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

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

Sunday, September 30, 2018

Why It’s So Hard to Be an ‘Ethical’ Investor

Jon Sindreu and Sarah Kent
The Wall Street Journal
Originally posted September 1, 2018

In life, ethics are in the eye of the beholder. In investing, ethics are up to the whims of your fund manager.

With little regulation governing what a fund manager can call a “socially responsible” or “ethical” investment, a myriad of bespoke standards have popped up. Increasingly, these fund strategies are designed to beat the market rather than uphold morality.

This has created a dizzying of array possibilities when it comes to what these funds might hold. Fund companies can craft their definitions in such a way that they can simply rename existing products with an ethical allusion, without having to change their fund holdings.

Fund managers have rebranded at least two dozen existing mutual funds over the past few years, adding terms such as “sustainable,” and “ESG”—which stands for environmental, social and corporate governance, an industry buzzword.

The info is here.

Saturday, September 29, 2018

Want to live longer? Consider the ethics

John K. Davis
TheConversation.com
Originally published

Here is an excerpt:

Many people, such as philosopher John Harris and those in the Pew Center survey, worry that life extension would be available only to the rich and make existing inequalities even worse.

Indeed, it is unjust when some people live longer than the poor because they have better health care. It would be far more unjust if the rich could live several decades or centuries longer than anyone else and gain more time to consolidate their advantages.

Some philosophers suggest that society should prevent inequality by banning life extension. This is equality by denial – if not everyone can get it, then no one gets it.

However, as philosopher Richard J. Arneson notes, “leveling-down” – achieving equality by making some people worse off without making anyone better off – is unjust.

Indeed, as I argue in my recent book on life extension ethics, most of us reject leveling-down in other situations. For example, there are not enough human organs for transplant, but no one thinks the answer is to ban organ transplants.

Moreover, banning or slowing down the development of life extension may simply delay a time when the technology gets cheap enough for everyone to have it. TV sets were once a toy for the wealthy; now even poor families have them. In time, this could happen with life extension.

The info is here.

Friday, September 28, 2018

Nike, Kaepernick and the morality of capitalism

Steve Chapman
The Chicago Tribune
Originally posted September 5, 2018

Here is an excerpt:

The Republican Party has a large complement of corporate titans in its camp. But conservatives are reminded every day that some of the most successful and innovative companies are led and staffed by people whose worldview is deeply at odds with conservative ideology.

There is Amazon, whose founder and CEO, Jeff Bezos, owns The Washington Post, a frequent target of Trump’s animosity. There is Apple, where CEO Tim Cook has been a vocal critic of racial injustice and anti-gay discrimination. Facebook executive Sheryl Sandberg has written, “A truly equal world would be one where women ran half our countries and companies and men ran half our homes.”

Starbucks responded to Trump’s travel ban by pledging to hire 10,000 refugees. After the Parkland school massacre, Dick’s Sporting Goods stopped selling military-style firearms. Google, under pressure from employees opposed to creating “warfare technology,” withdrew from a Pentagon project on artificial intelligence.

But at the moment, the most visible face of corporate liberalism is Nike, whose new ad campaign features Kaepernick, a former San Francisco 49ers quarterback known for kneeling during the pregame national anthem to protest police abuses and racism. The campaign decision provoked a tweet from the president, who asserted, “Nike is getting absolutely killed with anger and boycotts.”

The info is here.

A Debate Over ‘Rational Suicide’

Paula Span
The New York Times
Originally posted August 31, 2018

Here is an excerpt:

Is suicide by older adults ever a rational choice? It’s a topic many older people discuss among themselves, quietly or loudly — and one that physicians increasingly encounter, too. Yet most have scant training or experience in how to respond, said Dr. Meera Balasubramaniam, a geriatric psychiatrist at the New York University School of Medicine.

“I found myself coming across individuals who were very old, doing well, and shared that they wanted to end their lives at some point,” said Dr. Balasubramaniam. “So many of our patients are confronting this in their heads.”

She has not taken a position on whether suicide can be rational — her views are “evolving,” she said. But hoping to generate more medical discussion, she and a co-editor explored the issue in a 2017 anthology, “Rational Suicide in the Elderly,” and she revisited it recently in an article in the Journal of the American Geriatrics Society.

The Hastings Center, the ethics institute in Garrison, N.Y., also devoted much of its latest Hastings Center Report to a debate over “voluntary death” to forestall dementia.

Every part of this idea, including the very phrase “rational suicide,” remains intensely controversial. (Let’s leave aside the related but separate issue of physician aid in dying, currently legal in seven states and the District of Columbia, which applies only to mentally competent people likely to die of a terminal illness within six months.)

The info is here.

Thursday, September 27, 2018

UNC protests present debate of law versus morality

Ali Akhyari
Charleston City Paper
Originally posted September 5, 2018

Here is an excerpt:

Immediately afterwards, UNC Chancellor Carol Folt referenced a 2015 law that protects historical monuments from being removed from any public property. Instead of making a public statement about the gross persistence of monuments to hate, she claimed her hands were tied and that students shouldn't break the law. Remember, after Charlottesville, it was president Trump who seemed incapable of acknowledging hate, saying there were "very fine people on both sides" after a woman was killed protesting the white supremacist march.

The debate regarding Confederate monuments and flags will never end so long as there are southerners more interested in rewriting history than admitting the Confederacy is intimately related to white supremacy. The true danger, though, is the normalization of white supremacy and nationalism in the Trump era. So it should follow, then, that Americans toppling monuments to oppression and hate will be increasingly forgivable as long as the the state and federal government coddles white nationalism.

Right after UNC, Trump tweeted a popular white nationalist talking point about land redistribution in post-Apartheid South Africa — a mirror of the battle minorities in this country have fought since emancipation.

So, I applaud the removal of Silent Sam. The monument fell at a time when the president has not only failed to recognize racism and historical oppression, instead encouraging it, pining for the return of Anglo-Saxon supremacy.

The info is here.

Superstition predicts perception of illusory control

Oren Griffiths, Noor Shehabi  Robin A. Murphy  Mike E. Le Pelley
British Journal of Psychology
First published August 24, 2018

Abstract

Superstitions are common, yet we have little understanding of the cognitive mechanisms that bring them about. This study used a laboratory‐based analogue for superstitious beliefs that involved people monitoring the relationship between undertaking an action (pressing a button) and an outcome occurring (a light illuminating). The task was arranged such that there was no objective contingency between pressing the button and the light illuminating – the light was just as likely to illuminate whether the button was pressed or not. Nevertheless, most people rated the causal relationship between the button press and the light illuminating to be moderately positive, demonstrating an illusion of causality. This study found that the magnitude of this illusion was predicted by people's level of endorsement of common superstitious beliefs (measured using a novel Superstitious Beliefs Questionnaire), but was not associated with mood variables or their self‐rated locus of control. This observation is consistent with a more general individual difference or bias to overweight conjunctive events over disjunctive events during causal reasoning in those with a propensity for superstitious beliefs.

