Ron Carucci
Harvard Business Review
Originally posted August 29, 2017
Here is an excerpt:
Facing high-risk decisions.
For routine decisions, most leaders fall into one of two camps: The “trust your gut” leader makes highly intuitive decisions, and the “analyze everything” leader wants lots of data to back up their choice. Usually, a leader’s preference for one of these approaches poses minimal threat to the decision’s quality. But the stress caused by a high-stakes decision can provoke them to the extremes of their natural inclination. The highly intuitive leader becomes impulsive, missing critical facts. The highly analytical leader gets paralyzed in data, often failing to make any decision. The right blend of data and intuition applied to carefully constructing a choice builds the organization’s confidence for executing the decision once made. Clearly identify the risks inherent in the precedents underlying the decision and communicate that you understand them. Examine available data sets, identify any conflicting facts, and vet them with appropriate stakeholders (especially superiors) to make sure your interpretations align. Ask for input from others who’ve faced similar decisions. Then make the call.
Solving an intractable problem.
To a stressed-out leader facing a chronic challenge, it often feels like their only options are to either (1) vehemently argue for their proposed solution with unyielding certainty, or (2) offer ideas very indirectly to avoid seeming domineering and to encourage the team to take ownership of the challenge. The problem, again, is that neither extreme works. If people feel the leader is being dogmatic, they will disengage regardless of the merits of the idea. If they feel the leader lacks confidence in the idea, they will struggle to muster conviction to try it, concluding, “Well, if the boss isn’t all that convinced it will work, I’m not going to stick my neck out.”
The article is here.
Thursday, August 31, 2017
Wednesday, August 30, 2017
Vignette 36: The Cancellation Conundrum
Dr. Wendy Malik operates an independent practice in a suburban area. She receives a referral from a physician, with whom she has a positive working relationship. Dr. Malik contacts the patient, completes a phone screening, and sets up an appointment with Mr. Larry David.
As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent. She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.
Several days later, Dr. Malik checks her email. In it, Mr. David sent her an email with an attachment. Mr. David asks Dr. Malik to review his edits on the informed consent document.
While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy. Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient. Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.
Flustered by this edit, Dr. Malik contacts you for a consultation.
What are the ethical issues involved in this case?
What are the pertinent clinical issues in this case?
How would you help Dr. Malik work through these issues?
Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?
At this point, must Dr. Malik keep Mr. David as a patient?
If not, does Dr. Malik need to contact her referral source about the issue?
As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent. She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.
Several days later, Dr. Malik checks her email. In it, Mr. David sent her an email with an attachment. Mr. David asks Dr. Malik to review his edits on the informed consent document.
While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy. Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient. Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.
Flustered by this edit, Dr. Malik contacts you for a consultation.
What are the ethical issues involved in this case?
What are the pertinent clinical issues in this case?
How would you help Dr. Malik work through these issues?
Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?
At this point, must Dr. Malik keep Mr. David as a patient?
If not, does Dr. Malik need to contact her referral source about the issue?
Fat Shaming in the Doctor's Office Can Be Mentally and Physically Harmful
American Psychological Association
Press Release from August 3, 2017
Medical discrimination based on people’s size and negative stereotypes of overweight people can take a toll on people’s physical health and well-being, according to a review of recent research presented at the 125th Annual Convention of the American Psychological Association.
“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behavior, is stressful and can cause patients to delay health care seeking or avoid interacting with providers,” presenter Joan Chrisler, PhD, a professor of psychology at Connecticut College, said during a symposium titled “Weapons of Mass Distraction — Confronting Sizeism.”
Sizeism can also have an effect on how doctors medically treat patients, as overweight people are often excluded from medical research based on assumptions about their health status, Chrisler said, meaning the standard dosage for drugs may not be appropriate for larger body sizes. Recent studies have shown frequent under-dosing of overweight patients who were prescribed antibiotics and chemotherapy, she added.
“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average weight patients.”
In some cases, providers might not take fat patients’ complaints seriously or might assume that their weight is the cause of any symptoms they experience, Chrisler added. “Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
The pressor is here.
