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

Saturday, November 30, 2013

What Is Wrong With Discharges Against Medical Advice (And How to Fix It)

By David Alfrandre and John Henning Schumann
First published November 11, 2013

Here is an excerpt:

It is time to rethink the approach to this issue. For a profession accountable to the public and committed to patient-centered care, continued use of the discharged against medical advice designation is clinically and ethically problematic. Designating a discharge as against medical advice is a clinical practice without standards, legal requirements, or demonstrated benefits to patients, and there is evidence of its harm. The more relevant and pressing question should be, “Why would you discharge a patient against medical advice?” Without a compelling answer to that question, continued use of the practice does not seem justified. Taking leadership on this problem through enhanced research, teaching, and quality patient care ensures that the profession will honor its commitment to providing patient-centered care and improving clinical outcomes.

The entire article is here.

Thanks to Gary Schoener for this information.

No Faith in Science

By Jerry A. Coyne
Originally published November 14, 2013

A common tactic of those who claim that science and religion are compatible is to argue that science, like religion, rests on faith: faith in the accuracy of what we observe, in the laws of nature, or in the value of reason. Daniel Sarewitz, director of a science policy center at Arizona State University and an occasional Slate contributor, wrote this about the Higgs boson in the pages of Nature, one of the world’s most prestigious science journals: “For those who cannot follow the mathematics, belief in the Higgs is an act of faith, not of rationality.”

Such statements imply that science and religion are not that different because both seek the truth and use faith to find it. Indeed, science is often described as a kind of religion.

But that’s wrong, for the “faith” we have in science is completely different from the faith believers have in God and the dogmas of their creed.

The entire article is here.

Friday, November 29, 2013

Gruesome case videos became too much for top psychiatrist

Chris Cobb, Postmedia News | Originally published 11/11/13

Dr. John Bradford’s mental breakdown hit without warning less than half an hour after he watched Canadian Air Force colonel Russell Williams sexually assaulting two young women whom he would later kill.

During his long and distinguished career as a doctor and teacher, the internationally renowned forensic psychiatrist had become skilled at emotionally detaching himself from all manner of horrendous images.

He was relatively comfortable sitting across a table from the likes of notorious sex killers Paul Bernardo, Robert (Willie) Pickton and Williams.

And like all professionals in his line of work, Dr. Bradford was trained to focus on the killer, not the crime. His job is to get inside a killer’s mind, not to pass judgment on the severity or brutality of the killer’s actions.

The entire article is here.

Thanks to Gary Schoener for this article.

So much for Hippocrates: Why docs won’t reveal each other’s mistakes

Research suggests physicians are concerned about becoming known as a tattler and losing referrals

By Marshall Allen
Originally published November 12, 2013

Patients don’t always know when their doctor has made a medical error. But other doctors do.

A few years ago I called a Las Vegas surgeon because I had hospital data showing which of his peers had high rates of surgical injuries – things like removing a healthy kidney, accidentally puncturing a young girl’s aorta during an appendectomy and mistakenly removing part of a woman’s pancreas.

I wanted to see if he could help me investigate what happened. But the surgeon surprised me.

Before I could get a question out, he started rattling off the names of surgeons he considered the worst in town. He and his partners often had to correct their mistakes — “cleanup” surgeries, he said. He didn’t need a database to tell him which surgeons made the most mistakes.

The entire story is here.

Thanks to Gary Schoener for this article.

Thursday, November 28, 2013

When Healers Get Too Friendly

By Abigail Zuger
The New York Times - Well
Originally published November 11, 2013

Here is an excerpt:

The incident that it set it off: Dr. Schiff (now 63, an experienced senior clinician) had tangled with an insurer on the phone for two hours before he gave up and handed an impoverished patient $30 to pay for her pain pills. A resident observed the transaction and turned him in. But Dr. Schiff is a proud repeat offender, whose past infractions include helping patients get jobs, giving them jobs himself, offering them rides home, extending the occasional dinner invitation and, yes, once handing over a computer.

He was told physicians should stay away from “random acts of kindness” — an activity that may sound harmless but is quite distinct from the practice of medicine, and has its risks. Patients might get too familiar, expect too much.

The entire story is here.

Robert Wright's Interview with Paul Bloom

Originally published November 13, 2013
Just Babies: The Origins of Good and Evil

Wednesday, November 27, 2013

US courts see rise in defendants blaming their brains for criminal acts

By Ian Sample, Science Correspondent in San Diego
The Guardian, Sunday 10 November 2013

Criminal courts in the United States are facing a surge in the number of defendants arguing that their brains were to blame for their crimes and relying on questionable scans and other controversial, unproven neuroscience, a legal expert who has advised the president has warned.

Nita Farahany, a professor of law who sits on Barack Obama's bioethics advisory panel, told a Society for Neuroscience meeting in San Diego that those on trial were mounting ever more sophisticated defences that drew on neurological evidence in an effort to show they were not fully responsible for murderous or other criminal actions.

Lawyers typically drew on brain scans and neuropsychological tests to reduce defendants' sentences, but in a substantial number of cases the evidence was used to try to clear defendants of all culpability.

The entire story is here.

Superhero Comics as Moral Pornography

By David Pizarro and Roy Baumeister
Superhero Comics as Moral Pornography.
In R. Rosenberg (Ed.) Our Superheroes, Ourselves. Oxford University Press.

Here is an excerpt:

Modern superhero comics (and the films they’ve inspired) are moral tales on steroids.  While they present variations on the theme of good versus evil, these stories describe individuals who commit moral deeds of global (and often cosmic) significance on a weekly basis. In this chapter we will argue that superhero comics, like other moralistic tales, are popular in part because they satisfy a basic human motivation: the motivation to divide the social world into good people and bad, and to morally praise and condemn them accordingly. In their modern superhero comic incarnation, however, these tales depict an exaggerated morality that has been stripped of its real-world subtlety. In tales of superhero versus supervillain, moral good and moral bad are always the actions of easily identifiable moral agents with unambiguous intentions and actions. And it is these very qualities that make these stories so enjoyable. Much like the appeal of the exaggerated, caricatured sexuality found in pornography, superhero comics offer the appeal of an exaggerated and caricatured morality that satisfies the natural human inclination toward moralization. In short, the modern superhero comic is a form of “moral pornography”— built to satisfy our moralistic urges, but ultimately unrealistic and, in the end, potentially misleading.

The entire chapter is here.

Tuesday, November 26, 2013

The Roots of Good and Evil: An Interview with Paul Bloom

By Sam Harris
Sam Harris Blog
Originally published November 12, 2013

Here is one excerpt:

Harris: What are the greatest misconceptions people have about the origins of morality?

Bloom: The most common misconception is that morality is a human invention. It’s like agriculture and writing, something that humans invented at some point in history. From this perspective, babies start off as entirely self-interested beings—little psychopaths—and only gradually come to appreciate, through exposure to parents and schools and church and television, moral notions such as the wrongness of harming another person.

Now, this perspective is not entirely wrong. Certainly some morality is learned; this has to be the case because moral ideals differ across societies. Nobody is born with the belief that sexism is wrong (a moral belief that you and I share) or that blasphemy should be punished by death (a moral belief that you and I reject). Such views are the product of culture and society. They aren’t in the genes.
But the argument I make in Just Babies is that there also exist hardwired moral universals—moral principles that we all possess. And even those aspects of morality—such as the evils of sexism—that vary across cultures are ultimately grounded in these moral foundations.

