Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Wednesday, April 30, 2014

The Heinz Dilemma Might Reveal That Morality Is Meaningless

By Esther Inglis-Arkell
Originally published April 29, 2014

Here is an excerpt:

But if this finding is true, it seems there are bigger problems with morality. What this experiment seems to say is people can take the same situation, and argue the same principles - social roles, the importance of interpersonal relationships, the likelihood of punishment, and pure humanitarian principles - and come to exactly opposite moral conclusions. And they do this for their whole lives. Sure, it's interesting to see that principles evolve over time, but it's more interesting to see that principles - at least the ones confined solely to the human mind - are irrelevant. There is no method or guiding idea that could possibly allow any group of humanity to come to a consensus. Morality, then, is basically chaos. We can start from the same place, and follow the same principles, and end at diametrically opposite ends of a problem, and there's no way to resolve that.

The entire blog post is here.

Editor's note:

I posted this piece to demonstrate that many struggle to understand morality.  First, moral psychology has moved well past Kohlberg.  Psychologists, especially those who study moral psychology, understand the theoretical and research limitations of Kohlberg.  Please listen to podcast Episode 7 to get a flavor of this.

Second, to believe "morality, then, is basically chaos" is also uninformed.  In moral decision-making, individuals can use different principles to generate different conclusions.  This does not indicate that morality is in chaos, rather, it demonstrates how people use different moral systems to judge and respond to moral dilemmas.

Third, a true moral dilemma involves competing principles.  If it is truly a moral dilemma, then there is no "correct" or "right" answer.  A true dilemma shows how an individual is in a moral or ethical bind and there are cognitive and emotional strategies to generate solutions to sometimes impossible problems. Podcasts 5 and 6 demonstrate how psychologists can knit together possible solutions to ethical dilemmas because, in part, they bring their own moral systems, values, and biases to their work.

The podcasts can be found here.

Is the Doctor-Patient Relationship Turning Into a Business Partnership?

Reports say patients are increasingly asking doctors for drugs by name, and docs are complying. If they don’t write the script, they risk a low rating on one of many doc-ranking sites.

By Russell Saunders
The Daily Beast
Originally posted April 11, 2014

“The customer is always right.” We all know the saying. It’s a truism in business. Businesses need happy customers. Happy customers keep coming back and they tell their friends. Keeping the customer happy is a businessperson’s number one priority.

Except when the business is a medical practice, and the customer is a patient.

That ever-blurring line between patient and customer is one of the most difficult things to walk in medical practice. On the one hand, people need to keep coming through the door in order to keep it open in the first place, and making sure people have a good experience when they come to you for care is important.

The entire article is here.

Tuesday, April 29, 2014

Raising a Moral Child

By Adam Grant
The New York Times - Opinion
Originally posted April 11, 2014

Here is an excerpt:

By age 2, children experience some moral emotions — feelings triggered by right and wrong. To reinforce caring as the right behavior, research indicates, praise is more effective than rewards. Rewards run the risk of leading children to be kind only when a carrot is offered, whereas praise communicates that sharing is intrinsically worthwhile for its own sake. But what kind of praise should we give when our children show early signs of generosity?

Many parents believe it’s important to compliment the behavior, not the child — that way, the child learns to repeat the behavior. Indeed, I know one couple who are careful to say, “That was such a helpful thing to do,” instead of, “You’re a helpful person.”

The entire article is here.

This will hurt a bit

By David Hunter
BMJ Group Blogs
Originally posted April 11, 2014

Here is an excerpt:

In this piece she describes the case of a Cornell graduate student who carried out a piece of self-experimentation without IRB approval (based on the mistaken belief it wasn’t required) which aimed to assess which part of the body was worst to be stung by a bee on and involved:  ”five stings a day, always between 9 and 10am, and always starting and ending with “test stings” on his forearm to calibrate the ratings. He kept this up for 38 days, stinging himself three times each on 25 different body parts.”

The entire blog is here.

Monday, April 28, 2014

Episode 7: The Moral Self, Moral Injury, and Moral Emotions

In this episode, John interviews Dr. Nina Strohminger about moral psychology and her research on the moral self and moral emotions.  While they discuss her research about the moral self and moral emotions, the discussion leads to clinical examples related to values in psychotherapy, moral injury and other conditions treated by psychologists.  John and Nina also exchange ideas on emotions in decision-making.

At the end of this podcast, the listener will be able to:

1. Describe the moral self,
2. Explain moral injury and how it applies to psychotherapy,
3. Identify how emotions are important to decision-making.


Nina Strohminger and Shaun Nichols

Nina Strohminger, Richard L. Lewis, and David D. Meyer

John Gavazzi and Sam Knapp

Morality, Disgust and Countertransference in Psychotherapy
John Gavazzi and Sam Knapp

Shira Maguen and Brett Litz

Scrupulosity: Where OCD Meets Religion, Faith and Belief
Kevin Foss, The OCD Center of Los Angeles

Sunday, April 27, 2014

With Guns, Suicide Is the Biggest Problem

By Sarah Wickline
MedPage Today
Originally posted April 11, 2014

Every day, 88 people die from firearm-related injury; two-thirds of those deaths are suicides, a high proportion of which are committed by seniors and individuals living in rural areas, researchers reported here.

"Mass shooting episodes are obviously horrible," Molly Cooke, MD, president of the American College of Physicians (ACP), told reporters in a press briefing. "But one of the points we make in the paper is that every day there are 88 firearms-related deaths."

The entire article is here.

Saturday, April 26, 2014

Practitioner Pointer: Does the use of Skype raise HIPAA compliance issues?

Practitioners should be aware of the risk involved.

By Legal and Regulatory Affairs staff
American Psychological Association - Practice Central
Originally published April 24, 2014

Given the growing use of technology for communication, many practitioners are interested in knowing whether popular options are compatible with Health Insurance Portability and Accountability Act (HIPAA) requirements. Skype, whose basic features are free and easy to use, is one such option of interest to practicing psychologists.

