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, May 31, 2014

Forced to be free? Increasing patient autonomy by constraining it

By Neil Levy
Journal of Medical Ethics
Originally published February 2010


It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their decisions and which therefore make it more difficult for them to pursue their most important goals by giving informed consent. It is further argued that patient autonomy is best promoted by constraining the informed consent procedure. By limiting the degree of freedom patients have to choose, the good that informed consent is supposed to protect can be promoted.

The entire article is here.

Friday, May 30, 2014

N.I.H. Tells Researchers to End Sex Bias in Early Studies

By Roni Caryn Rabin
The New York Times
Originally published May 14, 2014

Amid growing evidence that many drugs are not as effective in women as in men, the National Institutes of Health on Wednesday warned scientists that they must take steps to alter longstanding basic research methods.

The N.I.H. has already taken researchers to task for their failure to include adequate numbers of women in clinical trials. The new announcement is an acknowledgment that this gender disparity begins much earlier in the research process.

Even in the most preliminary stages of investigation, many scientists for decades have tested their theories only in male lab rats or only in male tissues and cells. Now the N.I.H. wants scientists that it funds to include female lab animals and female cell lines.

The entire article is here.

Now The Military Is Going To Build Robots That Have Morals

By Patrick Tucker
Defense One
Originally posted May 13, 2014

Are robots capable of moral or ethical reasoning? It’s no longer just a question for tenured philosophy professors or Hollywood directors. This week, it’s a question being put to the United Nations.

The Office of Naval Research will award $7.5 million in grant money over five years to university researchers from Tufts, Rensselaer Polytechnic Institute, Brown, Yale and Georgetown to explore how to build a sense of right and wrong and moral consequence into autonomous robotic systems.

The entire article is here.

Thursday, May 29, 2014

Shared Decision Making and Motivational Interviewing: Achieving Patient-Centered Care Across the Spectrum of Health Care Problems

By Glyn Elwyn, Christine Dehlendorf, Ronald Epstein, Katy Marrin, James White, and Dominick Frosch
doi: 10.1370/afm.1615
Ann Fam Med May/June 2014 vol. 12 no. 3 270-275


Patient-centered care requires different approaches depending on the clinical situation. Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient’s preferences. Many clinical consultations may require elements of both approaches, however. This article describes these 2 approaches—one to address ambivalence to medically indicated behavior change and the other to support patients in making health care decisions in cases where there is more than one reasonable option—and discusses how clinicians can draw on these approaches alone and in combination to achieve patient-centered care across the range of health care problems.

The entire article is here.

Enforcing Morality through Criminal Law (Part One)

By John Danaher
Philosophical Disquisitions
Originally posted May 10, 2014

What kinds of conduct ought to be criminalised? According to a position known as legal moralism, the criminal law ought only to prohibit immoral/wrongful conduct. That is to say: a necessary condition for the criminalisation of any conduct is that the conduct be immoral.

Legal moralism does not state a sufficient condition for criminalisation. It just limits the possible scope of criminal law to the set of immoral conduct. Follow up questions must be asked of the moralist. Which members of that set are most apt for criminalisation? What kinds of factors speak against the criminalisation of immoral conduct? Only when those questions are will we be able to tell whether a particular type of conduct ought to be criminalised.

The entire blog post is here.

Wednesday, May 28, 2014

The Ethics of Human Enhancement (Index to all Posts)

By John Danaher
Philosophical Disquisitions Blog
Originally published June 13, 2013

As some of you may have noticed, I've written quite a bit about the ethics of human enhancement over the past few years. For better or worse it has become one of my major research interests. This all started when I wrote a paper about human enhancement and criminal responsibility when completing my PhD (I now think that paper is terrible, but you can find it here). Subsequently, I wrote a (much better) article about the use of enhancement to improve the legitimacy of legal trials.

Well, just this month I finished writing first drafts of three separate articles on the topic,* and thought that now might be a good time to do a retrospective on all the blog posts I've done on enhancement. So here's a complete list, in reverse chronological order:

1. Douglas on Moral Enhancement and Superficiality (July 2013)
There is some evidence to suggest that technologies could be used to directly manipulate our moral emotions, thereby encouraging us to engage in morally conforming behaviour. Is this a welcome development? Some argue it leads to a more superficial, less worthy type of moral behaviour.

The entire blog post and index on human enhancement is here.

Stanford panel debates: Does teaching ethics do any good?

In an event sponsored by the McCoy Family Center for Ethics in Society, faculty from Stanford’s business school, law school and Philosophy Department say such courses equip students with the tools to engage with ethical problems.

Stanford Report
Originally posted May 13, 2014

Stanford University requires every undergraduate to take a class that deals with ethics. But can something as personal as ethics be taught in a classroom? Can classes in ethics make students more virtuous individuals? Or is that the wrong question to focus on?

These are the issues that a panel of Stanford scholars addressed in an event titled Does Teaching Ethics do any Good? It was sponsored by the McCoy Family Center for Ethics in Society as part of a series of talks marking its 25th anniversary.

Approaching the topic from diverse academic backgrounds, the Stanford professors who participated in the discussion agreed that ethics classes cannot be expected to make students more ethical. However, they articulated several other benefits, such as teaching students to fruitfully and confidently engage in ethical dialogue.

The entire article is here.

Editor's note: In podcast Episode 8, we discuss the counterintuitive fact that teaching ethics or ethics codes does not necessarily make a person more ethical.

Tuesday, May 27, 2014

Are we ready for a prenatal screening test for autism?