The research is here.

Wednesday, September 26, 2018

Do psychotropic drugs enhance, or diminish, human agency?

Rami Gabriel
aeon.co
Originally posted September 3, 2018

Here is an excerpt:

Psychological medications such as Xanax, Ritalin and aspirin help to modify undesirable behaviours, thought patterns and the perception of pain. They purport to treat the underlying chemical cause rather than the social, interpersonal or psychodynamic causes of pathology. Self-knowledge gained by introspection and dialogue are no longer our primary means for modifying psychological states. By prescribing such medication, physicians are implicitly admitting that cognitive and behavioural training is insufficient and impractical, and that ‘the brain’, of which nonspecialists have little explicit understanding, is in fact the level where errors occur. Indeed, drugs are reliable and effective because they implement the findings of neuroscience and supplement (or in many cases substitute for) our humanist discourse about self-development and agency. In using such drugs, we become transhuman hybrid beings who build tools into the regulatory plant of the body.

Recreational drugs, on the other hand, are essentially hedonic tools that allow for stress-release and the diminishment of inhibition and sense of responsibility. Avenues of escape are reached through derangement of thought and perception; many find pleasure in this transcendence of quotidian experience and transgression of social norms. There is also a Dionysian, or spiritual, purpose to recreational inebriation, which can enable revelations that enhance intimacy and the emotional need for existential reflection. Here drugs act as portals into spiritual rituals and otherwise restricted metaphysical spaces. The practice of imbibing a sacred substance is as old as ascetic and mindfulness practices but, in our times, drugs are overwhelmingly the most commonly used tool for tending to this element of the human condition.

The info is here.

Navigating the Ethical Boundaries of Grateful Patient Fundraising

Collins ME, Rum SA, Sugarman J.
JAMA. Published online August 27, 2018.
doi:10.1001/jama.2018.11655

Here are two excerpts:

There is limited literature examining the ethical issues that grateful patient fundraising raises for physicians. The last American Medical Association report on this topic was issued in 2004.4 The report recognized the value of philanthropy and physicians’ role in it, but rightly emphasized the paramount importance of patients’ rights and welfare in efforts directed at grateful patient fundraising. As such, the report highlighted the need to ensure that gifts are voluntary, that patients should not perceive an obligation to give, and the need to protect privacy. In addition, the report cautioned against physicians initiating discussions about philanthropy during direct patient care. Furthermore, there is also limited literature about the ethical issues grateful patient fundraising poses for development professionals and the health care institutions they represent. Grappling with the ethical issues in grateful patient fundraising necessitates considering them from all of these perspectives.

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Among the key issues were challenges related to clinicians having discussions about philanthropy with patients who might be especially vulnerable due to their diseases or conditions, the tensions related to conflicts in regard to clinicians’ primary obligations to patient care and a competing obligation to fundraising, the potential effects of fundraising on patient care, possible unintended consequences of concierge services provided to donors, and concerns about privacy.5 The recommendations for clinicians include those concerning when grateful patient fundraising is appropriate (eg, ideally separate from the clinical encounter, not in situations of heightened vulnerability), minimizing conflicts of obligation and commitment, and respecting the donor’s intent of a gift. The recommendations for fundraising professionals and institutions include the need for transparency in relationships, not interfering with clinical care, attending to confidentiality and privacy, appropriateness of concierge services, and institutional policies and training in grateful patient fundraising.

The info is here.

Tuesday, September 25, 2018

Doctors’ mental health at tipping point

Chris Hemmings
BBC.co.uk
Originally posted September 3, 2018

Here is an excerpt:

'Last taboo'

Dr Gerada says the lack of confidentiality is a barrier and wants NHS England to extend the London approach to any doctor who needs support.

She believes acknowledging that doctors also have mental health problems is "the last taboo in the NHS".

Louise Freeman, a consultant in emergency medicine, says she left her job after she felt she could not access appropriate support for her depression.

"On the surface you might think 'Oh, doctors will get great mental health care because they'll know who to go to'.

"But actually we're kind of a hard-to-reach group. We can be quite worried about confidentiality," she said, adding that she believes doctors are afraid of coming forwards in case they lose their jobs.

"I was absolutely desperate to stay at work. I never wavered from that."

One of the biggest issues, according to Dr Gerada, is the effect on doctors of complaints from the public, which she says can "shatter their sense of self".

The info is here.

Horrific deaths, brutal treatment: Mental illness in America’s jails

Gary A. Harki
The Virginian-Pilot
Originally published August 23, 2018

Here is an excerpt:

“We are arresting people who have no idea what the laws are or the rules are because they're off their medications,” said Nashville Sheriff Daron Hall, a vice president of the National Sheriffs’ Association. “You'd never arrest someone for a heart attack, but you're comfortable arresting someone who is diagnosed mentally ill. No other country in the world is doing it this way.”

In addition to causing pain and suffering for people with mental illness, the practice is costing municipalities millions.

At least 53 percent of the deaths examined have resulted in a lawsuit. Combined, the cases have cost municipalities at least $145 million. The true cost is much higher – in many cases, lawsuits are still pending and in others the settlement amount is secret. The figures also do not take into account lawyers’ fees.

The article is here.

There are a series of articles related to mental health issues in prison.

Monday, September 24, 2018

How to find the right therapist

Nicole Spector
www.nbcnews.com
Originally posted August 5, 2018

Here are two excerpts:

What does therapy mean to you? What areas of your life do you want to explore and how? Do you want to talk about your family, or would you rather focus on a very specific past trauma or would you just like someone to talk with about whatever might be troubling you that week? The answers to these questions may change over time, but when you first go into therapy, ideally you should have some picture of what you want.

“You should know what you want to work on [when beginning therapy],” says Dr. Cira. “Do you feel really strong that you don't want to focus on your past and only the present? Do you want to focus more on things that have happened to you in the past? Do you want someone to help you ‘solve’ your problems or someone who will really sit with you in your pain or both? These are all things you should ask yourself that will help guide your search.”

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“Listen to your intuition,” says Humphreys. “If you feel instinctively unsafe with a therapist, that will probably inhibit the progress you will make. In contrast, if you feel you ‘click’ with a therapist, that's a good sign that you will be able to build a working alliance with them.”

Jor-El Caraballo, a licensed therapist, wellness coach and co-creator of Viva Wellness, notes that while there are measures that are clinical in nature there is also “a visceral feeling of just being comfortable enough to sit in a room with someone for the therapy hour. That can't be replaced and if you don't feel comfortable enough in a few sessions then it's probably best to tell your therapist this and work toward moving on.”

The info is here.

