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

Saturday, February 28, 2015

Believing that life is fair might make you a terrible person

By Oliver Burkeman
The Guardian
Originally posted on February 3, 2015

Here is an excerpt:

What’s truly unsettling about the just-world bias is that while it can have truly unpleasant effects, these follow from what seems like the entirely understandable urge to believe that things happen for a reason. After all, if we didn’t all believe that to some degree, life would be an intolerably chaotic and terrifying nightmare in, which effort and payback were utterly unrelated, and there was no point planning for the future, saving money for retirement or doing anything else in hope of eventual reward. We’d go mad. Surely wanting the world to make a bit more sense than that is eminently forgivable?

Yet, ironically, this desire to believe that things happen for a reason leads to the kinds of positions that help entrench injustice instead of reducing it.

The entire article is here.

Editor's Note: My suspicion is that this has a direct application to therapist's views of patients.  Self-reflection and understanding biases help to reduce negative influences in our lives.

Friday, February 27, 2015

Medical Necessity and Unnecessary Care

By Paul Keckley
The Health Care Blog
Originally posted January 29, 2015

Unnecessary care that’s not evidence-based—usually associated with excess testing, surgical procedures or over-prescribing—accounts for up to 30% of what is spent in healthcare. In recent months, enforcement actions against physicians and hospitals have gained increased attention. But unnecessary care and over-utilization is not a new story or one that’s easy to understand.

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What does it mean?

Documentation is key. Accurate clinical documentation across sites and systems of care is table stakes.

Transparency about medical necessity and unnecessary care is assured. Data about the performance of every practitioner, hospital, and health system will be widely accessible.

The entire blog post is here.

U.S. Military Document Says Force-Feeding Violates Medical Ethics and International Law

Physicians for Human Rights
Press Release
Originally published January 30, 2015

Physicians for Human Rights (PHR) said today that a newly public U.S. military document acknowledging that force-feeding violates medical ethics shows the unlawfulness of hunger strike practices at the detention center at Guantánamo Bay. PHR called on the U.S. government to end all policies requiring clinicians to violate professional ethics and to immediately drop charges against the Navy nurse who refused to force-feed detainees.

“This document exposes the flawed medical and legal reasoning at the heart of Guantánamo’s force-feeding policy,” said Dr. Vincent Iacopino, PHR’s senior medical advisor. “Forcing treatment on mentally competent persons constitutes ill-treatment and possibly torture and is contrary to professional ethics. There is no evidence for the government’s claim that it is diagnosing or treating suicide or self-harm. Yet the command structure orders doctors and nurses to carry out force-feeding anyway, and attempts to justify the practice on the basis of medical necessity. The Navy nurse who stood up against this contradictory and harmful policy should not be discharged.”

The entire story is here.

Thursday, February 26, 2015

Burnout Rates Soar Among Family Physicians

By Diana Philips
Medscape
Originally published January 28, 2015

Nearly half of family physicians younger than 35 years feel burned out, according to a new survey conducted by Medscape. In the 2015 Family Physician Lifestyle report, which updates a previous report on physician lifestyle and burnout, 43% of family physicians in this age group responded that they had burnout, defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. This is a substantial increase over the rates documented in the 2013 report, in which fewer than 10% of the youngest family physicians said they felt burned out.

The entire article is here.

Reason and Science Make Us Moral

Michael Shermer on "The Moral Arc"
Reason.TV
Originally posted January 20, 2015

"You can't just say, 'This is the way it is, therefore it ought to be that way.' You've got to have good reasons," says Michael Shermer, referencing the common "is-ought fallacy" most famously explained by David Hume. "Well, I claim that we do have good reasons: Democracies are better than autocracies. Free markets are better than tyrannical, top-down economic systems. There are certain things we know work. You can measure it!"

Shermer is the longtime editor of Skeptic magazine, a visiting professor at Chapman University, and author of the new book The Moral Arc: How Science and Reason Lead Humanity Towards Truth, Justice, and Freedom, in which he argues that humanity has become measurably more moral over time and that this is a direct outgrowth of the rise of Enlightenment ideals of reason, empricism, and the rejection of blind faith and tradition.

Reason TV's Zach Weissmueller interviewed Shermer and explored such topics as the meaning of morality, the relationship between morality and markets, the possibility (or impossibility) of consensus around moral truths, and the biggest obstacles impeding further moral progress.