A blood test for diagnosing autism is becoming a realistic possibility, but the ethical implications are profound

By David Cox

Originally published May 1, 2014

Here are two excerpts:

One approach is to compare blood samples from autism patients and healthy individuals and search for what is known as a protein fingerprint – a set of protein levels that is consistently and markedly different in people with autism. So far this has been done relatively successfully in Asperger's syndrome, forming the basis of a blood test that can diagnose the disorder with 80% accuracy, and there are hopes this feat can soon be replicated for autism disorder.


"The whole ethos behind medicine is to do no harm and if the test is only 80% accurate, it means a proportion of people will be told they have the condition when they don't, so you've raised anxieties unnecessarily. Equally if the test is missing people, then they'll be going away thinking I'm fine when they could be getting support."

Whether measuring protein levels alone should ever be sufficient for a diagnosis is also open to question. Like all neuropsychiatric conditions, autism has varying degrees of severity, meaning some patients require constant care while those with "high-functioning autism" are capable of living independently, adapting to society around them and holding down a job. Right now, such a test would merely pool everyone with autism into the same category. Should we be intervening at all in some cases?

The entire story is here.

Ever-so-slight delay improves decision-making accuracy

By Columbia University Medical Center
Press Release
Originally released on March 8, 2014

Here is an excerpt:

“Decision making isn’t always easy, and sometimes we make errors on seemingly trivial tasks, especially if multiple sources of information compete for our attention,” said first author Tobias Teichert, PhD, a postdoctoral research scientist in neuroscience at CUMC at the time of the study and now an assistant professor of psychiatry at the University of Pittsburgh. “We have identified a novel mechanism that is surprisingly effective at improving response accuracy.

The mechanism requires that decision-makers do nothing—just briefly. “Postponing the onset of the decision process by as little as 50 to 100 milliseconds enables the brain to focus attention on the most relevant information and block out irrelevant distractors,” said last author Jack Grinband, PhD, associate research scientist in the Taub Institute and assistant professor of clinical radiology (physics). “This way, rather than working longer or harder at making the decision, the brain simply postpones the decision onset to a more beneficial point in time.”

The entire press release can be found at PsyPost here.

Monday, May 26, 2014

Episode 9: Psychologist as Collaborative Coach

In this episode, John interviews Lori Gephart, a psychologist from the Greater Pittsburgh area on her work as a collaborative coach.  Collaborative coaching is yet another area of practice for specially trained psychologists. Lori talks about her role as a collaborative coach in the divorce process. Skills related to collaborative coaching include helping clients identify shared interests and engage in interest-based resolution.  The collaborative coach also assists with improving communication, facilitating teamwork, providing information on marital transition, and referring for psychotherapy when needed. Lori also outlines information about training, networking, and becoming more involved in the collaborative coaching arena.

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

1. Define the role of a Collaborative Coach.
2. Identify the role of the Child Specialist.
3. Explain the additional training needed to be a collaborative coach

Or listen directly on this site


Lori Gephart's Homepage                           Follow Lori on Twitter @NHPAwellness

Sunday, May 25, 2014

What Happens Before? A Field Experiment Exploring How Pay and Representation Differentially Shape Bias on the Pathway into Organizations

By Katherine Milkman, Modupe Akinola, and Dolly Chugh
Originally posted April 23, 2014


Little is known about how bias against women and minorities varies within and between organizations or how it manifests before individuals formally apply to organizations. We address this knowledge gap through an audit study in academia of over 6,500 professors at top U.S. universities drawn from 89 disciplines and 259 institutions. We hypothesized that discrimination would appear at the informal “pathway” preceding entry to academia and would vary by discipline and university as a function of faculty representation and pay. In our experiment, professors were contacted by fictional prospective students seeking to discuss research opportunities prior to applying to a doctoral program. Names of students were randomly assigned to signal gender and race (Caucasian, Black, Hispanic, Indian, Chinese), but messages were otherwise identical. We found that faculty ignored requests from women and minorities at a higher rate than requests from White males, particularly in higher-paying disciplines and private institutions. Counterintuitively, the representation of women and minorities and bias were uncorrelated, suggesting that greater representation cannot be assumed to reduce bias. This research highlights the importance of studying what happens before formal entry points into organizations and reveals that discrimination is not evenly distributed within and between organizations.

The entire research paper is here.

Saturday, May 24, 2014

5 ways thinking philosophically helps you choose more wisely

By Russell Downham
Originally published November 14, 2014

Life is confusing. What does it all mean? So begins philosophy.

When you think philosophically, you question your assumptions about yourself, other people, and the world, to clarify your perspective and deepen your understanding of what matters to you. You can pursue these questions as far as your curiosity desires, but when you think philosophically about your choices, you naturally have a practical end in view: you want to make the wisest choice you can.

‘Philosophy’ literally means ‘the love of wisdom’, but even if its heart is in the right place, can thinking philosophically really help you to make wiser choices? Aside from the intrinsic value, and pleasure of making philosophical sense of your choices, can it also make practical sense to do so?

Thinking philosophically does make practical sense, when it engages with life as you experience it – questioning, but never ignoring, your pre-philosophical commitments, taking seriously everything that matters to you, including the things you think shouldn’t. When you are honest and determined not to be holier-than-thyself, thinking philosophically about your life enables you to create more meaningful connections between who you are and what you do, leading to choices that truly reflect your own personal values.

The entire article is here.

