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

Thursday, June 30, 2016

State's top physician endorses opioid education mandate

By Rich Lord
Pittsburgh Post-Gazette
Originally posted June 8, 2016

Pennsylvania’s top physician said today that legislation compelling most doctors to take refresher courses in proper narcotic prescribing won’t overburden her colleagues in medicine -- and could help to counter the opioid and heroin epidemic.

“The bill that’s being discussed would be requirements for two hours of opioid education,” said Physician General Rachel Levine. “But it would also count toward [every doctor’s] quality and safety [education] requirement.”

Some doctors have said they don’t want to be told which continuing education courses to take. “But I think that there are sometimes topics that are so necessary to get updated on that all physicians should get updated,” Dr. Levine said. Opioid prescribing is one such topic, she said, “because of the very serious nature of the epidemic.”

The article is here.

When regulators close a 'pill mill,' patients sometimes turn to heroin

By Rich Lord
Pittsburgh Post-Gazette
Originally published May 25, 2016

Here is an excerpt:

In late 2013, Maryland launched its prescription drug monitoring program, allowing — but not requiring — doctors to access a database to see the drug histories of their patients. Nearly every state has such a system, designed to thwart people who seek drugs from multiple doctors. Some state medical boards use the data to flag physicians whose prescribing goes out of bounds.

Maryland’s board, though, can’t tap into the data “without going through major legal hoops,” Dr. Singh said. Physician groups, he said, have opposed efforts to ease access, because they fear “over-policing.”

Maryland has not adopted official opioid prescribing guidelines, as some states have.

The article is here.

Wednesday, June 29, 2016

It’s time society discussed the ethical issues raised by the gene revolution

Linda Geddes
The Guardian
Originally posted June 11, 2016

Here is an excerpt:

Since the method was first published in 2012, CRISPR has swept through the scientific community. On Wednesday, the US National Academy of Sciences published a report on the transformative potential of one such application: genetic engineering technology called gene drive. Mosquitoes are currently being engineered with “gene drives” that could render female offspring sterile and potentially wipe species of mosquitoes off the planet .

The technology could also be used to eliminate invasive species such as Japanese knotweed or to reverse herbicide resistance and make agriculture more productive. Until now, such efforts have been stymied because in changing an organism’s DNA, you are reducing its ability to survive and reproduce, meaning the changes are eventually weeded out by natural selection. Gene drives overcome this by ensuring the changes are passed to all offspring. The technology could irreversibly alter entire ecosystems. Another potential application of CRISPR is growing human organs in pigs to meet the demand from transplant recipients. Already, genetically altered pig embryos have been injected with human cells, which it is hoped will develop into pancreases that could be transplanted into humans without the risk of rejection by the immune system.

The article is here.

The Meaning(s) of Situationism

Michelle Ciurria
Teaching Ethics 15:1 (Spring 2015)
DOI: 10.5840/tej201411310


This paper is about the meaning(s) of situationism. Philosophers have drawn various conclusions about situationism, some more favourable than others. Moreover, there is a difference between public reception of situationism, which has been very enthusiastic, and scholarly reception, which has been more cynical. In this paper, I outline what I take to be four key implications of situationism, based on careful scrutiny of the literature. Some situationist accounts, it turns out, are inconsistent with others, or incongruous with the logic of situationist psychology. If we are to teach students about situationism, we must first strive for relative consensus amongst experts, and then disseminate the results to philosophical educators in various fields.

The article is here.

Tuesday, June 28, 2016

California doctor opens end-of-life clinic

by Michael Cook
Originally published June 11, 2016

California’s right-to-die law was rolled out this week and at least one doctor immediately opened up a dedicated assisted suicide clinic in San Francisco.

At Bay Area End of Life Options, Dr Lonny Shavelson, a well-known advocate of assisted suicide, will advise people who are wondering whether they ought to end their lives.

Dr Shavelson denies that he will be operating a drive-in suicide service. He says that he wants to work with patients to explore all the legal and therapeutic options. "When somebody says to a physician that they want to talk about the End of Life Option Act and says, 'Can you give me a prescription that will end my life?' I want them to tell me why," he told the San Jose Mercury. "A major goal of physicians is to make this (prescription) not happen."

His fees will be US$200 for an initial consultation plus $1800 if the patient is qualified and wishes to continue.

The article is here.

Moral enhancements 2

By Michelle Ciurria
Moral Responsibility Blog
Originally published June 4, 2016

Here is an excerpt:

Here, I want to consider whether intended moral enhancements – those intended to induce pro-moral effects – can, somewhat paradoxically, undermine responsibility. I say ‘intended’ because, as we saw, moral interventions can have unintended (even counter-moral) consequences. This can happen for any number of reasons: the intervener can be wrong about what morality requires (imagine a Nazi intervener thinking that anti-Semitism is a pro-moral trait); the intervention can malfunction over time; the intervention can produce traits that are moral in one context but counter-moral in another (which seems likely, given that traits are highly context-sensitive, as I mentioned earlier); and so on – I won’t give a complete list. Even extant psychoactive drugs – which can count as a type of passive intervention – typically come with adverse side-effects; but the risk of unintended side-effects for futuristic interventions of a moral nature is substantially greater and more worrisome, because the technology is new, it operates on complicated cognitive structures, and it specifically operates on those structures constitutive of a person’s moral personality. Since intended moral interventions do not always produce their intended effects (pro-moral effects), I’ll discuss these interventions under two guises: interventions that go as planned and induce pro-moral traits (effective cases), and interventions that go awry (ineffective cases). I’ll also focus on the most controversial case of passive intervention: involuntary intervention, without informed consent.

The blog post is here.

Monday, June 27, 2016

In treating obese patients, too often doctors can’t see past weight

By Jennifer Adaeze Okwerkwu @JenniferAdaeze
Originally published June 3, 2016

Here is an excerpt:

An earlier survey of primary care physicians and cardiologists showed a similar pattern. Though heart disease is the leading cause of death among women, the study found only 39 percent of physicians were “extremely concerned” about this issue, whereas 48 percent of physicians were “extremely concerned” about women’s weight.

“We haven’t really thought about this before” but we need to explore the issue “because women are dying,” said study leader Dr. Noel Bairey Merz, medical director of the Barbra Streisand Women’s Heart Center at Cedars-Sinai Heart Institute.

It’s not just heart disease. Another study has found that other types of preventative care, including breast exams and pap smears, are often delayed by obese women. While obesity is associated with a variety of health conditions, if the medical profession fails to provide a safe space for patient care, these missed opportunities for intervention may be partly to blame.

The article is here.