HIPAA does not specify the kinds of technologies that covered entities should use for creating, receiving, storing or transmitting electronic patient health information (ePHI). Under the HIPAA Security Rule, covered entities must conduct individual risk assessments about the technologies (hardware, software, etc.) they use that store or transmit ePHI.

The entire story is here.

Philosophy of biology

Peter Godfrey-Smith interviewed by Richard Marshall
3AM Magazine
Originally published April 11, 2014

Peter Godfrey-Smith is the go-to guy in the philosophy of biology. He is forever evolving his thoughts on externalism, complexity and why we shouldn’t expect a settled outcome, the contribution of pragmatists to philosophy of biology, why Fodor gets it wrong, on how best to understand what science is, on Darwinian theory, Darwinian populations, on why Richard Dawkins and David Hull are wrong and on the contribution of philosophy to biology. Like Cool Hand Luke, this one bites like a ‘gator!


PGS: It’s fine with me if the biologists (and other scientists) get on with their scientific work without input from philosophers. Philosophy does often contribute ideas and theory-sketches to science, which then acquire a life of their own in the new setting, but this “incubator” role is a secondary role for philosophy. The same applies to the “clarification” of scientific concepts by philosophers. It happens, and sometimes it’s helpful for scientists, and that’s a good thing, but it’s not central to philosophy. I don’t think of philosophy as essentially a field that contributes to other fields. Philosophy is, roughly speaking, its own field, though it has a special status because it’s so integrative – because the aim of philosophy is to get a coherent and defensible picture of everything going on. I very much like the one-line description of philosophy given by Sellars: philosophy is about “how things in the broadest possible sense of the term hang together in the broadest possible sense of the term.” If we take this view on board, it implies that philosophy will always be interacting with the sciences and drawing on them, but it won’t be swallowed up by them.

So I have no problem with scientists who do their scientific work while ignoring philosophy. It’s a different matter when scientists start trying to answer philosophical questions, or trying to distill philosophical messages from their work. Sometimes they do this well, sometimes badly. Either way, then they are part of the philosophical conversation.

The entire article is here.

Friday, April 25, 2014

U.S. Prisons Becoming De Facto Home of the Mentally Ill

A new study reveals that prisons in America house ten times as many mentally ill as the state-run psychiatric wards that could actually treat them.

By Abby Haglage
The Daily Beast
Originally published April 10, 2014

Here is an excerpt:

While TAC’s study—titled The Treatment of Persons With Mental Illness in Prisons and Jails—isn’t the first of its kind, it’s notable for two reasons: it’s the first to analyze the data by state, and it’s the most recent illustration that the problem is growing more acute. One of the worst offenders is New York, where the law mandates mentally ill inmates be sent to psychiatric hospitals (which—given the lack of available beds—is mostly useless). A 2011 study estimated that of the 12,200 inmates at Riker’s Island, ⅓ of the men and ⅔ of the women are mentally ill.

The entire article is here.

Happiness and Its Discontents

By Daniel Haybron
The New York Times
Originally posted April 13, 2014

Here are two excerpts:

Over the past 30 years or so, as the field of happiness studies has emerged from social psychology, economics and other disciplines, many researchers have had the same thought. Indeed this “life satisfaction” view of happiness lies behind most of the happiness studies you’ve read about. Happiness embodies your judgment about your life, and what matters for your happiness is something for you to decide.

This is an appealing view. But I have come to believe that it is probably wrong. Or at least, it can’t do justice to our everyday concerns about happiness.


I would suggest that when we talk about happiness, we are actually referring, much of the time, to a complex emotional phenomenon. Call it emotional well-being. Happiness as emotional well-being concerns your emotions and moods, more broadly your emotional condition as a whole. To be happy is to inhabit a favorable emotional state.

The entire story is here.

Note: This article has implications for psychological treatment and psychological health.

Thursday, April 24, 2014

Study confirms impact of clinician-patient relationship on health outcomes

Meta-analysis finds relationship improvement has beneficial effects similar to some common treatments

Massachusetts General Hospital Press Release
Originally released on April 9, 2014

A meta-analysis of studies that investigated measures designed to improve health professionals' interactions with patients confirms that such efforts can produce health effects just as beneficial as taking a daily aspirin to prevent heart attack. In contrast to previous such reviews, the current report from the Empathy and Relational Science Program at Massachusetts General Hospital (MGH) only included randomized, controlled trials with more reliable results than those included in earlier studies. While it has long been believed that a good patient-clinician relationship can improve health outcomes, objective evidence to support that belief has been hard to come by.

"Although the effect we found was small, this is the first analysis of the combined results of previous studies to show that relationship factors really do make a difference in patients' health outcomes," says Helen Riess, MD, director of the Empathy and Relational Science Program in the MGH Department of Psychiatry, senior author of the report in the open-access journal PLOS ONE.

The entire press release is here.

The entire article is here.

How We Hope: A Moral Psychology

Adrienne M. Martin, How We Hope: A Moral Psychology, Princeton University Press, 2014
ISBN 9780691151526.

Reviewed by Erica Lucast Stonestreet, College of St. Benedict/St. John’s University

Adrienne Martin’s book is a detailed analysis of an ordinary phenomenon that has not had much attention in recent moral psychology. The account extends the “orthodox” view of hope (as a desire for an outcome together with a belief in the outcome’s possibility) by adding what Martin calls an “incorporation” element: what distinguishes hope from other attitudes is the hopeful person’s incorporating the desire into her agency as a reason for hopeful activities. Her treatment seriously engages many historical and contemporary views of hope, ultimately aligning most closely with Kantian ideas of moral psychology.

The entire book review is here.

