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

Thursday, November 30, 2023

The Cynical Genius Illusion: Exploring and Debunking Lay Beliefs About Cynicism and Competence

Stavrova, O., & Ehlebracht, D. (2019).
Personality & social psychology bulletin, 45(2),
254–269.

Abstract

Cynicism refers to a negative appraisal of human nature-a belief that self-interest is the ultimate motive guiding human behavior. We explored laypersons' beliefs about cynicism and competence and to what extent these beliefs correspond to reality. Four studies showed that laypeople tend to believe in cynical individuals' cognitive superiority. A further three studies based on the data of about 200,000 individuals from 30 countries debunked these lay beliefs as illusionary by revealing that cynical (vs. less cynical) individuals generally do worse on cognitive ability and academic competency tasks. Cross-cultural analyses showed that competent individuals held contingent attitudes and endorsed cynicism only if it was warranted in a given sociocultural environment. Less competent individuals embraced cynicism unconditionally, suggesting that-at low levels of competence-holding a cynical worldview might represent an adaptive default strategy to avoid the potential costs of falling prey to others' cunning.


Here is my summary:

This article explores the relationship between cynicism and competence. The authors find that people tend to believe that cynical people are more intelligent and competent than others. However, they also find that this belief is not supported by evidence. In fact, cynical people tend to perform worse on cognitive ability and academic competency tasks.

The authors suggest that the belief that cynical people are more intelligent and competent may be due to a number of factors, including:
  • The fact that cynical people are often seen as being more realistic and worldly.
  • The fact that cynical people are often more confident and assertive.
  • The fact that cynical people are often more successful in certain professions, such as law and business.
However, the authors argue that these factors do not necessarily mean that cynical people are more intelligent or competent. In fact, they suggest that cynicism may actually be a sign of low intelligence and competence.

Wednesday, November 29, 2023

A justification-suppression model of the expression and experience of prejudice

Crandall, C. S., & Eshleman, A. (2003).
Psychological bulletin, 129(3), 414–446.
https://doi.org/10.1037/0033-2909.129.3.414

Abstract

The authors propose a justification-suppression model (JSM), which characterizes the processes that lead to prejudice expression and the experience of one's own prejudice. They suggest that "genuine" prejudices are not directly expressed but are restrained by beliefs, values, and norms that suppress them. Prejudices are expressed when justifications (e.g., attributions, ideologies, stereotypes) release suppressed prejudices. The same process accounts for which prejudices are accepted into the self-concept The JSM is used to organize the prejudice literature, and many empirical findings are recharacterized as factors affecting suppression or justification, rather than directly affecting genuine prejudice. The authors discuss the implications of the JSM for several topics, including prejudice measurement, ambivalence, and the distinction between prejudice and its expression.


This is an oldie, but goodie!!  Here is my summary:

This article is about prejudice and the factors that influence its expression. The authors propose a justification-suppression model (JSM) to explain how prejudice is expressed. The JSM suggests that people have genuine prejudices that are not directly expressed. Instead, these prejudices are suppressed by people’s beliefs, values, and norms. Prejudice is expressed when justifications (e.g., attributions, ideologies, stereotypes) release suppressed prejudices.

The authors also discuss the implications of the JSM for prejudice measurement, ambivalence, and the distinction between prejudice and its expression.

Here are some key takeaways from the article:
  • Prejudice is a complex phenomenon that is influenced by a variety of factors, including individual beliefs, values, and norms, as well as social and cultural contexts.
  • People may have genuine prejudices that they do not directly express. These prejudices may be suppressed by people’s beliefs, values, and norms.
  • Prejudice is expressed when justifications (e.g., attributions, ideologies, stereotypes) release suppressed prejudices.
  • The JSM can be used to explain a wide range of findings on prejudice, including prejudice measurement, ambivalence, and the distinction between prejudice and its expression.

Tuesday, November 28, 2023

Ethics of psychotherapy rationing: A review of ethical and regulatory documents in Canadian professional psychology

Gower, H. K., & Gaine, G. S. (2023).
Canadian Psychology / Psychologie canadienne. 
Advance online publication.

