Erik Angner
BPP Blog, the companion blog to the new journal Behavioural Public Policy
Originally posted June 2, 2017
Cass R. Sunstein’s ‘Nudges That Fail’ explores why some nudges work, why some fail, and what should be done in the face of failure. It’s a useful contribution in part because it reminds us that nudging – roughly speaking, the effort to improve people’s welfare by helping them make better choices without interfering with their liberty or autonomy – is harder than it might seem. When people differ in beliefs, values, and preferences, or when they differ in their responses to behavioral interventions, for example, it may be difficult to design a nudge that benefits at least some without violating anyone’s liberty or autonomy. But the paper is a useful contribution also because it suggests concrete, positive steps that may be taken to help us get better simultaneously at enhancing welfare and at respecting liberty and autonomy.
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Moreover, even if a nudge is on the net welfare enhancing and doesn’t violate any other values, it does not follow that it should be implemented. As economists are fond of telling you, everything has an opportunity cost, and so do nudges. If whatever resources would be used in the implementation of the nudge could be put to better use elsewhere, we would have reason not to implement it. If we did anyway, we would be guilty of the Econ 101 fallacy of ignoring opportunity costs, which would be embarrassing.
The blog post is here.
Wednesday, January 10, 2018
Our enemies are human: that’s why we want to kill them
Tage Rai, Piercarlo Valdesolo, and Jesse Graham
aeon.co
Originally posted December 13, 2017
Here are two excerpts:
What we found was that dehumanising victims predicts support for instrumental violence, but not for moral violence. For example, Americans who saw Iraqi civilians as less human were more likely to support drone strikes in Iraq. In this case, no one wants to kill innocent civilians, but if they die as collateral damage in the pursuit of killing ISIS terrorists, dehumanising them eases our guilt. In contrast, seeing ISIS terrorists as less human predicted nothing about support for drone strikes against them. This is because people want to hurt and kill terrorists. Without their humanity, how could terrorists be guilty, and how could they feel the pain that they deserve?
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Many people believe that it is only a breakdown in our moral sensibilities that causes violence. To reduce violence, according to this argument, we need only restore our sense of morality by generating empathy toward victims. If we could just see them as fellow human beings, then we would do them no harm. Yet our research suggests that this is untrue. In cases of moral violence, our experiments suggest that it is the engagement of our moral sense, not its disengagement, that often causes aggression. When Myanmar security forces plant landmines at the Bangladesh border in an attempt to kill the Rohingya minorities who are trying to escape the slaughter, the primary driver of their behaviour is not dehumanisation, but rather moral outrage toward an enemy conceptualised as evil, but also completely human.
The article is here.
aeon.co
Originally posted December 13, 2017
Here are two excerpts:
What we found was that dehumanising victims predicts support for instrumental violence, but not for moral violence. For example, Americans who saw Iraqi civilians as less human were more likely to support drone strikes in Iraq. In this case, no one wants to kill innocent civilians, but if they die as collateral damage in the pursuit of killing ISIS terrorists, dehumanising them eases our guilt. In contrast, seeing ISIS terrorists as less human predicted nothing about support for drone strikes against them. This is because people want to hurt and kill terrorists. Without their humanity, how could terrorists be guilty, and how could they feel the pain that they deserve?
(cut)
Many people believe that it is only a breakdown in our moral sensibilities that causes violence. To reduce violence, according to this argument, we need only restore our sense of morality by generating empathy toward victims. If we could just see them as fellow human beings, then we would do them no harm. Yet our research suggests that this is untrue. In cases of moral violence, our experiments suggest that it is the engagement of our moral sense, not its disengagement, that often causes aggression. When Myanmar security forces plant landmines at the Bangladesh border in an attempt to kill the Rohingya minorities who are trying to escape the slaughter, the primary driver of their behaviour is not dehumanisation, but rather moral outrage toward an enemy conceptualised as evil, but also completely human.
The article is here.