Distinct Brain Areas involved in Anger versus Punishment during Social Interactions

Olga M. Klimecki, David Sander & Patrik Vuilleumier
Scientific Reports volume 8, Article number: 10556 (2018)

Abstract

Although anger and aggression can have wide-ranging consequences for social interactions, there is sparse knowledge as to which brain activations underlie the feelings of anger and the regulation of related punishment behaviors. To address these issues, we studied brain activity while participants played an economic interaction paradigm called Inequality Game (IG). The current study confirms that the IG elicits anger through the competitive behavior of an unfair (versus fair) other and promotes punishment behavior. Critically, when participants see the face of the unfair other, self-reported anger is parametrically related to activations in temporal areas and amygdala – regions typically associated with mentalizing and emotion processing, respectively. During anger provocation, activations in the dorsolateral prefrontal cortex, an area important for regulating emotions, predicted the inhibition of later punishment behavior. When participants subsequently engaged in behavioral decisions for the unfair versus fair other, increased activations were observed in regions involved in behavioral adjustment and social cognition, comprising posterior cingulate cortex, temporal cortex, and precuneus. These data point to a distinction of brain activations related to angry feelings and the control of subsequent behavioral choices. Furthermore, they show a contribution of prefrontal control mechanisms during anger provocation to the inhibition of later punishment.

The research is here.

Sunday, September 23, 2018

The radical moral implications of luck in human life

David Roberts
vox.com
Originally posted August 21, 2018

Here is an excerpt:

So, then, here you are. You turn 18. You are no longer a child; you are an adult, a moral agent, responsible for who you are and what you do.

By that time, your inheritance is enormous. You’ve not only been granted a genetic makeup, an ethnicity and appearance, by accidents of nature and parentage. You’ve also had your latent genetic traits “activated” in a very specific way through a specific upbringing, in a specific environment, with a specific set of experiences.

Your basic mental and emotional wiring is in place; you have certain instincts, predilections, fears, and cravings. You have a certain amount of money, certain social connections and opportunities, a certain family lineage. You’ve had a certain amount and quality of education. You’re a certain kind of person.

You are not responsible for any of that stuff; you weren’t yet capable of being responsible. You were just a kid (or worse, a teen). You didn’t choose your genes or your experiences. Both nature and the vast bulk of the nurture that matters happened to you.

And yet when you turn 18, it’s all yours — the whole inheritance, warts and all. By the time you are an autonomous, responsible moral agent, you have effectively been fired out of a cannon, on a particular trajectory. You wake up, morally speaking, midflight.

The info is here.

Saturday, September 22, 2018

The Business Case for Curiosity

Francesca Gino
Harvard Business Review
Originally posted September-October Issue

Here are two excerpts:

The Benefits of Curiosity

New research reveals a wide range of benefits for organizations, leaders, and employees.

Fewer decision-making errors.

In my research I found that when our curiosity is triggered, we are less likely to fall prey to confirmation bias (looking for information that supports our beliefs rather than for evidence suggesting we are wrong) and to stereotyping people (making broad judgments, such as that women or minorities don’t make good leaders). Curiosity has these positive effects because it leads us to generate alternatives.

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It’s natural to concentrate on results, especially in the face of tough challenges. But focusing on learning is generally more beneficial to us and our organizations, as some landmark studies show. For example, when U.S. Air Force personnel were given a demanding goal for the number of planes to be landed in a set time frame, their performance decreased. Similarly, in a study led by Southern Methodist University’s Don VandeWalle, sales professionals who were naturally focused on performance goals, such as meeting their targets and being seen by colleagues as good at their jobs, did worse during a promotion of a product (a piece of medical equipment priced at about $5,400) than reps who were naturally focused on learning goals, such as exploring how to be a better salesperson. That cost them, because the company awarded a bonus of $300 for each unit sold.

A body of research demonstrates that framing work around learning goals (developing competence, acquiring skills, mastering new situations, and so on) rather than performance goals (hitting targets, proving our competence, impressing others) boosts motivation. And when motivated by learning goals, we acquire more-diverse skills, do better at work, get higher grades in college, do better on problem-solving tasks, and receive higher ratings after training. Unfortunately, organizations often prioritize performance goals.

The information is here.

Friday, September 21, 2018

Surprised By A Medical Bill? Join The Club. Most Americans Say They Have Been

Alison Kodjak
www.npr.org
Originally posted September 2, 2018

Here is an excerpt:

Most survey respondents — 57 percent — have been surprised by a medical bill they thought would be paid for by their insurance companies, the survey from the research group NORC at the University of Chicago finds.

"People get surprised by all kinds of bills, for all kinds of reasons," says Caroline Pearson, a senior fellow at NORC.

Pearson herself says she was not expecting the problem to be so widespread.

The survey shows that 53 percent of those surveyed were surprised by a bill for a physician's service, and 51 percent got an unexpected bill for a laboratory test – like the urine test featured in our earlier story.

Hospital and health care facility charges surprised 43 percent of respondents, and 35 percent reported getting unexpected bills for imaging services, like the CT scan featured by NPR.

The survey shows that while some of the unexpected bills come because doctors or hospitals where patients are treated don't participate in the patients' insurance networks, the majority come because patients expect their insurance to cover more than it actually does.

The info is here.

Why Social Science Needs Evolutionary Theory

Christine Legare
Nautilus.com
Originally posted June 15, 2018

Here is an excerpt:

Human cognition and behavior is the product of the interaction of genetic and cultural evolution. Gene-culture co-evolution has allowed us to adapt to highly diverse ecologies and to produce cultural adaptations and innovations. It has also produced extraordinary cultural diversity. In fact, cultural variability is one of our species’ most distinctive features. Humans display a wider repertoire of behaviors that vary more within and across groups than any other animal. Social learning enables cultural transmission, so the psychological mechanisms supporting it should be universal. These psychological mechanisms must also be highly responsive to diverse developmental contexts and cultural ecologies.

Take the conformity bias. It is a universal proclivity of all human psychology—even very young children imitate the behavior of others and conform to group norms. Yet beliefs about conformity vary substantially between populations. Adults in some populations are more likely to associate conformity with children’s intelligence, whereas others view creative non-conformity as linked with intelligence. Psychological adaptations for social learning, such as conformity bias, develop in complex and diverse cultural ecologies that work in tandem to shape the human mind and generate cultural variation.

The info is here.

Thursday, September 20, 2018

Man-made human 'minibrains' spark debate on ethics and morality

Carolyn Y. Johnson
www.iol.za
Originally posted September 3, 2018

Here is an excerpt:

Five years ago, an ethical debate about organoids seemed to many scientists to be premature. The organoids were exciting because they were similar to the developing brain, and yet they were incredibly rudimentary. They were constrained in how big they could get before cells in the core started dying, because they weren't suffused with blood vessels or supplied with nutrients and oxygen by a beating heart. They lacked key cell types.

Still, there was something different about brain organoids compared with routine biomedical research. Song recalled that one of the amazing but also unsettling things about the early organoids was that they weren't as targeted to develop into specific regions of the brain, so it was possible to accidentally get retinal cells.

"It's difficult to see the eye in a dish," Song said.

