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

Monday, February 29, 2016

Mental health care 'is ruining lives'

By Nick Triggle
Health correspondent - BBC
Originally posted February 15, 2016

Inadequate and underfunded mental health care in England is leading to thousands of "tragic and unnecessary deaths" a review has found.

The report - by a taskforce set up by NHS England - said around three-quarters of people with mental health problems received no help at all.

It said more needs to be done to tackle rising suicide rates.

Ministers agreed with the findings, committing a £1bn extra a year by 2020 to treat a million more people.

This is to come out of the £8.4bn the government has promised to the health service during this Parliament and comes on top of extra money already announced for children's services.

Prime Minister David Cameron said the plan would help put "mental and physical healthcare on an equal footing".

The article is here.

Editorial Note: In spite of federal legislation in the United States insuring mental health parity, there are frequent reports of insurance companies not following the law.  Additionally, the mental health system in the US is chronically underfunded through insurance companies as well as local, state, and federal systems.

Iranians launch app to escape morality police

The Observers
Originally posted February 10, 2016

Iranian developers just launched a mobile app called "Gershad", which alerts users if the morality police are nearby.

In the Islamic Republic of Iran, the morality police, a unit of the National Police, are charged with insuring that Iranian citizens comply with so-called Islamic law. For example, morality officers have to make sure that women wear their veil correctly. If they see a young man and woman walking together, they can stop them and ask if they are married or from the same family. If the morality police suspect that they are an unmarried couple, they can reprimand them.

The new app is meant for young Iranians, especially young women who wear their veil loosely, pushed far back on their heads and showing their hair and face.

The article is here.

Sunday, February 28, 2016

When Ethical Leader Behavior Breaks Bad

How Ethical Leader Behavior Can Turn Abusive via Ego Depletion and Moral Licensing

Szu-Han (Joanna) Lin, Jingjing Ma, and Russell E. Johnson
Journal of Applied Psychology. 01/2016; DOI: 10.1037/apl0000098

Abstract

The literature to date has predominantly focused on the benefits of ethical leader behaviors for recipients (e.g., employees and teams). Adopting an actor-centric perspective, in this study we examined whether exhibiting ethical leader behaviors may come at some cost to leaders. Drawing from ego depletion and moral licensing theories, we explored the potential challenges of ethical leader behavior for actors. Across 2 studies which employed multiwave designs that tracked behaviors over consecutive days, we found that leaders’ displays of ethical behavior were positively associated with increases in abusive behavior the following day. This association was mediated by increases in depletion and moral credits owing to their earlier displays of ethical behavior. These results suggest that attention is needed to balance the benefits of ethical leader behaviors for recipients against the challenges that such behaviors pose for actors, which include feelings of mental fatigue and psychological license and ultimately abusive interpersonal behaviors.

The article is here.

Saturday, February 27, 2016

Neuroethics

Roskies, Adina, "Neuroethics", The Stanford Encyclopedia of Philosophy (Spring 2016 Edition), Edward N. Zalta (ed.), forthcoming

Neuroethics is an interdisciplinary research area that focuses on ethical issues raised by our increased and constantly improving understanding of the brain and our ability to monitor and influence it, as well as on ethical issues that emerge from our concomitant deepening understanding of the biological bases of agency and ethical decision-making.

1. The rise and scope of neuroethics

Neuroethics focuses on ethical issues raised by our continually improving understanding of the brain, and by consequent improvements in our ability to monitor and influence brain function. Significant attention to neuroethics can be traced to 2002, when the Dana Foundation organized a meeting of neuroscientists, ethicists, and other thinkers, entitled Neuroethics: Mapping the Field. A participant at that meeting, columnist and wordsmith William Safire, is often credited with introducing and establishing the meaning of the term “neuroethics”, defining it as
the examination of what is right and wrong, good and bad about the treatment of, perfection of, or unwelcome invasion of and worrisome manipulation of the human brain. (Marcus 2002: 5)
Others contend that the word “neuroethics” was in use prior to this (Illes 2003; Racine 2010), although all agree that these earlier uses did not employ it in a disciplinary sense, or to refer to the entirety of the ethical issues raised by neuroscience.

The entire entry is here.

Friday, February 26, 2016

Automated empathy allows doctors to check on patients daily

By Barbara Feder Ostrov
Kaiser Health News
Originally posted February 10, 2016

Here is an excerpt:

"Automating empathy" is a new healthcare buzzword for helping doctors stay in touch with patients before and after medical procedures — cheaply and with minimal effort from already overextended physicians.

It may sound like an oxymoron, but it's a powerful draw for hospitals and other health care providers scrambling to adjust to sweeping changes in how they're paid for the care they provide. Whether the emails actually trigger an empathetic connection or not, the idea of tailoring regular electronic communications to patients counts as an innovation in health care with potential to save money and improve quality.

Startups like HealthLoop are promising that their technologies will help patients stick to their treatment and recovery regimens, avoid a repeat hospital stay, and be more satisfied with their care. Similar companies in the "patient engagement" industry include Wellframe, Curaspan, and Infield Health.

The article is here.

