned. Nature, said the great nineteenth-century biologist T. H. Huxley, “is no school of virtue.”
The insistence that science cannot make you good, or make the scientist into a moral authority, flowed from a natural philosophical position: there are no spiritual forces operating in nature and there is no divine meaning to be discerned in nature. That is to say, Weber was making a sociological statement about what belongs to certain social roles, but he was doing so by way of historical changes in science and metaphysics.
The entire article is here.
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.
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.
Science cannot determine human values
Earp, B. D. (in press). Science cannot determine human values.
Think: A Journal of the Royal Institute of Philosophy, in press.
Sam Harris, in his book The Moral Landscape, famously argues that “science can determine human values.” Against this view, I argue that while secular moral philosophy can certainly help us to determine our values, science—at least as that word is commonly understood—must play a subservient role. To the extent that science can “determine” what we ought to do, it is only by providing us with empirical information, which can then be slotted into a chain of deductive (moral) reasoning. The premises of such reasoning, however, can in no way be derived from the scientific method: they come, instead, from philosophy—and common sense.
The entire article is here.
Think: A Journal of the Royal Institute of Philosophy, in press.
Sam Harris, in his book The Moral Landscape, famously argues that “science can determine human values.” Against this view, I argue that while secular moral philosophy can certainly help us to determine our values, science—at least as that word is commonly understood—must play a subservient role. To the extent that science can “determine” what we ought to do, it is only by providing us with empirical information, which can then be slotted into a chain of deductive (moral) reasoning. The premises of such reasoning, however, can in no way be derived from the scientific method: they come, instead, from philosophy—and common sense.
The entire article is here.
Wednesday, February 18, 2015
The neural pathways, development and functions of empathy
By Jean Decety
Current Opinion in Behavioral Sciences
Volume 3, June 2015, Pages 1–6
Highlights
• Empathy has evolved in the context of parental care and kinship relationships.
• Conserved neural circuits connecting brainstem, basal ganglia, insula and orbitofrontal cortex.
• It emerges early in life.
• Empathy is modulated by interpersonal and contextual factors.
• Empathy is flexible and can be promoted.
Abstract
Empathy reflects an innate ability to perceive and be sensitive to the emotional states of others coupled with a motivation to care for their wellbeing. It has evolved in the context of parental care for offspring as well as within kinship. Current work demonstrates that empathy is underpinned by circuits connecting the brainstem, amygdala, basal ganglia, anterior cingulate cortex, insula and orbitofrontal cortex, which are conserved across many species. Empirical studies document that empathetic reactions emerge early in life, and that they are not automatic. Rather they are heavily influenced and modulated by interpersonal and contextual factors, which impact behavior and cognitions. However, the mechanisms supporting empathy are also flexible and amenable to behavioral interventions that can promote caring beyond kin and kith.
The entire article is here.
Current Opinion in Behavioral Sciences
Volume 3, June 2015, Pages 1–6
Highlights
• Empathy has evolved in the context of parental care and kinship relationships.
• Conserved neural circuits connecting brainstem, basal ganglia, insula and orbitofrontal cortex.
• It emerges early in life.
• Empathy is modulated by interpersonal and contextual factors.
• Empathy is flexible and can be promoted.
Abstract
Empathy reflects an innate ability to perceive and be sensitive to the emotional states of others coupled with a motivation to care for their wellbeing. It has evolved in the context of parental care for offspring as well as within kinship. Current work demonstrates that empathy is underpinned by circuits connecting the brainstem, amygdala, basal ganglia, anterior cingulate cortex, insula and orbitofrontal cortex, which are conserved across many species. Empirical studies document that empathetic reactions emerge early in life, and that they are not automatic. Rather they are heavily influenced and modulated by interpersonal and contextual factors, which impact behavior and cognitions. However, the mechanisms supporting empathy are also flexible and amenable to behavioral interventions that can promote caring beyond kin and kith.
The entire article is here.
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