Moral enhancements & moral responsibility

By Michelle Ciurria
Moral Responsibility Blog
Originally published May 25, 2016

Here is an excerpt:

What are our duties with respect to moral enhancements? We can approach this question from two directions: our individual duty to use or submit to moral interventions, and our duty to provide or administer them to people with moral deficits. This might seem to suggest a distinction between self-regarding duties and other-regarding duties, but this is a false dichotomy because the duty to enhance oneself is partly a duty to others – a duty to equip oneself to respect other people’s rights and interests. So both duties have an other-regarding dimension. The distinction I’m talking about is between duties to enhance oneself, and duties to enhance other other people: self-directed duties and other-directed duties.

These two duties also cannot be neatly demarcated because we might need to weigh self-directed duties against other-directed duties to achieve a proper balance. That is, given finite time and resources, my duty to enhance myself in some way might be outweighed by my duty to foster the capabilities of another person. So we need to work out a proper balance, and different normative frameworks will provide different answers. All frameworks, however, seem to support these two kinds of duties, though they balance them differently.

The article is here.

Sunday, June 26, 2016

Moral Chivalry: Gender and Harm Sensitivity Predict Costly Altruism

Oriel FeldmanHall, Tim Dalgleish, Davy Evans, Lauren Navrady, Ellen Tedeschi, & Dean Mobbs
Social Psychological and Personality Science May 25, 2016


Moral perceptions of harm and fairness are instrumental in guiding how an individual navigates moral challenges. Classic research documents that the gender of a target can affect how people deploy these perceptions of harm and fairness. Across multiple studies, we explore the effect of an individual’s moral orientations (their considerations of harm and justice) and a target’s gender on altruistic behavior. Results reveal that a target’s gender can bias one’s readiness to engage in harmful actions and that a decider’s considerations of harm—but not fairness concerns—modulate costly altruism. Together, these data illustrate that moral choices are conditional on the social nature of the moral dyad: Even under the same moral constraints, a target’s gender and a decider’s gender can shift an individual’s choice to be more or less altruistic, suggesting that gender bias and harm considerations play a significant role in moral cognition.

The article is here.

Saturday, June 25, 2016

The Triggers We Don't Notice

By Lisa Ordóñez & David Welsh
Notre Dame Center for Ethical Leadership
Posted in 2016

Many companies’ ethics trainings focus on building frameworks and decision trees as tools for their employees to use in making ethically sound decisions. The assumption is that when these employees are confronted with morally ambiguous situations, the tools will allow them to reason their way through them and figure out the best option.

Based on innovative behavioral research, we now know that it’s not that simple. There are a lot of factors that go into determining whether a decision is ethical or unethical. People need to have the energy and resources to resist the temptation to be immoral. They need to feel like the choice matters and that their behavior will actually make a difference. Perhaps most importantly, people need to frame the situation as an ethical question. It’s not just about the tools to make the right decision when you know it’s a hard one. Employees need to flip on their “ethical switch” if they are going to recognize that there is an ethical question at hand.

The article is here.

Friday, June 24, 2016

Former FDA Commissioner Charged in RICO Lawsuit

The Alliance For Human Research Protection

A Federal Lawsuit charges Dr. Margaret Hamburg, former Commissioner of the Food and Drug Administration (FDA) with conspiracy, racketeering & colluding to conceal deadly drug dangers – under the federal Racketeer Influenced and Corrupt Organizations law (RICO) law. The amended RICO lawsuit was filed on April 11, 2016 in the U.S. District Court in Washington DC on behalf of eight plaintiffs who claim they have suffered severe harm by ingesting the drug, Levaquin whose deadly risks were concealed to protect financial interests.

The drug is one of the controversial group of antibiotics, including  Levaquin, Cipro, Avelox and other fluoroquinolones. Public Citizen petitioned the FDA in 1996 and again in 2006, to issue Black Box warnings for tendon rupture and tendinitis. Had warnings been issued, the death toll from Levaquin– reputedly more than 5,000 — and the tens of thousands who were debilitated with life-threatening diseases would likely have been averted.

The article is here.

War Wounds That Time Alone Can't Heal

by Jane E. Brody
The New York Times
Originally published June 6, 2016

Here are two excerpts:

Therapists both within and outside the Department of Veterans Affairs increasingly recognize moral injury as the reason so many returning vets are self-destructive and are not helped, or only partly helped, by established treatments for PTSD.

Moral injury has some of the symptoms of PTSD, especially anger, depression, anxiety, nightmares, insomnia and self-medication with drugs or alcohol. And it may benefit from some of the same treatments. But moral injury has an added burden of guilt, grief, shame, regret, sorrow and alienation that requires a very different approach to reach the core of a sufferer’s psyche.


Therapists who study and treat moral injury have found that no amount of medication can relieve the pain of trying to live with an unbearable moral burden. They say those suffering from moral injury contribute significantly to the horrific toll of suicide among returning vets — estimated as high as 18 to 22 a day in the United States, more than the number lost in combat.

The article is here.

Thursday, June 23, 2016

How to Fix a Broken Mental-Health System

by Norm Ornstein
The Atlantic
Originally published June 8, 2016

Here is an excerpt:

And, for people with the most serious diseases, who cannot recognize they are ill or who have deep psychoses that leave them detached from much of reality, we need to recalibrate the balance between civil liberties and the need to provide real treatment—the kind of wraparound, assisted outpatient treatment (AOT) that Leifman has pioneered in Florida—while making it easier, with appropriate safeguards, for family members to intervene to help their loved ones.

In Washington, the good news is that reforming the system to deal with mental illness is one of the few areas where there is serious bipartisan cooperation and action—including, in the Senate, Democrats like Debbie Stabenow, Chris Murphy, and Al Franken, and Republicans like Roy Blunt, Bill Cassidy, and John Cornyn. In the House, there’s a major bill cosponsored by Republican Tim Murphy, the body’s only psychologist, and Democrat Eddie Bernice Johnson, a former psychiatric nurse.

Of course, there is bad news—this is American politics in 2016. The highly dysfunctional Congress is stymied from action so far even in areas that have broad and deep bipartisan support, like  Puerto Rico’s debt crisis, the opioid crisis, and criminal-justice reform.

The article is here.

“We Didn’t Know”: Silence and Silencing in Organizations

Nina K. Thomas
International Journal of Group Psychotherapy 


This article examines the dynamic processes within organizations that contribute to systemic silence and silencing and the “we didn’t know” defense, particularly for those groups in which secrecy replaces transparency to the detriment of the organization and its members. The events of the past more than 10 years within the American Psychological Association (APA) surrounding the role of psychologists in interrogation of detainees, including advising on and monitoring interrogations that have been construed as torture, will serve as a case example of the systemic forces that may contribute to leading an organization away from its principal mission. I explore how what was done was turned into its opposite. That is: “We are protecting psychologists by providing them with ethical guidelines in detention centers with detainees” became the explanatory rubric for a position that violated the association’s stated mission and exposed the organization and individual members to public shame. In addition, I explore how self-silencing becomes a way of adapting to a culture that censures dissent.


