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, February 19, 2020

American Psychological Association Calls for Immediate Halt to Sharing Immigrant Youths' Confidential Psychotherapy Notes with ICE

American Psychological Association
Press Release
Released 17 Feb 20

The American Psychological Association expressed shock and outrage that the federal Office of Refugee Resettlement has been sharing confidential psychotherapy notes with U.S. Immigration and Customs Enforcement to deny asylum to some immigrant youths.

“ORR’s sharing of confidential therapy notes of traumatized children destroys the bond of trust between patient and therapist that is vital to helping the patient,” said APA President Sandra L. Shullman, PhD. “We call on ORR to stop this practice immediately and on the Department of Health and Human Services and Congress to investigate its prevalence. We also call on ICE to release any immigrants who have had their asylum requests denied as a result.”

APA was reacting to a report in The Washington Post focused largely on the case of then-17-year-old Kevin Euceda, an asylum-seeker from Honduras whose request for asylum was granted by a judge, only to have it overturned when lawyers from ICE revealed information he had given in confidence to a therapist at a U.S. government shelter. According to the article, other unaccompanied minors have been similarly detained as a result of ICE’s use of confidential psychotherapy notes. These situations have also been confirmed by congressional testimony since 2018.

Unaccompanied minors who are detained in U.S. shelters are required to undergo therapy, ostensibly to help them deal with trauma and other issues arising from leaving their home countries. According to the Post, ORR entered into a formal memorandum of agreement with ICE in April 2018 to share details about children in its care. The then-head of ORR testified before Congress that the agency would be asking its therapists to “develop additional information” about children during “weekly counseling sessions where they may self-disclose previous gang or criminal activity to their assigned clinician,” the newspaper reported. The agency added two requirements to its public handbook: that arriving children be informed that while it was essential to be honest with staff, self-disclosures could affect their release and that if a minor mentioned anything having to do with gangs or drug dealing, therapists would file a report within four hours to be passed to ICE within one day, the Post said.

"For this administration to weaponize these therapy sessions by ordering that the psychotherapy notes be passed to ICE is appalling,” Shullman added. “These children have already experienced some unimaginable traumas. Plus, these are scared minors who may not understand that speaking truthfully to therapists about gangs and drugs – possibly the reasons they left home – would be used against them.”

How to talk someone out of bigotry

Brian Resnick
Originally published 29 Jan 20

Here is an excerpt:

Topping and dozens of other canvassers were a part of that 2016 effort. It was an important study: Not only has social science found very few strategies that work, in experiments, to change minds on issues of prejudice, but even fewer tests of those strategies have occurred in the real world.

Typically, the conversations begin with the canvasser asking the voter for their opinion on a topic, like abortion access, immigration, or LGBTQ rights. Canvassers (who may or may not be members of the impacted community) listen nonjudgmentally. They don’t say if they are pleased or hurt by the response. They are supposed “to appear genuinely interested in hearing the subject ruminate on the question,” as Broockman and Kalla’s latest study instructions read.

The canvassers then ask if the voters know anyone in the affected community, and ask if they relate to the person’s story. If they don’t, and even if they do, they’re asked a question like, “When was a time someone showed you compassion when you really needed it?” to get them to reflect on their experience when they might have felt something similar to the people in the marginalized community.

The canvassers also share their own stories: about being an immigrant, about being a member of the LGBTQ community, or about just knowing people who are.

It’s a type of conversation that’s closer to what a psychotherapist might have with a patient than a typical political argument. (One clinical therapist I showed it to said it sounded a bit like “motivational interviewing,” a technique used to help clients work through ambivalent feelings.) It’s not about listing facts or calling people out on their prejudicial views. It’s about sharing and listening, all the while nudging people to be analytical and think about their shared humanity with marginalized groups.

The info is here.

Tuesday, February 18, 2020

Is it okay to sacrifice one person to save many? How you answer depends on where you’re from.

Sigal Samuel
Originally posted 24 Jan 20

Here is an excerpt:

It turns out that people across the board, regardless of their cultural context, give the same response when they’re asked to rank the moral acceptability of acting in each case. They say Switch is most acceptable, then Loop, then Footbridge.