Now, researchers are succeeding at keeping organoids alive for longer periods of time. At a talk, Hyun recalled one researcher joking that the lab had sung "Happy Birthday" to an organoid when it was a year old. Some researchers are implanting organoids into rodent brains, where they can stay alive longer and grow more mature. Others are building multiple organoids representing different parts of the brain, such as the hippocampus, which is involved in memory, or the cerebral cortex - the seat of cognition - and fusing them together into larger "assembloids."

Even as scientists express scepticism that brain organoids will ever come close to sentience, they're the ones calling for a broad discussion, and perhaps more oversight. The questions range from the practical to the fantastical. Should researchers make sure that people who donate their cells for organoid research are informed that they could be used to make a tiny replica of parts of their brain? If organoids became sophisticated enough, should they be granted greater protections, like the rules that govern animal research? Without a consensus on what consciousness or pain would even look like in the brain, how will scientists know when they're nearing the limit?

The info is here.

John Rawls’ ‘A Theory of Justice’

Ben Davis
1000-Word Philosophy
Originally posted July 27, 2018

Here is an excerpt:

Reasonable people often disagree about how to live, but we need to structure society in a way that reasonable members of that society can accept. Citizens could try to collectively agree on basic rules. We needn’t decide every detail: we might only worry about rules concerning major political and social institutions, like the legal system and economy, which form the ‘basic structure’ of society.

A collective agreement on the basic structure of society is an attractive ideal. But some people are more powerful than others: some may be wealthier, or part of a social majority. If people can dominate negotiations because of qualities that are, as Rawls (72-75) puts it, morally arbitrary, that is wrong. People don’t earn these advantages: they get them by luck. For anyone to use these unearned advantages to their own benefit is unfair, and the source of many injustices.

This inspires Rawls’ central claim that we should conceive of justice ‘as fairness.’ To identify fairness, Rawls (120) develops two important concepts: the original position and the veil of ignorance:

The original position is a hypothetical situation: Rawls asks what social rules and institutions people would agree to, not in an actual discussion, but under fair conditions, where nobody knows whether they are advantaged by luck. Fairness is achieved through the veil of ignorance, an imagined device where the people choosing the basic structure of society (‘deliberators’) have morally arbitrary features hidden from them: since they have no knowledge of these features, any decision they make can’t be biased in their own favour.

The brief, excellent synopsis is here.

Wednesday, September 19, 2018

Why “happy” doctors die by suicide

Pamela Wible
www.idealmedicalcare.org
Originally posted on August 24, 2018

Here is an excerpt:

Doctor suicides on the registry were submitted to me during a six-year period (2012-2018) by families, friends, and colleagues who knew the deceased. After speaking to thousands of suicidal physicians since 2012 on my informal doctor suicide hotline and analyzing registry data, I discovered surprising themes—many unique to physicians.

Public perception maintains that doctors are successful, intelligent, wealthy, and immune from the problems of the masses. To patients, it is inconceivable that doctors would have the highest suicide rate of any profession (5).

Even more baffling, “happy” doctors are dying by suicide. Many doctors who kill themselves appear to be the most optimistic, upbeat, and confident people. Just back from Disneyland, just bought tickets for a family cruise, just gave a thumbs up to the team after a successful surgery—and hours later they shoot themselves in the head.

Doctors are masters of disguise and compartmentalization.

Turns out some of the happiest people—especially those who spend their days making other people happy—may be masking their own despair.

The info is here.

Many Cultures, One Psychology?

Nicolas Geeraert
American Scientist
Originally published in the July-August issue

Here is an excerpt:

The Self

If you were asked to describe yourself, what would you say? Would you list your personal characteristics, such as being intelligent or funny, or would you use preferences, such as “I love pizza”? Or perhaps you would instead mention social relationships, such as “I am a parent”? Social psychologists have long maintained that people are much more likely to describe themselves and others in terms of stable personal characteristics than they are to describe themselves in terms of their preferences or relationships.

However, the way people describe themselves seems to be culturally bound. In a landmark 1991 paper, social psychologists Hazel R. Markus and Shinobu Kitayama put forward the idea that self-construal is culturally variant, noting that individuals in some cultures understand the self as independent, whereas those in other cultures perceive it as interdependent.

People with an independent self-construal view themselves as free, autonomous, and unique individuals, possessing stable boundaries and a set of fixed characteristics or attributes by which their actions are guided. Independent self-construal is more prevalent in Europe and North America. By contrast, people with an interdependent self-construal see themselves as more connected with others close to them, such as their family or community, and think of themselves as a part of different social relationships.

The information is here.

Tuesday, September 18, 2018

Changing the way we communicate about patients

Abraar Karan
BMJ Blog
Originally posted August 29, 2018

Here is an excerpt:

There are many changes that we can make to improve how we communicate about patients. One of the easiest and most critical transformations is how we write our medical notes. One of the best doctors I ever worked with did exactly this, and is famous at the Brigham (our hospital) for doing it. He systematically starts every single note with the person’s social history. Who is this patient? It is not just a lady with abdominal pain. It is a mother of three, a retired teacher, and an active cyclist. That is the first thing we read about her, and so when I enter her room, I can’t help but see her this way rather than as a case of appendicitis.

This matters because patients deserve to be treated as people—a statement that’s so obvious it shouldn’t need to be said, but which physician behaviour doesn’t always reflect. You wouldn’t expect to know the most sensitive and vulnerable aspects of someone before even knowing their most basic background, yet we do this in medicine all the time. This is also important because in many clinical presentations, it provides critical information that helps deduce how they got sick, and why they may get sick again in the same way if we don’t restructure something essential in their life. For instance, if I didn’t know that the 22 year old opioid addict had just been kicked out of his house and is on the street without transportation to get to his suboxone clinic, I will not have truly solved what brought him to the hospital in the first place.

The info is here.

The So-Called Right to Try Law Gives Patients False Hope

Claudia Wallis
Scientific American
Originally posted in the September 2018 issue

There's no question about it: the new law sounds just great. President Donald Trump, who knows a thing or two about marketing, gushed about its name when he signed the “Right to Try” bill into law on May 30. He was surrounded by patients with incurable diseases, including a second grader with Duchenne muscular dystrophy, who got up from his small wheelchair to hug the president. The law aims to give such patients easier access to experimental drugs by bypassing the Food and Drug Administration.

The crowd-pleasing name and concept are why 40 states had already passed similar laws, although they were largely symbolic until the federal government got onboard. The laws vary but generally say that dying patients may seek from drugmakers any medicine that has passed a phase I trial—a minimal test of safety. “We're going to be saving tremendous numbers of lives,” Trump said. “The current FDA approval process can take many, many years. For countless patients, time is not what they have.”

But the new law won't do what the president claims. Instead it gives false hope to the most vulnerable patients. “This is a right to ask, not a right to try,” says Alison Bateman-House, a medical ethicist at New York University and an expert on the compassionate use of experimental drugs.

The info is here.

Monday, September 17, 2018

Who Is Experiencing What Kind of Moral Distress?

Carina Fourie
AMA J Ethics. 2017;19(6):578-584.