We didn't know" is the all too common legitimizing trope used to establish distance from disturbing events of a sociopsychological and political nature.  Is such a plea of ignorance consciously or unconsciously motivated lest the speaker be implicated in the acts being opposed?  "We didn't know" typically is invoked when a threat of shame, culpability, or punishment of a sort hangs in the balance.  It may be utilized when social service agencies fail to respond to negligent, abusive, or violent behavior toward those for whom they are responsible for care, or in instances of sexual abuse in military, academic, or religious institutions.  Examples also may be found in the justifications of neighbors of concentration camps during the Second World War, or corporate officers deaf to workers' complaints of malfeasance or corruption within an organization.  It is a widespread self- justificatory response to situations in which the individual might have known, even ought to or could have known what was going on, but for a variety of reasons turned away from knowing.

The article is here.

Wednesday, June 22, 2016

A New Theory Explains How Consciousness Evolved

Michael Graziano
The Atlantic
Originally posted June 6, 2016

Here is an excerpt:

The Attention Schema Theory (AST), developed over the past five years, may be able to answer those questions. The theory suggests that consciousness arises as a solution to one of the most fundamental problems facing any nervous system: Too much information constantly flows in to be fully processed. The brain evolved increasingly sophisticated mechanisms for deeply processing a few select signals at the expense of others, and in the AST, consciousness is the ultimate result of that evolutionary sequence. If the theory is right—and that has yet to be determined—then consciousness evolved gradually over the past half billion years and is present in a range of vertebrate species.

Even before the evolution of a central brain, nervous systems took advantage of a simple computing trick: competition. Neurons act like candidates in an election, each one shouting and trying to suppress its fellows. At any moment only a few neurons win that intense competition, their signals rising up above the noise and impacting the animal’s behavior. This process is called selective signal enhancement, and without it, a nervous system can do almost nothing.

The article is here.

Moral intuitions: Are philosophers experts?

Kevin Tobia, Wesley Buckwalter, and Stephen Stich
Philosophical Psychology, 26(5): 629-638.


Recently psychologists and experimental philosophers have reported findings showing that in some cases ordinary people’s moral intuitions are affected by factors of dubious relevance to the truth of the content of the intuition. Some defend the use of intuition as evidence in ethics  by arguing that philosophers are the experts in this area, and philosophers’ moral intuitions are  both different from those of ordinary people and more reliable. We conducted two experiments indicating that philosophers and non-philosophers do indeed sometimes have different moral intuitions, but challenging the notion that philosophers have better or more reliable intuitions.

The article is here.

Tuesday, June 21, 2016

Dignity, Politics, and Medical Assistance in Dying

by Harry Critchley
Impact Ethics
Originally published June 6, 2016

Here is an excerpt:

A common problem with both of these approaches to understanding dignity, however, is the underlying assumption that dignity is best understood from a theoretical perspective. Another, more fruitful approach might be to examine the meaning of dignity with reference to its use in public discourse. On this view, to determine what dignity is requires that we ask what appeals to dignity are intended to do. Dignity is not only, or even primarily, appealed to in the solitude of philosophical contemplation, but rather in the company of others. Regardless of whether we understand dignity as sanctity of life or as autonomy, its emergence and acknowledgement in the political arena is an achievement not wholly dependent on its theoretical grounding.

The article is here.

Keep a List of Unethical Things You’ll Never Do

Mark Chussil
Harvard Business Review
Originally posted May 30, 2016

Here is an excerpt:

In a recent class we talked about less-than-virtu­ous actions we’ve seen in business. Fraudulent ac­counting that wiped out jobs and investors. Efficient operations that inflict misery on food animals. Shortcuts and cover-ups that cost people their lives. It’s easy to create a long list and it’s hard not to be depressed by it.

I asked my students: who, among you, aspires to take such actions? They were appalled, of course. Then I mentioned that the real-life people who actually took those actions were once just like them. They were young; they were eager; they wanted to do fine things. And yet.

The room was very quiet.

The article is here.

Monday, June 20, 2016

Americans Remain Pessimistic About State of Moral Values

by Justin McCarthy
Gallup: Social Issues
MAY 25, 2016

Story Highlights
  • Majority continues to say state of morals getting worse
  • Americans most likely to describe morals in U.S. as "poor"
  • Republicans, GOP leaners most negative on state of morals
Americans remain far more likely to say the state of moral values in the U.S. is getting worse (73%) than to say it is getting better (20%). Over a 15-year trend, solid majorities have consistently viewed the direction of the country's values negatively, ranging from 67% in 2002 and 2003 to 82% in 2007.

Scientists debate effort to build a human genome

By Andrew Joseph
Originally posted  on June 4, 2016

Here is an excerpt:

Church said the core science of assembling a human genome from basic molecular ingredients dates back to at least 2009. And he noted that scientists have been grappling with related ethical questions for more than a decade, since the early days of synthetic biology opened the door to the idea of someone being able to build a pathogen from basic genetic components.

He said that although the project has no intention of spawning actual humans, the project’s leaders would not ignore the “ethical, social, legal” issues that inherently materialize given where the project could lead.

The article is here.

Sunday, June 19, 2016

The Ethics of Large-Scale Genomic Research

Benjamin E. Berkman, Zachary E. Shapiro, Lisa Eckstein, Elizabeth R. Pike
Chapter in Ethical Reasoning in Big Data
Part of the series Computational Social Sciences pp 53-69


The potential for big data to advance our understanding of human disease has been particularly heralded in the field of genomics. Recent technological advances have accelerated the massive data generation capabilities of genomic research, which has allowed researchers to undertake larger scale genomic research, with significantly more participants, further spurring the generation of massive amounts of data. The advance of technology has also triggered a significant reduction in cost, allowing large-scale genomic research to be increasingly feasible, even for smaller research sites. The rise of genetic research has triggered the creation of many large-scale genomic repositories (LSGRs) some of which contain the genomic information of millions of research participants. While LSGRs have genuine potential, they also have raised a number of ethical concerns. Most prominently, commentators have raised questions about the privacy implications of LSGRs, given that all genomic data is theoretically re-identifiable. Privacy can be further threatened by the possibility of aggregation of data sets, which can give rise to unexpected, and potentially sensitive, information. Beyond privacy concerns, LSGRs also raise questions about participant autonomy, public trust in research, and justice. In this chapter, we explore these ethical challenges, with the goal of elucidating which ones require closer scrutiny and perhaps policy action. Our analysis suggests that caution is warranted before any major policies are implemented. Much attention has been directed at privacy concerns raised by LSGRs, but perhaps for the wrong reasons, and perhaps at the expense of other relevant concerns. We do not think that there is yet sufficient evidence to motivate enactment of major policy changes in order to safeguard welfare interests, although there might be some stronger reasons to worry about subjects’ non-welfare interests. We also believe that LSGRs raise genuine concerns about autonomy and justice. Big data research, and LSGRs in particular, have the potential to radically advance our understanding of human disease. While these new research resources raise important ethical concerns, any policies implemented concerning LSGRs should be carefully tailored to ensure that research is not unduly burdened.