Abstract

Ethical and regulatory documents in Canadian professional psychology were reviewed for principles and standards related to the rationing of psychotherapy. Despite Canada’s high per capita health care expenses, mental health in Canada receives relatively low funding. Further, surveys indicated that Canadians have unmet needs for psychotherapy. Effective and ethical rationing of psychological treatment is a necessity, yet the topic of rationing in psychology has received scant attention. The present study involved a qualitative review of codes of ethics, codes of conduct, and standards of practice documents for their inclusion of rationing principles and standards. Findings highlight the strengths and shortcomings of these documents related to guiding psychotherapy rationing. The discussion offers recommendations for revising these ethical and regulatory documents to promote more equitable and cost-effective use of limited psychotherapy resources in Canada.

Impact Statement

Canadian professional psychology regulatory documents contain limited reference to rationing imperatives, despite scarce psychotherapy resources. While the foundation of distributive justice is in place, rationing-specific principles, standards, and practices are required to foster the fair and equitable distribution of psychotherapy by Canadian psychologists.

From the recommendations:

Recommendations for Canadian Psychology Regulatory Documents
  1. Explicitly widen psychologists’ scope of concern to include not only current clients but also waiting clients and those who need treatment but face access barriers.
  2. Acknowledge the scarcity of health care resources (in public and private settings) and the high demand for psychology services (e.g., psychotherapy) and admonish inefficient and cost-ineffective use.
  3. Draw an explicit connection between the general principle of distributive justice and the specific practices related to rationing of psychology resources, including, especially, mitigation of biases likely to weaken ethical decision making.
  4. Encourage the use of outcome monitoring measures to aid relative utility calculations for triage and termination decisions and to ensure efficiency and distributive justice.
  5. Recommend advocacy by psychologists to address barriers to accessing needed services (e.g., psychotherapy), including promoting the cost effectiveness of psychotherapy as well as highlighting systemic barriers related to presenting problem, disability, ethnicity, race, gender, sexuality, or income.

Monday, November 27, 2023

Synthetic human embryos created in groundbreaking advance

Hannah Devlin
The Guardian
Originally posted 14 JUNE 23

Here is an excerpt:

“Our human model is the first three-lineage human embryo model that specifies amnion and germ cells, precursor cells of egg and sperm,” ┼╗ernicka-Goetz told the Guardian before the talk. “It’s beautiful and created entirely from embryonic stem cells.”

The development highlights how rapidly the science in this field has outpaced the law, and scientists in the UK and elsewhere are already moving to draw up voluntary guidelines to govern work on synthetic embryos. “If the whole intention is that these models are very much like normal embryos, then in a way they should be treated the same,” Lovell-Badge said. “Currently in legislation they’re not. People are worried about this.”

There is also a significant unanswered question on whether these structures, in theory, have the potential to grow into a living creature. The synthetic embryos grown from mouse cells were reported to appear almost identical to natural embryos. But when they were implanted into the wombs of female mice, they did not develop into live animals. In April, researchers in China created synthetic embryos from monkey cells and implanted them into the wombs of adult monkeys, a few of which showed the initial signs of pregnancy but none of which continued to develop beyond a few days. Scientists say it is not clear whether the barrier to more advanced development is merely technical or has a more fundamental biological cause.


Here is my summary:

Researchers used stem cells to create structures that resembled early-stage human embryos, with a beating heart and primitive brain-like structures.

The synthetic embryos could be used to study human development and to develop new treatments for infertility and miscarriage. However, the research also raises ethical concerns, as it is not clear whether the synthetic embryos should be considered the same as natural embryos.

Some bioethicists have argued that the synthetic embryos should be treated with the same respect as natural embryos, as they have the potential to develop into human beings. Others have argued that the synthetic embryos are not the same as natural embryos, as they were not created through the union of an egg and sperm.

The research has been welcomed by some scientists, who believe it has the potential to revolutionize our understanding of human development. However, other scientists have expressed concern about the ethical implications of the research.