Tuesday, January 9, 2018
Drug Companies’ Liability for the Opioid Epidemic
Rebecca L. Haffajee and Michelle M. Mello
N Engl J Med 2017; 377:2301-2305
December 14, 2017
DOI: 10.1056/NEJMp1710756
Here is an excerpt:
Opioid products, they alleged, were defectively designed because companies failed to include safety mechanisms, such as an antagonist agent or tamper-resistant formulation. Manufacturers also purportedly failed to adequately warn about addiction risks on drug packaging and in promotional activities. Some claims alleged that opioid manufacturers deliberately withheld information about their products’ dangers, misrepresenting them as safer than alternatives.
These suits faced formidable barriers that persist today. As with other prescription drugs, persuading a jury that an opioid is defectively designed if the Food and Drug Administration approved it is challenging. Furthermore, in most states, a drug manufacturer’s duty to warn about risks is limited to issuing an adequate warning to prescribers, who are responsible for communicating with patients. Finally, juries may resist laying legal responsibility at the manufacturer’s feet when the prescriber’s decisions and the patient’s behavior contributed to the harm. Some individuals do not take opioids as prescribed or purchase them illegally. Companies may argue that such conduct precludes holding manufacturers liable, or at least should reduce damages awards.
One procedural strategy adopted in opioid litigation that can help overcome defenses based on users’ conduct is the class action suit, brought by a large group of similarly situated individuals. In such suits, the causal relationship between the companies’ business practices and the harm is assessed at the group level, with the focus on statistical associations between product use and injury. The use of class actions was instrumental in overcoming tobacco companies’ defenses based on smokers’ conduct. But early attempts to bring class actions against opioid manufacturers encountered procedural barriers. Because of different factual circumstances surrounding individuals’ opioid use and clinical conditions, judges often deemed proposed class members to lack sufficiently common claims.
The article is here.
N Engl J Med 2017; 377:2301-2305
December 14, 2017
DOI: 10.1056/NEJMp1710756
Here is an excerpt:
Opioid products, they alleged, were defectively designed because companies failed to include safety mechanisms, such as an antagonist agent or tamper-resistant formulation. Manufacturers also purportedly failed to adequately warn about addiction risks on drug packaging and in promotional activities. Some claims alleged that opioid manufacturers deliberately withheld information about their products’ dangers, misrepresenting them as safer than alternatives.
These suits faced formidable barriers that persist today. As with other prescription drugs, persuading a jury that an opioid is defectively designed if the Food and Drug Administration approved it is challenging. Furthermore, in most states, a drug manufacturer’s duty to warn about risks is limited to issuing an adequate warning to prescribers, who are responsible for communicating with patients. Finally, juries may resist laying legal responsibility at the manufacturer’s feet when the prescriber’s decisions and the patient’s behavior contributed to the harm. Some individuals do not take opioids as prescribed or purchase them illegally. Companies may argue that such conduct precludes holding manufacturers liable, or at least should reduce damages awards.
One procedural strategy adopted in opioid litigation that can help overcome defenses based on users’ conduct is the class action suit, brought by a large group of similarly situated individuals. In such suits, the causal relationship between the companies’ business practices and the harm is assessed at the group level, with the focus on statistical associations between product use and injury. The use of class actions was instrumental in overcoming tobacco companies’ defenses based on smokers’ conduct. But early attempts to bring class actions against opioid manufacturers encountered procedural barriers. Because of different factual circumstances surrounding individuals’ opioid use and clinical conditions, judges often deemed proposed class members to lack sufficiently common claims.
The article is here.
Dangers of neglecting non-financial conflicts of interest in health and medicine
Wiersma M, Kerridge I, Lipworth W.
Journal of Medical Ethics
Published Online First: 24 November 2017.
doi: 10.1136/medethics-2017-104530
Abstract
Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest.
The article is here.
Journal of Medical Ethics
Published Online First: 24 November 2017.
doi: 10.1136/medethics-2017-104530
Abstract
Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest.
The article is here.
Monday, January 8, 2018
Advocacy group raises concerns about psychological evaluations on hundreds of defendants
Keith L. Alexander
The Washington Post
Originally published December 14, 2017
A District employee who has conducted mental evaluations on hundreds of criminal defendants as a forensic psychologist has been removed from that role after concerns surfaced about her educational qualifications, according to city officials.