Friday, May 23, 2014

Cognitive science and threats to free will

By Joshua Shepherd
Practical Ethics
Originally published on May 6, 2014

It is often asserted that emerging cognitive science – especially work in psychology (e.g., that associated with work on automaticity, along with work on the power of situations to drive behavior) and cognitive neuroscience (e.g., that associated with unconscious influences on decision-making) – threatens free will in some way or other. What is not always clear is how this work threatens free will. As a result, it is a matter of some controversy whether this work actually threatens free will, as opposed to simply appearing to threaten free will. And it is a matter of some controversy how big the purported threat might be. Could work in cognitive science convince us that there is no free will? Or simply that we have less free will? And if it is the latter, how much less, and how important is this for our practices of holding one another morally responsible for our behavior?

The entire article is here.

Architect Of Health Law Says Reform Is 'Never Finished'

The University of New Orleans
Originally published May 7, 2014

Two polls released this week reveal challenges ahead for the Affordable Care Act.

Gallup found the nation’s uninsured rate dropped to 13.4 percent last month, the lowest monthly uninsured rate since the company began tracking it in 2008. But that means 32 million people remain without coverage.

And a Pew Research Center poll shows that 55 percent of Americans disapprove of the 2010 health care reform law, which mandates that everyone have health insurance and that it be made available to even those with pre-existing medical conditions.

The entire story is here.

Thursday, May 22, 2014

Second VA doctor blows whistle on patient-care failures

By Dennis Wagner
The Republic
Originally published May 2, 2014

Here is an excerpt:

Both physicians, as well as other VA employees who asked not to be named for fear of retribution, said the Phoenix VA leadership disdains internal criticism and retaliates against those who speak out. In interviews and a written statement, Mitchell told The Republic she can no longer remain silent.

"I am violating the VA 'gag' order for ethical reasons," she wrote. "I am cognizant of the consequences. As a VA employee I have seen what happens to employees who speak up for patient safety and welfare within the system. The devastation of professional careers is usually the end result, and likely is the only transparent process that actually exists within the Phoenix VA Medical Center today."

The entire story is here.

Responding to Suicidal Risk

This is chapter 17 of the book Ethics in Psychotherapy and Counseling: A Practical Guide, 4th Edition by Kenneth S. Pope, Ph.D., ABPP & Melba J.T. Vasquez, Ph.D., ABPP, published by John Wiley.

Few responsibilities are so heavy and intimidating as responding to suicidal risk. The need for careful assessment is great. Suicide remains among the top dozen causes of death in the United States, as high as number two for some groups. Homicide rates seize popular attention, but far more people kill themselves than kill others.  Authorities in the field are almost unanimous in their view that the reported figures vastly understate the actual incidence because of problems in reporting procedures.

The book chapter is here, published by Ken Pope on his site.

Wednesday, May 21, 2014

Ethical Systems: Insight # 4 on Darwin and Ethics

By Joshua Elle
Ethicalsystems.org Blog
Originally published May 5, 2014

#EthSys Insights is a video series where we have experts answer questions about ethical systems design. For our fourth installment, we had the pleasure of asking our Cheating & Honesty contributor, Robert Frank, to clear up contemporary misconceptions about the Darwinian view on cheating and honesty in business (the video is 148 seconds long).

Ethical Systems blog post can be found here.

Fresh Misconduct Charges Hit Dutch Social Psychology

By Frank van Kolfschooten
Originally published May 6, 2014

Scientists here are still searching their souls about two previous scandals--involving Diederik Stapel of Tilburg University in 2011 and Dirk Smeesters of Erasmus University in Rotterdam a year later.

Now they have learned that a national research integrity panel has found evidence of data manipulation in the work of Jens Forster, a social psychologist at the University of Amsterdam (UvA).

The university has already announced that it will request the retraction of one of Forster's articles.

The case is drawing widespread international attention as well, in part because Forster, who's German and came to Amsterdam in 2007, enjoys a sterling reputation.

"He is among the most creative and influential social psychologists of his generation," says Jeffrey Sherman of the University of California, Davis.

The entire article is here, behind a paywall.

Tuesday, May 20, 2014

Dealing with all the behavioral conditions of unknown etiology

By Steven Reidbord
Originally published May 1, 2014

Here are some excerpts:

A few years ago I wrote that uncertainty is inevitable in psychiatry.  We literally don’t know the pathogenesis of any psychiatric disorder.  Historically, when the etiology of abnormal behavior became known, the disease was no longer considered psychiatric.  Thus, neurosyphilis and myxedema went to internal medicine; seizures, multiple sclerosis, Parkinson’s, and many other formerly psychiatric conditions went to neurology; brain tumors and hemorrhages went to neurosurgery; and so forth.


Patients are told they suffer a “chemical imbalance” in the brain, when none has ever been shown.  Rapid advances in brain imaging and genetics have yielded an avalanche of findings that may well bring us closer to understanding the causes of mental disorders.  But they haven’t done so yet — a sad fact obscured by popular and professional rhetoric.  In particular, functional brain imaging (e.g., fMRI) fascinates brain scientists and the public alike.  We can now see, in dramatic three-dimensional colorful computer graphics, how different regions of the living brain “light up,” that is, vary in metabolic activity.  Population studies reveal systematic differences in patients with specific psychiatric disorders as compared to normals.  Don’t such images prove that psychiatric disorders are neurobiological brain diseases?

Note quite.

The entire article is here.

Thanks to Ed Zuckerman for this information.

