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

Wednesday, April 8, 2020

How a Ship’s Coronavirus Outbreak Became a Moral Crisis for the Military

Navy fires USS Theodore Roosevelt captain over loss of confidence ...Helene Cooper,
Thomas Gibbons-Neff, & Eric Schmitt
The New York Times
Originally posted 6 April 20

Here is an excerpt:

In the close-knit world of the American military, the crisis aboard the Roosevelt — known widely as the “T.R.”— generated widespread criticism from men and women who are usually careful to steer clear of publicly rebuking their peers.

Mr. Modly’s decision to remove Captain Crozier without first conducting an investigation went contrary to the wishes of both the Navy’s top admiral, Michael M. Gilday, the chief of naval operations, and the military’s top officer, Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff.

“I am appalled at the content of his address to the crew,” retired Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff under Presidents George W. Bush and Barack Obama, said in a telephone interview, referring to Mr. Modly.

Mr. Modly, Admiral Mullen said, “has become a vehicle for the president. He basically has completely undermined, throughout the T.R. situation, the uniformed leadership of the Navy and the military leadership in general.”

Mr. Modly, Admiral Mullen said, “has become a vehicle for the president. He basically has completely undermined, throughout the T.R. situation, the uniformed leadership of the Navy and the military leadership in general.”

“At its core, this is about an aircraft carrier skipper who sees an imminent threat and is forced to make a decision that risks his career in the act of what he believes to be the safety of the near 5,000 members of his crew,” said Sean O’Keefe, a former Navy secretary under President George Bush. “That is more than enough to justify the Navy leadership rendering the benefit of the doubt to the deployed commander.”

The info is here.

The ethics of ordering non-essential items online during the coronavirus lockdown

imgLaura Steele
Originally posted 3 April 20

In response to the Coronavirus crisis, the UK government announced that all retail outlets, except for those considered to provide essential goods and services, were to close with immediate effect. Online retail is, however, 'still open and encouraged'.

So, does that mean we can click with a clear conscience?

Business academics Andrew Crane and Dirk Matten argue that a decision has an ethical dimension to it if it has a significant effect on others it is characterised by choice, and it is perceived as ethically relevant to one or more parties.

Most of us would likely agree that ordering essential items, such as food or medicine, is ethically acceptable. Especially if there is no alternative, as is currently the case for millions of people who have been deemed at high risk due to underlying health conditions, are self-isolating as the result symptoms of COVID-19, or are otherwise unable to shop in person.

But what about goods that are not absolutely necessary, such as clothing that is wanted but not needed, home decor, toys and games, garden furniture and accessories, beauty products or even, depending on your view on the matter, the humble Easter egg?

The info is here.

Tuesday, April 7, 2020

Four pieces of ethical advice for practitioners during COVID-19

Four pieces of ethical advice for practitioners during COVID-19Rebecca Schwartz-Mette
Originally posted 2 April 20

Are you transitioning to full-time telepsychology? Launching a virtual classroom? Want to expand your competence in the use of technology in practice? You can look to APA’s Ethics Committee for support in transforming your practice. Even in times of crisis, the Ethical Principles of Psychologists and Code of Conduct (hereafter “Ethics Code” or “Code;” 2002, Amended June 1, 2010 and Jan. 1, 2017) continues to guide psychologists’ actions based on our shared values. Here are four ways to practice in good faith while meeting the imminent needs of your community:

Lean in

Across the nation, rather than closing their practices and referring out, psychologists are accepting the challenge to diligently obtain training and expand their competence in telepsychology. Standard 2.02, “Providing Services in Emergencies,” allows psychologists to provide services for individuals for whom other services aren’t available through the duration of such emergencies, even if they have not obtained the necessary training. The Ethics Committee supports those psychologists working in good faith to meet the needs of patients, clients, supervisees and students.

