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

Monday, November 30, 2015

Lessons in End-of-Life Care From the V.A.

By David Casarett
The New York Times
November 11, 2015

Here are two excerpts:

Sheila had just received a “patient experience” survey that asked for her opinions about her recent stay in one of our hospitals. He read off some of the questions, in a voice that was tinged with a mix of anger and amusement. Those questions were about the quality of the food (“unimpressive”), the availability of parking (“O.K.”), and the cleanliness of the rooms (“perfect”).

But, he said, “You didn’t ask us about what really matters.”

What he meant, he explained, was that these questions didn’t reflect what was important to a 73-year-old woman with incurable breast cancer who knows she’s going to die in the next six months. And they didn’t assess how well we were supporting her husband, who was overwhelmed with being a caregiver and advocate, a father and grandfather. We asked for their opinions, but we didn’t ask the right questions.


We need to be asking these questions. National surveys could easily be modified to include questions that are important to patients like Sheila. We could include questions about emotional and spiritual support, control over decisions, adequacy of information and respect for dignity. Those sorts of questions are arguably important for all of us, but they’re particularly relevant to those who are facing advanced, incurable illnesses.

The entire article is here.

Moral cleansing and moral licenses: experimental evidence

Pablo Brañas-Garzaa, Marisa Buchelia, María Paz Espinosa and Teresa García-Muñoz
Economics and Philosophy / Volume 29 / Special Issue 02 / July 2013, pp 199-212


Research on moral cleansing and moral self-licensing has introduced dynamic considerations in the theory of moral behavior. Past bad actions trigger negative feelings that make people more likely to engage in future moral behavior to offset them. Symmetrically, past good deeds favor a positive self-perception that creates licensing effects, leading people to engage in behavior that is less likely to be moral. In short, a deviation from a “normal state of being” is balanced with a subsequent action that compensates the prior behavior. We model the decision of an individual trying to reach the optimal level of moral self-worth over time and show that under certain conditions the optimal sequence of actions follows a regular pattern which combines good and bad actions. We conduct an economic experiment where subjects play a sequence of giving decisions (dictator games) to explore this phenomenon. We find that donation in the previous period affects present decisions and the sign is negative: participants’ behavior in every round is negatively correlated to what they did in the past. Hence donations over time seem to be the result of a regular pattern of self-regulation: moral licensing (being selfish after altruist) and cleansing (altruistic after selfish).

The entire article is here.

Sunday, November 29, 2015

You’re not as virtuous as you think

By Nitin Nohria
The Washington Post
Originally published October 15, 2015

Moral overconfidence is on display in politics, in business, in sports — really, in all aspects of life. There are political candidates who say they won’t use attack ads until, late in the race, they’re behind in the polls and under pressure from donors and advisers, their ads become increasingly negative. There are chief executives who come in promising to build a business for the long-term but then condone questionable accounting gimmickry to satisfy short-term market demands. There are baseball players who shun the use of steroids until they age past their peak performance and start to look for something to slow the decline. These people may be condemned as hypocrites. But they aren’t necessarily bad actors. Often, they’ve overestimated their inherent morality and underestimated the influence of situational factors.

Moral overconfidence is in line with what studies find to be our generally inflated view of ourselves. We rate ourselves as above-average drivers, investors and employees, even though math dictates that can’t be true for all of us. We also tend to believe we are less likely than the typical person to exhibit negative qualities and to experience negative life events: to get divorced, become depressed or have a heart attack.

The entire article is here.

Saturday, November 28, 2015

Penn study: Pay patients to take their pills

By Tom Avril
Originally posted November 8, 2015

Here are two excerpt:

While the field of medicine has moved increasingly toward paying doctors for performance, there has been little controlled research on whether it works. Studies of patients, meanwhile, have found that incentives can encourage healthy behaviors such as giving up cigarettes.

But in a study of 1,503 patients announced Sunday, the Penn team reported that the most effective approach, at least where statins are concerned, may be to reward both patient and physician.

"In some respects, it takes two to tango," said lead author David A. Asch, a professor at Penn's Perelman School of Medicine.


Even if money helps, the notion of paying people to do the right thing may rub some the wrong way.

"We shouldn't have to," said Bobbi Cecco, president of the Hackensack, N.J., chapter of the Mended Hearts patient support group. "But if that's what it comes down to . . ."

Wei, the Michigan physician, said she already is motivated to help her patients stick with their medicine.

"Financial incentives wouldn't change my values or patient care," she said. "I am also an idealist."

The entire article is here.

Friday, November 27, 2015

Neuroscience: Tortured reasoning

Lasana T. Harris
Nature 527, 35–36 (05 November 2015) doi:10.1038/527035a
Published online 04 November 2015

In 2009, following the abuse of prisoners at its Guantanamo Bay detention camp, the US government made a significant decision. It moved the responsibility for 'enhanced interrogation techniques' from the CIA to a new government organization: the High-Value Detainee Interrogation Group (HIG). The move upset many CIA insiders; torture had been in their toolkit since the early days of the cold war. The remarks of one official at a HIG-organized conference on torture in Washington DC can be summed up as: how could a new agency, created to both conduct and study torture, replace the decades of practice and perfection attained by the CIA? By adding a scientific component, responded the newly appointed head of the HIG.

This exchange highlights the theme of neuroscientist Shane O'Mara's Why Torture Doesn't Work. Rightly, O'Mara takes a moral stand against torture (forced retrieval of information from the memories of the unwilling). However, instead of simply providing utilitarian arguments, he argues that there is no evidence from psychology or neuroscience for many of the specious justifications of torture as an information-gathering tool. Providing an abundance of gruesome detail, O'Mara marshals vast, useful information about the effects of such practices on the brain and the body.

(Underline provided by me.)

The entire book review is here.