Sunday, November 26, 2023

How robots can learn to follow a moral code

Neil Savage
Nature.com
Originally posted 26 OCT 23

Here is an excerpt:

Defining ethics

The ability to fine-tune an AI system’s behaviour to promote certain values has inevitably led to debates on who gets to play the moral arbiter. Vosoughi suggests that his work could be used to allow societies to tune models to their own taste — if a community provides examples of its moral and ethical values, then with these techniques it could develop an LLM more aligned with those values, he says. However, he is well aware of the possibility for the technology to be used for harm. “If it becomes a free for all, then you’d be competing with bad actors trying to use our technology to push antisocial views,” he says.

Precisely what constitutes an antisocial view or unethical behaviour, however, isn’t always easy to define. Although there is widespread agreement about many moral and ethical issues — the idea that your car shouldn’t run someone over is pretty universal — on other topics there is strong disagreement, such as abortion. Even seemingly simple issues, such as the idea that you shouldn’t jump a queue, can be more nuanced than is immediately obvious, says Sydney Levine, a cognitive scientist at the Allen Institute. If a person has already been served at a deli counter but drops their spoon while walking away, most people would agree it’s okay to go back for a new one without waiting in line again, so the rule ‘don’t cut the line’ is too simple.

One potential approach for dealing with differing opinions on moral issues is what Levine calls a moral parliament. “This problem of who gets to decide is not just a problem for AI. It’s a problem for governance of a society,” she says. “We’re looking to ideas from governance to help us think through these AI problems.” Similar to a political assembly or parliament, she suggests representing multiple different views in an AI system. “We can have algorithmic representations of different moral positions,” she says. The system would then attempt to calculate what the likely consensus would be on a given issue, based on a concept from game theory called cooperative bargaining.


Here is my summary:

Autonomous robots will need to be able to make ethical decisions in order to safely and effectively interact with humans and the world around them.

The article proposes a number of ways that robots can be taught to follow a moral code. One approach is to use supervised learning, in which robots are trained on a dataset of moral dilemmas and their corresponding solutions. Another approach is to use reinforcement learning, in which robots are rewarded for making ethical decisions and punished for making unethical decisions.

The article also discusses the challenges of teaching robots to follow a moral code. One challenge is that moral codes are often complex and nuanced, and it can be difficult to define them in a way that can be understood by a robot. Another challenge is that moral codes can vary across cultures, and it is important to develop robots that can adapt to different moral frameworks.

The article concludes by arguing that teaching robots to follow a moral code is an important ethical challenge that we need to address as we develop more sophisticated artificial intelligence systems.

Saturday, November 25, 2023

An autonomy-based approach to assisted suicide: a way to avoid the expressivist objection against assisted dying laws

Braun, E.
Journal of Medical Ethics 
2023;49:497-501

Abstract

In several jurisdictions, irremediable suffering from a medical condition is a legal requirement for access to assisted dying. According to the expressivist objection, allowing assisted dying for a specific group of persons, such as those with irremediable medical conditions, expresses the judgment that their lives are not worth living. While the expressivist objection has often been used to argue that assisted dying should not be legalised, I show that there is an alternative solution available to its proponents. An autonomy-based approach to assisted suicide regards the provision of assisted suicide (but not euthanasia) as justified when it is autonomously requested by a person, irrespective of whether this is in her best interests. Such an approach has been put forward by a recent judgment of the German Federal Constitutional Court, which understands assisted suicide as an expression of the person’s right to a self-determined death. It does not allow for beneficence-based restrictions regarding the person’s suffering or medical diagnosis and therefore avoids the expressivist objection. I argue that on an autonomy-based approach, assisted suicide should not be understood as a medical procedure but rather as the person’s autonomous action.

Conclusion

Assuming that the expressivist argument is valid, it only applies to (partly) beneficence-based approaches to assisted dying that require irremediable suffering. An autonomy-based approach to assisted suicide, as put forward by the German Federal Constitutional Court, avoids the expressivist objection. It understands
assisted suicide as an act justified by autonomy and does not imply objective judgments of whether the person’s life is worth living. I have argued that on an autonomy-based approach, assisted suicide should not be understood as a medical intervention but rather as an autonomous action that does not invoke
traditional medical principles such as beneficence.