Wednesday, April 23, 2014

The Social Capital Benefits of Ethical Leadership

By Pastoriza, David; Ariño Martín, Miguel Angel
Journal of Business Ethics
November 2013, Volume 118, Issue 1, pp 1-12

Ethics has gained prominence in debates around social capital creation. According to social learning theory, employees learn standards of appropriate behavior by observing the behavior of role models.

The rest of the article summary is here.


Ethics has recently gained prominence in debates surrounding social capital creation. Despite the significant theoretical progress in this field, it still lacks empirical research. The goal of this study is to empirically explore the ethical leadership of supervisors as an antecedent of the firm’s social capital. We build on social learning theory to argue that employees can learn standards of appropriate behavior by observing the behavior of role models. By displaying and enforcing ethical behavior, supervisors can facilitate the process through which employees learn to feel empathy toward others and establish profound affective relationships with them. Data were collected from 408 Spanish, French, and Portuguese part-time MBA students. Using structural equation modeling techniques, we show that the ethical leadership of supervisors exerts a significant influence on the structural, relational, and cognitive dimensions of social capital.

The research article is here, behind a paywall.

Damage to the prefrontal cortex increases utilitarian moral judgements

By Michael Koenigs, Liane Young, Ralph Adolphs, Daniel Tranel, Fiery Cushman, Marc Hauser, and Antonio Damasio
Nature. Apr 19, 2007; 446(7138): 908–911.
Published online Mar 21, 2007
doi:  10.1038/nature05631


The psychological and neurobiological processes underlying moral judgement have been the focus of many recent empirical studies. Of central interest is whether emotions play a causal role in moral judgement, and, in parallel, how emotion-related areas of the brain contribute to moral judgement. Here we show that six patients with focal bilateral damage to the ventromedial prefrontal cortex (VMPC), a brain region necessary for the normal generation of emotions and, in particular, social emotions, produce an abnormally ‘utilitarian’ pattern of judgements on moral dilemmas that pit compelling considerations of aggregate welfare against highly emotionally aversive behaviours (for example, having to sacrifice one person’s life to save a number of other lives). In contrast, the VMPC patients’ judgements were normal in other classes of moral dilemmas. These findings indicate that, for a selective set of moral dilemmas, the VMPC is critical for normal judgements of right and wrong. The findings support a necessary role for emotion in the generation of those judgements.

The entire article is here.

Tuesday, April 22, 2014

Feminist Political Philosophy

First published Sun Mar 1, 2009; substantive revision Tue Apr 1, 2014
Stanford Encyclopedia of Philosophy

Feminist political philosophy is an area of philosophy that is in part focused on understanding and critiquing the way political philosophy is usually construed—often without any attention to feminist concerns—and on articulating how political theory might be reconstructed in a way that advances feminist concerns. Feminist political philosophy is a branch of both feminist philosophy and political philosophy. As a branch of feminist philosophy, it serves as a form of critique or a hermeneutics of suspicion (Ricœur 1970). That is, it serves as a way of opening up or looking at the political world as it is usually understood and uncovering ways in which women and their current and historical concerns are poorly depicted, represented, and addressed. As a branch of political philosophy, feminist political philosophy serves as a field for developing new ideals, practices, and justifications for how political institutions and practices should be organized and reconstructed.

The entire article is here.

Editorial note: Feminist Political Philosophy is relevant to the practice of psychology: think therapeutic relationship, certain clinical interventions, Guidelines for Psychological Practice with Girls and Women, and advocacy work.

Buddhism and Modern Psychology

By Robert Wright
Princeton University/Coursera

The Buddha said that human suffering—ranging from anxiety to sadness to unfulfilled craving—results from not seeing reality clearly. He described a kind of meditation that promises to ease suffering by dispelling illusions about the world and ourselves. What does psychological science say about this diagnosis and prescription—and about the underlying model of the mind?

The course description and course can be found here.

Monday, April 21, 2014

Debating Dishonesty in Context of Morality and Culture

Cross-Coursera Dishonesty Debate
Originally published on April 3, 2014

Watch the legendary moral philosopher Peter Singer, the distinguished psychologist Paul Bloom, and the expert behavioral economist Dan Ariely as they join hands to discuss their views and research on dishonesty, morality, and ethics.

The three authorities will try not to cross moral boundaries as they cross the digital divisions of their online classes: Singer's "Practical Ethics," Bloom's "Moralities of Everyday Life," and Ariely's "A Beginner's Guide to Irrational Behavior."

Joint Chiefs' Chairman Wants Military to Rethink Ethics Training

By Julian E. Barnes
The Wall Street Journal
Originally published March 27, 2014

The military needs to rethink how it teaches character and ethics, eschew staid briefing slides and avoid disciplining subordinates via email, the nation's top uniformed officer said Thursday.

Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, visited the U.S. Naval Academy and the U.S. Military Academy this week, as part of a series of talks emphasizing the need to focus on ethics. In meetings with students, Gen. Dempsey made clear that he thinks the military talks about sexual harassment, sexual assault and ethics in a way that is too abstract.

"The issue of ethics is personal and to be persuasive, it has to be relational," Gen. Dempsey said in an interview Thursday. "It can't be an issue of abstract values; you have to bring them to life."

The entire story is here.

Sunday, April 20, 2014

Solitude’s Despair

By Alexander Nazaryan
Newsweek Magazine
Originally published on April 3, 2014

Here is an excerpt:

Though daunting, Solitary Confinement is lucid as hell. Lucid about hell, too. Its fundamental premise is that no man is an island, and that throwing inmates into concrete rooms, especially for minor offenses like possessing Black Panther writings or disobeying guards, is an exile no human psyche should (or can) bear. "The absence of even the possibility of touching or being touched by another," Guenther writes, "threatens to unhinge us." Jean-Paul Sartre said hell is other people. Guenther reminds that this hell of Others is far better than the hell of no Others at all. You don't have to care about prisons or prisoners to care about the philosophical valence of the human touch. That, I'm pretty sure, is what this book is really about.