A very different misconception sometimes arises, often stemming from a religious or spiritual outlook. It’s that we start off as Noble Savages, as fundamentally good and moral beings. From this perspective, society and government and culture are corrupting influences, blotting out and overriding our natural and innate kindness.

This, too, is mistaken. We do have a moral core, but it is limited—Hobbes was closer to the truth than Rousseau. Relative to an adult, your typical toddler is selfish, parochial, and bigoted. I like the way Kingsley Amis once put it: “It was no wonder that people were so horrible when they started life as children.” Morality begins with the genes, but it doesn’t end there.

The entire interview is here.

Moral signals, public outrage, and immaterial harms

David Tannenbaum, Eric Luis Uhlmann, & Daniel Diermeier
Journal of Experimental Social Psychology 47 (2011) 1249–1254


Public outrage is often triggered by “immaterially” harmful acts (i.e., acts with relatively negligible consequences). A well-known example involves corporate salaries and perks: they generate public outrage yet their financial cost is relatively minor. The present research explains this paradox by appealing to a person-centered approach to moral judgment. Strong moral reactions can occur when relatively harmless acts provide highly diagnostic information about moral character. Studies 1a and 1bfirst demonstrate dissociation between moral evaluations of persons and their actions—although violence toward a human was viewed as a more blameworthy act than violence toward an animal, the latter was viewed as more revealing of bad moral character. Study 2 then shows that person-centered cues directly influence moral judgments—participants preferred to hire a more expensive CEO when the alternative candidate requested a frivolous perk as part of his compensation package, an effect mediated by the informativeness of his request.

The entire article is here.

Monday, November 25, 2013

Initial Session Price Tag—$150? Or Free?

Will that be cash or credit?

By Sharon Anderson and Mitchell Handelsman
The Ethical Therapist
Originally published on August 14, 2013

The initial meeting between potential clients and psychotherapist is of critical importance [Anderson & Handelsman, in press]. Shopping for the right therapist is an important investment in time and money. Before making a commitment to the relationship, the potential client needs some answers to important questions. In prior blog posts, where we talked about shopping for a psychotherapist and what to look for, we suggested questions potential clients can ask therapists to help make good decisions and ultimately answer the question, “Is this therapist the right therapist for me?” In this entry we tackle the issue of the ethics of charging money for the first session.

The entire post is here.

Bamboozled by Bad Science

The first myth about "evidence-based" therapy

Published on October 31, 2013 by Jonathan Shedler, PhD in Psychologically Minded

Media coverage of psychotherapy often advises people to seek "evidence-based therapy."
Few outside the mental health professions realize the term “evidence-based therapy” is a form of branding. It refers to therapies conducted by following instruction manuals, originally developed to create standardized treatments for research trials. These "manualized" therapies are typically brief, highly structured, and almost exclusively identified with cognitive behavioral therapy or CBT.

Academic researchers routinely extoll the “evidence-based” therapies studied in research laboratories and denigrate psychotherapy as it is actually practiced by most clinicians in the real world. Their comments range from the hysteric (“The disconnect between what clinicians do and what science has discovered is an unconscionable embarrassment.”–Professor Walter Mischel, quoted in Newsweek) to the seemingly cautious and sober (“Evidence-based therapies work a little faster, a little better, and for more problematic situations, more powerfully.”–Professor Steven Hollon, quoted in the Los Angeles Times).

The entire blog post is here.

Sunday, November 24, 2013

Are We Just a Bunch of Busybodies? (A Dialogue)

By Tamler Sommers
Flickers of Freedom Blog
Originally posted on November 9, 2013

Here is an excerpt:

Busybody [biz-ee-bod-ee] noun: a person who pries into or meddles in the affairs of others.

In the last two posts I described some cases that are hard for most existing theories of moral responsibility to handle.  What I want to suggest in this post is that any attempt to develop a systematic condition-based theory of responsibility is both philosophically and morally problematic.   Why morally?  Because it turns philosophers into meddlesome busybodies who stick their noses in the private affairs of others and don't know when to mind their own business.

So here's the set-up:  Sarah is at a party and has a few too many glasses of wine on a relatively empty stomach.  She overhears her colleague Emma talking about her in another conversation.  She’s drunk and she misinterprets the meaning of Emma’s remarks and gets angry.  Without thinking, Sarah confronts Emma and lets off some biting insults about her performance at work.  Emma is bewildered and humiliated in front of her friends and co-workers.  Soon, the initial misunderstanding is cleared up and Sarah, mortified, realizes she was way out of line. She offers a bunch of drunken apologies, but the damage is done.  Emma is furious and resentful and Sarah feels terrible overwhelming guilt what happened.

The entire blog post is here.

Note: This philosophical discussion of morality has direct implications for both individual and couples therapy.

Vantage Points and The Trolley Problem

By Thomas Nadelhoffer
Leiter Reports: A Philosophy Blog
Originally posted November 10, 2013

Here is an excerpt:

The standard debates about scenarios like BAS (Bystander at the Switch) typically focus on what it is permissible for the bystander to do given the rights of the few who have to be sacrificed involuntarily in order to save the many. In a paper I have been working on in fits and starts for too damn long now, I try to shift the vantage point from which we view cases like BAS and I suggest doing so yields some interesting results.  Rather than looking at BAS from the perspective of the bystanders—and what it is permissible (or impermissible) for them to do—I examine BAS instead from the point of view of the individuals whose lives hang in the balance. This change of vantage points highlights some possible tensions that may exist in our ever shifting intuitions.

For instance, let’s reexamine BAS from the point of view of the five people who will be killed if the bystander perhaps understandably cannot bring herself to hit the switch. Imagine that one of the five workmen has a gun and it becomes clear that the bystander is not going to be able to bring herself to divert the trolley.  Would it be permissible for the workman with the gun to shoot and kill the bystander if doing so was the only way of getting her to fall onto the switch?

The entire blog post is here.

Saturday, November 23, 2013

The Moral Responsibility of Volunteer Soldiers

Should they say no to fighting in an unjust war?

Jeff McMahan
The Boston Review
Wednesday, November 6, 2013

Here is an excerpt:

Traditional Just War Theory

The idea that voluntary enlistment in the military can be morally problematic derives from a neglected tradition of just war thinking. This approach to the ethics of war informed the work of some of the classical just war theorists, such as the 16th century Spanish philosophers Francisco de Vitoria and Francisco Suárez. It was, however, gradually abandoned by thinkers whose views together constitute what I call “traditional just war theory.” The traditional theory has been ascendant since at least the 18th century, but the older approach has recently been resurrected by a group of “revisionists.” The best way to understand revisionist just war theory is to contrast it with the traditional theory, which has had a profound influence in shaping common sense thinking about the ethics of war, in part because it was developed in tandem with the international law of armed conflict.

According to traditional just war theory, a soldier does no wrong by fighting in an unjust war, provided that he or she obeys the rules regulating the conduct of war. This theoretical idea finds powerful expression in public sentiments. For centuries it has been regarded as not merely permissible but conspicuously noble and admirable for a soldier to go to war without any concern for whether the war’s cause was just.

The entire article is here.

Swastikas, Slurs and Torment in Town’s Schools

By Benjamin Weiser
The New York Times
Originally published November 7, 2013

Here is an excerpt:

“There are anti-Semitic incidents that have occurred that we need to address,” John Boyle, Crispell Middle School’s principal, said in a deposition in April.