Said differently: 

The article argues that an autonomy-based approach to assisted suicide can avoid the expressivist objection against assisted dying laws. The expressivist objection is the claim that assisted dying laws send the message that suicide is a good thing, which could lead to more people committing suicide. The author argues that this objection is not valid because autonomy is a fundamental value that should be respected, even if it means allowing people to die.  (Autonomy > beneficence)

Friday, November 24, 2023

UnitedHealth faces class action lawsuit over algorithmic care denials in Medicare Advantage plans

Casey Ross and Bob Herman
Statnews.com
Originally posted 14 Nov 23

A class action lawsuit was filed Tuesday against UnitedHealth Group and a subsidiary alleging that they are illegally using an algorithm to deny rehabilitation care to seriously ill patients, even though the companies know the algorithm has a high error rate.

The class action suit, filed on behalf of deceased patients who had a UnitedHealthcare Medicare Advantage plan and their families by the California-based Clarkson Law Firm, follows the publication of a STAT investigation Tuesday. The investigation, cited by the lawsuit, found UnitedHealth pressured medical employees to follow an algorithm, which predicts a patient’s length of stay, to issue payment denials to people with Medicare Advantage plans. Internal documents revealed that managers within the company set a goal for clinical employees to keep patients rehab stays within 1% of the days projected by the algorithm.

The lawsuit, filed in the U.S. District Court of Minnesota, accuses UnitedHealth and its subsidiary, NaviHealth, of using the computer algorithm to “systematically deny claims” of Medicare beneficiaries struggling to recover from debilitating illnesses in nursing homes. The suit also cites STAT’s previous reporting on the issue.

“The fraudulent scheme affords defendants a clear financial windfall in the form of policy premiums without having to pay for promised care,” the complaint alleges. “The elderly are prematurely kicked out of care facilities nationwide or forced to deplete family savings to continue receiving necessary care, all because an [artificial intelligence] model ‘disagrees’ with their real live doctors’ recommendations.”


Here are some of my concerns:

The use of algorithms in healthcare decision-making has raised a number of ethical concerns. Some critics argue that algorithms can be biased and discriminatory, and that they can lead to decisions that are not in the best interests of patients. Others argue that algorithms can lack transparency, and that they can make it difficult for patients to understand how decisions are being made.

The lawsuit against UnitedHealth raises a number of specific ethical concerns. First, the plaintiffs allege that UnitedHealth's algorithm is based on inaccurate and incomplete data. This raises the concern that the algorithm may be making decisions that are not based on sound medical evidence. Second, the plaintiffs allege that UnitedHealth has failed to adequately train its employees on how to use the algorithm. This raises the concern that employees may be making decisions that are not in the best interests of patients, either because they do not understand how the algorithm works or because they are pressured to deny claims.

The lawsuit also raises the general question of whether algorithms should be used to make healthcare decisions. Some argue that algorithms can be used to make more efficient and objective decisions than humans can. Others argue that algorithms are not capable of making complex medical decisions that require an understanding of the individual patient's circumstances.

The use of algorithms in healthcare is a complex issue with no easy answers. It is important to carefully consider the potential benefits and risks of using algorithms before implementing them in healthcare settings.

Thursday, November 23, 2023

How to Maintain Hope in an Age of Catastrophe

Masha Gessen
The Atlantic
Originally posted 12 Nov 23

Gessen interviews psychoanalyst and author Robert Jay Lifton.  Here is an excerpt from the beginning of the article/interview:

Lifton is fascinated by the range and plasticity of the human mind, its ability to contort to the demands of totalitarian control, to find justification for the unimaginable—the Holocaust, war crimes, the atomic bomb—and yet recover, and reconjure hope. In a century when humanity discovered its capacity for mass destruction, Lifton studied the psychology of both the victims and the perpetrators of horror. “We are all survivors of Hiroshima, and, in our imaginations, of future nuclear holocaust,” he wrote at the end of “Death in Life.” How do we live with such knowledge? When does it lead to more atrocities and when does it result in what Lifton called, in a later book, “species-wide agreement”?

