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

Sunday, June 5, 2016

Memories of unethical actions become obfuscated over time

Maryam Kouchakia and Francesca Gino
PNAS 2016 ; published ahead of print May 16, 2016
doi:10.1073/pnas.1523586113

Abstract

Despite our optimistic belief that we would behave honestly when facing the temptation to act unethically, we often cross ethical boundaries. This paper explores one possibility of why people engage in unethical behavior over time by suggesting that their memory for their past unethical actions is impaired. We propose that, after engaging in unethical behavior, individuals’ memories of their actions become more obfuscated over time because of the psychological distress and discomfort such misdeeds cause. In nine studies (n = 2,109), we show that engaging in unethical behavior produces changes in memory so that memories of unethical actions gradually become less clear and vivid than memories of ethical actions or other types of actions that are either positive or negative in valence. We term this memory obfuscation of one’s unethical acts over time “unethical amnesia.” Because of unethical amnesia, people are more likely to act dishonestly repeatedly over time.

The article is here.

Saturday, June 4, 2016

Scientists show how we start stereotyping the moment we see a face

Sarah Kaplan
The Independent
Originally posted May 2, 2016

Scientists have known for a while that stereotypes warp our perceptions of things. Implicit biases — those unconscious assumptions that worm their way into our brains, without our full awareness and sometimes against our better judgment — can influence grading choices from teachers, split-second decisions by police officers and outcomes in online dating.

We can't even see the world without filtering it through the lens of our assumptions, scientists say. In a study published Monday in the journal Nature Neuroscience, psychologists report that the neurons that respond to things such as sex, race and emotion are linked by stereotypes, distorting the way we perceive people's faces before that visual information even reaches our conscious brains.

The article is here.

Friday, June 3, 2016

Secret Harvard meeting on synthetic human genomes incites ethics debate

By Joel Achenbach
The Washington Post
Originally published May 13, 2016

About 150 scientists assembled at Harvard on Tuesday for an off-the-record, no-media-allowed discussion of how to create, from scratch, an intact genome, including the genetic code of a human being. The idea is to go beyond "reading" genetic material to actively "writing" it, George Church, a Harvard Medical School researcher who helped organized the event, told The Post in an interview Friday morning.

Scientists can synthesize DNA chemically, and these techniques could ultimately lead to complete genomes that could be implanted in cells for research purposes. No one should panic just yet about mad scientists running amok: The researchers are not talking about making synthetic human beings. But the gathering drew a rebuke from two academics who heard about the event and didn't think it should have been held behind closed doors.

The article is here.

Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists

Manuel Trachsel & Jens Gaab
J Med Ethics 2016;0:1–3.
doi:10.1136/medethics-2015-102986

Abstract

Informed consent to medical intervention reflects the moral principle of respect for autonomy and the patient's right to self-determination. In psychotherapy, this includes a requirement to inform the patient about those components of treatment purported to cause the therapeutic effect. This information must encompass positive expectancies of change and placebo-related or incidental constituent therapy effects, which are as important as specific intervention techniques for the efficacy of psychotherapy. There is a risk that informing the patient about possible incidental constituents of therapy may reduce or even completely impede these effects, with negative consequences for overall outcome. However, withholding information about incidental constituents of psychotherapy would effectively represent a paternalistic action at the expense of patient autonomy; whether such paternalism might in certain circumstances be justified forms part of the present discussion.

The article is here.

Thursday, June 2, 2016

Age-Related Differences in Moral Identity Across Adulthood

T. Krettenauer, L. A. Murua, & F. Jia
Developmental Psychology, Apr 28 , 2016

Abstract

In this study, age-related differences in adults’ moral identity were investigated. Moral identity was conceptualized a context-dependent self-structure that becomes differentiated and (re)integrated in the course of development and that involves a broad range of value-orientations. Based on a cross-sectional sample of 252 participants aged 14 to 65 years (148 women, M = 33.5 years, SD = 16.9) and a modification of the Good Self-Assessment, it was demonstrated that mean-level of moral identity (averaged across the contexts of family, school/work, and community) significantly increased in the adult years, whereas cross-context differentiation showed a nonlinear trend peaking at the age of 25 years. Value-orientations that define individuals’ moral identity shifted so that self-direction and rule-conformity became more important with age. Age-related differences in moral identity were associated with, but not fully attributable to changes in personality traits. Overall, findings suggest that moral identity development is a lifelong process that starts in adolescence but expands well into middle age.