In 2011, when one parent complained about continued harassment of her daughter and another Jewish girl, Pine Bush’s superintendent from 2008 to 2013, Philip G. Steinberg, wrote in an email, “I have said I will meet with your daughters and I will, but your expectations for changing inbred prejudice may be a bit unrealistic.”

Mr. Steinberg, who, along with two other administrators named as defendants, is Jewish, described the lawsuit in recent interviews as a “money grab.” He contended that the plaintiffs had “embellished” some allegations.

The entire story is here.

Friday, November 22, 2013

The Morning Morality Effect: The Influence of Time of Day on Unethical Behavior.

By M. Kouchaki & I.H. Smith
Edmond J. Safra Center for Ethics, Harvard University
Psychol Sci. 2013 Oct 28


Are people more moral in the morning than in the afternoon? We propose that the normal, unremarkable experiences associated with everyday living can deplete one's capacity to resist moral temptations. In a series of four experiments, both undergraduate students and a sample of U.S. adults engaged in less unethical behavior (e.g., less lying and cheating) on tasks performed in the morning than on the same tasks performed in the afternoon. This morning morality effect was mediated by decreases in moral awareness and self-control in the afternoon. Furthermore, the effect of time of day on unethical behavior was found to be stronger for people with a lower propensity to morally disengage. These findings highlight a simple yet pervasive factor (i.e., the time of day) that has important implications for moral behavior.

The entire story is here, hiding behind a paywall.

‘Don’t Tell Coach’: Playing Through Concussions

By Jan Hoffman
The New York Times - Well
Originally published November 5, 2013

Here is an excerpt:

An extensive report about sports-related concussions in young people, released last week by the Institute of Medicine and the National Research Council, made recommendations that included bolstering research, collecting data, examining injury protocols and educating the public. But the report identified one particularly stubborn challenge: the “culture of resistance” among high school and college athletes, who may be inclined to shrug off the invisible injuries and return immediately to the field.

“There is still a culture among athletes,” the report said, “that resists both the self-reporting of concussions and compliance with appropriate concussion management plans.”

The entire story is here.

Thursday, November 21, 2013

Morality in Psychotherapy

By John Gavazzi and Samuel Knapp
Submitted to The Pennsylvania Psychologist

Individuals rarely, if ever, enter psychotherapy with the explicit goals of understanding the origins of their morality, their moral reasoning skills, or matching their expressed moral ideals with their everyday behavior.  Nonetheless, clients and psychologists always bring their moral values into the psychotherapy session.  Although morality and moral values may not be an overt part of the therapeutic dialogue, many psychotherapy sessions are rife with moral issues, value-laden comments, ethical conflicts, and moral reasoning.  

If morality is seldom overtly addressed in psychotherapy, what makes morality so important to the practicing psychologist? 

The entire article is here.

Talking with Patients about Other Clinicians' Errors

By Thomas H. Gallagher, Michelle M. Mello, and others
The New England Journal of Medicine
Originally published November 6, 2013

Here is an excerpt:

The rationales for disclosing harmful errors to patients are compelling and well described. Nonetheless, multiple barriers, including embarrassment, lack of confidence in one's disclosure skills, and mixed messages from institutions and malpractice insurers, make talking with patients about errors challenging. Several distinctive aspects of disclosing harmful errors involving colleagues intensify the difficulties.

One challenge is determining what happened when a clinician was not directly involved in the event in question. He or she may have little firsthand knowledge about the event, and relevant information in the medical record may be lacking. Beyond this, potential errors exist on a broad spectrum ranging from clinical decisions that are “not what I would have done” but are within the standard of care to blatant errors that might even suggest a problem of professional competence or proficiency.

The entire article is here.

Thanks to Gary Schoener for this information.

Wednesday, November 20, 2013

Medical, Military, and Ethics Experts Say Health Professionals Designed and Participated in Cruel, Inhumane, and Degrading Treatment

Press Release
Institute of Medicine as a Profession

An independent panel of military, ethics, medical, public health, and legal experts today charged that U.S. military and intelligence agencies directed doctors and psychologists working in U.S. military detention centers to violate standard ethical principles and medical standards to avoid infliction of harm. The Task Force on Preserving Medical Professionalism in National Security Detention Centers (see attached) concludes that since September 11, 2001, the Department of Defense (DoD) and CIA improperly demanded that U.S. military and intelligence agency health professionals collaborate in intelligence gathering and security practices in a way that inflicted severe harm on detainees in U.S. custody.

These practices included “designing, participating in, and enabling torture and cruel, inhumane and degrading treatment” of detainees, according to the report. Although the DoD has taken steps to address some of these practices in recent years, including instituting a committee to review medical ethics concerns at Guantanamo Bay Prison, the Task Force says the changed roles for health professionals and anemic ethical standards adopted within the military remain in place.

“The American public has a right to know that the covenant with its physicians to follow professional ethical expectations is firm regardless of where they serve,” said Task Force member Dr. Gerald Thomson, Professor of Medicine Emeritus at Columbia University. “It’s clear that in the name of national security the military trumped that covenant, and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice. We have a responsibility to make sure this never happens again.”

The entire press release is here.

Thanks for Gary Schoener for this release.

The Morality of Sport-Hatred

By Joshua Shepherd
Practical Ethics
Published on November 7, 2013

Here is an excerpt:

The question: is sport-hatred morally permissible?

Obviously Updyke’s crime crossed moral boundaries. I am not asking about the moral permissibility of all actions motivated by sport-hatred. I am asking whether sport-hatred itself is morally permissible: do those of us who frequently undergo strong bouts of sport-hatred exhibit a moral defect? Am I morally blameworthy because I hate (citing teams here to avoid naming names) Arsenal, Duke University’s basketball team, or the Philadelphia Eagles?

Hatred itself is rarely if ever praiseworthy. Hate-crimes are taken to be especially odious crimes, and come with increased sentences. And hatred in daily life is frequently an overreaction, based on biased or otherwise mistaken judgments about the nature of some agent, some agent’s character, some action.

The entire story is here.

Tuesday, November 19, 2013

You Can't Learn about Morality from Brain Scans

By Thomas Nagel
New Republic
Originally posted November 1, 2013

This story includes information from Joshua Green's book: Moral Tribes: Emotion, Reason, and the Gap Between Us and Them

Here is an excerpt:

Morality evolved to enable cooperation, but this conclusion comes with an important caveat. Biologically speaking, humans were designed for cooperation, but only with some people. Our moral brains evolved for cooperation within groups, and perhaps only within the context of personal relationships. Our moral brains did not evolve for cooperation between groups (at least not all groups).... As with the evolution of faster carnivores, competition is essential for the evolution of cooperation.

The tragedy of commonsense morality is conceived by analogy with the familiar tragedy of the commons, to which commonsense morality does provide a solution. In the tragedy of the commons, the pursuit of private self-interest leads a collection of individuals to a result that is contrary to the interest of all of them (like over-grazing the commons or over-fishing the ocean). If they learn to limit their individual self-interest by agreeing to follow certain rules and sticking to them, the commons will not be destroyed and they will all do well.

The entire article is here.

Internet forums can have a positive influence on self-harmers, say researchers

By Jochan Embley
The Independent
Originally published October 31, 2013

Internet forums and chatrooms can have a positive influence on young people at risk from self-harm or suicide, researchers have found.

The review, which comes from researchers at Oxford University, does admit that there are also negative, potentially dangerous aspects to forums, however.