Some researchers have tried to quantify the suffering of solitary confinement. In 2003, Craig W. Haney of the University of California at Santa Cruz published a study of inmates in the Security Housing Unit at Pelican Bay State Prison in Crescent City, Calif. He found that 88 percent of those in prolonged isolation suffered from irrational anger; chronic depression plagued 77 percent, while violent fantasies visited 61 percent of these prisoners. Nearly a third (27 percent) wanted to kill themselves.

The entire story is here.

In essence, the author is arguing that solitary confinement is an attack on the "self."

Saturday, April 19, 2014

Wall Street Is Not a Death Trap

By Sally L. Satel
Bloomberg News
Originally posted March 31, 2014

After the suicides of eight people in the global financial sector over six months, investment banks have come under pressure to pay more attention to the mental health of their employees. The high-stress, competitive environment -- with its unpredictably punishing workweeks -- are seen as creating the conditions for pushing some people over the edge.


In answer to the question raised in a recent Fortune magazine article, no, there isn't a suicide contagion on Wall Street. Rather, the handful of suicides, tragic as each one is, involved the segment of the population most at risk: white men, particularly over 50.

The entire article is here.

Friday, April 18, 2014

Defending Disgust

By Jason A. Clark and Philip A. Powell
Emotional Researcher

Many argue that moral disgust developed as a regulator of social behavior, and that it still dutifully serves that purpose (Tybur et al. 2013). However, a growing number have criticised disgust as a morally objectionable emotion in modern society, emphasizing features that, while adaptive in response to pathogens, render disgust unsuitable for policing morality (Nussbaum 2009; Kelly 2011; Bloom 2013). These include: cognitive and behavioral inflexibility, the generation of “dumbfounded” moral judgments lacking reasons, insensitivity to contextual factors and reappraisal, dehumanization, and a focus on the whole person, rather than their actions (Schnall et al. 2008; Russell & Giner-Sorolla 2011).

Critics of disgust compare it unfavorably with other moral emotions (especially anger), which they hold to be more flexible and reasoned, and lump it together with related emotions such as shame, which are often viewed negatively for similar reasons. Specifically moral critiques of disgust have been largely qualitative, based on historical case studies and anecdotal examples. Arguments condemning disgust as a moral emotion emphasise disgust’s negative role in instances of stigmatization, such as homophobia, racism, and genocide.

The entire article is here.

Judge wants back on bench after insanity ruling

By Steve Schmadeke
Chicago Tribune
Originally published March 28, 2014

Can a suspended Cook County judge return to the bench after being declared legally insane at the time she shoved a sheriff’s deputy in 2012?

For the first time in Illinois, attorneys on the case say, a judicial disciplinary panel has begun tackling the question of whether a judge whose psychotic episodes can apparently be controlled through medication should be allowed to return to the bench.

The entire article is here.

Thursday, April 17, 2014

Oxytocin Boosts Dishonesty

The so-called “love hormone” can make people more dishonest when it serves the interests of their group.

By Ed Yong
The Scientist
Originally published March 31, 2014

The hormone oxytocin is usually associated with positive traits like trust, cooperation, and empathy, but scientists have now found that it can make people more dishonest when their lies serve the interests of their group.

“This is the best evidence yet that oxytocin is not the ‘moral molecule,’” said Carsten de Dreu from the University of Amsterdam, who co-led the study, which was published today (March 31) in PNAS. “It doesn’t make people more moral or immoral. It shifts people’s focus from themselves to their group or tribe.”

The entire story is here.

Do The Right Thing: Making Ethical Decisions in Everyday Life

By Tom Marshall
The New York Times
Originally published April 1, 2014


Something happens — a moment of injustice, a threat to the nation, a potentially criminal act. Why do some people speak out or take action, while others remain silent? And how can we encourage more people to recognize the moment when bravery is required?

In this lesson, we explore ethical dilemmas that face normal people around the world, in all walks of life. Some of their cases are familiar, while others are obscure. But they hold one thing in common: They feature individuals who followed the guidance of their own moral code, often risking personal injury or community censure to do so. We’ll ask students to examine the underlying characteristics of such episodes, and consider whether some acts are more deserving of support than others.

The entire article is here.

Wednesday, April 16, 2014

Statistical Flaw Punctuates Brain Research in Elite Journals

By Gary Stix
Scientific American
Originally published March 27, 2014

Here is an excerpt:

That is the message of a new analysis in Nature Neuroscience that shows that more than half of 314 articles on neuroscience in elite journals   during an 18-month period failed to take adequate measures to ensure that statistically significant study results were not, in fact, erroneous. Consequently, at  least some of the results from papers in journals like Nature, Science, Nature Neuroscience and Cell were likely to be false positives, even after going through the arduous peer-review gauntlet.

The entire article is here.

The strange phenomenon of the cult of facts: three case studies

By Masimo Pigliucci
Scientia Salon
Originally published March 30, 2014

Here is an excerpt:

Moreover, as a fellow Bayesian, Silver ought to know that his own analogy is ironically flawed: in Bayesian analysis you always begin with priors, and the whole point is to revise those priors as new data comes in. That is, embedded in the very fabric of the Bayesian approach [4] is that you start with beliefs, you add data (collected on the basis of your beliefs!), and end up with (likely modified) beliefs. You just can’t take the belief components out of the analysis, it’s integral to it, and it’s both affected by the data one gathers and determines which bits of information “out there” actually get to count as data.

As Wieseltier astutely observes, “Silver wishes to impugn not only the quality of opinion journalism, he wishes to impugn also its legitimacy. The new technology, which produces numbers the way plants produce oxygen, has inspired a new positivism, and he is one of its princes. He dignifies only facts … He does not recognize the calling of, or grasp the need for, public reason.”

The entire story is here.

