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, October 31, 2016

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Cassandra L. Boness
Ethics & Behavior-Volume 26, 2016 - Issue 7

Abstract

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.

The article is here.

A Plan To Defend Against the War on Science

By Shawn Otto
Scientific American
Originally published October 9, 2016

Here is an excerpt:

In the years since, the situation has gotten worse. We’ve seen the emergence of a “post-fact” politics, which has normalized the denial of scientific evidence that conflicts with the political, religious or economic agendas of authority. Much of this denial centers, now somewhat predictably, around climate change—but not all. If there is a single factor to consider as a barometer that evokes all others in this election, it is the candidates’ attitudes toward science.

Consider, for example, what has been occurring in Congress. Rep. Lamar Smith, the Texas Republican who chairs the House Committee on Science, Space and Technology, is a climate change denier. Smith has used his post to initiate a series of McCarthy-style witch-hunts, issuing subpoenas and demanding private correspondence and testimony from scientists, civil servants, government science agencies, attorneys general and nonprofit organizations whose work shows that global warming is happening, humans are causing it and that—surprise—energy companies sought to sow doubt about this fact.

The article is here.

Sunday, October 30, 2016

The ethics of animal research: a survey of the public and scientists in North America

Ari R. Joffe, Meredith Bara, Natalie Anton and Nathan Nobis
BMC Medical Ethics
BMC series – open, inclusive and trusted 2016

Background

To determine whether the public and scientists consider common arguments (and counterarguments) in support (or not) of animal research (AR) convincing.

Methods

After validation, the survey was sent to samples of public (Sampling Survey International (SSI; Canadian), Amazon Mechanical Turk (AMT; US), a Canadian city festival and children’s hospital), medical students (two second-year classes), and scientists (corresponding authors, and academic pediatricians). We presented questions about common arguments (with their counterarguments) to justify the moral permissibility (or not) of AR. Responses were compared using Chi-square with Bonferonni correction.

Results

There were 1220 public [SSI, n = 586; AMT, n = 439; Festival, n = 195; Hospital n = 107], 194/331 (59 %) medical student, and 19/319 (6 %) scientist [too few to report] responses. Most public respondents were <45 years (65 %), had some College/University education (83 %), and had never done AR (92 %). Most public and medical student respondents considered ‘benefits arguments’ sufficient to justify AR; however, most acknowledged that counterarguments suggesting alternative research methods may be available, or that it is unclear why the same ‘benefits arguments’ do not apply to using humans in research, significantly weakened ‘benefits arguments’. Almost all were not convinced of the moral permissibility of AR by ‘characteristics of non-human-animals arguments’, including that non-human-animals are not sentient, or are property. Most were not convinced of the moral permissibility of AR by ‘human exceptionalism’ arguments, including that humans have more advanced mental abilities, are of a special ‘kind’, can enter social contracts, or face a ‘lifeboat situation’. Counterarguments explained much of this, including that not all humans have these more advanced abilities [‘argument from species overlap’], and that the notion of ‘kind’ is arbitrary [e.g., why are we not of the ‘kind’ ‘sentient-animal’ or ‘subject-of-a-life’?]. Medical students were more supportive (80 %) of AR at the end of the survey (p < 0.05).

Conclusions

Responses suggest that support for AR may not be based on cogent philosophical rationales, and more open debate is warranted.

Saturday, October 29, 2016

Genome Editing: An Ethical Review

Nuffield Council on Bioethics
Published September 2016

This review considers the impact of recent advances in genome editing, which have diffused rapidly across many fields of biological research, and the range of ethical questions to which they give rise. It was carried out by an interdisciplinary Working Group that included expertise in science, law, philosophy, ethics, sociology and industry. In coming to its conclusions, the Working Group invited contributions from a wide range of people, including through an open call for evidence that ran from November 2015 until February 2016.

The review sets out our preliminary findings on the impact of genome editing across different areas of biological research and applications, and the range of questions to which this gives rise.

Read on:

  • Genome editing in brief: what, why and how?
  • The context of genome editing
  • Moral perspectives
  • Human health
  • Food
  • Wildlife and ecosystems
  • Other applications: industrial, military and amateur use
  • Conclusions

The next stages of this programme of work will focus on examining and addressing the ethical and practical questions arising in two contexts where genome editing may have a significant impact: firstly, the avoidance of genetic disease and, secondly, livestock farming. Reports on each of these two areas, with recommendations for policy and practice, will be published in 2017.

The full resource can be downloaded here.

Friday, October 28, 2016

How Large Is the Role of Emotion in Judgments of Moral Dilemmas?