The entire story is here.

Monday, November 18, 2013

Inside the Cheater's Mind

By Maria Konnikova
The New Yorker
Originally published October 31, 2013

A few years ago, acting on a tip, school administrators at Great Neck North High School, a prominent, academically competitive public school in Long Island, took a closer look at students’ standardized test scores. Some of them seemed suspiciously high. What’s more, some of the high scorers had registered to take the test well outside their home district. When the Educational Testing Service conducted a handwriting analysis on the suspect exams, they concluded that the same person had taken multiple tests, registering each time under a different name. In November, 2011, twenty students from schools in Nassau County were arrested and accused of cheating. The arrests, combined with the social prominence of the school and its students, made the case one of the most prominent cheating scandals in recent history.

When a student sits down at a test, he knows how to cheat, in principle. But how does he decide whether or not he’ll actually do it? Is it logic? An impulse? A subconscious reaction to the adrenaline in his blood and the dopamine in his brain? People cheat all the time. But why, exactly, do they decide to do it in the first place?

The entire story is here.

Psyching Us Out: The Promises of ‘Priming’

The New York Times - Opinionator
Originally published October 31, 2013

Reports of psychological experiments are journalistic favorites.  This is especially true of experiments revealing the often surprising effects of “priming” on human behavior. Priming occurs when a seemingly trivial alteration in an experimental situation produces major changes in the behavior of the subjects.

The classic priming experiment was one in which college students had been asked to form various sentences from a given set of words.  Those in one group were given words that included several associated with older people (like bingo, gray and Florida).  Those in a second group were given words with no such associations.  After the linguistic exercise, each participant was instructed to leave the building by walking down a hallway.  Without letting the participants know what was going on, the experimenters timed their walks down the hall.  They found that those in the group given words associated with old people walked significantly slower than those in the other group.  The first group had been primed to walk more slowly.

The entire story is here.

Sunday, November 17, 2013

Ethical dilemmas surround those willing to sell, buy kidneys on black market

By Michelle Castillo
CBS News
Originally published November 1, 2013

There's no denying that there is a shortage of organ donations in the United States. Government estimates show 18 people die each day waiting for a transplant, and every 10 minutes someone is added to the transplant list.

The need for kidneys is especially high. As of October 25, 98,463 people were waiting for a new kidney in the U.S., the most requested organ by far. Thus far this year, only 9,708 kidney transplants have been completed.

The beauty of kidney donation compared to other organs is that people are born with two of them, making possible donation from a living person. Other organs, like hearts, can only be donated from recently-deceased individuals. But, the fact that people can live a normal life with one kidney has helped the black market kidney trade flourish.

The entire story is here.

How Ayn Rand ruined my childhood

By Alyssa Bereznak
Originally published April 4, 2013

My parents split up when I was 4. My father, a lawyer, wrote the divorce papers himself and included one specific rule: My mother was forbidden to raise my brother and me religiously. She agreed, dissolving Sunday church and Bible study with one swift signature. Mom didn’t mind; she was agnostic and knew we didn’t need religion to be good people. But a disdain for faith wasn’t the only reason he wrote God out of my childhood. There was simply no room in our household for both Jesus Christ and my father’s one true love: Ayn Rand.

You might be familiar with Rand from a high school reading assignment. Perhaps a Tea Partyer acquaintance name-dropped her in a debate on individual rights. Or maybe you’ve heard the film adaptation of her magnum opus “Atlas Shrugged” is due out April 15. In short, she is a Russian-born American novelist who championed her self-taught philosophy of objectivism through her many works of fiction. Conservatives are known to praise her for her support of laissez-faire economics and meritocracy. Liberals tend to criticize her for being too simplistic. I know her more intimately as the woman whose philosophy dictates my father’s every decision.

What is objectivism? If you’d asked me that question as a child, I could have trotted to the foyer of my father’s home and referenced a framed quote by Rand that hung there like a cross. It read: “My philosophy, in essence, is the concept of man as a heroic being, with his own happiness as the moral purpose of his life, with productive achievement as his noblest activity, and reason as his only absolute.”

The entire story is here.

Saturday, November 16, 2013

Your pain, my gain: Feeling pleasure over the misfortune of those you envy is biological

Press Release
Princeton University
Released October 28, 2013

Mina Cikara found her thesis when she wore a Boston Red Sox hat to a New York Yankees baseball game. Nicknames and vulgarities were among the souvenirs she took home. And, after hearing about the name-calling and heckling her then-PhD student endured, Princeton professor Susan Fiske was compelled to join her in pursuing the phenomenon further, exploring why people fail to empathize with others based on stereotypes.

Through a series of four experiments – one involving the aforementioned sports rivalry – the researchers found that people are actually biologically responsive to taking pleasure in the pain of others, a reaction known as "Schadenfreude." By measuring the electrical activity of cheek muscles, the researchers show that people smile more when someone they envy experiences misfortune or discomfort. While these findings hold significance for interpersonal relationships, the researchers also cite associated policy implications, such as how other countries view and stereotype the United States especially given that many countries envy the U.S., Fiske said. Their findings were reported in the Annals of the New York Academy of Sciences.

"Jealousy and envy are highly correlated," said Fiske, coauthor of the study and the Eugene Higgins Professor of Psychology and Public Affairs in the Woodrow Wilson School. "When we ask people on surveys who is envied in American society, they report the same groups: objects of jealousy. This is all very much based on stereotypes. And so, in this study, we sought to better understand who is among these envied groups and whether that envy and jealousy elicits a harmful response."

"We were interested in the conditions under which people fail to empathize with one another and how, for some of those people, they experience happiness at another's expense," said lead author Cikara, now an assistant professor at Carnegie Mellon University. "We wanted to start in a place where people would be willing to express their opinions and willingness to harm more freely, like we see in sports. We asked ourselves: what is it about rivalries that elicit a harmful response? And can we predict who will have this response?"

The entire press release is here.

A Pilot Study Examining Moral Distress in Nurses Working in One United States Burn Center

By Jeanie Legget and others
Journal of Burn Care & Research:
September/October 2013 - Volume 34 - Issue 5 - p 521-528
doi: 10.1097/BCR.0b013e31828c7397

Moral distress is described as the painful feelings and psychological disequilibrium when a person believes she knows the morally right action to take and is unable to carry it out because of external or internal constraints. It has been studied in intensive care unit (ICU) nurses, but to the best of our knowledge not in burn ICU nurses. A pilot study was performed to gather initial data on moral distress among nurses treating burn victims. Findings from an intervention aimed at decreasing the level of moral distress in these nurses are reported. Nurses (n = 13) were recruited from one U.S. burn ICU and were randomized into two groups. A separate sample pretest post-test design was used. Group A completed the Moral Distress Scale-Revised (MDS-R) and Self-efficacy (SE) Scale before a 4-week educational intervention involving weekly 60-minute sessions, and Group B completed both scales afterward. Participants also completed written evaluations after each session. The MDS-R and SE Scale were readministered to both groups 6 weeks after the intervention was completed. Given the size and distribution of the sample, nonparametric data analyses were used. The MDS-R median score for Group B (92.0) was significantly different statistically from Group A (40.5) with P = .032 directly after the intervention was completed. No significant difference was found in the median SE scores between Group A (34.5) and Group B (34.0; P = .616). The median for Group B was 69 and Group A was 60.5 (P = .775). At the 6-week follow up, the difference between the two groups was no longer observed. Defining and discussing moral distress may have contributed to increased awareness and higher levels of moral distress in Group B directly postintervention. The changes in moral distress levels postintervention and at the 6-week follow up highlight the need to examine the intervention in a larger sample.