Thursday, November 26, 2015

Inability and Obligation in Moral Judgment

Wesley Buckwalter and John Turri
Published: August 21, 2015
DOI: 10.1371/journal.pone.0136589


Morality is central to human social life [1–3]. Fulfilling moral obligations often requires us to put other people’s interests before our own. Sometimes this is easy, but other times it is hard. For example, it is plausible we are obligated to alleviate terrible suffering if we can do so at very little cost to ourselves, as happens when we donate money to famine relief or vaccination programs. But how far does this obligation extend? Some argue that it extends to the point where we would be making ourselves worse off than the people receiving charitable aid [4]. Many have found this suggestion implausible, sometimes on the grounds that the requirements for morality are limited by our psychology [5–7]. Given the way we are constituted, perhaps we are simply incapable of donating that much. This raises an important question: how demanding is morality and what are the limits of moral requirements?

According to a longstanding principle of moral philosophy, moral requirements are limited by ability. This is often glossed by the slogan that “ought implies can” (hereafter “OIC” for short). The principle says that one is obliged to perform an action only if one can perform the action. Support for OIC can be traced back to at least Cicero [8]. A more explicit articulation comes from Immanuel Kant, who writes, “Duty commands nothing but what we can do,” and that, “If the moral law commands that we ought to be better human beings now, it inescapably follows that we must be capable of being better human beings”.

The entire article is here.

Wednesday, November 25, 2015

The ‘blame and shame society’

Jean Knox
Psychoanalytic Psychotherapy
Volume 28, Issue 3, 2014


In this opinion piece, I explore some of the social and cultural factors that contribute to the creation of feelings of shame in those members of society who are vulnerable or disadvantaged in various ways. I suggest that a ‘blame and shame’ attitude has become pervasive in today's political culture, reassuring the comfortable and privileged that they deserve their own success and allowing them to blame the disadvantaged for their own misfortune. Those who feel that they must become invulnerable in order to succeed therefore project their own vulnerable child onto the vulnerable in our society and attack and condemn in others what they most fear in themselves.


One of the most intractable problems all therapists encounter is shame – the persistent negative sense of self that is evident when patients persist in describing themselves as disgusting, bad, dirty and all the other words of self-loathing which reflect a deeply painful self-hatred that the person clings to in spite of all attempts to shift it. These feelings are often accompanied by self-harm of various kinds – repeated cutting or overdosing, alcohol or drug abuse, eating disorders and by difficulty in affect regulation, mentalisation, attachment and sexuality.

An understanding of the unique personal relationships that have contributed to this kind of self-disgust and shame is vital if psychotherapists are to help their patients as effectively as possible. Herman (1992) first identified this as one key part of complex PTSD, suggesting that it arises from chronic developmental trauma.

The entire article is here.

Americans With Government Health Plans Most Satisfied

by Rebecca Riffkin
Originally published November 6, 2015

Americans' satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with veterans or military health insurance, Medicare and Medicaid, and is lower among those with employer-paid and self-paid insurance. Americans with no health insurance are least satisfied of all.


  • Uninsured Americans least satisfied with health system
  • Those with veterans or military insurance most satisfied
  • Self-insured less satisfied than others who have insurance

Tuesday, November 24, 2015

Genetically enhance humanity or face extinction - PART 2

Julian Savulescu presents at Sydney's Festival of Dangerous Ideas

In his talk at the Festival of Dangerous Ideas (Sydney Opera House), philosopher and bioethicist Julian Savulescu examines the nature of human beings as products of evolution, in particular their limited altruism, limited cooperative instincts and limited ability to take account of the future consequences of actions. He argues that humans' biology and psychology are unfit for the kind of society we live in and we must either alter our political institutions, severely restrain our technology or change our nature. Or face annihilation by our own design.

Genetically enhance humanity or face extinction - PART 1

Julian Savulescu presents at Sydney's Festival of Dangerous Ideas

In his talk at the Festival of Dangerous Ideas (Sydney Opera House), philosopher and bioethicist Julian Savulescu examines the nature of human beings as products of evolution, in particular their limited altruism, limited cooperative instincts and limited ability to take account of the future consequences of actions. He argues that humans' biology and psychology are unfit for the kind of society we live in and we must either alter our political institutions, severely restrain our technology or change our nature. Or face annihilation by our own design.

Monday, November 23, 2015

Moral Cleansing

Colin West and Chen-Bo Zhong
Current Opinion in Psychology
Available online 3 November 2015

Moral cleansing describes behaviors aimed at restoring moral self-worth in response to past transgressions. People are motivated to maintain a moral self-image and to eliminate apparent gaps between their perceived self-image and their desired moral self. Moral cleansing behaviors fall into three over-arching categories. Restitution cleansing behaviors directly resolve past misdeeds. Behavioral cleansing involves counter-balancing across multiple dimensions of the moral self whereby threats in one sub-domain are alleviated by bolstering a separate sub-domain. Symbolic cleansing includes restitution behaviors that are only symbolically connected to the provoking moral threat, such as physical or ritual cleansing. The moral cleansing literature seeks to understand these seemingly erratic sequences of compensatory behaviors.

“Every saint has a past, and every sinner has a future.” -Oscar Wilde

• We review the literature on the psychology of moral cleansing.
• There are three categories: restitution, behavioral, and symbolic cleansing.
• The psychological mechanism is based on a malleable moral self-image.
• Moral cleansing examines the implications of sequential ethical decision-making.

The entire article is here.

Treatment-resistant depression and physician-assisted death

By Franklin G Miller
J Med Ethics doi:10.1136/medethics-2015-103060


In a recent article, Udo Schuklenk and Suzanne van de Vathorst argued in favour of a legal option of physician-assisted death for patients with ‘treatment-resistant’ depression. In this commentary, I contend that their argument neglects the important consideration of the professional integrity of physicians. In light of this consideration, coupled with uncertainty about whether additional interventions with the patient can improve quality of life and restore the will to live, it is not appropriate to include patients with ‘treatment-resistant’ depression within a legal option of physician-assisted death.

The entire article is here.