The abstract to the book chapter is here.

You may want to contact the author for a copy for personal use.

Saturday, June 18, 2016

The New Era of Informed Consent

Getting to a Reasonable-Patient Standard Through Shared Decision Making

Erica S. Spatz, Harlan M. Krumholz, MD, Benjamin W. Moulton
JAMA. 2016; 315(19):2063-2064. doi:10.1001/jama.2016.3070.

Here is an excerpt:

Informed consent discussions are often devoid of details about the material risks, benefits, and alternatives that are critical to meaningful patient decision making. Informed consent documents for procedures, surgery, and medical treatments with material risks (eg, radiation therapy) tend to be generic, containing information intended to protect the physician or hospital from litigation. These documents are often written at a high reading level and sometimes presented in nonlegible print, putting a premium on health literacy and proactive information-seeking behavior. Moreover, informed consent documents are often signed minutes before the start of a procedure, a time when patients are most vulnerable and least likely to ask questions—hardly consistent with what a reasonable patient would deem acceptable. In the United States, with the exception of 1 state, Washington, that explicitly recognizes shared decision making as an alternative to the traditional informed consent process, the law has yet to promote a process that truly supports a reasonable-patient–centered standard through shared decision making.

The article is here.

Friday, June 17, 2016

Vignette 34: A Dreadful Voicemail

Dr. Vanessa Ives works in a solo private practice. She has been working with Mr. Dorian Gray for several months for signs and symptoms of depression. Mr. Gray comes to some sessions as emotionally intense, and high strung.  Dr. Ives has considered the possibility that Mr. Gray suffers with some type of cyclic mood disorder.

As part of treatment, Mr. Gray admitted to experiencing anger management problems, to the point where he described physically intimidating his wife and pushing her down. They worked on anger management skills. Mr. Gray reported progress in this area.

Dr. Ives receives a phone message from Mr. Gray’s wife.  In the voicemail, Mrs. Gray reports that Mr. Gray has become more physically intimidating and has starting to push her around.  The voicemail indicated he has not caused her any significant harm.  She requested a session to see Dr. Ives to explain what is happening between them.  Dr. Ives only met Mrs. Gray informally while she sat in the waiting room before and after several sessions.

Dr. Ives wants to be helpful, but she is struggling with whether she should even return Mrs. Gray’s phone call.  Dr. Ives has a personal history of being involved in a physically abusive relationship herself and is concerned about both the clinical and ethical issues involved regarding calling Mrs. Gray back.

Feeling uncomfortable about what is happening with this patient and his wife, Dr. Ives calls you for a professional consultation.  She wants to make an appointment to talk with you candidly about her history as well as the dynamics of the current case.

What are the ethical issues involved in this case?

What are the pertinent clinical issues in this case?

How would you help Dr. Ives deal with her emotions related to this situation, given how her history relates to this patient and his wife?

Would you recommend Dr. Ives return the call or not?

What are some possible options should Dr. Ives return the phone call?

How much transparency would you suggest to Dr. Ives with Mr. Gray about the phone message?

Thursday, June 16, 2016

The Corporate Joust with Morality

by Caroline Kaeb And David Scheffer
Opino Juris
Originally posted June 6, 2016

Here is the end:

This duel between corporate responsibility and corporate deceit and culpability is no small matter.  The fate of human society and of the earth increasingly falls on the shoulders of corporate executives who either embrace society’s challenges and, if necessary, counterattack for worthy aims or they succumb to dangerous gambits for inflated profits, whatever the impact on society.

The fulcrum of risk management must be forged with sophisticated strategies that propel corporations into the great policy debates of our times in order to promote social responsibility and thus strengthen the long-term viability of corporate operations.  We believe that task must begin in business schools and in corporate boardrooms where decisions that shape the world are made every day.

The article is here.

The End of Absolutes: America's New Moral Code

The BARNA Group
Research Releases in Culture & Media
Originally published on May 25, 2016

Christian morality is being ushered out of American social structures and off the cultural main stage, leaving a vacuum in its place—and the broader culture is attempting to fill the void. New research from Barna reveals growing concern about the moral condition of the nation, even as many American adults admit they are uncertain about how to determine right from wrong. So what do Americans believe? Is truth relative or absolute? And do Christians see truth and morality in radically different ways from the broader public, or are they equally influenced by the growing tide of secularism and religious skepticism?

A majority of American adults across age group, ethnicity, gender, socioeconomic status and political ideology expresses concern about the nation’s moral condition—eight in 10 overall (80%). The proportion is closer to nine in 10 among Elders (89%) and Boomers (87%), while about three-quarters of Gen-Xers (75%) and Millennials (74%) report concern. Similarly, practicing Christians (90%) are more likely than adults of no faith (67%) or those who identify with a religious faith other than Christianity (72%) to say they are concerned about the moral condition of the nation. Though measurable differences exist between population segments, moral concern is widespread across the demographic board.

The article and survey can be found here.

Wednesday, June 15, 2016

Netherlands to grow human embryos for research

By www.rt.com
Originally posted May 26, 2016

The Dutch government will allow labs to grow human embryos to be used for research in a limited number of fields, it announced on Friday. Currently scientists have to rely on a limited supply of leftover embryos from in vitro fertilization patients.
The ban on the cultivation of embryos [has] hampered research which could help with the treatment of diseases on the short to medium-long term," the government said in a statement, justifying the ethically controversial move.
The new regulations would not change the so-called “14-day rule”, which demands that any human embryo kept in a lab be destroyed no later than two weeks after fertilization.

The article is here.