Abstract

Moral distress, according to Andrew Jameton’s highly influential definition, occurs when a nurse knows the morally correct action to take but is constrained in some way from taking this action. The definition of moral distress has been broadened, first, to include morally challenging situations that give rise to distress but which are not necessarily linked to nurses feeling constrained, such as those associated with moral uncertainty. Second, moral distress has been broadened so that it is not confined to the experiences of nurses. However, such a broadening of the concept does not mean that the kind of moral distress being experienced, or the role of the person experiencing it, is morally irrelevant. I argue that differentiating between categories of distress—e.g., constraint and uncertainty—and between groups of health professionals who might experience moral distress is potentially morally relevant and should influence the analysis, measurement, and amelioration of moral distress in the clinic.

The info is here.

How our lives end must no longer be a taboo subject

Kathryn Mannix
The Guardian
Originally published August 16, 2018

Here is an excerpt:

As we age and develop long-term health conditions, our chances of becoming suddenly ill rise; prospects for successful resuscitation fall; our youthful assumptions about length of life may be challenged; and our quality of life becomes increasingly more important to us than its length. The number of people over the age of 85 will double in the next 25 years, and dementia is already the biggest cause of death in this age group. What discussions do we need to have, and to repeat at sensible intervals, to ensure that our values and preferences are understood by the people who may be asked about them?

Our families need to know our answers to such questions as: how much treatment is too much or not enough? Do we see artificial hydration and nutrition as “treatment” or as basic care? Is life at any cost or quality of life more important to us? And what gives us quality of life? A 30-year-old attorney may not understand that being able to hear birdsong, or enjoy ice-cream, or follow the racing results, is more important to a family’s 85-year-old relative than being able to walk or shop. When we are approaching death, what important things should our carers know about us?

The info is here.

Sunday, September 16, 2018

Time to abandon grand ethical theories?

Julian Baggini
TheTLS.co
Originally posted May 22, 2018

Here are two excerpts:

Social psychologists, sociologists and anthropologists would not be baffled by this apparent contradiction. Many have long believed that morality is essentially a system of social regulation. As such it is in no more need of a divine foundation or a philosophical justification than folk dancing or tribal loyalty. Indeed, if ethics is just the management of the social sphere, it should not be surprising that as we live in a more globalized world, ethics becomes enlarged to encompass not only how we treat kith and kin but our distant neighbours too.

Philosophers have more to worry about. They are not generally satisfied to see morality as a purely pragmatic means of keeping the peace. To see the world muddling through morality is deeply troubling. Where’s the consistency? Where’s the theoretical framework? Where’s the argument?

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There is then a curious combination of incoherence and vagueness about just what it is to be ethical, and a bogus precision in the ways in which organizations prove themselves to be good. All this confusion helps fuel philosophical ethics, which has become a vibrant, thriving discipline, providing academic presses with a steady stream of books. Looking over a sample of their recent output, it is evident that moral philosophers are keen to show that they are not just playing intellectual games and that they have something to offer the world.

The info is here.

Saturday, September 15, 2018

Social Science One And How Top Journals View The Ethics Of Facebook Data Research

Kalev Leetaru
Forbes.com
Originally posted on August 13, 2018

Here is an excerpt:

At the same time, Social Science One’s decision to leave all ethical questions TBD and to eliminate the right to informed consent or the ability to opt out of research fundamentally redefines what it means to conduct research in the digital era, normalizing the removal of these once sacred ethical tenets. Given the refusal of one of its committee members to provide replication data for his own study and the statement by another committee member that “I have articulated the argument that ToS are not, and should not be considered, ironclad rules binding the activities of academic researchers. … I don't think researchers should reasonably be expected to adhere to such conditions, especially at a time when officially sanctioned options for collecting social media data are disappearing left and right,” the result is an ethically murky landscape in which it is unclear just where Social Science One draws the line at what it will or will not permit.

Given Facebook’s new focus on “privacy first” I asked the company whether it would commit to offering its two billion users a new profile setting allowing them to opt out of having their data made available to academic researchers such as Social Science One. As it has repeatedly done in the past, the company declined to comment.

The info is here.

Friday, September 14, 2018

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home

Alexander D. McCourt, and Jon S. Vernick
AMA J Ethics. 2018;20(1):69-76.

Abstract

Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate.

The info is here.

What Are “Ethics in Design”?

Victoria Sgarro
slate.com
Originally posted August 13, 2018

Here is an excerpt:

As a product designer, I know that no mandate exists to integrate these ethical checks and balances in our process. While I may hear a lot of these issues raised at speaking events and industry meetups, more “practical” considerations can overshadow these conversations in my day-to-day decision making. When they have to compete with the workaday pressures of budgets, roadmaps, and clients, these questions won’t emerge as priorities organically.

Most important, then, is action. Castillo worries that the conversation about “ethics in design” could become a cliché, like “empathy” or “diversity” in tech, where it’s more talk than walk. She says it’s not surprising that ethics in tech hasn’t been addressed in depth in the past, given the industry’s lack of diversity. Because most tech employees come from socially privileged backgrounds, they may not be as attuned to ethical concerns. A designer who identifies with society’s dominant culture may have less personal need to take another perspective. Indeed, identification with a society’s majority is shown to be correlated with less critical awareness of the world outside of yourself. Castillo says that, as a black woman in America, she’s a bit wary of this conversation’s effectiveness if it remains only a conversation.

“You know how someone says, ‘Why’d you become a nurse or doctor?’ And they say, ‘I want to help people’?” asks Castillo. “Wouldn’t it be cool if someone says, ‘Why’d you become an engineer or a product designer?’ And you say, ‘I want to help people.’ ”

The info is here.

Thursday, September 13, 2018

How Should Clinicians Respond to Requests from Patients to Participate in Prayer?

A. R. Christensen, T. E. Cook, and R. M. Arnold
AMA J Ethics. 2018;20(7):E621-629.

Abstract

Over the past 20 years, physicians have shifted from viewing a patient’s request for prayer as a violation of professional boundaries to a question deserving nuanced understanding of the patient’s needs and the clinician’s boundaries. In this case, Mrs. C’s request for prayer can reflect religious distress, anxiety about her clinical circumstances, or a desire to better connect with her physician. These different needs suggest that it is important to understand the request before responding. To do this well requires that Dr. Q not be emotionally overwhelmed by the request and that she has skill in discerning potential reasons for the request.

The info is here.

Meet the Chatbots Providing Mental Health Care

Daniela Hernandez
Wall Street Journal
Originally published Aug. 9, 2018

Here is an excerpt:

Wysa Ltd., a London- and Bangalore-based startup, is testing a free chatbot to teach adolescents emotional resilience, said co-founder Ramakant Vempati.  In the app, a chubby penguin named Wysa helps users evaluate the sources of their stress and provides tips on how to stay positive, like thinking of a loved one or spending time outside.  The company said its 400,000 users, most of whom are under 35, have had more than 20 million conversations with the bot.