Tuesday, April 15, 2014

Automated ethics

When is it ethical to hand our decisions over to machines? And when is external automation a step too far?

by Tom Chatfield
Aeon Magazine
Originally published March 31, 2014

Here is an excerpt:

Automation, in this context, is a force pushing old principles towards breaking point. If I can build a car that will automatically avoid killing a bus full of children, albeit at great risk to its driver’s life, should any driver be given the option of disabling this setting? And why stop there: in a world that we can increasingly automate beyond our reaction times and instinctual reasoning, should we trust ourselves even to conduct an assessment in the first place?

Beyond the philosophical friction, this last question suggests another reason why many people find the trolley disturbing: because its consequentialist resolution presents not only the possibility that an ethically superior action might be calculable via algorithm (not in itself a controversial claim) but also that the right algorithm can itself be an ethically superior entity to us.

The entire article is here.

Moral Responsibility

Stanford Encyclopedia of Philosophy
First published Sat Jan 6, 2001; substantive revision Wed Mar 26, 2014

When a person performs or fails to perform a morally significant action, we sometimes think that a particular kind of response is warranted. Praise and blame are perhaps the most obvious forms this reaction might take. For example, one who encounters a car accident may be regarded as worthy of praise for having saved a child from inside the burning car, or alternatively, one may be regarded as worthy of blame for not having used one's mobile phone to call for help. To regard such agents as worthy of one of these reactions is to regard them as responsible for what they have done or left undone. (These are examples of other-directed ascriptions of responsibility. The reaction might also be self-directed, e.g., one can recognize oneself to be blameworthy). Thus, to be morally responsible for something, say an action, is to be worthy of a particular kind of reaction—praise, blame, or something akin to these—for having performed it.

The entire article is here.

Monday, April 14, 2014

Episode 6: Ethical Analysis of Vignettes (Number 1)

Dr. Richard F. Small joins John to discuss ethical decision-making, ethics education, and vignette analysis.  Rick and John will use information from Episodes 4 and 5 to demonstrate the differences among ethical issues, clinical concerns, legal matters, and risk management.  They will utilize the SHAPE decision-making model in conjunction with the acculturation model to demonstrate ways to consider ethical and clinical decision-making.  There will be some discussion on risk management and legal issues.  They will also discuss possible emotional issues that complicate decision-making skills.

At the end of this podcast, the listener will be able to:

1. Outline the relevant factors if the SHAPE decision-making model,
2. Identify the competing ethical principles in the vignettes, and,
3. Practice integrating personal values with professional ethics.

Find this podcast in iTunes

Click here to purchase 1 APA-approved Continuing Education credit

Listen directly from here


Episode 4: Ethical Decision-making (Part 1)

Episode 5: Ethical Decision-making (Part 2)

American Psychological Association's Ethical Principles of Psychologists and Code of Conduct

Handelsman, M. M., Gottlieb, M. C., & Knapp, S. (2005). Training ethical psychologists: An acculturation model. Professional Psychology: Research and Practice, 36, 59-65.

Motivated Moral Reasoning in Psychotherapy
John Gavazzi and Sam Knapp

Nonrational Processes in Ethical Decision-making
Mark Rogerson, Michael C. Gottlieb Mitchell M. Handelsman Samuel Knapp  & Jeffrey Younggren

Link to Dr. Small's Practice

Sunday, April 13, 2014

Arrested development: early prefrontal lesions impair the maturation of moral judgement

By Bradley Taber-Thomas, Erik Asp, Michael Koenings, Matthew Sutterer, Steven Anderson, and Daniel Tranel
Brain (2014) 137 (4): 1254-1261 first published online February 11, 2014
doi: 10.1093/brain/awt377


Learning to make moral judgements based on considerations beyond self-interest is a fundamental aspect of moral development. A deficit in such learning is associated with poor socialization and criminal behaviour. The neural systems required for the acquisition and maturation of moral competency are not well understood. Here we show in a unique sample of neurological patients that focal lesions involving ventromedial prefrontal cortex, acquired during development, result in an abnormally egocentric pattern of moral judgement. In response to simple hypothetical moral scenarios, the patients were more likely than comparison participants to endorse self-interested actions that involved breaking moral rules or physically harming others in order to benefit themselves. This pattern (which we also found in subjects with psychopathy) differs from that of patients with adult-onset ventromedial prefrontal cortex lesions—the latter group showed normal rejection of egocentric rule violations. This novel contrast of patients with ventromedial prefrontal cortex lesions acquired during development versus during adulthood yields new evidence suggesting that the ventromedial prefrontal cortex is a critical neural substrate for the acquisition and maturation of moral competency that goes beyond self-interest to consider the welfare of others. Disruption to this affective neural system early in life interrupts moral development.

The article can be found here, behind a paywall.

Email Contact of Daniel Tranel

Beliefs in moral luck: When and why blame hinges on luck

By Heather C. Lench, Darren Domsky, Rachel Smallman and Kathleen E. Darbor
The British Journal of Psychology
DOI: 10.1111/bjop.12072


Belief in moral luck is represented in judgements that offenders should be held accountable for intent to cause harm as well as whether or not harm occurred. Scores on a measure of moral luck beliefs predicted judgements of offenders who varied in intent and the outcomes of their actions, although judgements overall were not consistent with abstract beliefs in moral luck. Prompting participants to consider alternative outcomes, particularly worse outcomes, reduced moral luck beliefs. Findings suggest that some people believe that offenders should be punished based on the outcome of their actions. Furthermore, prompting counterfactuals decreased judgements consistent with moral luck beliefs. The results have implications for theories of moral judgement as well as legal decision making.

The entire story is here, behind a paywall.

Saturday, April 12, 2014

In Genes We Trust: How Our Essentialist Biases Distort How We Think About Genes

Posted by Peter B. Reiner
Neuroethics at the Core
Posted March 7, 2014

This video was recorded on October 23-25, 2013 during a Peter Wall Institute for Advanced Studies International Roundtable, "We Are Our Brains", led by Principal Investigator Dr. Peter B. Reiner (Department of Psychiatry, UBC and the National Core for Neuroethics).