Lady Gaga's foundation supports youth mental health discussions - all by text messaging

By Will Schutt
Medill Reports
Originally posted April 24, 2014

Texting offers new way to get youth engaged in mental health discussions. Creating Community Solutions and Lady Gaga's Born This Way Foundation are sponsoring a texting conversation about mental health. All you need to chime in is a cell phone. The latest digital mental health discussion for and between young people kicks off today.

An emerging mental health “conference” offers a new kind of group rapport: a conversation entirely conducted by texting.


Occasionally, people text in who are in crisis. To make sure they get immediate assistance, one of the first texts people receive is the number for the national hotline for mental health crises.

The entire article is here.

Monday, May 19, 2014

Moral luck, agent regret and the doctor as drug

By Jonathon Tomlinson
BMJ Blogs
Originally posted April 3, 2014

Here is an excerpt:

Professional identity is particularly strong in doctors and medical students, and perhaps more than our non-medical peers we assimilate this into our personal identity. With this, comes an enhanced sense of moral responsibility; we cannot avoid thinking that we are morally responsible for what happens to our patients.

This spectrum of moral responsibility is intrinsic to our underlying constitution and moral predispositions. The efforts of lawyers, ethicists and moral philosphers to impose definitions seem far removed from experiences like those described above and our self-imposed moral standards. It is not only our attachment to our professional identity, but the nature of our work that makes us vulnerable to moral luck and agent regret. 

 The entire article is here.

Very overweight teens face stigma, discrimination, and isolation

From a synopsis in the British Medical Journal

Here is an excerpt of the synopsis of the article:

In general, young people thought that individuals were responsible for their own body size. They associated excess weight with negative stereotypes of laziness, greed, and a lack of control. And they felt that being overweight made an individual less attractive and opened them up to bullying and teasing.

Young people who were already overweight tended to blame themselves for their size. And those who were classified as very overweight said they had been bullied and physically and verbally assaulted, particularly at school. They endured beatings, kickings, name-calling, deliberate and prolonged isolation by peers, and sniggering/whispering.

Some young people described coping strategies, such as seeking out support from others. But the experiences of being overweight included feeling excluded, ashamed, marked out as different, isolated, ridiculed and ritually humiliated. Everyday activities, such as shopping and socialising, were difficult.

The entire synopsis is here.

A link to the study is here.

Sunday, May 18, 2014

Many Ivy League students don't view ADHD medication misuse as cheating: 18 percent use stimulants to help them study

By Science Daily
Source: American Academy of Pediatrics
Originally published May 1, 2014


Nearly one in five students at an Ivy League college reported misusing a prescription stimulant while studying, and one-third of students did not view such misuse as cheating, according to a new study. Stimulants are used to treat attention-deficit/hyperactivity disorder (ADHD). Recent studies have shown that students without ADHD are misusing these medications in hopes of gaining an academic edge.

The entire article is here.

Saturday, May 17, 2014

U.S. Should Significantly Reduce Rate of Incarceration

Unprecedented Rise in Prison Population ‘Not Serving the Country Well,’ Says New Report

Press Release from the National Academy of Sciences
Released April 30, 2014

Given the minimal impact of long prison sentences on crime prevention and the negative social consequences and burdensome financial costs of U.S. incarceration rates, which have more than quadrupled in the last four decades, the nation should revise current criminal justice policies to significantly reduce imprisonment rates, says a new report from the National Research Council.

A comprehensive review of data led the committee that wrote the report to conclude that the costs of the current rate of incarceration outweigh the benefits.  The committee recommended that federal and state policymakers re-examine policies requiring mandatory and long sentences, as well as take steps to improve prison conditions and to reduce unnecessary harm to the families and communities of those incarcerated.  In addition, it recommended a reconsideration of drug crime policy, given the apparently low effectiveness of a heightened enforcement strategy that resulted in a tenfold increase in the incarceration rate for drug offenses from 1980 to 2010 — twice the rate for other crimes.

“We are concerned that the United States is past the point where the number of people in prison can be justified by social benefits,” said committee chair Jeremy Travis, president of John Jay College of Criminal Justice in New York City.  “We need to embark on a national conversation to rethink the role of prison in society.  A criminal justice system that makes less use of incarceration can better achieve its aims than a harsher, more punitive system. There are common-sense, practical steps we can take to move in this direction.”

The rest of the press release is here.

Friday, May 16, 2014

How Chicago is using psychotherapy to fight crime — and winning

By Dylan Matthews
Originally published May 1, 2014

The basics

The program in question is called Becoming a Man (BAM), and was developed by the nonprofits Youth Guidance and World Sport Chicago for use in Chicago schools. BAM consists of weekly hour-long sessions with groups of no more than 15 high school boys (the average instructor-student ratio is 1 to 8). It's not therapy in the strictest of senses, but the overall approach is borrowed from cognitive-behavioral therapy (CBT), which has overtaken more Freudian approaches in recent decades among practitioners and has a large research base demonstrating its effectiveness:

CBT is all about teaching meta-cognition: thinking about thinking. In a pure therapy setting, that means teaching patients to identify thought patterns that contribute to depression, anxiety, and so forth, so that they can work to replace them with healthier patterns. For example, a common negative thought pattern is catastrophizing, or exaggerating the importance of a short-term negative event in a way that causes undue distress and overreaction; if you've ever gotten a small piece of negative feedback from your boss and within a few minutes started worrying that you're about to get fired, that's catastrophizing in action.

The entire article is here.

