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

Sunday, June 16, 2019

Kellyanne Conway Should Be Fired For Violating Ethics Law, Oversight Office Says

Brian Naylor & Peter Overby
www.npr.org
Originally published June 13, 2019

Presidential adviser Kellyanne Conway has repeatedly criticized Democratic candidates in her official capacity in violation of the Hatch Act and should lose her job, according to the U.S. Office of Special Counsel.

The OSC, which oversees federal personnel issues, issued a stinging report Thursday, calling Conway "a repeat offender."

"As a highly visible member of the Administration, Ms. Conway's violations, if left unpunished, send a message to all federal employees that they need not abide by the Hatch Act's restrictions. Her actions thus erode the principal foundation of our democratic system — the rule of law," the office wrote to President Trump.

OSC is an independent federal ethics agency that has no relationship with former Department of Justice special counsel Robert Mueller's investigation into Russian interference with the 2016 election.

The Hatch Act forbids executive branch employees from taking part in political activities while engaged in their official duties.

In March 2018, the ethics agency found Conway broke the law twice in interviews about the Alabama Senate race. The new report focuses on her commentary on Democratic presidential candidates. It cites examples of her rhetoric, including suggesting Sen. Cory Booker of New Jersey was "sexist" and alleging that former Vice President Joe Biden was unwilling to be "held to account for his record."

The info is here.

Saturday, June 15, 2019

Legal questions surround police use of facial recognition tech

Alexander J Martin, Technology Reporter and Tom Cheshire
news.sky.com
Originally posted August 23, 2017

Here is an excerpt:

He noted that despite this threat to privacy "this new database is subject to none of the governance controls or other protections which apply as regards the DNA and fingerprint databases" - and that it "has been put into operation without public or parliamentary consultation or debate."

Similar concerns were raised by Parliament's science and technology committee, which also complained to the Government that it was running two years late on its planned publication date for the joint forensics and biometrics strategy.

Although a separate forensics strategy has since been published, the biometrics strategy - which will set out how police can use technologies such as facial recognition - has still not been released by the Home Office, and it is now four years overdue.

The committee also noted that facial biometrics were currently not covered by strict rules that govern the police's collection of DNA profiles and fingerprints, and recommended the biometrics commissioner's role be expanded to include them.

The info is here.

Friday, June 14, 2019

From the talking cure to a disease of silence: Effects of ethical violations in a psychoanalytic institute

Jane Burka, Angela Sowa, Barbara A. Baer, & others
The International Journal of Psychoanalysis (2019) 100:2, 247-271,

Abstract

This article presents an in-depth study of one institute’s efforts to recover from effects of ethical violations by two senior members. Qualitative data analysis from voluntary member interviews details the damage that spread throughout the institute, demonstrating that a violation of one is a violation of many. Members at all levels reported feeling disturbed in ways that affected their emotional equilibrium, their thinking processes, and their social and professional relationships. The aggregated interview data were reported to the institute community in large and small group meetings designed to reverse the “disease of silence” and to allow members to talk with each other. Outside consultation helped with this emotionally arduous process. The authors offer hypotheses concerning the nature of group anxieties during ethics crises. We assert that both sexual and non-sexual boundary violations break the incest taboo, as they breach the generational protection required of professional interactions. Ethical violations attack the group’s foundational ethos of care, unleashing primitive anxieties and defences that interfere with capacities for thinking, containment, collaboration, and integration. Since the full reality of what happened is unknowable, hybrid truths emerge, causing conflict and disturbances that inhibit thoughtful group discourse.

The article can be downloaded here.

The Ethics of Treating Loved Ones

Christopher Cheney
www.medpagetoday.com
Originally posted May 19, 2019

When treating family members, friends, colleague, or themselves, ER physicians face ethical, professional, patient welfare, and liability concerns, a recent research article found.

Similar to situations arising in the treatment of VIP patients, ER physicians treating loved ones or close associates may vary their customary medical care from the standard treatment and inadvertently produce harm rather than benefit.

"Despite being common, this practice raises ethical concerns and concern for the welfare of both the patient and the physician," the authors of the recent article wrote in the American Journal of Emergency Medicine.

There are several liability concerns for clinicians, the lead author explained.


"Doctors would be held to the same standard of care as for other patients, and if care is violated and leads to damages, they could be liable. Intuitively, family and friends might be less likely to sue but that is not true of subordinates. In addition, as we state in the paper, for most ED physicians, practice outside of the home institution is not a covered event by the malpractice insurer," said Joel Geiderman, MD, professor and co-chairman of emergency medicine, Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles.

The info is here.

Thursday, June 13, 2019

Moral dilemmas in (not) treating patients who feel they are a burden

Metselaar S, Widdershoven G.
[published online April 23, 2019]
Bioethics. 2019;33(4):431-438.

Abstract

Working as clinical ethicists in an academic hospital, we find that practitioners tend to take a principle‐based approach to moral dilemmas when it comes to (not) treating patients who feel like a burden, in which respect for autonomy tends to trump other principles. We argue that this approach insufficiently deals with the moral doubts of professionals with regard to feeling that you are a burden as a motive to decline or withdraw from treatment. Neither does it take into adequately account the specific needs of the patient that might underlie their feeling of being a burden to others. We propose a care ethics approach as an alternative. It focuses on being attentive and responsive to the caring needs of those involved in the care process—which can be much more specific than either receiving or withdrawing from treatment. This approach considers these needs in the context of the patient's identity, biography and relationships, and regards autonomy as relational rather than as individual. We illustrate the difference between these two approaches by means of the case of Mrs K. Furthermore, we show that a care ethics approach is in line with interventions that are found to alleviate feeling a burden and maintain that facilitating moral case deliberation among practitioners can supports them in taking a care ethics approach to moral dilemmas in (not) treating patients who feel like a burden.