To learn more about We Are Our Brains.

Friday, April 11, 2014

Undercover Doctor: Cure Me, I'm Gay

By Christian Jessen
Channel 4
Originally published March 20, 2013

In this one-off documentary Dr Christian Jessen goes undercover to both investigate and undertake controversial gay 'cures' in the UK and the USA.

Christian is shocked to find that not only are there people who believe that homosexuality is a disorder which should be cured, but that there is a growing number of therapists and self-styled healers who believe that they have the 'cure' for the 'illness'.

He sets out to prove or disprove their claims by offering himself up as a suitable case for treatment.

How your brain makes moral judgments

By Elizabeth Landau
Originally posted March 26, 2014

Here is an excerpt:

A moral network?

Scientists have shown that there is a specific network of brain regions involved in mediating moral judgment. An influential study on this topic was published in 2001 and led by Joshua D. Greene, associate professor at Harvard University, author of "Moral Tribes: Emotion, Reason, and the Gap Between Us and Them."

Adrian Raine and Yaling Yang, in a 2006 review article, described this study as a breakthrough. It focused "on the specific difference between making judgments (i.e. 'appropriate' or 'inappropriate') on 'moral personal' dilemmas (e.g. throwing a person out of a sinking life-boat to save others), and 'moral impersonal' dilemmas (e.g. keeping money found in a lost wallet)," they wrote.

The entire article is here.

Thursday, April 10, 2014

Seeking and Finding Our Clients on the Internet: Boundary Considerations in Cyberspace

Kolmes, K. & Taube. D. O. (2012). Seeking and Finding Our Clients on the Internet: Boundary 
Considerations in Cyberspace. Professional Psychology: Research and Practice 
Advance online publication. doi: 10.1037/a0029958 


As psychologists and clients increasingly use the Internet for personal and professional activities, they run the risk of having more incidental contacts online. This survey examined the experiences of 227 mental health professionals of various disciplines and training levels about both accidental and intentional experiences encountering client information on the Internet. One hundred and nine participants intentionally sought information about current clients in noncrisis situations, and 63 participants accidentally discovered client information on the Internet. This paper explores how clinicians responded to these encounters and clinicians’ beliefs about how they influenced treatment. Recommendations are made for how mental health professionals may begin to address such issues in the clinical relationship. 

Yes, business ethics can be measured

By Leanne Hoagland Smith
The Chicago Sun-Times
Originally posted March 22, 2014

Here is an excerpt:

There is documented research from organizations, such as Ethics Resource Center, Gallup and various universities measuring the impact of business ethics or lack thereof on everything from employee morale to the negative impact on workplace productivity. So the reluctance to avoid business ethics as a key metric or key performance indicator (KPI) is illogical.

This begs the question of, “How does one measure ethical behavior within the workplace without being viewed as judgmental or worse yet getting sued?”

The entire article is here.

Wednesday, April 9, 2014

Stress undermines empathic abilities in men but increases them in women

By Sissa Medialab
Science Daily
Originally published March 17, 2014

Stressed males tend to become more self-centered and less able to distinguish their own emotions and intentions from those of other people.  For women the exact opposite is true.  Stress, this problem that haunts us every day, could be undermining not only our health but also our relationships with other people, especially for men. Stressed women, however, become more “prosocial,” according to new research.

The entire review is here.

The original article is:

L. Tomova, B. von Dawans, M. Heinrichs, G. Silani, C. Lamm. Is stress affecting our ability to tune into others? Evidence for gender differences in the effects of stress on self-other distinction. Psychoneuroendocrinology, 2014; 43: 95 DOI: 10.1016/j.psyneuen.2014.02.006

Editor's Note: These findings may have importance in terms of ethical decision-making while under duress.

Behavioural economics and public policy

By Tim Harford
The Financial Times
Originally published March 17, 2014

Here is an excerpt:

Behavioural economics is one of the hottest ideas in public policy. The UK government’s Behavioural Insights Team (BIT) uses the discipline to craft better policies, and in February was part-privatised with a mission to advise governments around the world. The White House announced its own behavioural insights team last summer.

So popular is the field that behavioural economics is now often misapplied as a catch-all term to refer to almost anything that’s cool in popular social science, from the storycraft of Malcolm Gladwell, author of The Tipping Point (2000), to the empirical investigations of Steven Levitt, co-author of Freakonomics (2005).

Yet, as with any success story, the backlash has begun. Critics argue that the field is overhyped, trivial, unreliable, a smokescreen for bad policy, an intellectual dead-end – or possibly all of the above.

The entire article is here.

Tuesday, April 8, 2014

Experimental Moral Philosophy

The Stanford Encyclopedia of Philosophy
First Published March 19, 2014

Experimental moral philosophy began to emerge as a methodology in the last decade of the twentieth century, a branch of the larger experimental philosophy (X-Phi, XΦ) approach. From the beginning, it has been embroiled in controversy on a number of fronts. Some doubt that it is philosophy at all. Others acknowledge that it is philosophy but think that it has produced modest results at best and confusion at worst. Still others think it represents an important advance.

The entire post is here.

Dark thoughts: why mental illness is on the rise in academia

By Claire Shaw and Lucy Ward
The Guardian
Originally published March 6, 2014

Mental health problems are on the rise among UK academics amid the pressures of greater job insecurity, constant demand for results and an increasingly marketised higher education system.

University counselling staff and workplace health experts have seen a steady increase in numbers seeking help for mental health problems over the past decade, with research indicating nearly half of academics show symptoms of psychological distress.

The entire story is here.