Blaming the Kids: Children’s Agency and Diminished Responsibility

By Michael Tiboris
Journal of Applied Philosophy,Vol. 31, No. 1, 2014
doi: 10.1111/japp.12046


Children are less blameworthy for their beliefs and actions because they are young. But the relationship between development and responsibility is complex. What exactly grounds the excuses we rightly give to young agents? This article presents three distinct arguments for children's diminished responsibility. Drawing on significant resources from developmental psychology, it rejects views which base the normative adult/child distinction on children's inability to participate in certain kinds of moral communication or to form principled self-conceptions which guide their actions. The article then argues that children's responsibility ought to be diminished because (and to the degree that) they are less competent at using features of their moral agency to meet social demands. This ‘normative competence’ view is philosophically defensible, supported by research in developmental psychology, and provides us with a method to evaluate whether things like peer pressure are relevant to responsibility.

The entire article is here.

Thursday, May 15, 2014

Erotic Feelings Toward the Therapist: A Relational Perspective

By Jenny H. Lotterman
Journal of Clinical Psychology
Volume 70, Issue 2, pages 135–146, February 2014


This article focuses on the relational treatment of a male patient presenting with sexual and erotic feelings toward the therapist. The use of relational psychotherapy allowed us to collaborate in viewing our therapeutic relationship as a microcosm of other relationships throughout the patient's life. In this way, the patient came to understand his fears of being close to women, his discomfort with his sexuality, and how these feelings impacted his ongoing romantic and sexual experiences. Use of the therapist's reactions to the patient, including conscious and unconscious feelings and behaviors, aided in the conceptualization of this case. Working under a relational model was especially helpful when ruptures occurred, allowing the patient and therapist to address these moments and move toward repair. The patient was successful in making use of his sexual feelings to understand his feelings and behaviors across contexts.

The entire article is here.

Editor's Note: Psychologists do not talk enough about erotic transference and countertransference in psychotherapy.  These emotions happen more frequently than psychologists are willing to admit.

The Reformation: Can Social Scientists Save Themselves?

By Jerry Adler
Pacific Standard: The Science of Society
Originally posted April 28, 2014

Here is two excerpts to a long, yet exceptional, article on research in the social sciences:

OUTRIGHT FAKERY IS CLEARLY more common in psychology and other sciences than we’d like to believe. But it may not be the biggest threat to their credibility. As the journalist Michael Kinsley once said of wrongdoing in Washington, so too in the lab: “The scandal is what’s legal.” The kind of manipulation that went into the “When I’m Sixty-Four” paper, for instance, is “nearly universally common,” Simonsohn says. It is called “p-hacking,” or, more colorfully, “torturing the data until it confesses.”

P is a central concept in statistics: It’s the mathematical factor that mediates between what happens in the laboratory and what happens in the real world. The most common form of statistical analysis proceeds by a kind of backwards logic: Technically, the researcher is trying to disprove the “null hypothesis,” the assumption that the condition under investigation actually makes no difference.


WHILE IT IS POSSIBLE to detect suspicious patterns in scientific data from a distance, the surest way to find out whether a study’s findings are sound is to do the study all over again. The idea that experiments should be replicable, producing the same results when run under the same conditions, was identified as a defining feature of science by Roger Bacon back in the 13th century. But the replication of previously published results has rarely been a high priority for scientists, who tend to regard it as grunt work. Journal editors yawn at replications. Honors and advancement in science go to those who publish new, startling results, not to those who confirm—or disconfirm—old ones.

The entire article is here.

Wednesday, May 14, 2014

Normative & Descriptive Ethics

By JW Gray
Ethical Realism
Originally posted May 5, 2014

I believe that one source of confusion can be solved by the distinction between normative and descriptive ethics. Whenever people talk about cultural relativism or evolutionary theories of ethics, I think they have descriptive ethics in mind, but they often jump to the conclusion that whatever they are talking about has certain obvious normative implications. In particular, some people claim that morality comes from evolution and others claim that morality is relative. What they have in mind often doesn’t actually make sense, as I will discuss in detail.

The short, yet interesting article is here.

The Ethics of Virtual Rape

By John Danaher
Philosophical Disquisitions
Originally published April 26, 2014

The notorious 1982 video game Custer’s Revenge requires the player to direct their crudely pixellated character (General Custer) to avoid attacks so that he can rape a Native American woman who is tied to a stake. The game, unsurprisingly, generated a great deal of controversy and criticism at the time of its release. Since then, video games with similarly problematic content, but far more realistic imagery, have been released. For example, in 2006 the Japanese company Illusion released the game RapeLay, in which the player stalks and rapes a mother and her two daughters.

The question I want to explore in this post is the morality of such representations. One could, of course, argue that they are extrinsically wrong, i.e. that they give rise to behaviour that is morally problematic and so should limited or prohibited for that reason. This is like the typical “violent video games cause real violence”-claim, and I suspect it would be equally hard to prove in practice. The more interesting question is whether there is something intrinsically wrong with playing (and perhaps enjoying) such video games. Prima facie, the answer would seem to be “no”, since no one is actually harmed or wronged in the virtual act. But maybe there is more to it than this?

The entire article is here.

Tuesday, May 13, 2014

Social media can cause problems for lawyers when it comes to ethics, professional responsibility

Bodies are trying to come up with guidelines for the legal profession when it comes to the use of social media

By Ed Silverstein
Inside Counsel
Originally published April 29, 2014

It is becoming increasingly confusing what lawyers, judges and courthouse employees can post on social media sites. For instance, can a judge “friend” someone who is an attorney on Facebook and then have the attorney appear before them in court?