There’s Argument, and there’s Disputation

by Iain Brassington
British Medical Journal Blogs
Originally posted June 6, 2016

Here is an excerpt:

Basically, the problem is this: that the model for debating contests is, presumably, based around the idea that debate is an effective way to whittle bad ideas away from good; if each participant is a doughty falsificationist, and equally able in debate as his opponent, then at the end of a process of debate, we’ll be closer to the truth of the matter than we were at the start.  So far, so good.  But there’s a handful of fairly obvious problems with that model.  First, that doesn’t lend itself to the idea that there is a winner and a loser in any particular debate.  Second, a shoddy argument presented by a good speaker might win a competitive debate over a good argument presented by a diffident speaker.  We might hope that a competent judge would account for that, but it’d be better if there wasn’t any need to solve what looks to be a structural problem to begin with.  Third – which is related, but probably more importantly when it comes to ethics – someone with a good understanding of the moral arguments and who is a decent orator might stand a fair chance of winning an argument; but it doesn’t follow that a good orator who’s won an argument has any particular understanding of the moral arguments.  Debating contests reward people for being good at debate; but that’s presumably not the true end of ethics education.  Fourth, this kind of strategy is possibly OK in politics, in which the point of oratory is to persuade people to adopt a certain cause; and so debating competitions might provide training for that.  (I suspect that that’s something like the rationale behind things like the IofI’s competition in schools: it’s directed at developing a certain set of skills, with one eye on a vivacious public debate.  Whatever my private suspicions of the IofI generally, that doesn’t seem like a bad idea.)  But ethical debate is qualitatively different.  It isn’t really about winning converts.  Or, at least: one might hope that a convincing argument would have moral gravity and attract agreement, but the mood of the thing is different.

The article is here.

Tuesday, June 14, 2016

The Immoral Landscape? Scientists Are Associated with Violations of Morality

Rutjens BT, Heine SJ
(2016)  PLoS ONE 11(4): e0152798.


Do people think that scientists are bad people? Although surveys find that science is a highly respected profession, a growing discourse has emerged regarding how science is often judged negatively. We report ten studies (N = 2328) that investigated morality judgments of scientists and compared those with judgments of various control groups, including atheists. A persistent intuitive association between scientists and disturbing immoral conduct emerged for violations of the binding moral foundations, particularly when this pertained to violations of purity. However, there was no association in the context of the individualizing moral foundations related to fairness and care. Other evidence found that scientists were perceived as similar to others in their concerns with the individualizing moral foundations of fairness and care, yet as departing for all of the binding foundations of loyalty, authority, and purity. Furthermore, participants stereotyped scientists particularly as robot-like and lacking emotions, as well as valuing knowledge over morality and being potentially dangerous. The observed intuitive immorality associations are partially due to these explicit stereotypes but do not correlate with any perceived atheism. We conclude that scientists are perceived not as inherently immoral, but as capable of immoral conduct.

The article is here.

There’s No Such Thing as Free Will

By Stephen Cave
The Atlantic
Originally posted June 2016

Here are two excerpts:

The 20th-century nature-nurture debate prepared us to think of ourselves as shaped by influences beyond our control. But it left some room, at least in the popular imagination, for the possibility that we could overcome our circumstances or our genes to become the author of our own destiny. The challenge posed by neuroscience is more radical: It describes the brain as a physical system like any other, and suggests that we no more will it to operate in a particular way than we will our heart to beat. The contemporary scientific image of human behavior is one of neurons firing, causing other neurons to fire, causing our thoughts and deeds, in an unbroken chain that stretches back to our birth and beyond. In principle, we are therefore completely predictable. If we could understand any individual’s brain architecture and chemistry well enough, we could, in theory, predict that individual’s response to any given stimulus with 100 percent accuracy.


The big problem, in Harris’s view, is that people often confuse determinism with fatalism. Determinism is the belief that our decisions are part of an unbreakable chain of cause and effect. Fatalism, on the other hand, is the belief that our decisions don’t really matter, because whatever is destined to happen will happen—like Oedipus’s marriage to his mother, despite his efforts to avoid that fate.

The article is here.

Monday, June 13, 2016

Morality in business: Oxymoron?

By Elfren S. Cruz
The Philippine Star
Updated May 26, 2016

Here is an excerpt:

Today, the Filipino businessman like  business leaders around the world, are confronted with moral questions that cannot be decided simply on the basis of what is “good for the company.” There is the issue of the minimum wage vs. the living wage that institutions like the Catholic Church have been advocating for more than a century. Then there is the issue of contractualization and the continuing practice of hiring “casuals” who will be laid off after a few months work and then rehired again to avoid giving them regular status.

Tax evasion and money laundering through tax havens in places like the British Virgin Islands are now considered as an integral part of doing business. And when transparency about financial transactions and bank accounts are demanded, businessmen object on the basis of the “right to privacy.”

The article is here.

Are research ethics guidelines culturally competent?

Ben Gray, Jo Hilder, Lindsay Macdonald, Rachel Tester, Anthony Dowell, & Maria Stubbe
Research Ethics May 20, 2016


Research ethics guidelines grew out of several infamous episodes where research subjects were exploited. There is significant international synchronization of guidelines. However, indigenous groups in New Zealand, Canada and Australia have criticized these guidelines as being inadequate for research involving indigenous people and have developed guidelines from their own cultural perspectives. Whilst traditional research ethics guidelines place a lot of emphasis on informed consent, these indigenous guidelines put much greater emphasis on interdependence and trust. This article argues that traditional guidelines are premised on relationships of equal power, and that often the researcher has more power that is not fully equalized by providing information. Where there is a relationship of unequal power, then focusing on interdependence and trust is more likely to achieve ethical safety. We illustrate this thesis by describing the detail of a research project looking at the use of interpreters, where we video-recorded live consultations and then interviewed the patient, interpreter and doctor. We conclude by suggesting that mainstream research ethics guidelines should pay more attention to the development of a trustworthy relationship between subject and researcher, and that, following the lead from clinical medicine, we should develop a culturally competent ethical framework for research on human subjects.

The article is here.

Sunday, June 12, 2016

Free to punish: a motivated account of free will belief.

Clark CJ, Luguri JB, Ditto PH, Knobe J, Shariff AF, Baumeister RF
J Pers Soc Psychol. 2014 Apr;106(4):501-13.


Belief in free will is a pervasive phenomenon that has important consequences for prosocial actions and punitive judgments, but little research has investigated why free will beliefs are so widespread. Across 5 studies using experimental, survey, and archival data and multiple measures of free will belief, we tested the hypothesis that a key factor promoting belief in free will is a fundamental desire to hold others morally responsible for their wrongful behaviors. In Study 1, participants reported greater belief in free will after considering an immoral action than a morally neutral one. Study 2 provided evidence that this effect was due to heightened punitive motivations. In a field experiment (Study 3), an ostensibly real classroom cheating incident led to increased free will beliefs, again due to heightened punitive motivations. In Study 4, reading about others' immoral behaviors reduced the perceived merit of anti-free-will research, thus demonstrating the effect with an indirect measure of free will belief. Finally, Study 5 examined this relationship outside the laboratory and found that the real-world prevalence of immoral behavior (as measured by crime and homicide rates) predicted free will belief on a country level. Taken together, these results provide a potential explanation for the strength and prevalence of belief in free will: It is functional for holding others morally responsible and facilitates justifiably punishing harmful members of society.