Press Release from August 3, 2017
Medical discrimination based on people’s size and negative stereotypes of overweight people can take a toll on people’s physical health and well-being, according to a review of recent research presented at the 125th Annual Convention of the American Psychological Association.
“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behavior, is stressful and can cause patients to delay health care seeking or avoid interacting with providers,” presenter Joan Chrisler, PhD, a professor of psychology at Connecticut College, said during a symposium titled “Weapons of Mass Distraction — Confronting Sizeism.”
Sizeism can also have an effect on how doctors medically treat patients, as overweight people are often excluded from medical research based on assumptions about their health status, Chrisler said, meaning the standard dosage for drugs may not be appropriate for larger body sizes. Recent studies have shown frequent under-dosing of overweight patients who were prescribed antibiotics and chemotherapy, she added.
“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average weight patients.”
In some cases, providers might not take fat patients’ complaints seriously or might assume that their weight is the cause of any symptoms they experience, Chrisler added. “Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
The pressor is here.
Tuesday, August 29, 2017
Must science be testable?
Massimo Pigliucci
Aeon
Originally published August 10, 2016
Here is an excerpt:
hat said, the publicly visible portion of the physics community nowadays seems split between people who are openly dismissive of philosophy and those who think they got the pertinent philosophy right but their ideological opponents haven’t. At stake isn’t just the usually tiny academic pie, but public appreciation of and respect for both the humanities and the sciences, not to mention millions of dollars in research grants (for the physicists, not the philosophers). Time, therefore, to take a more serious look at the meaning of Popper’s philosophy and why it is still very much relevant to science, when properly understood.
As we have seen, Popper’s message is deceptively simple, and – when repackaged in a tweet – has in fact deceived many a smart commentator in underestimating the sophistication of the underlying philosophy. If one were to turn that philosophy into a bumper sticker slogan it would read something like: ‘If it ain’t falsifiable, it ain’t science, stop wasting your time and money.’
But good philosophy doesn’t lend itself to bumper sticker summaries, so one cannot stop there and pretend that there is nothing more to say. Popper himself changed his mind throughout his career about a number of issues related to falsification and demarcation, as any thoughtful thinker would do when exposed to criticisms and counterexamples from his colleagues. For instance, he initially rejected any role for verification in establishing scientific theories, thinking that it was far too easy to ‘verify’ a notion if one were actively looking for confirmatory evidence. Sure enough, modern psychologists have a name for this tendency, common to laypeople as well as scientists: confirmation bias.
Nonetheless, later on Popper conceded that verification – especially of very daring and novel predictions – is part of a sound scientific approach. After all, the reason Einstein became a scientific celebrity overnight after the 1919 total eclipse is precisely because astronomers had verified the predictions of his theory all over the planet and found them in satisfactory agreement with the empirical data.
The article is here.
Aeon
Originally published August 10, 2016
hat said, the publicly visible portion of the physics community nowadays seems split between people who are openly dismissive of philosophy and those who think they got the pertinent philosophy right but their ideological opponents haven’t. At stake isn’t just the usually tiny academic pie, but public appreciation of and respect for both the humanities and the sciences, not to mention millions of dollars in research grants (for the physicists, not the philosophers). Time, therefore, to take a more serious look at the meaning of Popper’s philosophy and why it is still very much relevant to science, when properly understood.
As we have seen, Popper’s message is deceptively simple, and – when repackaged in a tweet – has in fact deceived many a smart commentator in underestimating the sophistication of the underlying philosophy. If one were to turn that philosophy into a bumper sticker slogan it would read something like: ‘If it ain’t falsifiable, it ain’t science, stop wasting your time and money.’
But good philosophy doesn’t lend itself to bumper sticker summaries, so one cannot stop there and pretend that there is nothing more to say. Popper himself changed his mind throughout his career about a number of issues related to falsification and demarcation, as any thoughtful thinker would do when exposed to criticisms and counterexamples from his colleagues. For instance, he initially rejected any role for verification in establishing scientific theories, thinking that it was far too easy to ‘verify’ a notion if one were actively looking for confirmatory evidence. Sure enough, modern psychologists have a name for this tendency, common to laypeople as well as scientists: confirmation bias.