Zachary Horne and Derek Powell
PLoS ONE
Originally published: July 6, 2016

Abstract

Moral dilemmas often pose dramatic and gut-wrenching emotional choices. It is now widely accepted that emotions are not simply experienced alongside people’s judgments about moral dilemmas, but that our affective processes play a central role in determining those judgments. However, much of the evidence purporting to demonstrate the connection between people’s emotional responses and their judgments about moral dilemmas has recently been called into question. In the present studies, we reexamined the role of emotion in people’s judgments about moral dilemmas using a validated self-report measure of emotion. We measured participants’ specific emotional responses to moral dilemmas and, although we found that moral dilemmas evoked strong emotional responses, we found that these responses were only weakly correlated with participants’ moral judgments. We argue that the purportedly strong connection between emotion and judgments of moral dilemmas may have been overestimated.

The article is here.

Is “Allison” more likely than “Lakisha” to get a call back from counseling professionals: A racism audit study.

Shin, R. Q., Smith, L.C., Welch, J., Ezeofor, I. (in press).
The Counseling Psychologist

Abstract:

Using an audit study, we studied racially biased call back responses in the mental health field by leaving voicemails soliciting services with practicing counselors and psychologists (N = 371). To manipulate perceived race, an actor identified herself with either a Black or White sounding name. While the difference in callback rate between the two names was not significant, the difference in voice messages from therapists that either promoted potential services or impeded services was significant. The caller with the White-sounding name received voice messages that promoted the potential for services at a 12% higher rate than the caller with the Black sounding name. Limitations, future directions for research, and counseling implications are discussed.

A review of the article is here.

Thursday, October 27, 2016

Sex and Other Sins: Public Morality, Public Health, and Funding PrEP

Guest Post by Nathan Emmerich
BMJ Blogs
Originally posted October 5, 2016

Here is an excerpt:

Consider the following thought experiments. Imagine a drug that could be taken to significantly lessen the risk that a smoker would develop lung cancer, or a drug that would lessen the risk of ‘at risk’ individuals developing diabetes. In such cases would we be inclined to refuse public funds for such drugs merely because such individuals could lessen their risks even more by giving up smoking, or by losing weight and eating a healthy or, at least, healthier diet?

There is, certainly, something regrettable about having to spend public money on a drug that offsets risks generated by an individual’s own behaviour. Nevertheless, from an epidemiological – and therefore public health – perspective, the notion that an individual makes a choice about whether or not to smoke, or to have a bad diet, is too simplistic, even when we place the issue of addiction to one side. Thus, even when smoking cessation programmes are available and even when nutritional advice is within easy reach (as it increasingly is), plenty of people still smoke and consume a less than healthy diet.

Smoking and bad diets are correlated with a variety of demographic factors, and our choices are always made within particular cultural and socio-political contexts. Even so, some have questioned if the NHS should be funding stomach-stapling operations for those who are overweight, or if smokers and non-smokers can expect to receive the same level of treatment and care.

The entire blog post is here.

Wednesday, October 26, 2016

7 Ways We Know Systemic Racism Is Real

benjerry.com

Here is an excerpt:

Racism at Every Level of Society

Systemic racism is about the way racism is built right into every level of our society. Many people point to what they see as less in-your-face prejudice and bias these days, compared to decades past, but as Archbishop Desmond Tutu said, “If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality.”

While fewer people may consider themselves racist, racism itself persists in our schools, offices, court system, police departments, and elsewhere. Think about it: when white people occupy most positions of decision-making power, people of color have a difficult time getting a fair shake, let alone getting ahead. Bottom line: we have a lot of work to do.

The blog post is here.

Ethics of Coercive Treatment and Misuse of Psychiatry

Tilman Steinert
Psychiatric Services
http://dx.doi.org/10.1176/appi.ps.201600066

Abstract

The author discusses a pragmatic approach to decisions about coercive treatment that is based on four principles from principle-based ethics: respect for autonomy, nonmaleficence, beneficence, and justice. This approach can reconcile psychiatry’s perspective with the U.N. Convention on the Rights of Persons With Disabilities. Coercive treatment can be justified only when a patient’s capacity to consent is substantially impaired and severe danger to health or life cannot be prevented by less intrusive means. In this case, withholding treatment can violate the principle of justice. In the case of danger to others, social exclusion and loss of freedom can be seen as harming psychosocial health, which can justify coercive treatment. Considerable efforts are required to support patients’ informed decisions and avoid allowing others to make substitute decisions. Mental disorder alone without impaired capacity does not justify involuntary treatment, which can be considered a misuse of psychiatry. Involuntary detention without treatment can be justified for short periods for assessment and to offer treatment options.

The article is here.