The article is here.

Saturday, June 11, 2016

Scientists Are Just as Confused About the Ethics of Big-Data Research as You

Sarah Zhang
Wired Magazine
Originally published May 20, 2016

Here is an excerpt:

Shockingly, though, the researchers behind both of those big data blowups never anticipated public outrage. (The OkCupid research does not seem to have gone through any kind of ethical review process, and a Cornell ethics review board approved the Facebook experiment.) And that shows just how untested the ethics of this new field of research is. Unlike medical research, which has been shaped by decades of clinical trials, the risks—and rewards—of analyzing big, semi-public databases are just beginning to become clear.

And the patchwork of review boards responsible for overseeing those risks are only slowly inching into the 21st century. Under the Common Rule in the US, federally funded research has to go through ethical review. Rather than one unified system though, every single university has its own institutional review board, or IRB. Most IRB members are researchers at the university, most often in the biomedical sciences. Few are professional ethicists.

The article is here.

Friday, June 10, 2016

Decriminalizing Mental Illness — The Miami Model

John K. Iglehart
N Engl J Med 2016; 374:1701-1703

Here is an excerpt:

Miami-Dade’s initiative was launched in 2000, when Judge Leifman, frustrated by the fact that people with mental disorders were cycling through his court repeatedly, created the Eleventh Judicial Circuit Criminal Mental Health Project (CMHP). As Leifman explained, “When I became a judge . . . I had no idea I would become the gatekeeper to the largest psychiatric facility in the State of Florida. . . . Of the roughly 100,000 bookings into the [county] jail every year, nearly 20,000 involve people with serious mental illnesses requiring intensive psychiatric treatment while incarcerated. . . . Because community-based delivery systems are often fragmented, difficult to navigate, and slow to respond to critical needs, many individuals with the most severe and disabling forms of mental illnesses . . . fall through the cracks and land in the criminal justice or state hospital systems” that emphasize crisis resolution rather than “promoting ongoing stable recovery and community integration.”

The article is here.

Lay attitudes toward deception in medicine: Theoretical considerations and empirical evidence

Jonathan Pugh, Guy Kahanea, Hannah Maslena & Julian Savulescua
AJOB Empirical Bioethics
Volume 7, Issue 1, 2016

Here is an excerpt:

In these cases, two fundamental principles of medical ethics—the principle of beneficence and the principle of respect for autonomy—appear to conflict (Beauchamp and Childress 2009). While ethicists have long been interested in the conflict between these two principles in cases of deception in medical practice, there is comparatively little empirical evidence concerning whether lay people—the potential targets of such deception—regard deception as morally acceptable across different medical contexts. Empirical studies that have been carried out thus far have concerned patient attitudes toward deception in specific medical contexts, such as cancer treatment (Jenkins, Fallowfield, and Saul, 2001; Yu and Bernstein 2011), palliative care, (Fallowfield, Jenkins, and Beveridge 2002), or more generally the use of placebo treatments in medical practice (Chen and Johnson, 2009; Hull et al. 2013). Similar studies have also been carried out on physician attitudes toward deception in these contexts (Howick et al. 2013; Lynöe, Mattsson, and Sandlund 1993).

However, several important dimensions of deception in medicine have not yet been addressed. Previous empirical studies have not directly compared patient attitudes toward deception across different medical contexts, nor have they investigated the relationship between patient attitudes toward deception in medicine and their attitudes toward truthfulness in nonmedical contexts. It remains unclear whether observed attitudes to deception reflect more general views about deception or whether they are specific to the medical sphere or even to particular medical contexts.

The article is here.

Thursday, June 9, 2016

Bad News Delivered Badly

By Susan Gubar
The New York Times - Well
Originally posted May 19, 2016

Here is an excerpt:

None of us were eased by communication strategies that have evolved since 2000 when Dr. Walter F. Baile and his associates published their paradigm for delivering bad news in The Oncologist. This article advocates a program called Spikes: S stands for finding the appropriate setting; P for gauging the perceptions of the patient; I for obtaining the patient’s invitation to hear bad news; K for providing the knowledge that the patient needs to receive; E for dealing with the emotional reactions of the patient with empathy; S for concluding with a needed summary.

Despite such a thoughtful template, miscommunication does not taint only diagnosis, as I.M. realized when she went on to confide about a more recent exchange. At her last meeting with her oncologist, they had discussed the sorry fact that the current cycle of chemotherapy had not inhibited tumor growth. The doctor gave her three choices: returning to the drug used in her first cycle, trying a clinical trial or “opting to do nothing.” Alarmed and shaken by this last proposal, she felt as if he were throwing up his hands or she had somehow been fired.

The article is here.

Ethics and the Eye of the Beholder

Thomas Pogge, one of the world’s most prominent ethicists, stands accused of manipulating students to gain sexual advantage. Did the fierce champion of the world's disempowered abuse his own power?

Katie J.M. Baker
BuzzFeed News 
Originally posted May 20, 2016

Here is an excerpt:

But a recent federal civil rights complaint describes a distinction unlikely to appear on any curriculum vitae: It claims Pogge uses his fame and influence to manipulate much younger women in his field into sexual relationships. One former student said she was punished professionally after resisting his advances.

Pogge did not respond to more than a dozen emails and phone calls from BuzzFeed News, nor to a detailed letter laying out all the claims that were likely to appear in this article. Yale’s spokesperson, Thomas Conroy, declined to comment.

Editor's note: Research shows that those who teach ethics do not act more ethically than the rest of the population.

Wednesday, June 8, 2016

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals

Neil Levy, Thomas Douglas, Guy Kahane, Sylvia Terbeck, Philip J. Cowen, Miles
Hewstone, and Julian Savulescu
Philos Psychiatr Psychol. 2014 June 1; 21(2): 111–125.


A number of concerns have been raised about the possible future use of pharmaceuticals designed
to enhance cognitive, affective, and motivational processes, particularly where the aim is to
produce morally better decisions or behavior. In this article, we draw attention to what is arguably
a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are
already having unintended effects on these processes, and thus on moral decision making and
morally significant behavior. We review current evidence on the moral effects of three widely
used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii)
drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision
making and behavior caused by these agents may have important and difficult-to-evaluate
consequences, at least at the population level. We argue that the moral effects of these and other
widely used pharmaceuticals warrant further empirical research and ethical analysis.

The paper is here.