Get training and support

Take advantage of the APA’s new (and often free) resources to develop and expand your competence, in line with Standard 2.03, “Maintaining Competence.” Expand your network by connecting with colleagues who can provide peer consultation and supervision to support your efforts.

Consider referrals

The decision to transition to telepsychology may not be for everyone. Competency concerns, lack of access to technology, and specific needs of particular clients may reflect good reasons to refer to practitioners who can provide telepsychology. Psychologists should assess each client’s needs in light of their own professional capacities and refer to others who can provide needed services in line with Standard 10.10(c), “Terminating Therapy.”

Take care of yourself

Psychologists are human and can feel lost in the ambiguity of this unprecedented time. It is your ethical mandate to also care for yourself. Practicing accurate self-assessment, leaning on colleagues when needed, and taking time to unplug from the news and practice to recharge helps to prevent burnout and is entirely consistent with 2.06, “Personal Problems and Conflicts.” Make self-care a verb and connect with your community of psychologists today.

Tavis Smiley Ordered To Pay PBS $1.5 Million For Violating Network's 'Morality' Clause

Vanessa Romo
Originally published 4 March 20

Here is an excerpt:

Throughout the three-week civil trial, jurors heard from six women who testified that Smiley subjected subordinates to unwanted sexual advances. "One woman who accused Smiley of sexual harassment left the show and received a $325,000 settlement," Variety reported.

The win for PBS may prove to be significant for other companies facing workplace suits stemming from sexual-misconduct allegations, who are seeking to break ties with accused individuals.

"In the midst of the #MeToo movement, he violated our morals clause... You can't have a consensual relationship between a manager and a subordinate because of the power dynamic. It's never consensual because that manager has power over all aspects of that person's employment," the network's lead attorney, Grace Speights, said in court.

Smiley's dismissal was one of many in the wake of the #MeToo movement which first gained global attention in 2017, after dozens of women accused movie producer Harvey Weinstein of sexual misconduct. Years later, a jury has convicted Weinstein of rape, Bill Cosby is behind bars for sexual assault, and popular hosts including Matt Lauer and Charlie Rose — who was fired by PBS in 2017 — have been removed from the airwaves amid accusations of misconduct.

The info is here.

Monday, April 6, 2020

JAIC launches pilot for implementing new DOD AI ethics principles

Jackson Barnett
Originally posted 2 April 20

Here is an excerpt:

The Department of Defense‘s Joint Artificial Intelligence Center is bringing together different types of engineers, policymakers and other DOD personnel to serve as “Responsible AI Champions” in support of the Pentagon’s new principles for AI ethics.

The pilot program brings together a “cross-functional group” of personnel from across the department to receive training on AI and DOD’s new ethical principles from JAIC staff who represent different parts of the AI development lifecycle. The intent is that when these trainees go back to their normal jobs, they will be “champions” for AI and the principles.

The model, which was announced through a JAIC blog post, is similar to a pilot Microsoft launched to implement its artificial intelligence governance structure. The JAIC did not say how many people will participate in the pilot program.

“The goal is to learn from this pilot so that we can develop a more robust and comprehensive program that can be implemented across the DOD,” Lt. Cmdr. Arlo Abrahamson, a JAIC spokesman, told FedScoop.

The info is here.

Life and death decisions of autonomous vehicles

Y. E. Bigman and K. Gray
Originally published 4 May 20

How should self-driving cars make decisions when human lives hang in the balance? The Moral Machine experiment (MME) suggests that people want autonomous vehicles (AVs) to treat different human lives unequally, preferentially killing some people (for example, men, the old and the poor) over others (for example, women, the young and the rich). Our results challenge this idea, revealing that this apparent preference for inequality is driven by the specific ‘trolley-type’ paradigm used by the MME. Multiple studies with a revised paradigm reveal that people overwhelmingly want autonomous vehicles to treat different human lives equally in life and death situations, ignoring gender, age and status—a preference consistent with a general desire for equality.