Sunday, November 22, 2015

A Driverless Car Dystopia? Technology and the Lives We Want to Live

By Anthony Painter
Originally published November 6, 2015

Here is an excerpt:

There needs to be a bigger public debate about the type of society we want, how technology can help us, and what institutions we need to help us all interface with the changes we are likely to see. Could block-chain, bitcoin and digital currencies help us spread new forms of collective ownership and give us more power over the public services we use? How do we find a sweet-spot where consumers and workers – and we are both - share equally in the benefits of the ‘sharing economy’? Is a universal Basic Income a necessary foundation for a world of varying frequency and diverse work arrangements and obligations to others such as elderly relatives and our kids? What do we want to be private and what are we happy to share with companies or the state? Should this be a security conversation or bigger question of ethics? How should we plan transport, housing, work and services around our needs and the types of lives we want to live in communities that have human worth?

The entire article is here.

Saturday, November 21, 2015

How to Live a Lie

By William Irwin
The New York Times
Originally published November 2, 2015

Here is an excerpt:

The philosopher Michael Ruse has argued that “morality is a collective illusion foisted upon us by our genes.” If that’s true, why have our genes played such a trick on us? One possible answer can be found in the work of another philosopher Richard Joyce, who has argued that this “illusion” — the belief in objective morality — evolved to provide a bulwark against weakness of the human will. So a claim like “stealing is morally wrong” is not true, because such beliefs have an evolutionary basis but no metaphysical basis. But let’s assume we want to avoid the consequences of weakness of will that would cause us to act imprudently. In that case, Joyce makes an ingenious proposal: moral fictionalism.

Following a fictionalist account of morality, would mean that we would accept moral statements like “stealing is wrong” while not believing they are true. As a result, we would act as if it were true that “stealing is wrong,” but when pushed to give our answer to the theoretical, philosophical question of whether “stealing is wrong,” we would say no. The appeal of moral fictionalism is clear. It is supposed to help us overcome weakness of will and even take away the anxiety of choice, making decisions easier.

The entire article is here.

Friday, November 20, 2015

Exemptions for child abuse reporting weighed

Jessica Masulli Reyes
The (Wilmington, Del.) New Journal
Originally published November 9, 2015

A Delaware judge is considering the constitutionality of a state law that exempts priests from being required to report suspected child abuse disclosed during confessions — and, if the law is constitutional, whether it should protect elders in a Jehovah's Witnesses congregation.

The Attorney General's Office filed a lawsuit against the Laurel Delaware Congregation of Jehovah's Witnesses last year alleging two elders failed to report to state authorities a sexual relationship between a woman and a 14-year-old boy, both of whom were members of the congregation.

State law says individuals and organizations must report suspected child abuse and neglect immediately via a 24-hour state hotline, unless they learn of the abuse in an attorney-client setting or "that between priest and penitent in a sacramental confession."

The entire article is here.

Should Doctors Be Tested for Competence at Age 65?

By Leigh Page
Originally published October 28, 2015

Should older physicians be forced to stop practicing once they begin to slow down? Some experts in competency testing are calling for doctors to be evaluated as early as age 65, arguing that that's when physical and mental disabilities start to become apparent.

A few hospitals have already started evaluating physicians in their 70s for competency. When results show significant impairment, these physicians are required to get remediation, submit to limitations of their privileges, or retire completely, depending on the severity of the impairment.

Some experts argue that the cutoff age for these exams should be 65 years, which would have a huge impact on America's doctors. Owing to the baby boom, 240,000 doctors are now in that age group—a fourfold increase since 1975, according to the American Medical Association (AMA).

In June 2015, delegates to the AMA decided to bring together stakeholders to create guidelines for such testing. But other physician groups are still on the fence, and the issue divides the medical community.

The entire article is here.

Thursday, November 19, 2015

Is moral bioenhancement dangerous?

Nicholas Drake
J Med Ethics doi:10.1136/medethics-2015-102944


In a recent response to Persson and Savulescu's Unfit for the Future, Nicholas Agar argues that moral bioenhancement is dangerous. His grounds for this are that normal moral judgement should be privileged because it involves a balance of moral subcapacities; moral bioenhancement, Agar argues, involves the enhancement of only particular moral subcapacities, and thus upsets the balance inherent in normal moral judgement. Mistaken moral judgements, he says, are likely to result. I argue that Agar's argument fails for two reasons. First, having strength in a particular moral subcapacity does not necessarily entail a worsening of moral judgement; it can involve strength in a particular aspect of morality. Second, normal moral judgement is not sufficiently likely to be correct to be the standard by which moral judgements are measured.

The entire article is here.

With Sobering Science, Doctor Debunks 12-Step Recovery

Interview with Lance Dodes
Originally posted March 23, 2014

Here is an excerpt:

There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don't seem to know that because it's not widely publicized. ... There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.

It's not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we'd say OK. But it's harmful to the 90 percent who don't do well. And it's harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it's you that's failed.

Wednesday, November 18, 2015

Religious upbringing associated with less altruism, study finds

By Susie Allen
University of Chicago News
Originally released November 5, 2015

Here is an excerpt:

Consistent with previous studies, in general the children were more likely to share as they got older. But children from households identifying as Christian and Muslim were significantly less likely than children from non-religious households to share their stickers. The negative relation between religiosity and altruism grew stronger with age; children with a longer experience of religion in the household were the least likely to share.

Children from religious households favored stronger punishments for anti-social behavior and judged such behavior more harshly than non-religious children. These results support previous studies of adults, which have found religiousness is linked with punitive attitudes toward interpersonal offenses.

The entire article is here. 

The Power of Nudges, for Good and Bad

By Richard Thaler
The New York Times - The Upshot
Originally published October 31, 2015

Here are two excerpts:

Whenever I’m asked to autograph a copy of “Nudge,” the book I wrote with Cass Sunstein, the Harvard law professor, I sign it, “Nudge for good.” Unfortunately, that is meant as a plea, not an expectation.

Three principles should guide the use of nudges:

■ All nudging should be transparent and never misleading.

■ It should be as easy as possible to opt out of the nudge, preferably with as little as one mouse click.

■ There should be good reason to believe that the behavior being encouraged will improve the welfare of those being nudged.