That’s probably because in Switch, the death of the worker is an unfortunate side effect of the action that saves the five, whereas in Footbridge, the death of the large man is not a side effect but a means to an end — and it requires the use of personal force against him.

It turns out that people across the board, regardless of their cultural context, give the same response when they’re asked to rank the moral acceptability of acting in each case. They say Switch is most acceptable, then Loop, then Footbridge.

That’s probably because in Switch, the death of the worker is an unfortunate side effect of the action that saves the five, whereas in Footbridge, the death of the large man is not a side effect but a means to an end — and it requires the use of personal force against him.

The info is here.

Can an Evidence-Based Approach Improve the Patient-Physician Relationship?

A. S. Cifu, A. Lembo, & A. M. Davis
JAMA. 2020;323(1):31-32.

Here is an excerpt:

Through these steps, the research team identified potentially useful clinical approaches that were perceived to contribute to physician “presence,” defined by the authors as a purposeful practice of “awareness, focus, and attention with the intent to understand and connect with patients.”

These practices were rated by patients and clinicians on their likely effects and feasibility in practice. A Delphi process was used to condense 13 preliminary practices into 5 final recommendations, which were (1) prepare with intention, (2) listen intently and completely, (3) agree on what matters most, (4) connect with the patient’s story, and (5) explore emotional cues. Each of these practices is complex, and the authors provide detailed explanations, including narrative examples and links to outcomes, that are summarized in the article and included in more detail in the online supplemental material.

If implemented in practice, these 5 practices suggested by Zulman and colleagues are likely to enhance patient-physician relationships, which ideally could help improve physician satisfaction and well-being, reduce physician frustration, improve clinical outcomes, and reduce health care costs.

Importantly, the authors also call for system-level interventions to create an environment for the implementation of these practices.

Although the patient-physician interaction is at the core of most physicians’ activities and has led to an entire genre of literature and television programs, very little is actually known about what makes for an effective relationship.

The info is here.

Monday, February 17, 2020

Religion’s Impact on Conceptions of the Moral Domain

S. Levine, and others
PsyArXiv Preprints
Last edited 2 Jan 20


How does religious affiliation impact conceptions of the moral domain? Putting aside the question of whether people from different religions agree about how to answer moral questions, here we investigate a more fundamental question: How much disagreement is there across religions about which issues count as moral in the first place? That is, do people from different religions conceptualize the scope of morality differently? Using a new methodology to map out how individuals conceive of the moral domain, we find dramatic differences among adherents of different religions. Mormons and Muslims moralize their religious norms, while Jews do not. Hindus do not seem to make a moral/non-moral distinction at all. These results suggest that religious affiliation has a profound effect on conceptions of the scope of morality.

From the General Discussion:

The results of Study 3 and 3a are predicted by neither Social Domain Theory nor Moral Foundations Theory: It is neither true that secular people and religious people share a common conception of the moral domain (as Social Domain Theory argues), nor that religious morality is expanded beyond secular morality in a uniform manner (as Moral Foundations Theory suggests).When participants in a group did make a moral/non-moral distinction, there was broad agreement that norms related to harm, justice, and rights count as moral norms. However, some religious individuals (such as the Mormon and Muslim participants) also moralized norms from their own religion that are not related to these themes. Meanwhile, others (such as the Jewish participants) acknowledged the special status of their own norms but did not moralize them. Yet others (such as the Hindu participants) made no distinction between the moral and the non-moral. 

The research is here.

BlackRock’s New Morality Marks the End for Coal

Nathaniel Bullard
Bloomberg News
Originally posted 17 Jan 20

Here is an excerpt:

In the U.S., the move away from coal was well underway before the $7 trillion asset manager announced its restrictions. Companies have been shutting down coal-fired power plants and setting “transformative responsible energy plans” removing coal from the mix completely, even in the absence of robust federal policies. 

U.S. coal consumption in power generation fell below 600 million tons last year. This year, the U.S. Energy Information Administration expects it to fall much further still, below 500 million tons. That’s not only down by more than 50% since 2007, but it would also put coal consumption back to 1978 levels.

That decline is thanks to a massive number of plant retirements, now totaling more than 300 since 2010. The U.S. coal fleet has not had any net capacity additions since 2011. 2015 is the most significant year for coal retirements to date, as a suite of Obama-era air quality standards took effect. 2018 wasn’t far behind, however, and 2019 wasn’t far behind 2018.