Officials with the District’s Department of Health said Reston N. Bell was not qualified to conduct the assessments without the help or review of a supervisor. The city said it had mistakenly granted Bell, who was hired in 2016, a license to practice psychology, but this month the license was downgraded to “psychology associate.”
Although Bell has a master’s degree in psychology and a doctorate in education, she does not have a PhD in psychology, which led to the downgrade.
The article is here.
The Washington Post
Originally published December 14, 2017
A District employee who has conducted mental evaluations on hundreds of criminal defendants as a forensic psychologist has been removed from that role after concerns surfaced about her educational qualifications, according to city officials.
Officials with the District’s Department of Health said Reston N. Bell was not qualified to conduct the assessments without the help or review of a supervisor. The city said it had mistakenly granted Bell, who was hired in 2016, a license to practice psychology, but this month the license was downgraded to “psychology associate.”
Although Bell has a master’s degree in psychology and a doctorate in education, she does not have a PhD in psychology, which led to the downgrade.
The article is here.
Nudging, informed consent and bullshit
William Simkulet
Journal of Medical Ethics Published Online
First: 18 November 2017. doi: 10.1136/medethics-2017-104480
Abstract
Some philosophers have argued that during the process of obtaining informed consent, physicians should try to nudge their patients towards consenting to the option the physician believes best, where a nudge is any influence that is expected to predictably alter a person’s behaviour without (substantively) restricting her options. Some proponents of nudging even argue that it is a necessary and unavoidable part of securing informed consent. Here I argue that nudging is incompatible with obtaining informed consent. I assume informed consent requires that a physician tells her patient the truth about her options and argue that nudging is incompatible with truth-telling. Instead, nudging satisfies Harry Frankfurt’s account of bullshit.
The article is here.
Journal of Medical Ethics Published Online
First: 18 November 2017. doi: 10.1136/medethics-2017-104480
Abstract
Some philosophers have argued that during the process of obtaining informed consent, physicians should try to nudge their patients towards consenting to the option the physician believes best, where a nudge is any influence that is expected to predictably alter a person’s behaviour without (substantively) restricting her options. Some proponents of nudging even argue that it is a necessary and unavoidable part of securing informed consent. Here I argue that nudging is incompatible with obtaining informed consent. I assume informed consent requires that a physician tells her patient the truth about her options and argue that nudging is incompatible with truth-telling. Instead, nudging satisfies Harry Frankfurt’s account of bullshit.
The article is here.
Sunday, January 7, 2018
Are human rights anything more than legal conventions?
John Tasioulas
aeon.co
Originally published April 11, 2017
We live in an age of human rights. The language of human rights has become ubiquitous, a lingua franca used for expressing the most basic demands of justice. Some are old demands, such as the prohibition of torture and slavery. Others are newer, such as claims to internet access or same-sex marriage. But what are human rights, and where do they come from? This question is made urgent by a disquieting thought. Perhaps people with clashing values and convictions can so easily appeal to ‘human rights’ only because, ultimately, they don’t agree on what they are talking about? Maybe the apparently widespread consensus on the significance of human rights depends on the emptiness of that very notion? If this is true, then talk of human rights is rhetorical window-dressing, masking deeper ethical and political divisions.
Philosophers have debated the nature of human rights since at least the 12th century, often under the name of ‘natural rights’. These natural rights were supposed to be possessed by everyone and discoverable with the aid of our ordinary powers of reason (our ‘natural reason’), as opposed to rights established by law or disclosed through divine revelation. Wherever there are philosophers, however, there is disagreement. Belief in human rights left open how we go about making the case for them – are they, for example, protections of human needs generally or only of freedom of choice? There were also disagreements about the correct list of human rights – should it include socio-economic rights, like the rights to health or work, in addition to civil and political rights, such as the rights to a fair trial and political participation?