Some argue that phishing — or evil nudging — is more dangerous in government than in the private sector. The argument is that government is a monopoly with coercive power, while we have more choice in the private sector over which newspapers we read and which airlines we fly.

I think this distinction is overstated. In a democracy, if a government creates bad policies, it can be voted out of office. Competition in the private sector, however, can easily work to encourage phishing rather than stifle it.

One example is the mortgage industry in the early 2000s. Borrowers were encouraged to take out loans that they could not repay when real estate prices fell. Competition did not eliminate this practice, because it was hard for anyone to make money selling the advice “Don’t take that loan.”

The entire article is here.

Tuesday, November 17, 2015

Doctors, Patients, and Nudging in the Clinical Context-Four Views on Nudging and Informed Consent

Ploug T and Holm S
Am J Bioeth. 2015 Oct;15(10):28-38.


In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.

The entire article is here.

Two Psychologists Charged in $25.2 Million Fraud Scheme Involving Psychological Testing in Gulf Coast States

FBI Press Release
Originally released October 22, 2015

Two clinical psychologists were charged today with participating in a $25 million Medicare fraud scheme involving psychological testing in nursing homes in Gulf Coast states.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael J. Anderson of the FBI’s New Orleans Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office made the announcement.

Beverly Stubblefield, Ph.D., 62, of Slidell, Louisiana, and John Teal, Ph.D., 46, of Jackson, Mississippi, were charged by a superseding indictment with conspiracy to commit health care fraud and conspiracy to make false statements related to health care matters. Two other defendants, Rodney Hesson, Psy.D., 46, and Gertrude Parker, 62, both of Slidell, were charged in the initial indictment returned in June 2015 in connection with a large-scale Medicare Fraud takedown, and were also charged in today’s superseding indictment.

According to the superseding indictment, Hesson and Parker owned and controlled Nursing Home Psychological Service (NHPS) and Psychological Care Services (PCS), each of which operated in Louisiana, Mississippi, Florida and Alabama. The superseding indictment alleges that NHPS and PCS contracted with nursing homes in these states to allow NHPS and PCS clinical psychologists, including Stubblefield, Teal and Hesson, to administer to nursing home residents psychological tests and related services that were not necessary and, in some instances, never provided.

According to the superseding indictment, between 2009 and 2015, NHPS and PCS submitted more than $25.2 million in claims to Medicare. Medicare paid approximately $17 million on those claims.

The entire pressor is here.

Monday, November 16, 2015

Believing What You Don’t Believe

By Jane L. Risen and David Nussbaum
The New York Times - Gray Matter
Originally published October 30, 2015

Here is an excerpt:

But as one of us, Professor Risen, discusses in a paper just published in Psychological Review, many instances of superstition and magical thinking indicate that the slow system doesn’t always behave this way. When people pause to reflect on the fact that their superstitious intuitions are irrational, the slow system, which is supposed to fix things, very often doesn’t do so. People can simultaneously recognize that, rationally, their superstitious belief is impossible, but persist in their belief, and their behavior, regardless. Detecting an error does not necessarily lead people to correct it.

This cognitive quirk is particularly easy to identify in the context of superstition, but it isn’t restricted to it. If, for example, the manager of a baseball team calls for an ill-advised sacrifice bunt, it is easy to assume that he doesn’t know that the odds indicate his strategy is likely to cost his team runs. But the manager may have all the right information; he may just choose not to use it, based on his intuition in that specific situation.

The entire article is here.

Believing What We Do Not Believe: Acquiescence to Superstitious Beliefs and Other Powerful Intuitions

By Risen, Jane L.
Psychological Review, Oct 19 , 2015


Traditionally, research on superstition and magical thinking has focused on people’s cognitive shortcomings, but superstitions are not limited to individuals with mental deficits. Even smart, educated, emotionally stable adults have superstitions that are not rational. Dual process models—such as the corrective model advocated by Kahneman and Frederick (2002, 2005), which suggests that System 1 generates intuitive answers that may or may not be corrected by System 2—are useful for illustrating why superstitious thinking is widespread, why particular beliefs arise, and why they are maintained even though they are not true. However, to understand why superstitious beliefs are maintained even when people know they are not true requires that the model be refined. It must allow for the possibility that people can recognize—in the moment—that their belief does not make sense, but act on it nevertheless. People can detect an error, but choose not to correct it, a process I refer to as acquiescence. The first part of the article will use a dual process model to understand the psychology underlying magical thinking, highlighting features of System 1 that generate magical intuitions and features of the person or situation that prompt System 2 to correct them. The second part of the article will suggest that we can improve the model by decoupling the detection of errors from their correction and recognizing acquiescence as a possible System 2 response. I suggest that refining the theory will prove useful for understanding phenomena outside of the context of magical thinking.

The article is here.

Sunday, November 15, 2015

Morality takes two: Dyadic morality and mind perception.

Gray, Kurt; Wegner, Daniel M.
Mikulincer, Mario (Ed); Shaver, Phillip R. (Ed), (2012). The social psychology of morality: Exploring the causes of good and evil. Herzliya series on personality and social psychology., (pp. 109-127). Washington, DC, US: American Psychological Association


We propose that all moral acts are (at least implicitly) dyadic, involving two different people, one as a moral agent and one as a moral patient. The idea that people cleave the moral world into agents and patients is as old as Aristotle (Freeland, 1985), but out of this simple claim—that morality takes two—grows a theory of morality with a host of implications for psychology and the real world. Dyadic morality can help explain, for instance, why victims escape blame, why people believe in God, why people harm saints, why some advocate torture, and why those who do good become more physically powerful. In this chapter, we explore the idea of dyadic morality, its extensions and implications. In particular, we examine the following four tenets of dyadic morality: 1. Morality involves a moral agent helping or harming a moral patient. 2. Morality and mind perception are linked: Agency is tied to moral agents; experience is tied to moral patients. 3. Morality requires a complete dyad: An isolated moral agent creates a moral patient; an isolated moral patient creates a moral agent. 4. Morality requires two different people as agent and patient, which means that people are perceived as either agents or patients, both in moral acts and more generally, a phenomenon called moral typecasting. We first explore the link between mind and morality, then examine dyadic help and harm, then explain how moral dyads complete themselves, and finally consider moral typecasting. Why start first with mind perception? Perceptions of mind are tightly bound to moral judgments, and as we show, the structure of mind perception is split into two complementary parts that correspond to the two parts of morality. Perceptions of mind underlie the most fundamental of moral decisions: who deserves moral rights and who deserves moral responsibility.