Wysa is a wellness app, not a medical intervention, Vempati said, but it relies on cognitive behavioral therapy, mindfulness techniques and meditations that are “known to work in a self-help context.”  If a user expresses thoughts of self-harm, Wysa reminds them that it’s just a bot and provides contact information for crisis hotlines.  Alternatively, for $30 a month, users can access unlimited chat sessions with a human “coach.”  Other therapy apps, such as Talkspace, offer similar low-cost services with licensed professionals.

Chatbots have potential, said Beth Jaworski, a mobile apps specialist at the National Center for PTSD in Menlo Park, Calif.  But definitive research on whether they can help patients with more serious conditions, like major depression, still hasn’t been done, in part because the technology is so new, she said.  Clinicians also worry about privacy.  Mental health information is sensitive data; turning it over to companies could have unforeseen consequences.

The article is here.

Wednesday, September 12, 2018

How Could Commercial Terms of Use and Privacy Policies Undermine Informed Consent in the Age of Mobile Health?

Cynthia E. Schairer, Caryn Kseniya Rubanovich, and Cinnamon S. Bloss
AMA J Ethics. 2018;20(9):E864-872.

Abstract

Granular personal data generated by mobile health (mHealth) technologies coupled with the complexity of mHealth systems creates risks to privacy that are difficult to foresee, understand, and communicate, especially for purposes of informed consent. Moreover, commercial terms of use, to which users are almost always required to agree, depart significantly from standards of informed consent. As data use scandals increasingly surface in the news, the field of mHealth must advocate for user-centered privacy and informed consent practices that motivate patients’ and research participants’ trust. We review the challenges and relevance of informed consent and discuss opportunities for creating new standards for user-centered informed consent processes in the age of mHealth.

The info is here.

‘My death is not my own’: the limits of legal euthanasia

Henk Blanken
The Guardian
Originally posted August 10, 2018

Here is an excerpt:

Of the 10,000 Dutch patients with dementia who die each year, roughly half of them will have had an advance euthanasia directive. They believed a doctor would “help” them. After all, this was permitted by law, and it was their express wish. Their naive confidence is shared by four out of 10 Dutch adults, who are convinced that a doctor is bound by an advance directive. In fact, doctors are not obliged to do anything. Euthanasia may be legal, but it is not a right.

As doctors have a monopoly on merciful killing, their ethical standard, and not the law, ultimately determines whether a man like Joop can die. An advance directive is just one factor, among many, that a doctor will consider when deciding on a euthanasia case. And even though the law says it’s legal, almost no doctors are willing to perform euthanasia on patients with severe dementia, since such patients are no longer mentally capable of making a “well-considered request” to die.

This is the catch-22. If your dementia is at such an early stage that you are mentally fit enough to decide that you want to die, then it is probably “too early” to want to die. You still have good years left. And yet, by the time your dementia has deteriorated to the point at which you wished (when your mind was intact) to die, you will no longer be allowed to die, as you are not mentally fit to make that decision. It is now “too late” to die.

The info is here.

Tuesday, September 11, 2018

Against mourning

Brian Earp
aeon.com
Originally posted August 21, 2018

Here is an excerpt:

That is what is so different about their intuitions and ours. To put it simply, if you are not a Stoic philosopher – if you have not been training yourself, year in and year out, to calmly face life’s vagaries and inescapables – and you feel no hint of sadness when your child, or spouse, or family member dies, then there probably is something wrong with you. You probably have failed to love or cherish that person appropriately or sufficiently while they were alive, and that would be a mark against you.

You might have been cruel and uncaring, for instance, or emotionally distant, or otherwise aloof. For had you not been those things, you would certainly grieve. This, in turn, can explain why the Stoics were (and are) often thought to be so callous – as though they must have advocated such detachment from one’s kith and kin in order to pre-empt any associated suffering.

However, nothing could be further from the truth. As Epictetus instructs, one should not ‘be unfeeling like a statue’ but rather maintain one’s relations, ‘both natural and acquired, as a pious man, a son, a brother, a father, a citizen’. He also repeatedly emphasises that we are social animals, for whom parental and other forms of love come naturally. ‘Even Epicurus,’ he says, derisively, about a philosopher from a competing school, ‘knows that if once a child is born, it will no longer be in our power not to love it or care for it.’

But is it not part of loving one’s child to feel at least some grief when it suffers or dies (you might ask)? Surely feeling no grief would itself be contrary to Nature! For just as virtue cannot exist without wrongdoing, as some Stoics held, so too might the prospect of grief be in some way bound up in love, so that you cannot have one without the other.

The info is here.

Motivated misremembering: Selfish decisions are more generous in hindsight

Ryan Carlson, Michel Marechal, Bastiaan Oud, Ernst Fehr, and Molly Crockett
Created on: July 22, 2018 | Last edited: July 22, 2018

Abstract

People often prioritize their own interests, but also like to see themselves as moral. How do individuals resolve this tension? One way to both maximize self-interest and maintain a moral self-image is to misremember the extent of one’s selfishness. Here, we tested this possibility. Across three experiments, participants decided how to split money with anonymous partners, and were later asked to recall their decisions. Participants systematically recalled being more generous in the past than they actually were, even when they were incentivized to recall accurately. Crucially, this effect was driven by individuals who gave less than what they personally believed was fair, independent of how objectively selfish they were. Our findings suggest that when people’s actions fall short of their own personal standards, they may misremember the extent of their selfishness, thereby warding off negative emotions and threats to their moral self-image.

The research is here.

Monday, September 10, 2018

The Vatican knew of a cover-up involving abusive priests, Pennsylvania AG says

Holly Yan
CNN.com
Originally published August 28, 2018

In the latest scathing allegation against the Catholic church, Pennsylvania's attorney general said the Vatican knew about a cover-up involving sex abuse allegations against priests.

"We have evidence that the Vatican had knowledge of the cover-up," Attorney General Josh Shapiro told NBC's "Today" show Tuesday.

He later told CNN's Wolf Blitzer, "Once the Vatican learned of it, I do not know if the Pope learned about it or not."

The accusation comes two weeks after the release of a grand jury report saying hundreds of "predator priests" had abused children in six Pennsylvania dioceses over the past seven decades.
Shapiro did not specify Tuesday what evidence he has that would suggest the Vatican knew of a cover-up.

The information is here.

Cognitive Biases Tricking Your Brain

Ben Yagoda
The Atlantic
September 2018 Issue

Here is an excerpt:

Because biases appear to be so hardwired and inalterable, most of the attention paid to countering them hasn’t dealt with the problematic thoughts, judgments, or predictions themselves. Instead, it has been devoted to changing behavior, in the form of incentives or “nudges.” For example, while present bias has so far proved intractable, employers have been able to nudge employees into contributing to retirement plans by making saving the default option; you have to actively take steps in order to not participate. That is, laziness or inertia can be more powerful than bias. Procedures can also be organized in a way that dissuades or prevents people from acting on biased thoughts. A well-known example: the checklists for doctors and nurses put forward by Atul Gawande in his book The Checklist Manifesto.