Nonetheless, later on Popper conceded that verification – especially of very daring and novel predictions – is part of a sound scientific approach. After all, the reason Einstein became a scientific celebrity overnight after the 1919 total eclipse is precisely because astronomers had verified the predictions of his theory all over the planet and found them in satisfactory agreement with the empirical data.
The article is here.
The Influence of (Dis)belief in Free Will on Immoral Behavior
Caspar, E. A., Vuillaume, L., Magalhães De Saldanha da Gama, P. A. and Cleeremans, A.
Frontiers in Psychology, 17 January 2017
Abstract
One of the hallmarks of human existence is that we all hold beliefs that determine how we act. Amongst such beliefs, the idea that we are endowed with free will appears to be linked to prosocial behaviors, probably by enhancing the feeling of responsibility of individuals over their own actions. However, such effects appear to be more complex that one might have initially thought. Here, we aimed at exploring how induced disbeliefs in free will impact the sense of agency over the consequences of one’s own actions in a paradigm that engages morality. To do so, we asked participants to choose to inflict or to refrain from inflicting an electric shock to another participant in exchange of a small financial benefit. Our results show that participants who were primed with a text defending neural determinism – the idea that humans are a mere bunch of neurons guided by their biology – administered fewer shocks and were less vindictive toward the other participant. Importantly, this finding only held for female participants. These results show the complex interaction between gender, (dis)beliefs in free will and moral behavior.
From the Conclusion:
To conclude, we observed that disbelief in free will had a positive impact on the morality of decisions toward others. The present work extends previous research by showing that additional factors, such as gender, could influence the impact of (dis)belief in free will on prosocial and antisocial behaviors. Our results also showed that previous results relative to the (moral) context underlying the paradigm in use are not always replicated.
The research is here.
Frontiers in Psychology, 17 January 2017
Abstract
One of the hallmarks of human existence is that we all hold beliefs that determine how we act. Amongst such beliefs, the idea that we are endowed with free will appears to be linked to prosocial behaviors, probably by enhancing the feeling of responsibility of individuals over their own actions. However, such effects appear to be more complex that one might have initially thought. Here, we aimed at exploring how induced disbeliefs in free will impact the sense of agency over the consequences of one’s own actions in a paradigm that engages morality. To do so, we asked participants to choose to inflict or to refrain from inflicting an electric shock to another participant in exchange of a small financial benefit. Our results show that participants who were primed with a text defending neural determinism – the idea that humans are a mere bunch of neurons guided by their biology – administered fewer shocks and were less vindictive toward the other participant. Importantly, this finding only held for female participants. These results show the complex interaction between gender, (dis)beliefs in free will and moral behavior.
From the Conclusion:
To conclude, we observed that disbelief in free will had a positive impact on the morality of decisions toward others. The present work extends previous research by showing that additional factors, such as gender, could influence the impact of (dis)belief in free will on prosocial and antisocial behaviors. Our results also showed that previous results relative to the (moral) context underlying the paradigm in use are not always replicated.
The research is here.
Monday, August 28, 2017
Maintaining cooperation in complex social dilemmas using deep reinforcement learning
Adam Lerer and Alexander Peysakhovich
(2017)
Abstract
In social dilemmas individuals face a temptation to increase their payoffs in the short run at a cost to the long run total welfare. Much is known about how cooperation can be stabilized in the simplest of such settings: repeated Prisoner’s Dilemma games. However, there is relatively little work on generalizing these insights to more complex situations. We start to fill this gap by showing how to use modern reinforcement learning methods to generalize a highly successful Prisoner’s Dilemma strategy: tit-for-tat. We construct artificial agents that act in ways that are simple to understand, nice (begin by cooperating), provokable (try to avoid being exploited), and forgiving (following a bad turn try to return to mutual cooperation). We show both theoretically and experimentally that generalized tit-for-tat agents can maintain cooperation in more complex environments. In contrast, we show that employing purely reactive training techniques can lead to agents whose behavior results in socially inefficient outcomes.
The paper is here.