Here is an excerpt from the Discussion section:

The finding suggests that during adolescence and emerging adulthood individuals become more aware of changing moral priorities under varying circumstances. This process of differentiation is followed by the tendency to (re)integrate value priorities so that moral identities are not only defined by the self-importance of particular values, but by their consistent importance across different areas of life. This consistency may bolster individuals' sense of agency, as moral actions may be experienced as emanating from the self rather than from demand characteristics of external circumstances. Thus, the decline in cross-context differentiation in moral identities in adulthood may indicate that agentic desires become better integrated with morality, which has been described as an important goal of moral identity development by Frimer andWalker (2009).

The article is here.

Scientific consent, data, and doubling down on the internet

Oliver Keyes
Originally published May 12, 2016

Here is an excerpt:

The Data

Yesterday morning I woke up to a Twitter friend pointing me to a release of OKCupid data, by Kirkegaard. Having now spent some time exploring the data, and reading both public statements on the work and the associated paper: this is without a doubt one of the most grossly unprofessional, unethical and reprehensible data releases I have ever seen.

There are two reasons for that. The first is very simple; Kirkegaard never asked anyone. He didn't ask OKCupid, he didn't ask the users covered by the dataset - he simply said 'this is public so people should expect it's going to be released'.

The blog post is here.

Wednesday, June 1, 2016

Competence in chronic mental illness: the relevance of practical wisdom

Guy A M Widdershoven, Andrea Ruissen, Anton J L M van Balkom, & Gerben Meynen
J Med Ethics doi:10.1136/medethics-2014-102575

Abstract

The concept of competence is central to healthcare because informed consent can only be obtained from a competent patient. The standard approach to competence focuses on cognitive abilities. Several authors have challenged this approach by emphasising the role of emotions and values. Combining cognition, emotion and values, we suggest an approach which is based on the notion of practical wisdom. This focuses on knowledge and on determining what is important in a specific situation and finding a balance between various values, which are enacted in an individual's personal life. Our approach is illustrated by two cases of patients with obsessive–compulsive disorder.

The article is here.

Don't make Important Decisions When You are Hungry

The Stomach-Derived Hormone Ghrelin Increases Impulsive Behavior

Rozita H Anderberg, Caroline Hansson, Maya Fenande and others
Neuropsychopharmacology (2016) 41, 1199–1209
doi:10.1038/npp.2015.297; published online 21 October 2015

Abstract

Impulsivity, defined as impaired decision making, is associated with many psychiatric and behavioral disorders, such as attention-deficit/hyperactivity disorder as well as eating disorders. Recent data indicate that there is a strong positive correlation between food reward behavior and impulsivity, but the mechanisms behind this relationship remain unknown. Here we hypothesize that ghrelin, an orexigenic hormone produced by the stomach and known to increase food reward behavior, also increases impulsivity. In order to assess the impact of ghrelin on impulsivity, rats were trained in three complementary tests of impulsive behavior and choice: differential reinforcement of low rate (DRL), go/no-go, and delay discounting. Ghrelin injection into the lateral ventricle increased impulsive behavior, as indicated by reduced efficiency of performance in the DRL test, and increased lever pressing during the no-go periods of the go/no-go test. Central ghrelin stimulation also increased impulsive choice, as evidenced by the reduced choice for large rewards when delivered with a delay in the delay discounting test. In order to determine whether signaling at the central ghrelin receptors is necessary for maintenance of normal levels of impulsive behavior, DRL performance was assessed following ghrelin receptor blockade with central infusion of a ghrelin receptor antagonist. Central ghrelin receptor blockade reduced impulsive behavior, as reflected by increased efficiency of performance in the DRL task. To further investigate the neurobiological substrate underlying the impulsivity effect of ghrelin, we microinjected ghrelin into the ventral tegmental area, an area harboring dopaminergic cell bodies. Ghrelin receptor stimulation within the VTA was sufficient to increase impulsive behavior. We further evaluated the impact of ghrelin on dopamine-related gene expression and dopamine turnover in brain areas key in impulsive behavior control. This study provides the first demonstration that the stomach-produced hormone ghrelin increases impulsivity and also indicates that ghrelin can change two major components of impulsivity—motor and choice impulsivity.

The article is here.

Tuesday, May 31, 2016

South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says

By Matt Apuzzomay
The New York Times
Originally posted May 2, 2016

When patients in South Dakota seek help for serious but manageable disabilities such as severe diabetes, blindness or mental illness, the answer is often the same: With few alternatives available, they end up in nursing homes or long-term care facilities, whether they need such care or not.

In a scathing rebuke of the state’s health care system, the Justice Department said on Monday that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago.

The Obama administration has opened more than 50 such investigations and reached settlements with eight states. One investigation, into Florida’s treatment of children with disabilities, ended in a lawsuit over policies that placed those children in nursing homes. With its report Monday, the Justice Department signaled that it might also sue South Dakota.

The article is here.