Is it really impossible, however, to shed or significantly mitigate one’s biases? Some studies have tentatively answered that question in the affirmative. These experiments are based on the reactions and responses of randomly chosen subjects, many of them college undergraduates: people, that is, who care about the $20 they are being paid to participate, not about modifying or even learning about their behavior and thinking. But what if the person undergoing the de-biasing strategies was highly motivated and self-selected? In other words, what if it was me?

The info is here.

Sunday, September 9, 2018

People Are Averse to Machines Making Moral Decisions

Yochanan E. Bigman and Kurt Gray
In press, Cognition

Abstract

Do people want autonomous machines making moral decisions? Nine studies suggest that that
the answer is ‘no’—in part because machines lack a complete mind. Studies 1-6 find that people
are averse to machines making morally-relevant driving, legal, medical, and military decisions,
and that this aversion is mediated by the perception that machines can neither fully think nor
feel. Studies 5-6 find that this aversion exists even when moral decisions have positive outcomes.
Studies 7-9 briefly investigate three potential routes to increasing the acceptability of machine
moral decision-making: limiting the machine to an advisory role (Study 7), increasing machines’
perceived experience (Study 8), and increasing machines’ perceived expertise (Study 9).
Although some of these routes show promise, the aversion to machine moral decision-making is
difficult to eliminate. This aversion may prove challenging for the integration of autonomous
technology in moral domains including medicine, the law, the military, and self-driving vehicles.

The research is here.

Saturday, September 8, 2018

Silicon Valley Writes a Playbook to Help Avert Ethical Disasters

Arielle Pardes
www.wired.com
Originally posted August 7, 2018

Here is an excerpt:

The first section outlines 14 near-future scenarios, based on contemporary anxieties in the tech world that could threaten companies in the future. What happens, for example, if a company like Facebook purchases a major bank and becomes a social credit provider? What happens if facial-recognition technology becomes a mainstream tool, spawning a new category of apps that integrates the tech into activities like dating and shopping? Teams are encouraged to talk through each scenario, connect them back to the platforms or products they're developing, and discuss strategies to prepare for these possible futures.

Each of these scenarios came from contemporary "signals" identified by the Institute of the Future—the rise of "deep fakes," tools for "predictive justice," and growing concerns about technology addiction.

"We collect things like this that spark our imagination and then we look for patterns, relationships. Then we interview people who are making these technologies, and we start to develop our own theories about where the risks will emerge," says Jane McGonigal, the director of game research at the Institute of the Future and the research lead for the Ethical OS. "The ethical dilemmas are around issues further out than just the next release or next growth cycle, so we felt helping companies develop the imagination and foresight to think a decade out would allow more ethical action today."

The info is here.

Friday, September 7, 2018

Nietzsche and the Death of God

Justin Remhof
1000-Word Philosophy

Here is an excerpt:

1. Nietzsche on Why People Believe in God

What is Nietzsche’s justification for claiming that God is a fiction? The answer lies in the function of the idea of God.

According to Nietzsche, the idea of God was created to help people handle widespread and seemingly senseless suffering. The ancient Israelites, who brought forward the Judeo-Christian God, lived in horrible conditions: for many generations, they were enslaved, beaten, and killed. Under such immense duress, it’s perfectly reasonable for them to find some reason to explain suffering and hope that those responsible for suffering will be punished.

The idea of God plays that role. The idea of God emerges to provide light in a dark world. From antiquity to today most people turn to God when awful tragedies happen – for example, when loved ones are gunned down by active shooters, trapped in cities bombarded by hurricanes, or diagnosed with cancer. For many, belief in God provides strength to endure such misery. Belief in God also provides hope that when our loved ones pass away we can live with them again for eternity. Belief in God ensures that no loss is inconsolable, no injustice unrequited, and that we can finally have everlasting peace, no matter the misery gone through to get there.

For Nietzsche, then, there is a natural explanation for belief in God. God is a psychological fabrication created to soothe distress, ease trauma, and provide companionship in the face of suffering.

The info is here.

23andMe's Pharma Deals Have Been the Plan All Along

Megan Molteni
www.wired.com
Originally posted August 3, 2018

Here is an excerpt:

So last week’s announcement that one of the world’s biggest drugmakers, GlaxoSmithKline, is gaining exclusive rights to mine 23andMe’s customer data for drug targets should come as no surprise. (Neither should GSK’s $300 million investment in the company). 23andMe has been sharing insights gleaned from consented customer data with GSK and at least six other pharmaceutical and biotechnology firms for the past three and a half years. And offering access to customer information in the service of science has been 23andMe’s business plan all along, as WIRED noted when it first began covering the company more than a decade ago.

But some customers were still surprised and angry, unaware of what they had already signed (and spat) away. GSK will receive the same kind of data pharma partners have generally received—summary level statistics that 23andMe scientists gather from analyses on de-identified, aggregate customer information—though it will have four years of exclusive rights to run analyses to discover new drug targets. Supporting this kind of translational work is why some customers signed up in the first place. But it’s clear the days of blind trust in the optimistic altruism of technology companies are coming to a close.

“I think we’re just operating now in a much more untrusting environment,” says Megan Allyse, a health policy researcher at the Mayo Clinic who studies emerging genetic technologies. “It’s no longer enough for companies to promise to make people healthy through the power of big data.”

The info is here.

Thursday, September 6, 2018

Building An Ethics-First Employee Culture Is Crucial For All Leaders

Patrick Quinlan
Forbes.com
Originally posted July 25, 2018

Here is an excerpt:

These issues — harassment, bias, sexism — are nothing new in the tech sector but, now more than ever before, employees are taking matters into their own hands to make sure ethical business practices and values are upheld, even when leadership fails to do so.

In the last few years, we have seen the entire employer-employee paradigm shift, from offices embracing open floor plans to leaders encouraging team bonding activities. Underlying this massive business transformation is a stronger emphasis on the people who make up organizations, their values and their opinions. What we’ve borne witness to is the rise of empowered employees.

For leaders, shifting gears to focus on people first may feel scary. No one wants their employees to point out something is wrong at the company. But if instilling core ethical values is truly your objective, openness to criticism is part of the job description. Your commitment to promoting a safe, empowering space is not only beneficial for your employees — it ultimately strengthens your company’s culture, values, ethics — and therefore your company’s success long-term.

When leaders lead proactively, encouraging employees to come forward with an opinion or idea, employees feel safe, heard and ready to improve their company culture from the inside out. Whether you’re running a technology giant or a small startup, it’s no overnight shift. But you can start small by asking questions, taking feedback seriously and celebrating your team’s autonomy.

The information is here.

When Doctors Struggle With Suicide, Their Profession Often Fails Them

Blake Farmer
NPR.org
Originally posted July 31, 2018

Here is an excerpt:

A particular danger for doctors trying to fend off suicidal urges is that they know exactly how to end their own lives and often have easy access to the means.

Wenger remembers his friend and colleague as the confident professional with whom he had worked in emergency rooms all over Knoxville — including the one where she died. That day three years ago still makes no sense to him.