Soon we’ll use science to make people more moral

By James J. Hughes
The Washington Post
Originally posted May 19, 2016

Here is an excerpt:

he emerging debate over the use of drugs and devices for moral enhancement has had three principal viewpoints: those who focus on boosting moral sentiments such as empathy; those who would just boost moral reasoning; and the skeptics. While the former two groups accept the goal of moral enhancement — and differ over the best method — the skeptics reject the project. They argue that moral enhancement therapies are overhyped, and that even if morality drugs were effective, they would be bad for our character to rely on them.

It is certainly true that the initial enthusiasm for certain moral enhancement therapies has been tempered by subsequent research. Dozens of studies have suggested that genes that regulate oxytocin, the “cuddle hormone,” affect trust and empathy, and that empathy is boosted when subjects snort oxytocin. But it now appears that the effects of boosting oxytocin were over-reported and that some of the hormone’s effects are less than cuddly — oxytocin tends to boost empathy only for people like us, increasing ethnocentric “in-group bias.”

The article is here.

Tuesday, June 7, 2016

The empty brain

by Robert Epstein
Aeon Magazine
Originally published May 18, 2016

Here are two excerpts:

Forgive me for this introduction to computing, but I need to be clear: computers really do operate on symbolic representations of the world. They really store and retrieve. They really process. They really have physical memories. They really are guided in everything they do, without exception, by algorithms.

Humans, on the other hand, do not – never did, never will. Given this reality, why do so many scientists talk about our mental life as if we were computers?


Misleading headlines notwithstanding, no one really has the slightest idea how the brain changes after we have learned to sing a song or recite a poem. But neither the song nor the poem has been ‘stored’ in it. The brain has simply changed in an orderly way that now allows us to sing the song or recite the poem under certain conditions. When called on to perform, neither the song nor the poem is in any sense ‘retrieved’ from anywhere in the brain, any more than my finger movements are ‘retrieved’ when I tap my finger on my desk. We simply sing or recite – no retrieval necessary.

The article is here.

Editor's note: This article may help clinician's reflect on the way we discuss memories and change with our patients.  Our understanding of how the brain works is quite limited.  And, the brain is not like a computer.

Student Resistance to Thought Experiments

Regina A. Rini
APA Newsletter - Teaching Philosophy
Spring 2016, Volume 15 (2)


From Swampmen to runaway trolleys, philosophers make routine use of thought experiments. But our students are not always so enthusiastic. Most teachers of introductory philosophy will be familiar with the problem: students push back against the use of thought experiments, and not for the reasons that philosophers are likely to accept. Rather than challenge whether the thought experiments actually
support particular conclusions, students instead challenge their realism or their relevance.

In this article I will look at these sorts of challenges, with two goals in mind. First, there is a practical pedagogical goal: How do we guide students to overcome their resistance to a useful method? Second, there is something I will call “pedagogical bad faith.” Many of us actually do have sincere doubts, as professional philosophers, about the value of thought experiment methodology. Some of
these doubts in fact correspond to our students’ naïve resistance. But we often decide, for pedagogical reasons, to avoid mentioning our own doubts to students. Is this practice defensible?

The article is here.

Editor's Note: I agree with this article in many ways.  After I have read a philosophy article and a podcast using a thought experiment, I provided critiques regarding how the thought experiments were limited to the author. My criticisms were dismissed with a more ad hominem attack of my lack of understanding of philosophy or how philosophers work.  I was told I should read more philosophy, especially Derek Parfit.  I wish I had this article several years ago.

Monday, June 6, 2016

Stopping the revolving prison door for the mentally ill

by Courtenay Harris Bond
Originally posted May 10, 2016

Here is an excerpt:

But the unfortunate reality right now is that many people with serious mental illness who commit even minor infractions are locked up, making over-crowded prisons and jails responsible for mental health services they are ill equipped to deal with.

“The police are called on to do too much, and the health care system is not doing enough,” Sisti said. “The whole idea that the police are now front-line mental health workers shows that we’ve abdicated our responsibilities as health care professionals.”

“The police in their best efforts aren’t equipped with the tools”—psychiatric medications, for example, that only physicians and nurses can administer­—“to de-escalate some of these situations,” added Cyndi Rickards, an assistant professor in the Department of Criminology and Justice Studies at Drexel.

Dr. Philip Candilis, director of the forensic psychiatry fellowship at St. Elizabeth’s Hospital in Washington, described a jail diversion program in Arlington, Va., where courts work with social service agencies to aid people struggling with mental illness who find themselves in trouble with the law. Mental health courts in Philadelphia and Washington function in a similar way.

The article is here.

Freedom of patient-physician conversations hinges on court case

AMA Wire
Originally posted May 16, 2016

A federal court will be hearing a case about the constitutionality of a state law that represses free discussion between physicians and patients regarding health and safety issues.

In a friend-of-the-court brief filed April 26, the AMA and eight other medical societies urged the Court of Appeals for the 11th Circuit to overturn a Florida law that restricts physicians from discussing firearm safety with patients and their families.

The brief argues that the Firearm Owners’ Privacy Act is unconstitutional and intrudes on the practice of medicine. The law will inevitably affect other aspects of patient care, the brief says.

The press release is here.

Sunday, June 5, 2016

Memories of unethical actions become obfuscated over time

Maryam Kouchakia and Francesca Gino
PNAS 2016 ; published ahead of print May 16, 2016


Despite our optimistic belief that we would behave honestly when facing the temptation to act unethically, we often cross ethical boundaries. This paper explores one possibility of why people engage in unethical behavior over time by suggesting that their memory for their past unethical actions is impaired. We propose that, after engaging in unethical behavior, individuals’ memories of their actions become more obfuscated over time because of the psychological distress and discomfort such misdeeds cause. In nine studies (n = 2,109), we show that engaging in unethical behavior produces changes in memory so that memories of unethical actions gradually become less clear and vivid than memories of ethical actions or other types of actions that are either positive or negative in valence. We term this memory obfuscation of one’s unethical acts over time “unethical amnesia.” Because of unethical amnesia, people are more likely to act dishonestly repeatedly over time.

The article is here.

Saturday, June 4, 2016

Scientists show how we start stereotyping the moment we see a face

Sarah Kaplan
The Independent
Originally posted May 2, 2016

Scientists have known for a while that stereotypes warp our perceptions of things. Implicit biases — those unconscious assumptions that worm their way into our brains, without our full awareness and sometimes against our better judgment — can influence grading choices from teachers, split-second decisions by police officers and outcomes in online dating.

We can't even see the world without filtering it through the lens of our assumptions, scientists say. In a study published Monday in the journal Nature Neuroscience, psychologists report that the neurons that respond to things such as sex, race and emotion are linked by stereotypes, distorting the way we perceive people's faces before that visual information even reaches our conscious brains.

The article is here.