The entire article is here.

Friday, November 15, 2013

Episode 35: Does Reading Harry Potter Make You Moral?

Very Bad Wizards Podcast

Special guest Will Wilkinson joins the podcast to talk about whether fiction makes us better people, and to discuss his recent Daily Beast article that trashed Dave's profession and livelihood. Also, Dave and Tamler try to make sense of Ancient Greek justice in a myth about incest, adultery, daughter-killing, husband-killing, matricide, cannibalism, and trash talking to disembodied heads.

Johnson & Johnson to pay over $2 billion to settle Risperdal investigations

By Joe Carlson
Modern Healthcare
Posted: November 4, 2013

In the largest-ever legal settlement for sales of a single drug, Johnson & Johnson has agreed to pay more than $2 billion and plead guilty to a misdemeanor charge of misbranding to end long-running investigations of its sales tactics involving Risperdal.

The New Brunswick, N.J.-based company and subsidiaries Janssen Pharmaceuticals and Scios told investors in August 2011 that they had agreed to settle allegations that J&J promoted its anti-psychotic Risperdal for off-label uses. On Thursday, company officials are scheduled to plead guilty in federal court.

The entire story is here.

Thursday, November 14, 2013

Robert Wright Interviews Joshua Greene on his New Book

The Robert Wright Show
Originally published October 13, 2013
Interview with Joshua Green
They discuss his new book: Moral Tribes: Emotion, Reason, and the Gap Between Us and Them

The website is here.

How medical researchers become morally entangled

By Henry S. Richardson
Oxford University Press Blog
Originally published October 27, 2013

A huge amount of ethical angst swirls around the topic of informed consent. Can lay people who are considering signing up as subjects in a medical study really be made to understand the risks they are facing? Can information about these risks be communicated across cultural and educational gulfs? What degree of informed understanding should we expect subjects to have, anyway? 

Underlying the process of informed consent, though, is a simpler and more fundamental issue. The one-sided focus of the medical-research ethics establishment on preventing harms and abuses has obscured this core function from view. We need to remember why consent is needed for participation in medical research in the first place. It is needed because the researchers need the subjects’ permission to do things that otherwise would be wrong to do. It is wrong to examine and touch people’s naked bodies in the ways researchers need to do, to collect samples of their blood, urine, and feces, and to collect detailed information on their medical histories without getting their permission.

The entire story is here.

Wednesday, November 13, 2013

Are mental illnesses real? (Part One)

John Danaher
Philosophical Disquisitions
Originally published November 12, 2013

Here are some excerpts:

It may be a push, but I think it is fair to say that no branch of modern medicine faces the same existential challenges as psychiatry. To give a sense of the problem, a quick browse through Amazon reveals a plethora of books, many published within the past ten years, that either directly challenge the legitimacy of mental illness, call into question the medicalisation of the mind, or dispute the unholy alliance between “pharma” and psychiatry. This is to say nothing of the organisations and religious groups (most famously the scientologists) who critique modern psychiatry and try to dismantle its apparatuses.


Part of the reason for this is philosophical. The attempt to identify, diagnose and treat mental illness seems to bring the mind within the scope of biomedical science: to “reduce” mental phenomena to scientifically tractable, manipulable and treatable “disorders”. This cuts to the core of one of the central projects in modern philosophy: the reconciliation project. This project tries to determine the appropriate relationship between the world as it seems to be to us (the manifest image) and the world as it seems to be when viewed through the lens of modern science (the scientific image).

As such, the topic of mental illness — what it is and how it should be treated — is one that is particularly ripe for philosophical analysis and debate. The purpose of this series of posts is to look at some aspects of this analysis and debate. Specifically, to look at various attempts to determine what an “illness” or “disease” really is, and at arguments for or against the legitimacy of “mental illness”.

The entire blog post is here.

The Real Privacy Problem

As Web companies and government agencies analyze ever more information about our lives, it’s tempting to respond by passing new privacy laws or creating mechanisms that pay us for our data. Instead, we need a civic solution, because democracy is at risk.

By Evgeny Morozov on October 22, 2013
MIT Technology Review

Here is an excerpt:

First, let’s address the symptoms of our current malaise. Yes, the commercial interests of technology companies and the policy interests of government agencies have converged: both are interested in the collection and rapid analysis of user data. Google and Facebook are compelled to collect ever more data to boost the effectiveness of the ads they sell. Government agencies need the same data—they can collect it either on their own or in coöperation with technology companies—to pursue their own programs.

Many of those programs deal with national security. But such data can be used in many other ways that also undermine privacy. The Italian government, for example, is using a tool called the redditometro, or income meter, which analyzes receipts and spending patterns to flag people who spend more than they claim in income as potential tax cheaters. Once mobile payments replace a large percentage of cash transactions—with Google and Facebook as intermediaries—the data collected by these companies will be indispensable to tax collectors. Likewise, legal academics are busy exploring how data mining can be used to craft contracts or wills tailored to the personalities, characteristics, and past behavior of individual citizens, boosting efficiency and reducing malpractice.

The updated story is here.

Tuesday, November 12, 2013

"I Wish I Were Black" and Other Tales of Privilege

By Angela Onwuachi-Willig
The Chronicle of Higher Education
Originally published October 28, 2013

To be white is to not think about it," a white legal scholar named Barbara Flagg wrote two decades ago.

After the University of Texas at Austin denied Abigail Fisher admission, she made several statements that revealed just how little she had ever had to think about her race. Fisher, the petitioner in the Supreme Court's recently decided affirmative-action case, said in a videotaped interview made available by her lawyers: "There were people in my class with lower grades who weren't in all the activities I was in, who were being accepted into UT, and the only other difference between us was the color of our skin."

As decades of debates over affirmative action have revealed, many whites spend so little time having to think about, much less deal with, race and racism, that they understand race as nothing more than a plus factor in the admissions process. Like Fisher, they fail to see the many disadvantages that stem from simply existing as a person of color in this country—disadvantages that often hamper opportunities to achieve the badges that help students "win" in the admissions game.

The entire article is here.

“I Quit Academia,” an Important, Growing Subgenre of American Essays

By  Rebecca Schuman
Slate's Culture Blog
Originally published October 24, 2013

But there’s an important way that Ernst’s essay distinguishes itself: Most I Quitters are like me, which is to say failed academics, or like Lord, whose disillusion hit her midway down the tenure track. Ernst is part of the sub-subgenre of quitters who did the unthinkable, giving up tenure. He joins, for example, scientist Terran Lane, who left the University of New Mexico for Google, and writer Anne Trubek, who ditched idyllic Oberlin when freelance writing was able to pay her bills.

It is still exceptionally rare for a tenured academic to publicly and voluntarily leave the field. (To understand the way the concept is viewed by academics, please say that phrase aloud the way you’d say “contract syphilis.”)  Despite their widespread and documented unhappiness, most associate professors (the rank one achieves upon being granted tenure) stick it out until the end, for numerous reasons.

The entire blog entry is here.