The info is here.

Alleviating Burdensome Beliefs Through a Care Ethics Approach

Medical Bag
Originally posted May 29, 2019

Compared with a principles-based approach, taking a care ethics approach to patients who believe they are a burden may be more effective for addressing moral dilemmas related to treatment, according to research published in Bioethics.

Two clinical ethicists from the department of medical humanities at VU University Medical Center in Amsterdam, The Netherlands, shared the case of Mrs K, a 66-year-old patient with leukemia, and examined the ways in which physicians can approach treating a patient who feels like a burden.

Mrs K recently received a bone marrow transplant, but because of rejection symptoms, is now taking an antirejection treatment. Although a cure is possible, the treatment is both taxing and extensive and presents a host of physical and mental challenges. Although Mrs K had previously focused on survival, her mindset has shifted: She says that she is burdening her husband and feels that he deserves better. Mrs K feels that life is no longer worth living and has considered stopping her antirejection treatment, which will result in her death.

Noticing that Mrs K’s mood has been poor over a long period of time, the treating physician suggests antidepressant therapy; they believe that by treating the patient’s depression, the patient will be more optimistic about continuing the antirejection therapy. Mrs K’s husband — also a physician — strongly disagrees with this course of treatment. Mrs K’s care team contacts the clinical ethicist to address this moral dilemma.

The info is here.

Wednesday, June 12, 2019

Americans Say U.S. Moral Values Not Good and Getting Worse

Megan Brenan
news.gallup.com
Originally posted May 31, 2019

Americans continue to rate U.S. moral values negatively, on balance, and overwhelmingly agree that they are getting worse. These readings, from Gallup's May 1-12 Values poll, are the latest in the 18-year trend that shows similarly bleak findings.

Line graph. Americans’ views of moral values in the U.S. getting worse since 2002, currently 77%.

For the third consecutive year, 77% of Americans think moral values in the U.S. are getting worse, slightly below Gallup's all-time 82% high in 2007. Just 19% currently believe that morals are getting better.

The info is here.

'Ethics Bots' and Other Ways to Move Your Code of Business Conduct Beyond Puffery

Michael Blanding
Harvard Business Week
Originally posted May 14, 2019

Here is an excerpt:

Even if not ready to develop or deploy such technologically advanced solutions, companies can still make their ethics codes more intuitive, interactive, and practical for day-to-day decision-making, Soltes says. That may mean reducing the number of broad-brush value statements and uninspired clip-art, instead making the document more concise in describing practical guidelines for the company’s employees.

He also recommends thinking beyond the legal department to bring in other areas of the company, such as marketing, communications, or consumer behavior specialists, to help design a code that will be understandable to employees. Uber, for example, rolled out a mobile app-focused version of its ethics code to better serve its employees, who are younger and more tech savvy.

Lastly, Soltes advises that firms not be afraid to experiment. An ethics code shouldn’t be a monolith, but rather a living document that can be adapted to the expanding needs of a firm and its employees. After rolling out a policy to a subgroup of employees, for example, companies should evaluate how the code is actually being used in practice and how it can be further refined and improved.

That kind of creativity can help companies stay away from the scrutiny of regulators and avoid negative headlines. “Ultimately, the goal should not simply be to just create a legal document, but instead a valuable tool that helps cultivate the kind of behavior and culture the firm wants to support on a day-to-day basis,” Soltes says.

The info is here.

Tuesday, June 11, 2019

The Lawyer Who Wants to Transform Legal Ethics with Behavioral Science

Brian Gallagher
www.ethicalsystems.org
Originally posted May 28, 2019

Here is an excerpt:

In a paper on the psychology of conflicts of interest, you wrote that, “Too often, the Supreme Court has made assumptions about the behavior of defense lawyers without empirical support.” How does behavioral science inform the way the Supreme Court should think about defense lawyers?

In the last 40 years, the Supreme Court has analyzed conflicts of interest in a manner that, I believe, makes unsupported assumptions about how criminal defense lawyers respond to allegations about their own misbehavior. My argument is that lawyers—like all people—are poorly equipped to recognize and address their own conflicts of interest. As a result, I propose that constitutional standards for conflicts of interest should be treated more like the ethical rules concerning conflicts, which focus on the risk that a conflict will influence a lawyer’s behavior rather than whether a conflict has, in fact, caused an adverse effect on the legal representation that a client received. I’m happy that my analysis has been cited by a few state courts that have looked at these and similar issues—and who knows, maybe someday the Supreme Court will cite behavioral research in forming its opinion on this topic.

You recently shared a paper on your blog, calling it a “fascinating discussion of the role of behavioral ethics in the context of judicial decision-making.” Which points or lessons stood out to you the most?

Interestingly, in a series of decisions about the constitutional standards for judicial conflicts of interest, the Supreme Court seems to be a bit more behaviorally realistic about conflicts of interest than it has been about attorney conflicts. For instance, in a case from a few terms ago, the Supreme Court—in deciding whether a justice on the Pennsylvania Supreme Court could properly adjudicate a death penalty case when he had previously been the prosecutor who authorized capital charges against the defendant—noted that “bias is easy to attribute to others and difficult to discern in oneself.” The Court went even further, noting that when a judge is asked to participate in a case in which he or she previously served as a prosecutor, there is “a risk that the judge would be so psychologically wedded to his or her previous position as a prosecutor that the judge would consciously or unconsciously avoid the appearance of having erred or changed position.”

The info is here.