(2017)
Abstract
In social dilemmas individuals face a temptation to increase their payoffs in the short run at a cost to the long run total welfare. Much is known about how cooperation can be stabilized in the simplest of such settings: repeated Prisoner’s Dilemma games. However, there is relatively little work on generalizing these insights to more complex situations. We start to fill this gap by showing how to use modern reinforcement learning methods to generalize a highly successful Prisoner’s Dilemma strategy: tit-for-tat. We construct artificial agents that act in ways that are simple to understand, nice (begin by cooperating), provokable (try to avoid being exploited), and forgiving (following a bad turn try to return to mutual cooperation). We show both theoretically and experimentally that generalized tit-for-tat agents can maintain cooperation in more complex environments. In contrast, we show that employing purely reactive training techniques can lead to agents whose behavior results in socially inefficient outcomes.
The paper is here.
Death Before Dishonor: Incurring Costs to Protect Moral Reputation
Andrew J. Vonasch, Tania Reynolds, Bo M. Winegard, Roy F. Baumeister
Social Psychological and Personality Science
First published date: July-21-2017
Abstract
Predicated on the notion that people’s survival depends greatly on participation in cooperative society, and that reputation damage may preclude such participation, four studies with diverse methods tested the hypothesis that people would make substantial sacrifices to protect their reputations. A “big data” study found that maintaining a moral reputation is one of people’s most important values. In making hypothetical choices, high percentages of “normal” people reported preferring jail time, amputation of limbs, and death to various forms of reputation damage (i.e., becoming known as a criminal, Nazi, or child molester). Two lab studies found that 30% of people fully submerged their hands in a pile of disgusting live worms, and 63% endured physical pain to prevent dissemination of information suggesting that they were racist. We discuss the implications of reputation protection for theories about altruism and motivation.
The article is here.
Social Psychological and Personality Science
First published date: July-21-2017
Abstract
Predicated on the notion that people’s survival depends greatly on participation in cooperative society, and that reputation damage may preclude such participation, four studies with diverse methods tested the hypothesis that people would make substantial sacrifices to protect their reputations. A “big data” study found that maintaining a moral reputation is one of people’s most important values. In making hypothetical choices, high percentages of “normal” people reported preferring jail time, amputation of limbs, and death to various forms of reputation damage (i.e., becoming known as a criminal, Nazi, or child molester). Two lab studies found that 30% of people fully submerged their hands in a pile of disgusting live worms, and 63% endured physical pain to prevent dissemination of information suggesting that they were racist. We discuss the implications of reputation protection for theories about altruism and motivation.
The article is here.
Sometimes giving a person a choice is an act of terrible cruelty
Lisa Tessman
aeon.com
Originally posted August 9, 2017
It is not always good to have the opportunity to make a choice. When we must decide to take one action rather than another, we also, ordinarily, become at least partly responsible for what we choose to do. Usually this is appropriate; it’s what makes us the kinds of creatures who can be expected to abide by moral norms.
Sometimes, making a choice works well. For instance, imagine that while leaving the supermarket parking lot you accidentally back into another car, visibly denting it. No one else is around, nor do you think there are any surveillance cameras. You face a choice: you could drive away, fairly confident that no one will ever find out that you damaged someone’s property, or you could leave a note on the dented car’s windshield, explaining what happened and giving contact information, so that you can compensate the car’s owner.
Obviously, the right thing to do is to leave a note. If you don’t do this, you’ve committed a wrongdoing that you could have avoided just by making a different choice. Even though you might not like having to take responsibility – and paying up – it’s good to be in the position of being able to do the right thing.
Yet sometimes, having a choice means deciding to commit one bad act or another. Imagine being a doctor or nurse caught in the following fictionalised version of real events at a hospital in New Orleans in the aftermath of Hurricane Katrina in 2005. Due to a tremendous level of flooding after the hurricane, the hospital must be evacuated. The medical staff have been ordered to get everyone out by the end of the day, but not all patients can be removed. As time runs out, it becomes clear that you have a choice, but it’s a choice between two horrifying options: euthanise the remaining patients without consent (because many of them are in a condition that renders them unable to give it) or abandon them to suffer a slow, painful and terrifying death alone. Even if you’re anguished at the thought of making either choice, you might be confident that one action – let’s say administering a lethal dose of drugs – is better than the other. Nevertheless, you might have the sense that no matter which action you perform, you’ll be violating a moral requirement.