A copy of the chapter is here.

Saturday, November 14, 2015

The Strange Case of Anna Stubblefield

By Daniel Engber
The New York Times Magazine
Originally published October 20, 2015

Here are two excerpts:

Then there was a lull in the conversation after Wesley came back in, and Anna took hold of D.J.’s hand. ‘‘We have something to tell you,’’ they announced at last. ‘‘We’re in love.’’

‘‘What do you mean, in love?’’ P. asked, the color draining from her face.

To Wesley, she looked pale and weak, like ‘‘Caesar when he found out that Brutus betrayed him.’’ He felt sick to his stomach. What made them so uncomfortable was not that Anna was 41 and D.J. was 30, or that Anna is white and D.J. is black, or even that Anna was married with two children while D.J. had never dated anyone. What made them so upset — what led to all the arguing that followed, and the criminal trial and million-­dollar civil suit — was the fact that Anna can speak and D.J. can’t; that she was a tenured professor of ethics at Rutgers University in Newark and D.J. has been declared by the state to have the mental capacity of a toddler.


Sitting at the keyboard, D.J. also seemed to have a lot to say. His messages were simple and misspelled at first, but his skill and fluency improved. Eventually he could hit a letter every second, and if Anna guessed the word before he finished typing, he would hit the ‘‘Y’’ key to confirm. Anna brought books for him to read, Maya Angelou and others, and discovered that he read like a savant — 10 pages every minute. (She turned the pages for him.) They discussed the possibility of his enrolling in a G.E.D. program.

As D.J. came into his own, Anna kept her mother posted on his progress. In the spring of 2010, Sandra asked if D.J. might like to give a paper for a panel she was organizing at a conference of the Society for Disability Studies in Philadelphia. The panel was on Article 21 of the United Nations Convention on the Rights of Persons With Disabilities, which lays out the right to freedom of expression and opinion. D.J. wasn’t sure he could do it, Anna said, but she convinced him he should try.

The entire article is here.

Note to readers: The article is long, detailed and (from my perspective) creepy. This case appears to demonstrate where compassion and personal values override good judgment, research, and professional responsibilities.

Friday, November 13, 2015

Why Self-Driving Cars Must Be Programmed to Kill

Emerging Technology From the arXiv
MIT Technology Review
Originally published October 22, 2015

Here is an excerpt:

One way to approach this kind of problem is to act in a way that minimizes the loss of life. By this way of thinking, killing one person is better than killing 10.

But that approach may have other consequences. If fewer people buy self-driving cars because they are programmed to sacrifice their owners, then more people are likely to die because ordinary cars are involved in so many more accidents. The result is a Catch-22 situation.

Bonnefon and co are seeking to find a way through this ethical dilemma by gauging public opinion. Their idea is that the public is much more likely to go along with a scenario that aligns with their own views.

The entire article is here.

Thursday, November 12, 2015

Neuroscientific Prediction and Free Will: What do ordinary people think?

By Gregg D. Caruso
Psychology Today Blog
Originally published October 26, 2015

Some theorists have argued that our knowledge of the brain will one day advance to the point where the perfect neuroscientific prediction of all human choices is theoretically possible. Whether or not such prediction ever becomes a reality, this possibility raises an interesting philosophical question: Would such perfect neuroscientific prediction be compatible with the existence of free will? Philosophers have long debated such questions. The historical debate between compatibilists and incompatibilists, for example, has centered on whether determinism and free will can be reconciled. Determinism is the thesis that every event or action, including human action, is the inevitable result of preceding events and actions and the laws of nature. The question of perfect neuro-prediction is just a more recent expression of this much older debate. While philosophers have their arguments for the compatibility or incompatibility of free will and determinism (or perfect neuroscientific prediction), they also often claim that their intuitions are in general agreement with commonsense judgments. To know whether this is true, however, we first need to know what ordinary folk think about these matters. Fortunately, recent research in psychology and experimental philosophy has begun to shed some light on this.

The entire article is here.

The Ethics of Killing Baby Hitler

By Matt Ford
The Atlantic
Originally published October 24, 2015

Here is an excerpt:

The strongest argument for removing Hitler from history is the Holocaust, since it can be directly tied to his existence. The exact mechanisms of the Holocaust—the Nuremburg laws, Kristallnacht, the death squads, the gas chambers, the forced marches, and more—are unquestionably the products of Hitler and his disciples, and they likely would not have existed without him. All other things being equal, a choice between Hitler and the Holocaust is an easy one.

But focusing on Hitler’s direct responsibility for the Holocaust blinds us to more disturbing truths about the early 20th century. His absence from history would not remove the underlying political ideologies or social movements that fueled his ascendancy. Before his rise to power, eugenic theories already held sway in Western countries. Anti-Semitism infected civic discourse and state policy, even in the United States. Concepts like ethnic hierarchies and racial supremacy influenced mainstream political thought in Germany and throughout the West. Focusing on Hitler’s central role in the Holocaust also risks ignoring the thousands of participants who helped carry it out, both within Germany and throughout occupied Europe, and on the social and political forces that preceded it. It’s not impossible that in a climate of economic depression and scientific racism, another German leader could also move towards a similar genocidal end, even if he deviated from Hitler’s exact worldview or methods.

The entire article is here.