The article is here.
aeon.co
Originally published April 11, 2017
We live in an age of human rights. The language of human rights has become ubiquitous, a lingua franca used for expressing the most basic demands of justice. Some are old demands, such as the prohibition of torture and slavery. Others are newer, such as claims to internet access or same-sex marriage. But what are human rights, and where do they come from? This question is made urgent by a disquieting thought. Perhaps people with clashing values and convictions can so easily appeal to ‘human rights’ only because, ultimately, they don’t agree on what they are talking about? Maybe the apparently widespread consensus on the significance of human rights depends on the emptiness of that very notion? If this is true, then talk of human rights is rhetorical window-dressing, masking deeper ethical and political divisions.
Philosophers have debated the nature of human rights since at least the 12th century, often under the name of ‘natural rights’. These natural rights were supposed to be possessed by everyone and discoverable with the aid of our ordinary powers of reason (our ‘natural reason’), as opposed to rights established by law or disclosed through divine revelation. Wherever there are philosophers, however, there is disagreement. Belief in human rights left open how we go about making the case for them – are they, for example, protections of human needs generally or only of freedom of choice? There were also disagreements about the correct list of human rights – should it include socio-economic rights, like the rights to health or work, in addition to civil and political rights, such as the rights to a fair trial and political participation?
The article is here.
Saturday, January 6, 2018
The Myth of Responsibility
Raoul Martinez
RSA.org
Originally posted December 7, 2017
Are we wholly responsible for our actions? We don’t choose our brains, our genetic inheritance, our circumstances, our milieu – so how much control do we really have over our lives? Philosopher Raoul Martinez argues that no one is truly blameworthy. Our most visionary scientists, psychologists and philosophers have agreed that we have far less free will than we think, and yet most of society’s systems are structured around the opposite principle – that we are all on a level playing field, and we all get what we deserve.
4 minutes video is worth watching.....
RSA.org
Originally posted December 7, 2017
Are we wholly responsible for our actions? We don’t choose our brains, our genetic inheritance, our circumstances, our milieu – so how much control do we really have over our lives? Philosopher Raoul Martinez argues that no one is truly blameworthy. Our most visionary scientists, psychologists and philosophers have agreed that we have far less free will than we think, and yet most of society’s systems are structured around the opposite principle – that we are all on a level playing field, and we all get what we deserve.
4 minutes video is worth watching.....
Friday, January 5, 2018
Changing genetic privacy rules may adversely affect research participation
Hayley Peoples
Baylor College of Medicine Blogs
Originally posted May 26, 2017
Do you know your genetic information? Maybe you’ve taken a “23andMe” test because you were curious about your ancestry or health. Maybe it was part of a medical examination. Maybe, like me, you underwent testing and received results as part of a class in college.
Do you ever worry about what could happen if your information landed in the wrong hands?
If you do, you aren’t alone. We’ve previously written about legislation affecting genetic privacy and public resistance to global data sharing, and the dialog about growing genetic privacy concerns only continues.
Wired.com recently ran an interesting piece on the House Health Plan and its approach to pre-existing conditions. While much about how a final, Senate-approved Affordable Care Act repeal and replace plan will address pre-existing conditions is still speculation, it brings up an interesting question – with respect to genetic information, will changing rules about pre-existing conditions have a chilling effect on research participation?
The information is here.
Baylor College of Medicine Blogs
Originally posted May 26, 2017
Do you know your genetic information? Maybe you’ve taken a “23andMe” test because you were curious about your ancestry or health. Maybe it was part of a medical examination. Maybe, like me, you underwent testing and received results as part of a class in college.
Do you ever worry about what could happen if your information landed in the wrong hands?
If you do, you aren’t alone. We’ve previously written about legislation affecting genetic privacy and public resistance to global data sharing, and the dialog about growing genetic privacy concerns only continues.
Wired.com recently ran an interesting piece on the House Health Plan and its approach to pre-existing conditions. While much about how a final, Senate-approved Affordable Care Act repeal and replace plan will address pre-existing conditions is still speculation, it brings up an interesting question – with respect to genetic information, will changing rules about pre-existing conditions have a chilling effect on research participation?
The information is here.
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