The problem with cognitive and moral psychology

Massimo Pigliucci and K.D. Irani
Plato's Footprint
Originally published February 8, 2016

Here is an excerpt:

The norm of cooperation is again presupposed as the fundamental means for deciding which of our moral intuitions we should heed. When discussing the more stringent moral principles that Peter Singer, for instance, takes to be rationally required of us concerning our duties to distant strangers, Bloom dismisses them as unrealistic in the sense that no plausible evolutionary theory could yield such requirements for human beings.” But of course evolution is what provided us with the very limited moral instinct that Bloom himself concedes needs to be expanded through the use of reason! He seems to want to have it both ways: we ought to build on what nature gave us, so long as what we come up with is compatible with nature’s narrow demands. But why?

Let me quote once more from Shaw, who I think puts her finger precisely where the problem lies: “it is a fallacy to suggest that expertise in psychology, a descriptive natural science, can itself qualify someone to determine what is morally right and wrong. The underlying prescriptive moral standards are always presupposed antecedently to any psychological research … No psychologist has yet developed a method that can be substituted for moral reflection and reasoning, for employing our own intuitions and principles, weighing them against one another and judging as best we can. This is necessary labor for all of us. We cannot delegate it to higher authorities or replace it with handbooks. Humanly created suffering will continue to demand of us not simply new ‘technologies of behavior’ [to use B.F. Skinner’s phrase] but genuine moral understanding. We will certainly not find it in the recent books claiming the superior wisdom of psychology.”

Please note that Shaw isn’t saying that moral philosophers are the high priests to be called on, though I’m sure she would agree that those are the people that have thought longer and harder about the issues in question, and so should certainly get a place at the discussion table. She is saying that good reasoning in general, and good moral reasoning in particular, are something we all need to engage in, for the sake of our own lives and of society at large.

The entire article is here.

Thursday, February 25, 2016

Empathy is a moral force

Jamil Zaki
FORTHCOMING in Gray, K. & Graham, J. (Eds.), The Atlas of Moral Psychology

Here is an excerpt:

More recently, however, a growing countercurrent has questioned the utility of empathy in driving moral action. This argument builds on the broader idea that emotions provide powerful but noisy inputs to people’s moral calculus (Haidt, 2001). Affective reactions often tempt people to make judgments that are logically and morally indefensible. Such emotional static famously includes moral dumbfounding, under which people’s experience of disgust causes them to judge others’ actions as wrong when they have no rational basis for doing so (Cushman, Young, & Hauser, 2006). Emotion drives other irrational moral judgments, such as people’s tendency to privilege physical force (a “hot” factor) over more important dimensions such as harm when judging the moral status of an action (Greene, 2014; Greene et al., 2009). Even incidental, morally irrelevant feelings alter moral judgment, further damaging the credibility of emotion in guiding a sense of right and wrong. (Wheatley & Haidt, 2005).

In sum, although emotions play a powerful role in moral judgment, they need not play a useful role. Instead, capricious emotion-driven intuitions often attract people towards internally inconsistent and wrong-headed judgments. From a utilitarian perspective aimed at maximizing well being, these biases render emotion a fundamentally mistaken moral engine (cf. Greene, 2014).

Does this criticism apply to empathy? In many ways, it does. Like other affective states, empathy arises in response to evocative experiences, often in noisy ways that hamper objectivity. For instance, people experience more empathy, and thus moral obligation to help, in response to the visible suffering of others, as in the case of Baby Jessica described above. This empathy leads people to donate huge sums of money to help individuals whose stories they read about or see on television, while ignoring widespread misery that they could more efficaciously relieve (Genevsky, Västfjäll,
Slovic, & Knutson, 2013; Slovic, 2007; Small & Loewenstein, 2003). Empathy also collapses reliably when sufferers and would-be empathizers differ along dimensions of race, politics, age, or even meaningless de novo group assignments (Cikara, Bruneau, & Saxe, 2011; Zaki & Cikara, in press).

The chapter is here.

The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals

Anna Wexler
J Med Ethics doi:10.1136/medethics-2015-102704

Abstract

Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications.

The article is here.

Wednesday, February 24, 2016

How Winning Leads to Cheating

By Jordana Cepelewicz
Scientific American
Originally published on February 2, 2016

We live, for better or for worse, in a competition-driven world. Rivalry powers our economy, sparks technological innovation and encourages academic discovery. But it also compels people to manipulate the system and commit crimes. Some figure it’s just easier—and even acceptable—to cheat.

But what if instead of examining how people behave in a competitive setting, we wanted to understand the consequences of competition on their everyday behavior? That is exactly what Amos Schurr, a business and management professor at Ben-Gurion University of the Negev, and Ilana Ritov, a psychologist at The Hebrew University of Jerusalem, discuss in a study in this week’s Proceedings of the National Academy of Sciences. “How can it be,” Schurr asks, “that successful, distinguished people—take [former New York State Gov.] Eliot Spitzer, who I think was a true civil servant when he started out his career with good intentions—turn corrupt? At the same time, you have other successful people, like Mother Theresa, who don’t become corrupt. What distinguishes between these two types of successful people?”

The article is here.