Wednesday, November 11, 2015

Putting a price on empathy: against incentivising moral enhancement

By Sarah Carter
J Med Ethics 


Concerns that people would be disinclined to voluntarily undergo moral enhancement have led to suggestions that an incentivised programme should be introduced to encourage participation. This paper argues that, while such measures do not necessarily result in coercion or undue inducement (issues with which one may typically associate the use of incentives in general), the use of incentives for this purpose may present a taboo trade-off. This is due to empirical research suggesting that those characteristics likely to be affected by moral enhancement are often perceived as fundamental to the self; therefore, any attempt to put a price on such traits would likely be deemed morally unacceptable by those who hold this view. A better approach to address the possible lack of participation may be to instead invest in alternative marketing strategies and remove incentives altogether.

Tinkering with consciousness: Morality & Enhancement

Daniel Faggella
Published on Dec 8, 2014

This talk was given at a local TEDx event, produced independently of the TED Conferences. We live in a world where paralyzed people can answer emails with a chip in their brain, where people with severe depression can get electrodes implanted into their brain to increase their sense of well-being and joy, and where we're successfully experimenting with replacing portions of mammalian brains with digital devices. Humanity is on the verge of a "leap" into a future where consciousness is malleable, accessible, expandable. If nothing "matters" outside of conscious awareness, isn't tinkering with consciousness itself (the bedrock or moral relevance) worth an open-minded, well-intended, and interdisciplinary global conversation ... as we take steps forward beyond what is now "human?"

Tuesday, November 10, 2015

Federal judge says neuroscience is not ready for the courtroom--yet

By Kevin Davis
ABA Journal
Originally published October 20, 2015

Here is an excerpt:

Rakoff, who long has had an interest in neuroscience and is a founding member of the MacArthur Foundation Research Network on Law and Neuroscience, says that judges are still cautious about allowing neuroscientific evidence in court. Criminal lawyers, for example, have introduced brain scans to show a defendant’s brain dysfunction, most often as mitigation in death penalty hearings. Lawyers also have tried to introduce brain scans to prove the existence of pain and as evidence for lie detection.

“The attitude of judges toward neuroscience is one of ambivalence and skepticism,” Rakoff said. “You ask them about the hippocampus, they say it’s something at the zoo.”

The entire article is here.

Neuromodulation of Group Prejudice and Religious Belief

C. Holbrook, K. Izuma, C, Deblieck, D. Fessler, and M. Iacoboni
Social Cognitive and Affective Neuroscience (2015)
doi: 10.1093/scan/nsv107


People cleave to ideological convictions with greater intensity in the aftermath of threat. The posterior medial frontal cortex (pMFC) plays a key role in both detecting discrepancies between desired and current conditions and adjusting subsequent behavior to resolve such conflicts. Building on prior literature examining the role of the pMFC in shifts in relatively low-level decision processes, we demonstrate that the pMFC mediates adjustments in adherence to political and religious ideologies. We presented participants with a reminder of death and a critique of their in-group ostensibly written by a member of an out-group, then experimentally decreased both avowed belief in God and out-group derogation by down-regulating pMFC activity via transcranial magnetic stimulation. The results provide the first evidence that group prejudice and religious belief are susceptible to targeted neuromodulation, and point to a shared cognitive mechanism underlying concrete and abstract decision processes. We discuss the implications of these findings for further research characterizing the cognitive and affective mechanisms at play.

The entire article is here.

Monday, November 9, 2015

When Students Become Patients, Privacy Suffers

By Charles Ornstein
Originally published October 23, 2015

Here is an excerpt:

Yale Health’s website informs parents that they cannot access their child’s health information without a signed written consent form. Andrea said she does not recall signing that document. When she recently asked to see any such form, she said, she was told by the counseling center’s chief that there was none. “Most of what happened while I was in the hospital happened without my knowing it,” she said. “I got an update every day or two about where my life was going.”

Andrea’s case is a vivid demonstration of how weaknesses in state and federal laws — and the often-conflicting motives of students, parents, and college officials — have left patient privacy vulnerable when students receive medical treatment on campus.

Universities walk a fine line when providing that treatment or mental-health services to students. If campus officials don’t know what’s going on or disclose too little, they risk being blamed if a student harms himself, herself, or others. If they pry too deeply, they may be accused of invading privacy, thereby discouraging students from seeking treatment.

The entire article is here.

The Illusion of Free Will

Originally published on Jul 7, 2015

Daniel Do asked us to reconsider whether we are the authors of our own thoughts.

Daniel is a student deeply engaged in brain science and philosophy of mind. He is an aspiring neuroscientist, writer, educator, and science communicator. In his free time, he enjoys biking, meditating, composing music, reading books, debating with his friends and family, and being alone with his thoughts.

Sunday, November 8, 2015

Deconstructing the seductive allure of neuroscience explanations

Weisberg DS, Keil FC, Goodstein J, Rawson E, Gray JR.
Judgment and Decision Making, Vol. 10, No. 5, 
September 2015, pp. 429–441


Explanations of psychological phenomena seem to generate more public interest when they contain neuroscientific information. Even irrelevant neuroscience information in an explanation of a psychological phenomenon may interfere with people's abilities to critically consider the underlying logic of this explanation. We tested this hypothesis by giving naïve adults, students in a neuroscience course, and neuroscience experts brief descriptions of psychological phenomena followed by one of four types of explanation, according to a 2 (good explanation vs. bad explanation) x 2 (without neuroscience vs. with neuroscience) design. Crucially, the neuroscience information was irrelevant to the logic of the explanation, as confirmed by the expert subjects. Subjects in all three groups judged good explanations as more satisfying than bad ones. But subjects in the two nonexpert groups additionally judged that explanations with logically irrelevant neuroscience information were more satisfying than explanations without. The neuroscience information had a particularly striking effect on nonexperts' judgments of bad explanations, masking otherwise salient problems in these explanations.

The entire article is here.

Saturday, November 7, 2015

The End of Expertise

By Bill Fischer
Harvard Business Review
Originally published October 19, 2015

Here is an excerpt:

Increasingly, expertise is losing the respect that for years had earned it premiums in any market where uncertainty was present and complex knowledge valued. Along with it, we are shedding our reverence for “expert evaluation,” losing our regard for our Michelin guides and casting our lot in with the peer-generated Yelps of the world.