Attorneys who post on sites like Facebook also have to worry about violating attorney-client confidentiality, disciplinary action, losing jobs, or engaging in the unauthorized or inadvertent practice of law, according to an article in the Touro Law Review. In addition, attorneys could “face sanctions for revealing misconduct or disparaging judges on social media sites,” the article adds.

The entire article is here.

Christianity and Eugenics: The Place of Religion in the British Eugenics Education Society and the American Eugenics Society, c.1907–1940

By Graham J. Baker
Social History of Medicine
Volume 27, Issue 2, pp 281-302


Historians have regularly acknowledged the significance of religious faith to the eugenics movement in Britain and the USA. However, much of this scholarship suggests a polarised relationship of either conflict or consensus. Where Christian believers participated in the eugenics movement this has been represented as an abandonment of ‘orthodox’ theology, and the impression has been created that eugenics was a secularising force. In contrast, this article explores the impact of religious values on two eugenics organisations: the British Eugenics Education Society, and the American Eugenics Society. It is demonstrated that concerns over religion resulted in both these organisations modifying and tempering the public work that they undertook. This act of concealing and minimising the visibly controversial aspects of eugenics is offered as an addition to the debate over ‘mainline’ versus ‘reform’ eugenics.

The entire article is here.

Monday, May 12, 2014

Episode 8: The Dark Side of Ethics - False Risk Management Strategies

In this episode, John talks with Dr. Sam Knapp, Psychologist and Ethics Educator, about false risk management strategies.  Using the acculturation model as a guide, Sam and John discuss how some psychologists have learned false risk management strategies.  They discuss the possible erroneous rationale for these strategies.  John and Sam provide good clinical and ethical reasons as how these strategies can actually hinder high quality of services.  They also discuss ethics education in general and why learning about ethics codes do not necessarily enhance ethical practice.

At the end of the workshop the participants will be able to:

  1. Explain the concept of a false risk management strategy,
  2. Identify two false risk management strategies,
  3. Outline how false risk management strategies hinder high quality psychological care.

Find this podcast in iTunes

Click here to purchase 1 APA-approved Continuing Education credit

Or listen directly here.


Podcast slides can be found here.

Knapp, Samuel; Handelsman, Mitchell M.; Gottlieb, Michael C.; VandeCreek, Leon D. The dark side of professional ethics. Professional Psychology: Research and Practice, Vol 44(6), Dec 2013, 371-377.

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.

No Suicide Contracts: An Effective Strategy?
John Gavazzi

Sunday, May 11, 2014

Fourth HIPAA breach for Kaiser

By Erin McCann
Healthcare IT News
Originally published April 7, 2014

Some 5,100 patients treated at Kaiser Permanente were sent HIPAA breach notification letters Friday after a KP research computer was found to have been infected with malicious software. Officials say the computer was infected with the malware for more than two and a half years before being discovered Feb. 12.

The computer was used by the Kaiser Permanente Northern California Division of Research to store research data. The breach, officials note, involved patients participating in specific research studies and may have compromised their names, birth dates, medical record numbers, lab results associated with research, addresses and additional medical research data.

The entire story is here.

Saturday, May 10, 2014

We may never teach robots about love, but what about ethics?

Do androids dream of electric Kant?

By Emma Wooliacott
New Statesman
Originally published May 6, 2014

Here are two excerpts:

But as AJung Moon of the University of British Columbia, points out, "It's really hard to create a robot that would have the same sense of moral agency as a human being. Part of the reason is that people can't even agree on what is the right thing to do. What would be the benchmark?"

Her latest research, led by colleague Ergun Calisgan, takes a pragmatic approach to the problem by examining a robot tasked with delivering a package in a building with only one small lift. How should it act? Should it push ahead of a waiting human? What if its task is urgent? What if the person waiting is in a wheelchair?


Indeed, professor Ronald Craig Arkin of the Georgia Institute of Technology has proposed an "ethical adaptor", designed give a military robot what he describes as a sense of guilt. It racks up, according to a pre-determined formula, as the robot perceives after an event that it has violated the rules of engagement - perhaps by killing a civilian in error - or if it is criticised by its own side. Once its guilt reaches a certain pre-determined level, the robot is denied permission to fire.

The entire article is here.

UC OKs paying surgeon $10 million in whistleblower-retaliation case

By Chad Terhune
The Los Angeles Times
Originally published April 22, 2014

University of California regents agreed to pay $10 million to the former chairman of UCLA's orthopedic surgery department, who had alleged that the well-known medical school allowed doctors to take industry payments that may have compromised patient care.


The seven-week trial in downtown Los Angeles offered a rare glimpse into those potential conflicts at a time when there is growing government scrutiny of industry payments to doctors.

Starting this fall, the federal Physician Payments Sunshine Act, part of President Obama's healthcare law, requires public disclosure of financial relationships between healthcare companies and physicians.

The entire article is here.

Friday, May 9, 2014

Are medical students ethically illiterate?

By Xavier Symons
Originally published June 1, 2013

Here is an excerpt:

Many experts believe that there needs to be more ethical education at a practical clinical level if students are to retain the information. “I would really encourage [faculties] to think about how to integrate ethical education also into the clinical realm,” said Dr Lauris Kaldjian, principal author and director of bioethics and humanities at the University of Iowa Carver College of Medicine.

The entire article is here.