Sunday, August 27, 2017
Will Trump Be the Death of the Goldwater Rule?
Jeannie Suk Gersen
The New Yorker
Originally posted August 23, 2017
Here is an excerpt:
The class of professionals best equipped to answer these questions has largely abstained from speaking publicly about the President’s mental health. The principle known as the “Goldwater rule” prohibits psychiatrists from giving professional opinions about public figures without personally conducting an examination, as Jane Mayer wrote in this magazine in May. After losing the 1964 Presidential election, Senator Barry Goldwater successfully sued Fact magazine for defamation after it published a special issue in which psychiatrists declared him “severely paranoid” and “unfit” for the Presidency. For a public figure to prevail in a defamation suit, he must demonstrate that the defendant acted with “actual malice”; a key piece of evidence in the Goldwater case was Fact’s disregard of a letter from the American Psychiatric Association warning that any survey of psychiatrists who hadn’t clinically examined Goldwater was invalid.
The Supreme Court denied Fact’s cert petition, which hoped to vindicate First Amendment rights to free speech and a free press. But Justice Hugo Black, joined by William O. Douglas, dissented, writing, “The public has an unqualified right to have the character and fitness of anyone who aspires to the Presidency held up for the closest scrutiny. Extravagant, reckless statements and even claims which may not be true seem to me an inevitable and perhaps essential part of the process by which the voting public informs itself of the qualities of a man who would be President.”
These statements, of course, resonate today. President Trump has unsuccessfully pursued many defamation lawsuits over the years, leading him to vow during the 2016 campaign to “open up our libel laws so when they write purposely negative and horrible and false articles, we can sue them and win lots of money.” (One of his most recent suits, dismissed in 2016, concerned a Univision executive’s social-media posting of side-by-side photos of Trump and Dylann Roof, the white supremacist who murdered nine black churchgoers in Charleston, South Carolina, in 2015; Trump alleged that the posting falsely accused him of inciting similar acts.)
The article is here.
The New Yorker
Originally posted August 23, 2017
Here is an excerpt:
The class of professionals best equipped to answer these questions has largely abstained from speaking publicly about the President’s mental health. The principle known as the “Goldwater rule” prohibits psychiatrists from giving professional opinions about public figures without personally conducting an examination, as Jane Mayer wrote in this magazine in May. After losing the 1964 Presidential election, Senator Barry Goldwater successfully sued Fact magazine for defamation after it published a special issue in which psychiatrists declared him “severely paranoid” and “unfit” for the Presidency. For a public figure to prevail in a defamation suit, he must demonstrate that the defendant acted with “actual malice”; a key piece of evidence in the Goldwater case was Fact’s disregard of a letter from the American Psychiatric Association warning that any survey of psychiatrists who hadn’t clinically examined Goldwater was invalid.
The Supreme Court denied Fact’s cert petition, which hoped to vindicate First Amendment rights to free speech and a free press. But Justice Hugo Black, joined by William O. Douglas, dissented, writing, “The public has an unqualified right to have the character and fitness of anyone who aspires to the Presidency held up for the closest scrutiny. Extravagant, reckless statements and even claims which may not be true seem to me an inevitable and perhaps essential part of the process by which the voting public informs itself of the qualities of a man who would be President.”
These statements, of course, resonate today. President Trump has unsuccessfully pursued many defamation lawsuits over the years, leading him to vow during the 2016 campaign to “open up our libel laws so when they write purposely negative and horrible and false articles, we can sue them and win lots of money.” (One of his most recent suits, dismissed in 2016, concerned a Univision executive’s social-media posting of side-by-side photos of Trump and Dylann Roof, the white supremacist who murdered nine black churchgoers in Charleston, South Carolina, in 2015; Trump alleged that the posting falsely accused him of inciting similar acts.)
The article is here.
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