Monday, November 11, 2013

Why Can't We All Just Get Along? The Uncertain Biological Basis of Morality

By Robert Wright
The Atlantic
November 2013

The article is really a review of several books.  However, it is not a formal book review, but compares and contrasts efforts by those studying morality, psychology, and biology.  Here are some excerpts:

The well-documented human knack for bigotry, conflict, and atrocity must have something to do with the human mind, and relevant parts of the mind are indeed coming into focus—not just thanks to the revolution in brain scanning, or even advances in neuroscience more broadly, but also thanks to clever psychology experiments and a clearer understanding of the evolutionary forces that shaped human nature. Maybe we’re approaching a point where we can actually harness this knowledge, make radical progress in how we treat one another, and become a species worthy of the title Homo sapiens.


...the impulses and inclinations that shape moral discourse are, by and large, legacies of natural selection, rooted in our genes. Specifically, many of them are with us today because they helped our ancestors realize the benefits of cooperation. As a result, people are pretty good at getting along with one another, and at supporting the basic ethical rules that keep societies humming.


When you combine judgment that’s naturally biased with the belief that wrongdoers deserve to suffer, you wind up with situations like two people sharing the conviction that the other one deserves to suffer. Or two groups sharing that conviction. And the rest is history. Rwanda’s Hutus and Tutsis, thanks to their common humanity, shared the intuition that bad people should suffer; they just disagreed—thanks to their common humanity—about which group was bad.

The entire article is here.

Getting In Touch With Your Inner Sexual Deviant

An Interview and article by David DiSalvo
Jesse Bering, Perv: The Sexual Deviant in all of Us
Originally posted on October 24, 2013

Here is an excerpt:

Q: One of the themes that comes through is that we feel so sure about the origins and motivations of various sexual behaviors, and for a good many of them there’s no scientific basis for feeling this way – indeed, in many cases science is far from reaching a conclusion. Why do you think we’re so prone to staunchly believing that how we feel about a sexual behavior is automatically true?

A: It’s certainly one of those areas where everyone has an opinion. But if there’s one thing I discovered while working on this book, it’s that the strength of one’s moral convictions about sex usually reflects the depths of one’s ignorance about the science of sex. The more one learns in this area, paradoxically, the more uncertain one becomes.

Human beings are “stomach philosophers”—we allow our gut feelings to make decisions about other people’s sex lives on the basis of whether or not we’re personally disgusted or uncomfortable with their erotic desires or behaviors. I draw the line at harm, but defining harm can be a slippery matter, too. Since we would be harmed, we presume that others must be harmed as well, even when that’s far from apparent. I joke in the book about how I’d be irreparably damaged if Kate Upton were to pin me to my chair and do a slow strip tease on my lap. Lovely as she is, I’m gay, and not only would I not enjoy that experience, I’d be made deeply uncomfortable by it. My straight brother or my lesbian cousin, by contrast, would process this identical Upton event very differently.

The entire interview/article is here.

Sunday, November 10, 2013

Hiring an End-of-Life Enforcer

By Paula Span
The New York Times - The New Old Age
Originally published October 24, 2013

The chilling dilemma of “the unbefriended elderly,” who don’t have family or close friends to make medical decisions on their behalf if they can’t speak for themselves, generated a bunch of ideas the last time we discussed it.

One reader, Elizabeth from Los Angeles, commented that as an only child who had no children, she wished she could hire someone to take on this daunting but crucial responsibility.

“I would much rather pay a professional, whom I get to know and who knows me, to make the decisions,” she wrote. “That way it is an objective decision-maker based on the priorities I have discussed with him/her before my incapacitation.”

The entire article is here.

Decomposing the Will - Book Review

Andy Clark, Julian Kiverstein, and Tillmann Vierkant (eds.), Decomposing the Will, Oxford University Press, 2013, 356pp., $74.00 (hbk), ISBN 9780199746996.

Reviewed by Marcela Herdova, King's College London

Decomposing the Will is a collection of 17 papers that examine recent developments in cognitive sciences in relation to claims about conscious agency (or lack thereof) and the implications of these findings for the free will debate. The overarching theme of the volume is exploring conscious will as "decomposed" into interrelated functions. The volume has four sections. Part 1 surveys scientific research that has been taken by many to support what the editors refer to as "the zombie challenge". The zombie challenge stems from claims about the limited role of consciousness in ordinary behavior. If conscious control is required for free will, this recent scientific research, which challenges conscious efficacy, also undermines free will. In part 2, authors explore various layers of the sense of agency. Part 3 investigates how to use both phenomenology and science to address the zombie challenge and discusses a variety of possible functions for conscious control. Part 4 offers decomposed accounts of the will.

Due to limitations of space, I will offer extended discussion of only a handful of papers. I provide a brief description for the remaining papers.

The entire book review is here.

Saturday, November 9, 2013

Trouble at the lab

Scientists like to think of science as self-correcting. To an alarming degree, it is not

The Economist
Originally posted October 19, 2013

“I SEE a train wreck looming,” warned Daniel Kahneman, an eminent psychologist, in an open letter last year. The premonition concerned research on a phenomenon known as “priming”. Priming studies suggest that decisions can be influenced by apparently irrelevant actions or events that took place just before the cusp of choice. They have been a boom area in psychology over the past decade, and some of their insights have already made it out of the lab and into the toolkits of policy wonks keen on “nudging” the populace.

Dr Kahneman and a growing number of his colleagues fear that a lot of this priming research is poorly founded. Over the past few years various researchers have made systematic attempts to replicate some of the more widely cited priming experiments. Many of these replications have failed. In April, for instance, a paper in PLoS ONE, a journal, reported that nine separate experiments had not managed to reproduce the results of a famous study from 1998 purporting to show that thinking about a professor before taking an intelligence test leads to a higher score than imagining a football hooligan.

The entire article is here.

Suicide Rate Climbs by 30 Percent in Kansas as Government Slashes Mental Health Budgets

Allison Kilkenny on October 21, 2013
The Nation

The Kansas Department of Health and Environment recently released a startling report (PDF) showing a 30 percent increase in suicides from 2011. Nationwide, the number of deaths by suicide surpassed the number of deaths by motor vehicle accidents in 2009, the most recent year for which the Centers for Disease Control and Prevention provided data.

The Wichita Eagle reports that the largest increase in suicides in Kansas occurred among white males, who already were the segment of the population most likely to take their own lives. More than 80 percent of suicides in Kansas last year were men, like Scott Dennis, a 42-year-old fitness company owner.

Friday, November 8, 2013

Do Emotions Play a Constitutive Role in Moral Cognition?

By Bryce Huebner
Georgetown University
February 2013

Behavioral experiments have revealed that the presence of an emotion-eliciting stimulus can affect the severity of a person's moral judgments, while imaging experiments have revealed that moral judgments evoke increased activity in brain regions classically associated with emotion, and studies using patient populations have confirmed that damage to these areas has a significant impact on the ability to make moral judgments. To many, these data seem to suggest that emotions may play a robustly causal or perhaps even a constitutive role in moral cognition (Cushman, Young, & Greene 2010; Greene et al. 2001, 2004; Nichols 2002, 2004; Paxton & Greene 2010; Plakias 2013; Prinz 2007; Strohminger et al. 2011; Valdesolo & DeSteno 2006). But others have noted that the existing data are also consistent with the possibility that emotions operate outside of moral cognition, ‘gating’ off morally significant information, or ‘amplifying’ the output of distinctively moral computations (Decety & Cacioppo 2012; Huebner, Dwyer, & Huaser 2009; Mikhail 2011; Pizarro, Inbar, & Helion 2011). While it is commonly thought that this debate can be settled by collecting further data, I maintain that the theoretical foundations of moral psychology are themselves to blame for this intractable dispute, and my primary aim in this paper is to make a case for this claim.