The large-scale adoption of autonomous vehicles raises ethical challenges because autonomous vehicles may sometimes have to decide between killing one person or another. The MME seeks to reveal people’s preferences in these situations and many of these revealed preferences, such as ‘save more people over fewer’ and ‘kill by inaction over action’ are consistent with preferences documented in previous research.

However, the MME also concludes that people want autonomous vehicles to make decisions about who to kill on the basis of personal features, including physical fitness, age, status and gender (for example, saving women and killing men). This conclusion contradicts well-documented ethical preferences for equal treatment across demographic features and identities, a preference enshrined in the US Constitution, the United Nations Universal Declaration of Human Rights and in the Ethical Guideline 9 of the German Ethics Code for Automated and Connected Driving.

The info is here.

Sunday, April 5, 2020

Why your brain is not a computer

Matthew Cobb
Originally posted 27 Feb 20

Here is an excerpt:

The processing of neural codes is generally seen as a series of linear steps – like a line of dominoes falling one after another. The brain, however, consists of highly complex neural networks that are interconnected, and which are linked to the outside world to effect action. Focusing on sets of sensory and processing neurons without linking these networks to the behaviour of the animal misses the point of all that processing.

By viewing the brain as a computer that passively responds to inputs and processes data, we forget that it is an active organ, part of a body that is intervening in the world, and which has an evolutionary past that has shaped its structure and function. This view of the brain has been outlined by the Hungarian neuroscientist György Buzsáki in his recent book The Brain from Inside Out. According to Buzsáki, the brain is not simply passively absorbing stimuli and representing them through a neural code, but rather is actively searching through alternative possibilities to test various options. His conclusion – following scientists going back to the 19th century – is that the brain does not represent information: it constructs it.

The metaphors of neuroscience – computers, coding, wiring diagrams and so on – are inevitably partial. That is the nature of metaphors, which have been intensely studied by philosophers of science and by scientists, as they seem to be so central to the way scientists think. But metaphors are also rich and allow insight and discovery. There will come a point when the understanding they allow will be outweighed by the limits they impose, but in the case of computational and representational metaphors of the brain, there is no agreement that such a moment has arrived. From a historical point of view, the very fact that this debate is taking place suggests that we may indeed be approaching the end of the computational metaphor. What is not clear, however, is what would replace it.

Scientists often get excited when they realise how their views have been shaped by the use of metaphor, and grasp that new analogies could alter how they understand their work, or even enable them to devise new experiments. Coming up with those new metaphors is challenging – most of those used in the past with regard to the brain have been related to new kinds of technology. This could imply that the appearance of new and insightful metaphors for the brain and how it functions hinges on future technological breakthroughs, on a par with hydraulic power, the telephone exchange or the computer. There is no sign of such a development; despite the latest buzzwords that zip about – blockchain, quantum supremacy (or quantum anything), nanotech and so on – it is unlikely that these fields will transform either technology or our view of what brains do.

The info is here.

Saturday, April 4, 2020

Suicide attempt survivors’ recommendations for improving mental health treatment for attempt survivors.

Melanie A. Hom and others
Psychological Services. 
Advance online publication.


Research indicates that connection to mental health care services and treatment engagement remain challenges among suicide attempt survivors. One way to improve suicide attempt survivors’ experiences with mental health care services is to elicit suggestions directly from attempt survivors regarding how to do so. This study aimed to identify and synthesize suicide attempt survivors’ recommendations for how to enhance mental health treatment experiences for attempt survivors. A sample of 329 suicide attempt survivors (81.5% female, 86.0% White/Caucasian, mean age = 35.07 ± 12.18 years) provided responses to an open-ended self-report survey question probing how treatment might be improved for suicide attempt survivors. Responses were analyzed utilizing both qualitative and quantitative techniques. Analyses identified four broad areas in which mental health treatment experiences might be improved for attempt survivors: (a) provider interactions (e.g., by reducing stigma of suicidality, expressing empathy, and using active listening), (b) intake and treatment planning (e.g., by providing a range of treatment options, including nonmedication treatments, and conducting a thorough assessment), (c) treatment delivery (e.g., by addressing root problems, bolstering coping skills, and using trauma-informed care), and (d) structural issues (e.g., by improving access to care and continuity of care). Findings highlight numerous avenues by which health providers might be able to facilitate more positive mental health treatment experiences for suicide attempt survivors. Research is needed to test whether implementing the recommendations offered by attempt survivors in this study might lead to enhanced treatment engagement, retention, and outcomes among suicide attempt survivors at large.

