How Should Clinicians Treat Patients Who Might Be Undocumented?

Commentary by Jeff Sconyers and Tyler Tate
AMA Journal of Ethics. March 2016, Volume 18, Number 3: 229-236.
 doi: 10.1001/journalofethics.2016.18.03.ecas4-1603.

Here is an excerpt:

Ethical Considerations

In terms of the ethical analysis of this case, there is no better place to start than the Hippocratic Oath. While the oath never explicitly states primum non nocere (first do no harm), a phrase it is often assumed to contain, it does give us the informative statement “Into whatever homes I go, I will enter them for the benefit of the sick…whether they are free men or slaves” [10]. The normative claim implicit here is that it is the duty of the physician to take care of anyone who comes to him or her for care, regardless of that person’s societal status. This claim is intimately related to the principle of beneficence, which is a broad concept encompassing acts of mercy, kindness, charity, altruism, love, humanity, and a deep concern for the promotion of the good of others [11]. At times, the demands of beneficence can conflict with an agent’s desire for a comfortable life; this conflict will influence Dr. Connelly’s analysis of a relationship with Ms. Nunez.

We believe that if a patient has an acute life-threatening condition (for example, a stroke, respiratory distress, or ongoing blood loss), it is the physician’s moral obligation to treat him or her, except under rare and extenuating circumstances—such as certain risk of dangerous exposure, injury, or death from attempting treatment. (This moral obligation is different from the legal rules outlined above.) If a patient is in extremis, a physician must attempt to treat. However, these clear obligations need not apply in less acute scenarios like that of Dr. Connelly and Ms. Nunez.

The article is here.

The Neuroscience Behind Bad Decisions

By Emily Singer
Quanta Magazine
Originally posted August 23, 2016

Here is an excerpt:

Glimcher is using both the brain and behavior to try to explain our irrationality. He has combined results from studies like the candy bar experiment with neuroscience data — measurements of electrical activity in the brains of animals as they make decisions — to develop a theory of how we make decisions and why that can lead to mistakes.

Glimcher has been one of the driving forces in the still young field of neuroeconomics. His theory merges far-reaching research in brain activity, neuronal networks, fMRI and human behavior. “He’s famous for arguing that neuroscience and economics should be brought together,” said Nathaniel Daw, a neuroscientist at Princeton University. One of Glimcher’s most important contributions, Daw said, has been figuring out how to quantify abstract notions such as value and study them in the lab.

In a new working paper, Glimcher and his co-authors — Kenway Louie, also of NYU, and Ryan Webb of the University of Toronto — argue that their neuroscience-based model outperforms standard economic theory at explaining how people behave when faced with lots of choices. “The neural model, described in biology and tested in neurons, works well to describe something economists couldn’t explain,” Glimcher said.

The article is here.

Forgive Us Our Trespasses: Priming a Forgiving (But Not a Punishing) God Increases Unethical Behavior

Amber E DeBono, Azim Shariff, Sarah Poole, and Mark Muraven
Psychology of Religion and Spirituality · December 2016

Abstract

Religious people differ in how punishing or forgiving they see their Gods. Such different beliefs may have distinct consequences in encouraging people to act in normative ways. Though a number of priming studies have shown a positive causal relationship between religion and normative behavior, few have primed different aspects of religion, and none has examined the punishing/forgiving dimension. In three experiments, Christians instructed to read and write about a forgiving God stole more money (Experiments 1 and 2) and cheated more on a math assignment (Experiment 3) than those who read and wrote about a punishing God, a forgiving human, a punishing human, or those in a control condition. These studies present a more complex and nuanced picture of the important relationship between religion and normative behavior.

The article is here.

Psychiatrist diagnosed local optician without meeting him

By Kelly Bennett
CBC News
Originally posted: Aug 25, 2016

A Burlington optician is outraged after discovering a psychiatrist he'd never met wrote a critical two-page psychiatric evaluation about him without ever seeing or talking to him.

The optician, Jay Hakim, filed a complaint with the provincial medical regulator, which concluded the psychiatrist's conduct was appropriate.

Hakim appealed the regulator's decision; that appeal was held in a hearing downtown Hamilton on Wednesday.

The case raises "some very serious consequences for society" if it's allowed to stand, Hakim argued.

It also parallels issues raised in the United States over whether psychiatrists can ethically provide opinions on the mental health of presidential candidates they've never met.

The article is here.