The entire paper is here. 

Does Studying Economics Breed Greed?

By Adam Grant
Author of Give and Take
LinkedIn article
Published October 21, 2013

In 1776, Adam Smith famously wrote: “It is not from the benevolence of the butcher, the brewer, or the baker, that we can expect our dinner, but from their regard to their own interest.”

Economists have run with this insight for hundreds of years, and some experts think they’ve run a bit too far. Robert Frank, an economist at Cornell, believes that his profession is squashing cooperation and generosity.  And he believes he has the evidence to prove it.

Consider these data points:

Less charitable giving: in the U.S., economics professors gave less money to charity than professors in other fields—including history, philosophy, education, psychology, sociology, anthropology, literature, physics, chemistry, and biology. More than twice as many economics professors gave zero dollars to charity than professors from the other fields.

More deception for personal gain: economics students in Germany were more likely than students from other majors to recommend an overpriced plumber when they were paid to do it.

Greater acceptance of greed: Economics majors and students who had taken at least three economics courses were more likely than their peers to rate greed as “generally good,” “correct,” and “moral.”

The entire article is here.

Thursday, November 7, 2013

“HIPAA-COMPLIANT” Texting of PHI: The Good. The Bad. The Ugly.

By Alaap Shah and Ali Lakhani
TechHealth Perspectives
Originally published October 14, 2013

Here is an excerpt:

Currently, there is a great deal of uncertainty around whether “HIPAA-compliant” texting of ePHI can be accomplished.  Even greater confusion exists around whether certain texting platforms themselves can be “HIPAA-compliant”.  Before you start to send ePHI via text message, there are a number of issues to consider.

The entire article is here.

The Not-So-Hidden Cause Behind the A.D.H.D. Epidemic

The New York Times
Published: October 15, 2013

Here are two excerpts:

Of the 6.4 million kids who have been given diagnoses of A.D.H.D., a large percentage are unlikely to have any kind of physiological difference that would make them more distractible than the average non-A.D.H.D. kid. It’s also doubtful that biological or environmental changes are making physiological differences more prevalent. Instead, the rapid increase in people with A.D.H.D. probably has more to do with sociological factors — changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids.

Which is not to say that A.D.H.D. is a made-up disorder.


This lack of rigor leaves room for plenty of diagnoses that are based on something other than biology. Case in point: The beginning of A.D.H.D. as an “epidemic” corresponds with a couple of important policy changes that incentivized diagnosis. The incorporation of A.D.H.D. under the Individuals With Disabilities Education Act in 1991 — and a subsequent overhaul of the Food and Drug Administration in 1997 that allowed drug companies to more easily market directly to the public — were hugely influential, according to Adam Rafalovich, a sociologist at Pacific University in Oregon.

The entire article is here.

Wednesday, November 6, 2013

Moral Mind-Sets: Abstract Thinking Increases a Preference for “Individualizing” Over “Binding” Moral Foundations

By Jaime L. Napier and Jamie B. Luguri
Social Psychological and Personality Science
November 2013 vol. 4 no. 6 754-759


Moral foundations theory contends that people’s morality goes beyond concerns about justice and welfare, and asserts that humans have five innate foundations of morality: harm and fairness (individualizing foundations) and in-group loyalty, deference to authority, and purity (binding foundations). The current research investigates whether people’s moral judgments are consistently informed by these five values, or whether individualizing and binding foundations might be differentially endorsed depending on individuals’ mind-sets. Results from our study demonstrated that when participants were experimentally manipulated to think abstractly (vs. concretely), which presumably makes their higher level core values salient, they increased in their valuations of the individualizing foundations and decreased in their valuations of the binding foundations. This effect was not moderated by political ideology. Implications and areas for future directions are discussed.

The entire article is here.

Are Forensic Evaluations “Health Care” and Are They Regulated by HIPAA?

By Bruce Borkosky,  Jon M. Pellett, and Mark S. Thomas
Psychological Injury and Law
June 2013


Forensic mental health providers (FMHPs) typically do not release records to the examinee. The Health Insurance Portability and Accountability Act (HIPAA) federal regulations might change this position, given that they have created a basic right of access to health care records. This legislation has led to a disagreement regarding whether HIPAA regulates forensic evaluations. The primary argument (and the majority of scholarly citations) has been that such evaluations do not constitute “health care.” Specifically, in this position, the nature and purpose of forensic evaluations are not considered related to treatment (amelioration of psychopathology) of the patient. In addition, it asserts that HIPAA applies solely to treatment services; thus, forensic evaluations are inapplicable to HIPAA. We describe the evidence for and against this argument, the strengths and limitations of the evidence, and recent court decisions related to it. The weakest part of the “HIPAA does not regulate forensics” argument is that HIPAA has no exclusion criteria based on type of services. It only creates an inclusion criteria for providers; once “covered,” all services provided by that provider are thence forward “covered.” Authoritative evidence for patient access can be found in the HIPAA regulations themselves, the US Department of Health and Human Services’ commentaries, additional statements and disciplinary cases, the research literature, other agency opinion, and legal opinion. It appears that the evidence strongly suggests that, for those forensic mental health practitioners who are covered entities, HIPAA does apply to forensic evaluations. The implication is that FMHPs potentially face various federal, state, and civil sanctions for refusing to permit patient access to records.

The article is here.

Tuesday, November 5, 2013

Economics as a moral science

The Crooked Timber

Here are some excerpts:

Why is it relevant now? In the lively discussion on what kind of science (or something else) economics is which is currently raging on the blogs, we should also consider the view of those who have argued that economics is a moral science. This, in Tony Atkinson’s words means that “Economists need to be more explicit about the relation between the welfare criteria and the objectives of government, policymakers and individual citizens”. Atkinson traces the expression back to Keynes, who had written in a letter that ‘economics is essentially a moral science’. More recent defenders of that view include Kenneth Boulding in his 1968 AEA presidential address, who defended the strong view that economics inherently depends on the acceptance of some values, and thus inherently has an ethical component.


My view is this: economics shouldn’t aspire to be a value-free science, but an intellectual enterprise that combines elements from the sciences with elements from ‘the arts’ done in a manner that makes it value-commitments explicit. Values in economics have many sources. There are values involved in the choice of questions that are asked (and not asked). Value judgements are embedded in the normative principles (such as the Pareto-criterion) that are endorsed. Value judgments flow from the choices in how basic categories and notions are conceptualized (is ‘labour’ only what we do for pay, or also what we do to reproduce the human species?).

The entire post is here.

Mental illness: is chemical imbalance theory a myth?

Torstar News Service
Originally published on October 19, 2013

Here is an excerpt:

Now, neuroscience would attribute such things as depression and psychosis to “chemical imbalances” — specifically to disruptions in the neurotransmitters that allow the brain’s billions upon billions of grey matter cells to speak to one another.

And so mental illnesses became normalized and destigmatized.

And so their treatments, to a huge extent, came off of the couch, out of the asylums and onto pharmacy counters.

And so a $70-billion drug market grew to feed tens of millions worldwide with daily doses of magic bullets — pills that could bring their brain chemistry back into balance.

Trouble is, in the minds of many neuroscientists today, that chemical imbalance theory has turned out to be a myth, with little more scientific or medicinal substance than poetry or song.

The entire article is here.

Thanks to Ned Jenny for this information.