The base effect of a smaller number of operational coal plants also means that consumption is declining at an accelerating rate. Using the EIA’s projection for 2020 coal burn in the power sector, year-on-year consumption will decline nearly 15%, the most since at least 1950.

Coal’s decline doesn’t exist in isolation. Most coal in the U.S. travels from mine to plant by rail, so there’s a predictable impact on rail cargoes. A decade ago, U.S. rail carriers shipped nearly 7 million carloads of coal. Last year, that figure was barely 4 million.

The info is here.

Sunday, February 16, 2020

Fast optimism, slow realism? Causal evidence for a two-step model of future thinking

Hallgeir Sjåstad and Roy F. Baumeister
Originally posted 6 Jan 20


Future optimism is a widespread phenomenon, often attributed to the psychology of intuition. However, causal evidence for this explanation is lacking, and sometimes cautious realism is found. One resolution is that thoughts about the future have two steps: A first step imagining the desired outcome, and then a sobering reflection on how to get there. Four pre-registered experiments supported this two-step model, showing that fast predictions are more optimistic than slow predictions. The total sample consisted of 2,116 participants from USA and Norway, providing 9,036 predictions. In Study 1, participants in the fast-response condition thought positive events were more likely to happen and that negative events were less likely, as compared to participants in the slow-response condition. Although the predictions were optimistically biased in both conditions, future optimism was significantly stronger among fast responders. Participants in the fast-response condition also relied more on intuitive heuristics (CRT). Studies 2 and 3 focused on future health problems (e.g., getting a heart attack or diabetes), in which participants in the fast-response condition thought they were at lower risk. Study 4 provided a direct replication, with the additional finding that fast predictions were more optimistic only for the self (vs. the average person). The results suggest that when people think about their personal future, the first response is optimistic, which only later may be followed by a second step of reflective realism. Current health, income, trait optimism, perceived control and happiness were negatively correlated with health-risk predictions, but did not moderate the fast-optimism effect.

From the Discussion section:

Four studies found that people made more optimistic predictions when they relied on fast intuition rather than slow reflection. Apparently, a delay of 15 seconds is sufficient to enable second thoughts and a drop in future optimism. The slower responses were still "unrealistically optimistic"(Weinstein, 1980; Shepperd et al., 2013), but to a much lesser extent than the fast responses. We found this fast-optimism effect on relative comparison to the average person and isolated judgments of one's own likelihood, in two different languages across two different countries, and in one direct replication.All four experiments were pre-registered, and the total sample consisted of about 2,000 participants making more than 9,000 predictions.

Saturday, February 15, 2020

Influencing the physiology and decisions of groups: Physiological linkage during group decision-making

Related imageThorson, K. R., and others.
(2020). Group Processes & Intergroup Relations. 


Many of the most important decisions in our society are made within groups, yet we know little about how the physiological responses of group members predict the decisions that groups make. In the current work, we examine whether physiological linkage from “senders” to “receivers”—which occurs when a sender’s physiological response predicts a receiver’s physiological response—is associated with senders’ success at persuading the group to make a decision in their favor. We also examine whether experimentally manipulated status—an important predictor of social behavior—is associated with physiological linkage. In groups of 5, we randomly assigned 1 person to be high status, 1 low status, and 3 middle status. Groups completed a collaborative decision-making task that required them to come to a consensus on a decision to hire 1 of 5 firms. Unbeknownst to the 3 middle-status members, high- and low-status members surreptitiously were told to each argue for different firms. We measured cardiac interbeat intervals of all group members throughout the decision-making process to assess physiological linkage. We found that the more receivers were physiologically linked to senders, the more likely groups were to make a decision in favor of the senders. We did not find that people were physiologically linked to their group members as a function of their fellow group members’ status. This work identifies physiological linkage as a novel correlate of persuasion and highlights the need to understand the relationship between group members’ physiological responses during group decision-making.

Friday, February 14, 2020

The Moral Self and Moral Duties

J. Everett, J. Skorburg, and J. Savulescu
Created on 6 Jan 20


Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity.

The research is here.