Direct to consumer genetic testing and the libertarian right to test

Michele Loi
J Med Ethics 2016;42:574-577

Abstract

I sketch a libertarian argument for the right to test in the context of ‘direct to consumer’ (DTC) genetic testing. A libertarian right to genetic tests, as defined here, relies on the idea of a moral right to self-ownership. I show how a libertarian right to test can be inferred from this general libertarian premise, at least as a prima facie right, shifting the burden of justification on regulators. I distinguish this distinctively libertarian position from some arguments based on considerations of utility or autonomy, which are sometimes labelled ‘libertarian’ because they oppose a tight regulation of the direct to consumer genetic testing sector. If one takes the libertarian right to test as a starting point, the whole discussion concerning autonomy and personal utility may be sidestepped. Finally, I briefly consider some considerations that justify the regulation of the DTC genetic testing market, compatible with the recognition of a prima facie right to test.

The article is here.

The first autonomous, entirely soft robot

By Leah Burrows
Harvard Gazette
Originally published August 24, 2016

Here are two excerpts:

Soft robotics could help revolutionize how humans interact with machines. But researchers have struggled to build entirely compliant robots. Electric power and control systems — such as batteries and circuit boards — are rigid, and until now soft-bodied robots have been either tethered to an off-board system or rigged with hard components.

(cut)

“One longstanding vision for the field of soft robotics has been to create robots that are entirely soft, but the struggle has always been in replacing rigid components like batteries and electronic controls with analogous soft systems and then putting it all together,” said Wood. “This research demonstrates that we can easily manufacture the key components of a simple, entirely soft robot, which lays the foundation for more complex designs.”

The article and video are here.

World's First Self-Driving Taxis Debut in Singapore

Annabelle Liang and Dee-Ann Durbin
Associated Press
August 24, 2016

Here is an excerpt:

The service will start small — six cars now, growing to a dozen by the end of the year. The ultimate goal, say nuTonomy officials, is to have a fully self-driving taxi fleet in Singapore by 2018, which will help sharply cut the number of cars on Singapore's congested roads. Eventually, the model could be adopted in cities around the world, nuTonomy says.

For now, the taxis only will run in a 2.5-square-mile business and residential district called "one-north," and pick-ups and drop-offs will be limited to specified locations. And riders must have an invitation from nuTonomy to use the service. The company says dozens have signed up for the launch, and it plans to expand that list to thousands of people within a few months.

The article is here.

Driven to extinction? The ethics of eradicating mosquitoes with gene-drive technologies

Jonathan Pugh
J Med Ethics 2016;42:578-581

Abstract

Mosquito-borne diseases represent a significant global disease burden, and recent outbreaks of such diseases have led to calls to reduce mosquito populations. Furthermore, advances in ‘gene-drive’ technology have raised the prospect of eradicating certain species of mosquito via genetic modification. This technology has attracted a great deal of media attention, and the idea of using gene-drive technology to eradicate mosquitoes has been met with criticism in the public domain. In this paper, I shall dispel two moral objections that have been raised in the public domain against the use of gene-drive technologies to eradicate mosquitoes. The first objection invokes the concept of the ‘sanctity of life’ in order to claim that we should not drive an animal to extinction. In response, I follow Peter Singer in raising doubts about general appeals to the sanctity of life, and argue that neither individual mosquitoes nor mosquitoes species considered holistically are appropriately described as bearing a significant degree of moral status. The second objection claims that seeking to eradicate mosquitoes amounts to displaying unacceptable degrees of hubris. Although I argue that this objection also fails, I conclude by claiming that it raises the important point that we need to acquire more empirical data about, inter alia, the likely effects of mosquito eradication on the ecosystem, and the likelihood of gene-drive technology successfully eradicating the intended mosquito species, in order to adequately inform our moral analysis of gene-drive technologies in this context.

The article is here.

Report: Gardens employer of Pulse nightclub shooter fined $150k

Lulu Ramadan
PalmBeachPost.com
Originally posted September 10, 2016

The Palm Beach Gardens-based security company that employed the Orlando nightclub shooter Omar Mateen was ordered to pay “the largest fine issued in history” of the Florida Department of Agriculture and Consumer Services for falsley reporting psychological testing information, the Orlando Sentinel reports.

G4S Secure Solutions was issued the $151,400 fine Friday, after the department found that the psychologist listed on a form that allowed Mateen to carry a weapon was not practicing as a screener. A total of 1,514 forms submitted between 2006 and 2016 erroneously listed psychologist Carol Nudelman’s name.

The form that allowed Mateen to carry a gun as a security guard was dated Sept. 6, 2007, nearly two years after Nudelman had retired.

The article is here.