Here is an excerpt from the Discussion:

On this point, this study revealed numerous recommendations for how providers might be able to improve their interactions with attempt survivors. Suggestions in this domain aligned with prior studies on treatment experiences among suicide attempt survivors. For instance, recommendations that providers not stigmatize attempt survivors and, instead, empathize with them, actively listen to them, and humanize them, are consistent with aforementioned studies (Berglund et al., 2016; Frey et al., 2016; Shand et al., 2018; Sheehan et al., 2017; Taylor et al., 2009). This study’s findings regarding the importance of a collaborative therapeutic relationship are also consistent with previous work (Shand et al., 2018). Though each of these factors has been identified as salient to treatment engagement efforts broadly (see Barrett et al., 2008, for review), several suggestions that emerged in this study were more specific to attempt survivors. For example, ensuring that patients feel comfortable openly discussing suicidal thoughts and behaviors and taking disclosures of suicidality seriously are suggestions specifically applicable to the care of at-risk individuals. These recommendations not only support research indicating that asking about suicidality is not iatrogenic (see DeCou & Schumann, 2018, for review), but they also underscore the importance of considering the unique needs of attempt survivors. Indeed, given that most participants provided a recommendation in this area, the impact of provider-related factors should not be overlooked in the provision of care to this group.

Friday, April 3, 2020

Treating “Moral” Injuries

Anna Harwood-Gross
Scientific American
Originally posted 24 March 20

Here is an excerpt:

Though PTSD symptoms such as avoidance of reminders of the traumatic event and intrusive thought patterns may also be present in moral injury, they appear to serve different purposes, with PTSD sufferers avoiding fear and moral injury sufferers avoiding shame triggers. Few comparison studies of PTSD and moral injury exist, yet there has been research that indirectly compares the two conditions by differentiating between fear-based and non-fear-based (i.e., moral injury) forms of PTSD, which have been demonstrated to have different neurobiological markers. In the context of the military, there are countless examples of potentially morally injurious events (PMIEs), which can include killing or wounding others, engaging in retribution or disproportionate violence, or failing to save the life of a comrade, child or civilian. The experience of PMIEs has been demonstrated to lead to a larger range of psychological distress symptoms, including higher levels of guilt, anger, shame, depression and social isolation, than those seen in traditional PTSD profiles.

Guilt is difficult to address in therapy and often lingers following standardized PTSD treatment (that is, if the sufferer is able to access therapy). It may, in fact, be a factor in the more than 49 percent of veterans who drop out of evidence-based PTSD treatment or in why, at times, up to 72% of sufferers, despite meaningful improvement in their symptoms, do not actually recover enough after such treatment for their PTSD diagnosis to be removed. Most often, moral injury symptoms that are present in the clinic are addressed through traditional PTSD treatments, with thoughts of guilt and shame treated similarly to other distorted cognitions. When guilt and the events it relates to are treated as “a feeling and not a fact,” as psychologist Lisa Finlay put it in a 2015 paper, there is an attempt to lessen or relieve such emotions while taking a shortcut to avoid experiencing those that are legitimate and reasonable after-wartime activities. Continuing, Finlay stated that “the idea that we might get good, as a profession, at talking people out of guilt following their involvement in traumatic incidents is frighteningly short-sighted in more ways than one.”

The info is here.