Here is a link to the original study.

Ethics is Contagious

By Linda Fisher Thornton
Leading in Context
Originally posted April 16, 2014

Here is an excerpt:

Ethics is catching, and leaders set the tone for the ethics of the organization. What would happen if everyone in the organization followed our lead? Would the organization be more or less ethical?  What kind of ethics are people catching as they work in our organization?

10 Reasons Why Ethics is Contagious:

1. We are social creatures.
2. People tend to “follow the leader.”
3. If their leader is unethical, people may be less likely to report ethical problems.

The entire article.

Thursday, May 8, 2014

The Effect of Belief in Free Will on Prejudice

By Xian Zhao, Li Liu, Xiao-xiao Zhang, Jia-xin Shi, and  Zhen-wei Huang
Published: March 12, 2014 DOI: 10.1371/journal.pone.0091572


The current research examined the role of the belief in free will on prejudice across Han Chinese and white samples. Belief in free will refers to the extent to which people believe human beings truly have free will. In Study 1, the beliefs of Han Chinese people in free will were measured, and their social distances from the Tibetan Chinese were used as an index of ethnic prejudice. The results showed that the more that Han Chinese endorsed the belief in free will, the less that they showed prejudice against the Tibetan Chinese. In Study 2, the belief of the Han Chinese in free will was manipulated, and their explicit feelings towards the Uyghur Chinese were used as an indicator of ethnic prejudice. The results showed that the participants in the condition of belief in free will reported less prejudice towards Uyghur Chinese compared to their counterparts in the condition of disbelief in free will. In Study 3, white peoples’ belief in free will was manipulated, and their pro-black attitudes were measured as an indirect indicator of racial prejudice. The results showed that, compared to the condition of disbelief in free will, the participants who were primed by a belief in free will reported stronger pro-black attitudes. These three studies suggest that endorsement of the belief in free will can lead to decreased ethnic/racial prejudice compared to denial of the belief in free will. The theoretical and practical implications are discussed.

The entire study is here.

We Aren’t the World

By Ethan Watters
Pacific Standard
Originally published February 25, 2013

Here is an excerpt:

The potential implications of the unexpected results were quickly apparent to Henrich. He knew that a vast amount of scholarly literature in the social sciences—particularly in economics and psychology—relied on the ultimatum game and similar experiments. At the heart of most of that research was the implicit assumption that the results revealed evolved psychological traits common to all humans, never mind that the test subjects were nearly always from the industrialized West. Henrich realized that if the Machiguenga results stood up, and if similar differences could be measured across other populations, this assumption of universality would have to be challenged.

Henrich had thought he would be adding a small branch to an established tree of knowledge. It turned out he was sawing at the very trunk. He began to wonder: What other certainties about “human nature” in social science research would need to be reconsidered when tested across diverse populations?

The entire article is here.

Wednesday, May 7, 2014

15-Minute Visits Take A Toll On The Doctor-Patient Relationship

By Roni Caryn Rabin
Kaiser Health News
Originally published April 21, 2014

Here is an excerpt:

“Doctors have one eye on the patient and one eye on the clock,” said David J. Rothman, who studies the history of medicine at Columbia University’s College of Physicians and Surgeons.

By all accounts, short visits take a toll on the doctor-patient relationship, which is considered a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave the office frustrated.

The entire story is here.

U.S. Special Ops Are Soldiers Committing Suicide in Record Numbers

By Charlie Campbell
Originally published April 18, 2014

U.S. special operations forces personnel are committing suicide in record numbers, according to a top military official, due to the traumatic effects of years of war.

The entire article is here.

Tuesday, May 6, 2014

Record numbers on 'happy pills'

Psychiatrists warning over soaring use of pills in 'depressed Britain'

By Laura Donnelley
The Telegraph
Originally posted April 20, 2014

Britons are taking anti-depressants in greater quantities than ever before, new figures have disclosed, with a near 25 per cent rise in prescriptions in the last three years alone.

According to official NHS data, more than 53 million prescriptions were handed out for drugs such as Prozac and Seroxat in England last year - a record high, and a rise of 24.6 per cent since 2010.

The entire story is here.

Beijing shuts down thousands of websites in online pornography purge

By Tom Paine
The Independent
Originally published April 21, 2014

The Chinese government has shut down thousands of websites and social media sites in a bid to purge the internet of online pornography, it was revealed today.

The nation’s state media services announced the progress of its ‘Cleaning the Web 2014’ campaign today, which has resulted in the closure of 110 websites and more than 3,300 accounts containing ‘obscene’ material since January.

The entire article is here.

Monday, May 5, 2014

Cost of Treatment May Influence Doctors

By Andrew Pollack
The New York Times
Originally published April 17, 2014

Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.

The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.

The entire article is here.

In Medical Decisions, Dread Is Worse Than Fear

Procrastination, on the other hand, may not be so bad.

By Gabriella Rosen Kellerman
The Atlantic
Originally published April 15, 2014

Here is an excerpt:

One of the solutions Rosenberg proposed was “interventions aimed at improving risk communication.” Meaning that, perhaps if healthcare providers can help patients more rationally assess the risks for now versus later, they can help them avoid unnecessary suffering. To do so, providers will have to help patients address the assumptions that enable get-it-out-of-the-way decision-making.

What, for example, is the "it" in "get-it-out-of-the-way" thinking? The pain or consequence one wishes to avoid are often moving, even unknowable, targets. In pathological anxiety states, estimations of what “it” is are part of what goes awry. Patients with phobias consistently overestimate the degree of unpleasantness of a particular exposure.