Lifton’s big books, though based on rigorous research, were written for popular audiences. He writes, essentially, by lecturing into a Dictaphone, giving even his most ambitious works a distinctive spoken quality. In between his five large studies, Lifton published academic books, papers and essays, and two books of cartoons, “Birds” and “PsychoBirds.” (Every cartoon features two bird heads with dialogue bubbles, such as, “ ‘All of a sudden I had this wonderful feeling: I am me!’ ” “You were wrong.”) Lifton’s impact on the study and treatment of trauma is unparalleled. In a 2020 tribute to Lifton in the Journal of the American Psychoanalytic Association, his former colleague Charles Strozier wrote that a chapter in “Death in Life” on the psychology of survivors “has never been surpassed, only repeated many times and frequently diluted in its power. All those working with survivors of trauma, personal or sociohistorical, must immerse themselves in his work.”


Here is my summary of the article and helpful tips.  Happy (hopeful) Thanksgiving!!

Hope is not blind optimism or wishful thinking, but rather a conscious decision to act in the face of uncertainty and to believe in the possibility of a better future. The article/interview identifies several key strategies for cultivating hope, including:
  • Nurturing a sense of purpose: Having a clear sense of purpose can provide direction and motivation, even in the darkest of times. This purpose can be rooted in personal goals, relationships, or a commitment to a larger cause.
  • Engaging in meaningful action: Taking concrete steps, no matter how small, can help to combat feelings of helplessness and despair. Action can range from individual acts of kindness to participation in collective efforts for social change.
  • Cultivating a sense of community: Connecting with others who share our concerns can provide a sense of belonging and support. Shared experiences and collective action can amplify our efforts and strengthen our resolve.
  • Maintaining a critical perspective: While it is important to hold onto hope, it is also crucial to avoid complacency or denial. We need to recognize the severity of the challenges we face and to remain vigilant in our efforts to address them.
  • Embracing resilience: Hope is not about denying hardship or expecting a quick and easy resolution to our problems. Rather, it is about cultivating the resilience to persevere through difficult times and to believe in the possibility of positive change.

The article concludes by emphasizing the importance of hope as a driving force for positive change. Hope is not a luxury, but a necessity for survival and for building a better future. By nurturing hope, we can empower ourselves and others to confront the challenges we face and to work towards a more just and equitable world.

Wednesday, November 22, 2023

The case for partisan motivated reasoning

Williams, D.
Synthese 202, 89 (2023).

Abstract

A large body of research in political science claims that the way in which democratic citizens think about politics is motivationally biased by partisanship. Numerous critics argue that the evidence for this claim is better explained by theories in which party allegiances influence political cognition without motivating citizens to embrace biased beliefs. This article has three aims. First, I clarify this criticism, explain why common responses to it are unsuccessful, and argue that to make progress on this debate we need a more developed theory of the connections between group attachments and motivated reasoning. Second, I develop such a theory. Drawing on research on coalitional psychology and the social functions of beliefs, I argue that partisanship unconsciously biases cognition by generating motivations to advocate for party interests, which transform individuals into partisan press secretaries. Finally, I argue that this theory offers a superior explanation of a wide range of relevant findings than purely non-motivational theories of political cognition.

My summary:

Partisan motivated reasoning is the tendency for people to seek out and interpret information in a way that confirms their existing political beliefs. This is a complex phenomenon, but Williams argues that it can be explained by the combination of two factors:

  1. Group attachments: People are strongly motivated to defend and promote the interests of their social groups, including their political parties.
  2. Motivated cognition: People are motivated to believe things that are true, but they are also motivated to believe things that are consistent with their values and goals.
Williams argues that partisan motivated reasoning is a natural and predictable consequence of these two factors. When people are motivated to defend and promote their political party, they will be motivated to seek out and interpret information in a way that confirms their existing beliefs. They will also be motivated to downplay or ignore information that is inconsistent with their beliefs.

Williams provides a number of pieces of evidence to support his argument, including studies that show that people are more likely to believe information that is consistent with their political beliefs, even when that information is false. He also shows that people are more likely to seek out and consume information from sources that they agree with politically.

Williams concludes by arguing that partisan motivated reasoning is a serious problem for democracy. It can lead to people making decisions that are not in their own best interests, and it can make it difficult for people to have productive conversations about political issues.