Not only is the character of expertise changing, but at the same time, new client needs are emerging. Firms are fearful of being vulnerable to an unknown (not uncertain) future; and at the same time, conditioned by living in an internet world, they expect instant knowledge responses at reasonable prices. Expertise providers are finding that the models that they have long relied upon (e.g., the familiar five forces model) are losing some of their potency, as they are based upon assumed knowledge that is increasingly difficult to determine (What industry are we in? Who are our competitors? What are our core-competencies?), and are more like time-lapse photography in presentation than the customer’s contemporary expectations of real-time, virtual streaming engagement.

The entire article is here.

Friday, November 6, 2015

People Don't Actually Want Equality

By Paul Bloom
The Atlantic
Originally published on October 22, 2015

Here is an excerpt:

Can Frankfurt really be right that people don’t value economic equality for its own sake? Many scholars believe otherwise. The primatologist Frans de Waal sums up a popular view when he writes: “Robin Hood had it right. Humanity’s deepest wish is to spread the wealth.”

In support of de Waal, researchers have found that if you ask children to distribute items to strangers, they are strongly biased towards equal divisions, even in extreme situations. The psychologists Alex Shaw and Kristina Olson told children between the ages of six and eight about two boys, Dan and Mark, who had cleaned up their room and were to be rewarded with erasers—but there were five of them, so an even split was impossible. Children overwhelmingly reported that the experimenter should throw away the fifth eraser rather than establish an unequal division. They did so even if they could have given the eraser to Dan or Mark without the other one knowing, so they couldn’t have been worrying about eliciting anger or envy.

It might seem as though these responses reflect a burning desire for equality, but more likely they reflect a wish for fairness. It is only because Dan and Mark did the same work that they should get the same reward. And so when Shaw and Olson told the children “Dan did more work than Mark,” they were quite comfortable giving three to Dan and two to Mark. In other words, they were fine with inequality, so long as it was fair.

The entire article is here.

Brain Gain: The Emerging Security and Ethical Challenges of Cognitive Enhancement

BY Nayef Al-Rodhan
Georgetown Journal of International Affairs 
Originally published July 2, 2015

The radically accelerating development of emerging strategic technologies (ESTs) poses important questions for the future of human societies.

On the one hand, ESTs promise great benefits. For example, newly developed forms of biotechnology, synthetic biology, and nanopharmaceuticals will begin to aid medical interventions, including those associated with psychological disorders. Drugs and nano-scaled mechanical delivery systems that enhance our memory and mental capacity will one day assist us in performing functions outside of our natural capabilities. On the other hand, cognitive enhancement presents us with numerous ethical dilemmas and raises fundamental questions about how we understand ourselves. Such ideas have until recently been consigned to the realm of the imagination, but the likelihood of having a roomful of superior beings with hyper-memory—or an army of them—is fast becoming technologically possible. These developments complicate longstanding debates in both philosophy and cognitive science. Cognitive enhancement questions our notions of self-understanding, as well as those aspects of our nature with which we tend to feel most familiar.

The entire article is here.

Thursday, November 5, 2015

A Code of Ethics for Health Care Ethics Consultants

Anita J. Tarzian & Lucia D. Wocial
American Journal of Bioethics 15 (5):38-51 (2015)


For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.

The entire paper is here.

The Funny Thing About Adversity

By David DeSteno
The New York Times
Originally published October 16, 2015

Here are several excerpts:

In both studies, the results were the same. Those who had faced increasingly severe adversities in life — loss of a loved one at an early age, threats of violence or the consequences of a natural disaster — were more likely to empathize with others in distress, and, as a result, feel more compassion for them. And of utmost importance, the more compassion they felt, the more money they donated (in the first study) or the more time they devoted to helping the other complete his work (in the second).

Now, if experiencing any type of hardship can make a person more compassionate, you might assume that the pinnacle of compassion would be reached when someone has experienced the exact trial or misfortune that another person is facing. Interestingly, this turns out to be dead wrong.


As a result of this glitch, reflecting on your own past experience with a specific misfortune will very likely cause you to under appreciate just how trying that exact challenge can be for someone else (or was, in fact, for you at the time). You overcame it, you think; so should he. The result? You lack compassion.

The entire article is here.

Wednesday, November 4, 2015

Psychological principles could explain major healthcare failings

Press Release
Bangor University
Originally released on

Here is an excerpt:

In the research paper, Dr Michelle Rydon-Grange who has just qualified as a Clinical Psychologist at the School of Psychology, applies psychological theory to find new understandings of the causes that lead to catastrophic failures in healthcare settings.  She explains that the aspect often neglected in inquiries is the role that human behaviour plays in contributing to these failures, and hopes that using psychological theories could prevent their reoccurrence in the future.

The value of psychological theory in safety-critical industries such as aviation and nuclear power has long been acknowledged and is based upon the notion that certain employee behaviours are required to maintain safety. However, the same is not yet true of healthcare.

Though there may not be obvious similarities between various healthcare scandals which have occurred in disparate areas of medicine over the last few decades, striking similarities in the conditions under which these crises occurred can be found, according to Rydon-Grange.

The entire pressor is here.

Only two sexes?

By Sarah Graham
The Independent
Originally posted October 17, 2015

Here is an excerpt:

It’s not surprising so many people are ignorant about us intersex people: Our very existence has been erased since the Roman Empire. It continued in the 20th century, as doctors got their scalpels out to “normalise” our bodies. In the last fifteen years, since some of us started finding our dissident voices and protesting, doctors have tried to rebrand us and said we have “Disorders of Sexual Development (DSDs)” - to legitimize their paternalism and on-going annihilation of our beings.

This is all to keep you - the public - in the dark. And to rigidly enforce the pink and blue boxes: the boring binary, straight-laced order. But let me bring you up-to-speed. There are not only the two sexes of male and female. This is an absolute barefaced lie. Nature produces bodies on a spectrum; a continuum of possibilities.