The entire article is here.

Sunday, May 4, 2014

Securing money for research is hard for everyone – but then there's the sexism

Anonymous Academic
The Guardian
Originally published April 15, 2014

Here is an excerpt:

As anyone who has ever applied for research funding will know, getting research money is hard. Only 30% of applicants to major research councils are successful, making it a highly competitive process.

But a growing body of literature suggests that getting research funding may be additionally difficult for women, as the peer review process is rife with sexism.

The entire article is here.

Saturday, May 3, 2014

The States With the Worst Healthcare Systems

Nearly a quarter of West Virginians have lost six or more teeth, and other findings from a new Commonwealth Fund report.

By Olga Khazan
The Atlantic
Originally published May 1, 2014

Here is an excerpt:

Healthcare in Mississippi and in other Southern states is unlikely to become more equitable anytime soon, however. As the study authors note, 16 of the states in the bottom half of the ranking have opted not to expand Medicaid under the Affordable Care Act to adults making up to 138 percent of the federal poverty level.

The entire article is here.

Religiosity, Political Orientation, and Consequentialist Moral Thinking

By Jared Piazza and Paulo Sousa
Social Psychological and Personality Science April 2014 vol. 5 no. 3 334-342


Three studies demonstrated that the moral judgments of religious individuals and political conservatives are highly insensitive to consequentialist (i.e., outcome-based) considerations. In Study 1, both religiosity and political conservatism predicted a resistance toward consequentialist thinking concerning a range of transgressive acts, independent of other relevant dispositional factors (e.g., disgust sensitivity). Study 2 ruled out differences in welfare sensitivity as an explanation for these findings. In Study 3, religiosity and political conservatism predicted a commitment to judging “harmless” taboo violations morally impermissible, rather than discretionary, despite the lack of negative consequences rising from the act. Furthermore, non-consequentialist thinking style was shown to mediate the relationship religiosity/conservatism had with impermissibility judgments, while intuitive thinking style did not. These data provide further evidence for the influence of religious and political commitments in motivating divergent moral judgments, while highlighting a new dispositional factor, non-consequentialist thinking style, as a mediator of these effects.

The entire article is here.

Friday, May 2, 2014

Justice and Bad Luck

Stanford Encyclopedia of Philosophy
First published Mon Jun 20, 2005; substantive revision Fri Apr 11, 2014

Some people end up worse off than others partly because of their bad luck. For instance, some die young due to a genetic disease, whereas others live long lives. Are such differential luck induced inequalities unjust? Many are inclined to answer this question affirmatively. To understand this inclination, we need a clear account of what luck involves. On some accounts, luck nullifies responsibility. On others, it nullifies desert. It is often said that justice requires luck to be ‘neutralized’. However, it is contested whether a distributive pattern that eliminates the influence of luck can be described. Thus an agent's level of effort—something few would initially see as a matter of luck—might be inseparable from her level of talent—something most would initially see as a matter of luck— and this might challenge standard accounts of just deviation from equality (or, for that matter, other favored distributive patterns). Critically, relational egalitarians argue that so-called luck egalitarians' preoccupation with eliminating inequalities reflecting differential bad luck misconstrues justice, which, according to the former, is a matter of social relations having a suitably egalitarian character.

The entire entry is here.

Q&A: Why 40% of us think we're in the top 5%

By Christie Nicholson
Originally published April 15, 2014

Here are two excerpt:

Since then Dunning has performed many studies on incompetence. And he has uncovered something particularly disturbing: We humans are terrible at self-assessment, often grading ourselves as far more intelligent and capable than we actually are. This widespread inability can lead to negative consequences for management and for recognizing genius.


Giving feedback especially in the workplace is a very touchy situation, and companies make reviews more touchy by directly connecting it to things like pay raises. There are two reasons people may not be receptive to feedback: One is it’s going to come as a complete surprise to them, because they probably don’t know what their weaknesses are, second is that it’s just a natural human tendency to be defensive.

So, you have to work around that. There are three different things you can do as a manager. The first thing is if you are going to give feedback make sure that it’s about a person’s behavior or their actions. Do not make it about their character or their ability.

The entire article is here.

Thursday, May 1, 2014

Hospice and Access to Medications - New CMS Guidance

Center for Medicare Advocacy
Originally posted April 10, 2014

Here are some excerpts:


Medications that should be covered by the Medicare Hospice Benefit are sometimes paid for by the insurance companies that administer Medicare Part D plans.  To prevent this from happening, effective May 1, 2014, all prescribed medications for hospice patients billed to Medicare Part D will initially be denied coverage.  To get their medications, hospice patients will have to initiate and ultimately succeed at a Medicare appeal.  In other words, to protect insurance companies, dying patients will have to jump through hoops to get medically necessary, potentially life-sustaining medications.



This burden-shifting to the dying patient is illogical and immoral.

CMS has erred in assuming that most hospice patients will not continue to have Part D covered medications.  Most older Americans are on medications for chronic conditions, and some of these medications...

The entire article is here.

Thanks to Deborah Derrickson Kossmann for this information.

Belgium: accelerating down the slippery slope

By Michael Cook
Careful! A blog about end-of-life issues
Originally published April 13, 2014

Here is an excerpt:

The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable”.

“Shortening the dying process” is a euphemism for administering a lethal injection.

Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia”. Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.

The entire story is here.

Thanks to Eric Affsprung for this information.