Monday, April 7, 2014

Nearly half of identity thefts involve medical data

By Adam Levin
Posted on Market Watch March 18, 2014

Here are two excerpts:

“Despite concerns about employee negligence and the use of insecure mobile devices, 88 percent of organizations permit employees and medical staff to use their own mobile devices such as smartphones or tablets to connect to their organization’s networks or enterprise systems such as email. Similar to last year more than half of (these) organizations are not confident that the personally-owned mobile devices or BYOD are secure.”

According to the report, very few organizations require their employees to install anti-virus/anti-malware software on their smartphones or tablets, scan them for viruses and malware, or scan and remove all mobile apps that present a security threat before allowing them to be connected their networks or systems.


Medical identity theft is on the rise, just as the rise in criminal breaches of health care providers is spiking. Medical identity theft accounted for 43% of all identity theft reported in 2013, and the U.S. Department of Health and Human Services estimates that somewhere between 27.8 and 67.7 million people’s medical records have been breached since 2009 (and that’s before the flawed rollout of the Affordable Care Act).

The entire article is here.

Be employable, study philosophy

The discipline teaches you how to think clearly, a gift that can be applied to just about any line of work

By Shannon Rupp
Originally published July 1, 2013

Here is an excerpt:

The phrase caveat emptor is never more useful to remember than when paying tuition fees. Which reminds me: At what point does the minister of advanced education ask if it’s prudent to spend taxpayers’ money subsidizing trade school programs training people for dead trades? Just wondering.

Which is why I also recall a philosophy teaching assistant, who took a sabbatical from his fat-salaried job in the computer industry to do a company-funded PhD. He had benefited from that wave of computer development that hired logical thinkers to be trained in the new-fangled gizmos. For a brief, shining moment, BAs in philosophy had been hot commodities at places like IBM. One of his pals even wrote patents for companies that developed innovative tools and techniques. It turns out you need to define that new chair-like thing that isn’t quite a chair before you can patent it.

The entire article is here.

Editor's Note: Comedian Steve Martin has a degree in philosophy.

Sunday, April 6, 2014

Dennett Willing to Abandon the term "Free Will"?

By Greg Caruso
Flickers of Freedom Blog
Originally posted March 19, 2014

Here is an excerpt:

But recently I have learned from discussions with a variety of scientists and other non-philosophers (e.g., the scientists participating with me in the Sean Carroll workshop on the future of naturalism) that they lean the other way: free will, in their view, is obviously incompatible with naturalism, with determinism, and very likely incoherent against any background, so they cheerfully insist that of course they don’t have free will, couldn’t have free will, but so what? It has nothing to do with morality or the meaning of life. Their advice to me at the symposium was simple: recast my pressing question as whether naturalism (materialism, determinism, science...) has any implications for what we may call moral competence. For instance, does neuroscience show that we cannot be responsible for our choices, cannot justifiably be praised or blamed, rewarded or punished? Abandon the term “free will” to the libertarians and other incompatibilists, who can pursue their fantasies untroubled. - See more at:

The entire blog post is here.

Saturday, April 5, 2014

Are We Obligated to Make Ourselves More Moral and Intelligent? (Part One)

By J. Hughes
Ethical Technology
Originally posted March 13, 2014

Most of the ethical discussion of the use of stimulant drugs without a prescription in education has been negative, associating their use with performance enhancement in sports and with drug abuse. But the use of stimulants as study drugs actually has few side effects, and is almost entirely applied to the student’s primary obligation, academic performance. In this I consider some objections to off-label stimulant use, and to stimulant therapy for ADD, and argue that there are ethical arguments for the use of stimulants, and for future cognitively and morally enhancing therapies, in education, the work place, and daily life.

In recent years, as the diagnosis of ADD has become more common, and increasing numbers of adults have begun taking stimulant medications as a treatment for ADD, or without a prescription as a study aid, there have been calls for stricter regulation of the diagnosis and the drugs. People have suggested that the treatment of ADD with stimulants is a conspiracy of pharmaceutical capitalists in league with dubious pediatricians, when the real cause of inattentiveness is allegedly a dysfunctional industrial era educational system obsessed with standardized testing. The alleged risks of the use by adults without prescriptions have been hyped, and the "users vilified as "cheaters" contributing to a pharmaceutical arms race.

The entire article is here.

Friday, April 4, 2014

Borderline Disorder: Medical Personnel and Law Enforcement

By Dien Ho, Kenneth A. Richman, and Mark Bigney
The Hastings Center - Bioethics and the Law
Originally published April 3, 2014

Here is an excerpt:

The American Civil Liberties Union recently filed a federal lawsuit on behalf of a 54-year old New Mexico resident, “Jane Doe.” The defendants are the board of managers of El Paso County Hospital District, the University Medical Center of El Paso, two physicians, and agents of the U.S. Customs and Border Protection (CBP). The lawsuit alleges that on December 8, 2012 Ms. Doe was returning from a visit in Mexico when an agent of CBP informed her that she had been chosen for increased inspection and secondary screening.

After frisking failed to produce any contraband, agents sent her back in line to finish customs procedures. According to the complaint, a drug-sniffing dog, possibly prompted by a CBP agent, lurched at Ms. Doe. Agents then led her to a private room where she was subjected to further searches, including visual examination of her anus and vagina with a flashlight and the insertion of an agent’s finger into her vagina. Throughout the search, Ms. Doe never expressed consent, nor did the agents present a warrant.

The entire story is here.

Disgust and biological descriptions bias logical reasoning during legal decision-making

By Beatrice Capestany and Lasana T. Harris
Social Neuroscience
Originally posted February 27, 2014

Legal decisions often require logical reasoning about the mental states of people who perform gruesome behaviors. We use functional magnetic resonance imaging (fMRI) to examine how brain regions implicated in logical reasoning are modulated by emotion and social cognition during legal decision-making. Participants read vignettes describing crimes that elicit strong or weak disgust matched on punishment severity using the US Federal Sentencing Guidelines. An extraneous sentence at the end of each vignette described the perpetrator’s personality using traits or biological language, mimicking the increased use of scientific evidence presented in courts. Behavioral results indicate that crimes weak in disgust receive significantly less punishment than the guidelines recommend. Neuroimaging results indicate that brain regions active during logical reasoning respond less to crimes weak in disgust and biological descriptions of personality, demonstrating the impact of emotion and social cognition on logical reasoning mechanisms necessary for legal decision-making.