You have met one of us somewhere, for sure. As many as 1 in 1,500 babies is born visibly intersex, while many more are born not so obviously unique and interesting to the eye.

The entire article is here.

Tuesday, November 3, 2015

The neuroscience of moral cognition: from dual processes to dynamic systems

Jay J Van Bavel, Oriel FeldmanHall, Peter Mende-Siedlecki
Current Opinion in Psychology
Volume 6, December 2015, Pages 167–172

Prominent theories of morality have integrated philosophy with psychology and biology. Although this approach has been highly generative, we argue that it does not fully capture the rich and dynamic nature of moral cognition. We review research from the dual-process tradition, in which moral intuitions are automatically elicited and reasoning is subsequently deployed to correct these initial intuitions. We then describe how the computations underlying moral cognition are diverse and widely distributed throughout the brain. Finally, we illustrate how social context modulates these computations, recruiting different systems for real (vs. hypothetical) moral judgments, examining the dynamic process by which moral judgments are updated. In sum, we advocate for a shift from dual-process to dynamic system models of moral cognition.

The entire article is here.

Are MBAs to blame for VW and other business ethics fiascos?

By  Ethan Baron
Originally published October 22, 2015

Here is an excerpt:

So, what’s wrong with recent business people today? In an interview, Queen points to an over-emphasis on tolerance, that makes it very difficult for many people to even say something is wrong. Students are entering business schools “almost as kind of blank slates in terms of [their] ability to think about, to argue about, the good,” Queen says. “Even if they may have a business ethics class, that’s not reinforced by the other messages they’re getting either in the school, from their peers, perhaps even from the business world as a whole.”

While Queen sees what may be the start of a shift away from this line of thinking, he believes that in B-schools, students are generally still coming away with a belief that a return on investment trumps all other values. And within business programs, that ideology makes it difficult for students to swim against the current. Taking an alternate view can lead students to feel alone and alienated.

The entire article is here.

Monday, November 2, 2015

Many Antidepressant Studies Found Tainted by Pharma Company Influence

By Roni Jacobson
Scientific American
Originally published October 21, 2015

Here is an excerpt:

Almost 80 percent of meta-analyses in the review had some sort of industry tie, either through sponsorship, which the authors defined as direct industry funding of the study, or conflicts of interest, defined as any situation in which one or more authors were either industry employees or independent researchers receiving any type of industry support (including speaking fees and research grants). Especially troubling, the study showed about 7 percent of researchers had undisclosed conflicts of interest. “There’s a certain pecking order of papers,” says Erick Turner, a professor of psychiatry at Oregon Health & Science University who was not associated with the research. “Meta-analyses are at the top of the evidence pyramid.” Turner was “very concerned” by the results but did not find them surprising. “Industry influence is just massive. What’s really new is the level of attention people are now paying to it.”

The researchers considered all meta-analyses of randomized controlled trials for all approved antidepressants including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, atypical antidepressants, monoamine oxidase inhibitors and others published between 2007 and March 2014.

The entire article is here.

Does Disbelief in Free Will Increase Anti-Social Behavior?

By Gregg Caruso
Psychology Today Blog
Originally published October 16, 2015

Here is an excerpt:

Rather than defend free will skepticism, however, I would like to examine an important practical question: What if we came to disbelieve in free will and basic desert moral responsibility? What would this mean for our interpersonal relationships, society, morality, meaning, and the law? What would it do to our standing as human beings? Would it cause nihilism and despair as some maintain? Or perhaps increase anti-social behavior as some recent studies have suggested (more of this in a moment)? Or would it rather have a humanizing effect on our practices and policies, freeing us from the negative effects of free will belief? These questions are of profound pragmatic importance and should be of interest independent of the metaphysical debate over free will. As public proclamations of skepticism continue to rise, and as the media continues to run headlines proclaiming that free will is an illusion, we need to ask what effects this will have on the general public and what the responsibility is of professionals.

In recent years a small industry has actually grown up around precisely these questions. In the skeptical community, for example, a number of different positions have been developed and advanced—including Saul Smilansky’s illusionism, Thomas Nadelhoffer’s disillusionism, Shaun Nichols’ anti-revolution, and the optimistic skepticism of Derk Pereboom, Bruce Waller, and myself.

The entire article is here.

Sunday, November 1, 2015

The Illusion of Choice: Free Will and Determinism

By Vexen Crabtree
Science and Truth Versus Mass Confusion

1. Nothing Escapes the Laws of Physics

Free will is an illusion. Our amazingly, wonderfully complex brains are comprised of various cognitive systems cycling amongst themselves and generating our thoughts, consciousness, choices and behaviour. These systems and their effects all result from the mechanical, inorganic laws of physics, over which we have no control.

Consciousness is presented to us as a result of our neurons, our brains, our senses. When we lose these, we lose consciousness. These systems are governed and controlled by neurochemicals, hormones, ionisation, impulses: in short, by biochemistry. Biochemistry is in turn merely a type of chemistry, and when we look at the molecules and atoms that make up our chemistry, they obey the laws of physics.

Balls bouncing around a pool table have no free will. The basic chemicals that make up our bodies and minds have no free will. Neurons fire when they should fire, according to their electrochemical properties. They don't randomly fire: They fire when they're stimulated to fire by other neurons or by environmental inputs. Stimulation results from a constant biochemical cycle. These natural cycles determine our states of mind and our choices. Through a long and complicated series of cause and effect, our choices are made. As such, all our 'choices' are ultimately the result of impersonal and mechanical forces. There is no "free will force" that causes neurons to fire some times and not at others. They fire in accordance with the rules of physics, firmly beyond our control but not beyond our appreciation. These facts are proclaimed also by none other than the foremost physicist Albert Einstein:
“I do not at all believe in human freedom in the philosophical sense. Everybody acts not only under external compulsion but also in accordance with inner necessity.”
Albert Einstein (1954)
Sociologists and psychologists have studied the subliminal, subconscious and external factors that affect our behaviour, and a vast number of studies that have found that our behaviour is determined by outside agency but that we always think it is caused by our own will.

The entire blog entry is here.