Friday, June 3, 2016

Secret Harvard meeting on synthetic human genomes incites ethics debate

By Joel Achenbach
The Washington Post
Originally published May 13, 2016

About 150 scientists assembled at Harvard on Tuesday for an off-the-record, no-media-allowed discussion of how to create, from scratch, an intact genome, including the genetic code of a human being. The idea is to go beyond "reading" genetic material to actively "writing" it, George Church, a Harvard Medical School researcher who helped organized the event, told The Post in an interview Friday morning.

Scientists can synthesize DNA chemically, and these techniques could ultimately lead to complete genomes that could be implanted in cells for research purposes. No one should panic just yet about mad scientists running amok: The researchers are not talking about making synthetic human beings. But the gathering drew a rebuke from two academics who heard about the event and didn't think it should have been held behind closed doors.

The article is here.

Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists

Manuel Trachsel & Jens Gaab
J Med Ethics 2016;0:1–3.


Informed consent to medical intervention reflects the moral principle of respect for autonomy and the patient's right to self-determination. In psychotherapy, this includes a requirement to inform the patient about those components of treatment purported to cause the therapeutic effect. This information must encompass positive expectancies of change and placebo-related or incidental constituent therapy effects, which are as important as specific intervention techniques for the efficacy of psychotherapy. There is a risk that informing the patient about possible incidental constituents of therapy may reduce or even completely impede these effects, with negative consequences for overall outcome. However, withholding information about incidental constituents of psychotherapy would effectively represent a paternalistic action at the expense of patient autonomy; whether such paternalism might in certain circumstances be justified forms part of the present discussion.

The article is here.

Thursday, June 2, 2016

Age-Related Differences in Moral Identity Across Adulthood

T. Krettenauer, L. A. Murua, & F. Jia
Developmental Psychology, Apr 28 , 2016


In this study, age-related differences in adults’ moral identity were investigated. Moral identity was conceptualized a context-dependent self-structure that becomes differentiated and (re)integrated in the course of development and that involves a broad range of value-orientations. Based on a cross-sectional sample of 252 participants aged 14 to 65 years (148 women, M = 33.5 years, SD = 16.9) and a modification of the Good Self-Assessment, it was demonstrated that mean-level of moral identity (averaged across the contexts of family, school/work, and community) significantly increased in the adult years, whereas cross-context differentiation showed a nonlinear trend peaking at the age of 25 years. Value-orientations that define individuals’ moral identity shifted so that self-direction and rule-conformity became more important with age. Age-related differences in moral identity were associated with, but not fully attributable to changes in personality traits. Overall, findings suggest that moral identity development is a lifelong process that starts in adolescence but expands well into middle age.

Here is an excerpt from the Discussion section:

The finding suggests that during adolescence and emerging adulthood individuals become more aware of changing moral priorities under varying circumstances. This process of differentiation is followed by the tendency to (re)integrate value priorities so that moral identities are not only defined by the self-importance of particular values, but by their consistent importance across different areas of life. This consistency may bolster individuals' sense of agency, as moral actions may be experienced as emanating from the self rather than from demand characteristics of external circumstances. Thus, the decline in cross-context differentiation in moral identities in adulthood may indicate that agentic desires become better integrated with morality, which has been described as an important goal of moral identity development by Frimer andWalker (2009).

The article is here.

Scientific consent, data, and doubling down on the internet

Oliver Keyes
Originally published May 12, 2016

Here is an excerpt:

The Data

Yesterday morning I woke up to a Twitter friend pointing me to a release of OKCupid data, by Kirkegaard. Having now spent some time exploring the data, and reading both public statements on the work and the associated paper: this is without a doubt one of the most grossly unprofessional, unethical and reprehensible data releases I have ever seen.

There are two reasons for that. The first is very simple; Kirkegaard never asked anyone. He didn't ask OKCupid, he didn't ask the users covered by the dataset - he simply said 'this is public so people should expect it's going to be released'.

The blog post is here.

Wednesday, June 1, 2016

Competence in chronic mental illness: the relevance of practical wisdom

Guy A M Widdershoven, Andrea Ruissen, Anton J L M van Balkom, & Gerben Meynen
J Med Ethics doi:10.1136/medethics-2014-102575


The concept of competence is central to healthcare because informed consent can only be obtained from a competent patient. The standard approach to competence focuses on cognitive abilities. Several authors have challenged this approach by emphasising the role of emotions and values. Combining cognition, emotion and values, we suggest an approach which is based on the notion of practical wisdom. This focuses on knowledge and on determining what is important in a specific situation and finding a balance between various values, which are enacted in an individual's personal life. Our approach is illustrated by two cases of patients with obsessive–compulsive disorder.

The article is here.

Don't make Important Decisions When You are Hungry

The Stomach-Derived Hormone Ghrelin Increases Impulsive Behavior

Rozita H Anderberg, Caroline Hansson, Maya Fenande and others
Neuropsychopharmacology (2016) 41, 1199–1209
doi:10.1038/npp.2015.297; published online 21 October 2015


Impulsivity, defined as impaired decision making, is associated with many psychiatric and behavioral disorders, such as attention-deficit/hyperactivity disorder as well as eating disorders. Recent data indicate that there is a strong positive correlation between food reward behavior and impulsivity, but the mechanisms behind this relationship remain unknown. Here we hypothesize that ghrelin, an orexigenic hormone produced by the stomach and known to increase food reward behavior, also increases impulsivity. In order to assess the impact of ghrelin on impulsivity, rats were trained in three complementary tests of impulsive behavior and choice: differential reinforcement of low rate (DRL), go/no-go, and delay discounting. Ghrelin injection into the lateral ventricle increased impulsive behavior, as indicated by reduced efficiency of performance in the DRL test, and increased lever pressing during the no-go periods of the go/no-go test. Central ghrelin stimulation also increased impulsive choice, as evidenced by the reduced choice for large rewards when delivered with a delay in the delay discounting test. In order to determine whether signaling at the central ghrelin receptors is necessary for maintenance of normal levels of impulsive behavior, DRL performance was assessed following ghrelin receptor blockade with central infusion of a ghrelin receptor antagonist. Central ghrelin receptor blockade reduced impulsive behavior, as reflected by increased efficiency of performance in the DRL task. To further investigate the neurobiological substrate underlying the impulsivity effect of ghrelin, we microinjected ghrelin into the ventral tegmental area, an area harboring dopaminergic cell bodies. Ghrelin receptor stimulation within the VTA was sufficient to increase impulsive behavior. We further evaluated the impact of ghrelin on dopamine-related gene expression and dopamine turnover in brain areas key in impulsive behavior control. This study provides the first demonstration that the stomach-produced hormone ghrelin increases impulsivity and also indicates that ghrelin can change two major components of impulsivity—motor and choice impulsivity.

The article is here.