Monday, November 4, 2013

World Medical Association Declaration of Helsinki

Ethical Principles for Medical Research Involving Human Subjects
World Medical Association
JAMA. Published online October 19, 2013. doi:10.1001/jama.2013.281053


1. The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human subjects, including research on identifiable human material and data.

The Declaration is intended to be read as a whole and each of its constituent paragraphs should be applied with consideration of all other relevant paragraphs.

2. Consistent with the mandate of the WMA, the Declaration is addressed primarily to physicians. The WMA encourages others who are involved in medical research involving human subjects to adopt these principles.

The entire document is here.

Medical research ethics: more than abuse prevention?

By Henry S. Richardson
Oxford University Press Blog
Originally posted on October 20, 2013

Scholarly and regulatory attention to the ethics of medical research on human subjects has been one-sidedly focused on the prevention of moral disasters. Scandals such the US Public Health Service (PHS)’s Tuskegee syphilis experiments, which for decades observed the effects of untreated syphilis on the participants, most of whom were poor black sharecroppers, rightly spurred the broad establishment of a regulatory regime that emphasized the importance of preventing such severe harming and exploitation of the human subjects of research. Revelations in 2011 about a similarly horrific set of studies conducted by the PHS from 1946 to 1948 on sexually transmitted diseases has renewed this kind of concern, which has been strongly underlined in a recent report by the Presidential Commission for the Study of Ethical Issues.

The entire article is here.

Sunday, November 3, 2013

Epigenetics: How to alter your genes

We’ve long been told our genes are our destiny. But it’s now thought they can be changed by habit, lifestyle, even finances. What does this mean for our children?

By Chris Bell
The Telegraph
Originally published on October 16, 2013

Here is an excerpt:

And yet a quiet scientific revolution is changing that thinking. For it seems you might also be what your mother ate. How much your father drank. And what your grandma smoked. Likewise your own children, too, may be shaped by whether you spend your evenings jogging, worrying about work, or sat on the sofa eating Wotsits. And that nurture, rather than our intractable nature, may determine who we are far more than was ever previously thought.

Epigenetics is a relatively new scientific field; research only began in earnest in the mid Nineties, and has only found traction in the wider scientific community in the last decade or so. And the sources of its data are eclectic, to say the least – stretching from famines in northern Sweden to the 9/11 attacks to the medical notes of Audrey Hepburn.

The entire story is here.

Artists and Health Insurance Survey

Taking the pulse of the artist community

Kristin Thomson & Jean Cook, Future of Music Coalition
Originally published October 15, 2013

Here is an excerpt:

This most recent survey confirms what many arts service organizations have known anecdotally for years: the US-based artist community is less likely to be insured than the general population, with cost and affordability as the prevailing factors.

Even more troubling is the finding that those respondents who spend more time or derive
more income from being an artist are less likely to be insured.

  • The more workweek hours spent on art, the less likely respondents are to have health insurance. 
  • The greater percentage of personal income derived from art, the less likely respondents are to have health insurance. 

The findings underscore the conditions experienced by artists; as self-employed or freelance workers with variable incomes, many are simultaneously not eligible for employer-based coverage and have difficulty affording individual health insurance purchased on the open market.

This was an important moment to take a snapshot of artists’ access to health insurance. In 2010, Congress passed the Affordable Health Care Act (ACA), which instituted a number of new protections, tax credits and safety nets for citizens. But, because of this law, health insurance is no longer an option; most Americans will need to secure coverage by 2014.

The entire survey can be accessed here.

Thanks to Deborah Derrickson Kossmann for this survey.

Saturday, November 2, 2013

Full Disclosure — Out-of-Pocket Costs as Side Effects

Peter A. Ubel, M.D., Amy P. Abernethy, M.D., Ph.D., and S. Yousuf Zafar, M.D., M.H.S.
N Engl J Med 2013; 369:1484-1486October 17, 2013DOI: 10.1056/NEJMp1306826

Few physicians would prescribe treatments to their patients without first discussing important side effects. When a chemotherapy regimen prolongs survival, for example, but also causes serious side effects such as immunosuppression or hair loss, physicians are typically thorough about informing patients about those effects, allowing them to decide whether the benefits outweigh the risks. Nevertheless, many patients in the United States experience substantial harm from medical interventions whose risks have not been fully discussed. The undisclosed toxicity? High cost, which can cause considerable financial strain.

Since health care providers don't often discuss potential costs before ordering diagnostic tests or making treatment decisions, patients may unknowingly face daunting and potentially avoidable health care bills. Because treatments can be “financially toxic,”1 imposing out-of-pocket costs that may impair patients' well-being, we contend that physicians need to disclose the financial consequences of treatment alternatives just as they inform patients about treatments' side effects. Health care costs have risen faster than the Consumer Price Index for most of the past 40 years.

The entire article is here.

Montreal Statement on Research Integrity in Cross-Boundary Research Collaborations

The Montreal Statement on Research Integrity in Cross-Boundary Research Collaborations was developed as part of the 3rd World Conference on Research Integrity, 5-8 May 2013, in Montréal, as a global guide to the responsible conduct of research. It is not a regulatory document and does not represent the official policies of the countries or organizations that funded or participated in the Conference.


Research collaborations that cross national, institutional, disciplinary and sector boundaries are important to the advancement of knowledge worldwide. Such collaborations present special challenges for the responsible conduct of research, because they may involve substantial differences in regulatory and legal systems, organizational and funding structures, research cultures, and approaches to training. It is critically important, therefore, that researchers be aware of and able to address such differences, as well as issues related to integrity that might arise in cross-boundary research collaborations. Researchers should adhere to the professional responsibilities set forth in the Singapore Statement on Research Integrity. In addition, the following responsibilities are particularly relevant to collaborating partners at the individual and institutional levels and fundamental to the integrity of collaborative research. Fostering the integrity of collaborative research is the responsibility of all individual and institutional partners.

The entire statement is here.

Friday, November 1, 2013

Why Are Hundreds of Harvard Students Studying Ancient Chinese Philosophy?

The Atlantic
Originally published October, 8 2013

Here is an excerpt:

Why are so many undergraduates spending a semester poring over abstruse Chinese philosophy by scholars who lived thousands of years ago? For one thing, the class fulfills one of Harvard's more challenging core requirements, Ethical Reasoning. It's clear, though, that students are also lured in by Puett's bold promise: “This course will change your life.”

His students tell me it is true: that Puett uses Chinese philosophy as a way to give undergraduates concrete, counter-intuitive, and even revolutionary ideas, which teach them how to live a better life.

The entire article is here.

The Spiritual Crisis Underlying American Politics

By John Amodeo
World of Psychology
Originally published October 17, 2013

America is a very religious nation. But sadly, we’re not a very spiritual one. Mother Teresa’s disquieting words resonate throughout the land: “You in the West have the spiritually poorest of the poor. . . . I find it easy to give a plate of rice to a hungry person . . . but to console or to remove the bitterness, anger, and loneliness that comes from being spiritually deprived, that takes a long time.”[i]

While it is obvious to anyone who graduated from sixth grade that America is reeling from a chronic political crisis, it may not be as apparent that the disabling political warfare is fueled by an underlying spiritual crisis. Disconnected from our human and spiritual roots, we flail around in a world that is oblivious to the suffering of others. Lacking a gentle mindfulness toward our own feelings and vulnerability, we quickly look away from those who are suffering or the environmental havoc we’re creating.

The entire article is here.