"She was very strong-willed, strong-minded, an independent, young, female physician," says emergency doctor Betsy Hull, a close friend. "I don't think any of us had any idea that she was struggling as much personally as she was for those several months."

That day she became part of a grim set of statistics.

A harsh reality

An estimated 300 to 400 doctors kill themselves each year, a rate of 28 to 40 per 100,000 or more than double that of general population. That is according to a review of 10 years of literature on the subject presented at the American Psychiatry Association annual meeting in May.

The information is here.

Wednesday, September 5, 2018

Are embryos people? The answer will determine the future of reproductive medicine

Eric Forman
Statnews.com
Originally posted July 24, 2018

Here is an excerpt:

The goal of this process is to achieve a healthy child, which now occurs at a remarkably high rate. For specific genetic disorders, preimplantation genetic testing can reduce the odds of having a child with a lethal disorder from 25 to 50 percent to less than 1 percent.

Medicine’s ability to culture embryos and select healthy ones has improved dramatically in the last few years. A clinical trial that I led several years ago showed that transferring a single genetically tested normal embryo resulted in the same delivery rate as transferring multiple untested embryos. When genetic testing is performed, it is now standard of care to transfer just a single embryo at a time — gone are the days of risky triplet and high-order multiples after IVF. Actual babies, not embryos, are being spared from dying from the complications of genetic diseases and severe prematurity thanks to the increased use of single-embryo transfer afforded by preimplantation genetic testing.

The information is here.

Judges as moral reasoners

Jeremy Waldron
International Journal of Constitutional Law
Published: 01 January 2009

Abstract

Debates about judicial authority―including debates about the desirability of judicial review of legislation—sometimes turn on the question of whether judges have superior skills when it comes to addressing what are, essentially, moral issues about rights. This paper considers the possibility that the answer may be “no,” not because judges are inept morally, but because the institutional setting in which they act and the role that they adopt both require them to address questions about rights in a particular legalistic way—indeed, in a way that, sometimes, makes it harder rather than easier for essential moral questions to be identified and addressed. Of course, what we want is for moral issues to be addressed, not as one would make a personal moral decision, but in the name of the whole society. Perhaps the judicial mode of addressing them satisfies that description, but there are other ways of satisfying it too—including legislative approaches, which proceed by identifying all the issues and all the opinions that might be relevant to a decision, rather than artificially limiting them in the way that courts do.

Tuesday, September 4, 2018

Financial Ties That Bind: Studies Often Fall Short On Conflict-Of-Interest Disclosures

Rachel Bluth
Kaiser Health News
Originally published August 15, 2018

Papers in medical journals go through rigorous peer review and meticulous data analysis.

Yet many of these articles are missing a key piece of information: the financial ties of the authors.

Nearly two-thirds of the 100 physicians who rake in the most money from 10 device manufacturers failed to disclose a conflict of interest in their academic writing in 2016, according to a study published Wednesday in JAMA Surgery.

The omission can have real-life impact for patients when their doctors rely on such research to make medical decisions, potentially without knowing the authors’ potential conflicts of interest.

“The issue is anytime there’s a new technology, people get really excited about it,” said lead researcher Dr. Mehraneh Jafari. “Whoever is reading the data on it needs to have the most information.”

The article is here.

Belief in God: Why People Believe, and Why They Don’t

Brett Mercier, , Stephanie R. Kramer, Azim F. Shariff
Current Directions in Psychological Science
First Published July 31, 2018

Abstract

Belief in a god or gods is a central feature in the lives of billions of people and a topic of perennial interest within psychology. However, research over the past half decade has achieved a new level of understanding regarding both the ultimate and proximate causes of belief in God. Ultimate causes—the evolutionary influences on a trait—shed light on the adaptive value of belief in God and the reasons why a tendency toward this belief exists in humans. Proximate causes—the immediate influences on the expression of a trait—explain variation and changes in belief. We review this research and discuss remaining barriers to a fuller understanding of belief in God.

The article is here.


Monday, September 3, 2018

Bishop says Catholic Church suffers from 'crisis of sexual morality'

Daniel Burke
CNN.com
Originally posted August 1, 2018

The sexual abuse accusations against a prominent American archbishop reveal a "grievous moral failure" within the Catholic Church, the president of the US Conference of Catholic Bishops said on Tuesday.

Cardinal Daniel DiNardo, president of the Catholic bishops conference, also said the conference "will pursue the many questions" about the accusations against Archbishop Theodore McCarrick "to the full extent of its authority."

"Our Church is suffering from a crisis of sexual morality," DiNardo said. "The way forward must involve learning from past sins."

DiNardo's statement comes as the Catholic Church, including Pope Francis, is facing a quickly escalating sexual abuse scandal that has ensnared top church leaders on several continents.

The information is here.

Sunday, September 2, 2018

Negative effects in psychotherapy

Alexander Rozental, Louis Castonguay, Sona Dimidjian, and others
BJPsych Open (2018) 4, 307–312.

Background

Psychotherapy can alleviate mental distress and improve quality of life, but little is known about its potential negative effects and how to determine their frequency.

Aims

To present a commentary on the current understanding and future research directions of negative effects in psychotherapy.

Method

An anonymous survey was distributed to a select group of researchers, using an analytical framework known as strengths, weaknesses, opportunities and threats.

Results

The researchers perceive an increased awareness of negative effects in psychotherapy in recent years, but also discuss some of the unresolved issues in relation to their definition, assessment and reporting. Qualitative methods and naturalistic designs are regarded as important to pursue, although a number of obstacles to using such methods are identified.

Conclusion

Negative effects of psychotherapy are multifaceted, warranting careful considerations in order for them to be monitored and reported in research settings and routine care.

The info is here.

Saturday, September 1, 2018

Why Ethical People Become Unethical Negotiators

Dina Gerdeman
Forbes.com
Originally posted July 31, 2018

Here is an excerpt:

With profit and greed driving the desire to deceive, it’s not surprising that negotiators often act unethically. But it’s too simplistic to think people always enter a negotiation looking to dupe the other side.

Sometimes negotiators stretch the truth unintentionally, falling prey to what Bazerman and his colleagues call “bounded ethicality” by engaging in unethical behavior that contradicts their values without knowing it.

Why does this happen? In the heat of negotiations, “ethical fading” comes into play, and people are unable to see the ethical implications of their actions because their desire to win gets in the way. The end result is deception.

In business, with dollars at stake, many people will interpret situations in ways that naturally favor them. Take Bazerman’s former dentist, who always seemed too quick to drill. “He was overtreating my mouth, and it didn’t make sense,” he says.

In service professions, he explains, people often have conflicts of interest. For instance, a surgeon may believe that surgery is the proper course of action, but her perception is biased: She has an incentive and makes money off the decision to operate. Another surgeon might just as easily come to the conclusion that if it’s not bothering you, don’t operate. “Lawyers are affected by how long a case takes to settle,” he adds. “

The info is here.