The entire article is here.

Thursday, April 3, 2014

Extraneous factors in judicial decisions

By Shai Danziger, Jonathan Levav, and Liora Avnaim-Pesso
PNAS - Originally posted in 2011, and still relevant today
doi: 10.1073/pnas.1018033108


Are judicial rulings based solely on laws and facts? Legal formalism holds that judges apply legal reasons to the facts of a case in a rational, mechanical, and deliberative manner. In contrast, legal realists argue that the rational application of legal reasons does not sufficiently explain the decisions of judges and that psychological, political, and social factors influence judicial rulings. We test the common caricature of realism that justice is “what the judge ate for breakfast” in sequential parole decisions made by experienced judges. We record the judges’ two daily food breaks, which result in segmenting the deliberations of the day into three distinct “decision sessions.” We find that the percentage of favorable rulings drops gradually from ≈65% to nearly zero within each decision session and returns abruptly to ≈65% after a break. Our findings suggest that judicial rulings can be swayed by extraneous variables that should have no bearing on legal decisions.

The entire article is here.

How we were fooled into thinking that sexual predators lurk everywhere

By Dana Boyd
From It’s Complicated: The Social Lives of Networked Teens
Published by Yale University Press

Here are two excerpts:

As moral panics about child safety take hold, politicians feel that they should take action—or at least capitalize on the appearance of doing so. They regularly campaign over safety issues and implement or expand laws targeted at curtailing the freedoms of minors. In the 1980s and 1990s, this included curfew laws, anti-loitering laws, and truancy laws. To expunge teens from public places, cities and towns limited where, when, and for how long teens could gather or hang out in public places. Many believed that curfew laws would combat crime; a 1997 survey of US mayors found that 88 percent believed that youth curfews reduced crime. It did not. As researchers began to examine the effects of these laws, they found that there was no correlation between curfews and youth crime. After analyzing the data, sociologist Michael Males concluded that authority figures use curfews more as a symbol of social control than an actual crime deterrent.


Through social media, teenagers have created digital streets that help define the networked publics in which they gather. In an effort to address online safety concerns, most adults respond by trying to quarantine youth from adults, limit teens’ engagement online, or track teens’ every move. Rhetoric surrounding online predation is used to drum up fear and justify isolation. But neither restrictions nor either adult or institutional surveillance will help those who are seriously struggling.

The entire chapter is here.

Thanks to Gary Schoener for this information.

Wednesday, April 2, 2014

Moral Injury

By David Wood
Huffington Post
Originally published March 17, 2014

Here is an excerpt:

It is what experts are coming to identify as a moral injury: the pain that results from damage to a person’s moral foundation. In contrast to Post-Traumatic Stress Disorder, which springs from fear, moral injury is a violation of what each of us considers right or wrong. The diagnosis of PTSD has been defined and officially endorsed since 1980 by the mental health community, and those suffering from it have earned broad public sympathy and understanding. Moral injury is not officially recognized by the Defense Department. But it is moral injury, not PTSD, that is increasingly acknowledged as the signature wound of this generation of veterans: a bruise on the soul, akin to grief or sorrow, with lasting impact on the individuals and on their families.

Moral injury raises uncomfortable questions about what happens in war, the dark experiences that many veterans have always been reluctant to talk about. Are the young Americans who volunteer for military service prepared for the ethical ambiguity that lies ahead? Can they be hardened against moral injury? Should they be?

The entire article is here.

There will be an upcoming podcast on morality and the moral self.

US Health Information Breaches Up 137%

By Roger Collier
Originally posted March 5, 2014

More than seven million health records in the United States were affected by data breaches in 2013, an increase of 137% over the previous year, according to the annual breach report by Redspin, an information security company based in Carpinteria, California.

Since 2009, there has been a rapid rise in the adoption of electronic health records in the US. There have also been 804 breaches of health information affecting nearly 30 million patient health records reported to the Secretary of Health and Human Services, as required by law.

The entire article is here.

Tuesday, April 1, 2014

Billionaires With Big Ideas Are Privatizing American Science

By William J. Broad
The New York Times
Originally published March 15, 2014

Here is an excerpt:

Absent from his narrative, though, was the back story, one that underscores a profound change taking place in the way science is paid for and practiced in America. In fact, the government initiative grew out of richly financed private research: A decade before, Paul G. Allen, a co-founder of Microsoft, had set up a brain science institute in Seattle, to which he donated $500 million, and Fred Kavli, a technology and real estate billionaire, had then established brain institutes at Yale, Columbia and the University of California. Scientists from those philanthropies, in turn, had helped devise the Obama administration’s plan.

American science, long a source of national power and pride, is increasingly becoming a private enterprise.

The entire story is here.

The Power of Conscious Intention Proven At Last?

By Neuroskeptic
The Neuroskeptic Blog
Originally published March 15, 2014

Here is an excerpt:

To simplify, one school of thought holds that (at least some of the time), our intentions or plans control our actions. Many people would say that this is what common sense teaches us as well.

But there’s an alternative view, in which our consciously-experienced intentions are not causes of our actions but are actually products of them, being generated after the action has already begun. This view is certainly counterintuitive, and many find it disturbing as it seems to undermine ‘free will’.

That’s the background. Zschorlich and Köhling say that they’ve demonstrated that conscious intentions do exist, prior to motor actions, and that these intentions are accompanied by particular changes in brain activity. They claim to have done this using transcranial magnetic stimulation (TMS), a way of causing a localized modulation of brain electrical activity.

The entire blog post is here.