Approximately 20 minutes. Interview by Zach Weissmueller. Shot by Justin Monticello and Paul Detrick. Edited by Weissmueller. Music by Chris Zabriskie.


Wednesday, February 25, 2015

The Myth of Harmless Wrongs in Moral Cognition: Automatic Dyadic Completion From Sin to Suffering

By Kurt Gray, Chelsea Schein, and Adrian Ward
Journal of Experimental Psychology: General
2014, Vol. 143, No. 4, 1600–1615

Abstract

When something is wrong, someone is harmed. This hypothesis derives from the theory of dyadic
morality, which suggests a moral cognitive template of wrongdoing agent and suffering patient (i.e.,
victim). This dyadic template means that victimless wrongs (e.g., masturbation) are psychologically
incomplete, compelling the mind to perceive victims even when they are objectively absent. Five studies reveal that dyadic completion occurs automatically and implicitly: Ostensibly harmless wrongs are perceived to have victims (Study 1), activate concepts of harm (Studies 2 and 3), and increase perceptions of suffering (Studies 4 and 5). These results suggest that perceiving harm in immorality is intuitive and does not require effortful rationalization. This interpretation argues against both standard interpretations of moral dumbfounding and domain-specific theories of morality that assume the psychological existence of harmless wrongs. Dyadic completion also suggests that moral dilemmas in which wrongness (deontology) and harm (utilitarianism) conflict are unrepresentative of typical moral cognition.

The entire article is here.

The Myth of the Harmless Wrong

By Kurt Gray and Chelsea Schein
The New York Times Sunday Review
Originally published January 30, 2015

Here is two excerpts:

The technical name for this psychological link between judgments of immorality and perceptions of harm is “dyadic completion.” Whether liberal or conservative, people understand immorality though a universal template — a dyad of perpetrator and victim. Most immoral acts have a “complete” dyad, such as murder (murderer and murdered), theft (thief and thieved) and abuse (abuser and abused). But with many morally controversial acts, such as those involving adult pornography, prostitution, drugs or homosexuality, the victims seem less obvious or absent altogether.

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Liberals and conservatives may disagree on specific issues, but fundamentally they have the same moral mind. Both demonstrate dyadic completion. Conservatives may see immorality and harm in homosexuality and gun control, and liberals may see immorality and harm in religion in schools and genetically modified foods.

The entire article is here.

Tuesday, February 24, 2015

Therapeutic Harm and Cultural Oppression

By Derald Wing Sue
The Counseling Psychologist 
January 6, 2015 0011000014565713

Abstract

The divergent discourses between scholars from the potentially harmful treatment and multicultural psychology camps are accurately observed by Wendt, Gone, and Nagata. I argue that the differences in perspectives between the two groups are more about a clash of therapeutic worldviews, that they are often antagonistic to one another, that conversations have been a one-way process (with one side “not wanting to hear”), and that sociopolitical forces play a significant role in preventing a true dialogue from occurring. I conclude that the ultimate harm to groups of color is cultural oppression.

The entire article is here.

The Importance of Moral Construal

Moral versus Non-Moral Construal Elicits Faster, More Extreme, Universal Evaluations of the Same Actions

By Jay J. Van Bavel, Dominic J. Packer, Ingrid J. Haas, and William A. Cunningham
PLoS ONE 7(11): e48693. doi:10.1371/journal.pone.0048693

Abstract

Over the past decade, intuitionist models of morality have challenged the view that moral reasoning is the sole or even primary means by which moral judgments are made. Rather, intuitionist models posit that certain situations automatically elicit moral intuitions, which guide moral judgments. We present three experiments showing that evaluations are also susceptible to the influence of moral versus non-moral construal. We had participants make moral evaluations (rating whether actions were morally good or bad) or non-moral evaluations (rating whether actions were pragmatically or hedonically good or bad) of a wide variety of actions. As predicted, moral evaluations were faster, more extreme, and more strongly associated with universal prescriptions—the belief that absolutely nobody or everybody should engage in an action—than non-moral (pragmatic or hedonic) evaluations of the same actions. Further, we show that people are capable of flexibly shifting from moral to non-moral evaluations on a trial-by-trial basis. Taken together, these experiments provide evidence that moral versus non-moral construal has an important influence on evaluation and suggests that effects of construal are highly flexible. We discuss the implications of these experiments for models of moral judgment and decision-making.

The entire article is here.