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

Friday, July 31, 2020

Antipsychotics for Children With ADHD Should Be a Last Resort

Jeannette Y. Wick
Originally published 20 Feb 20

Here is an excerpt:


A freestanding diagnosis of ADHD is not an indication for antipsychotic medications. Although no studies have determined which children who get an ADHD diagnosis are most likely to receive antipsychotic medications, mental health comorbidity is a possible factor.

ADHD often occurs in conjunction with other mental health conditions. Common comorbidities include conduct disorder (depression, or oppositional defiant disorder), and prescribers may use antipsychotic drugs to augment other approaches. The evidence does not support using antipsychotic medication for depression in youths, but some data support a risperidone trial for conduct disorder or oppositional defiant disorder in stimulant-resistant youths with ADHD.

A second concern is aggression. Aggression that stems from poor impulse control is common in youths who have ADHD, and it frequently occurs in children who have comorbidities. This behavior is often associated with a need for assessment, hospitalization, or urgent care and requires careful follow-up and cautious risk assessment. ADHD may not respond to stimulant medications, so prescribers may use antipsychotic drugs off-label in an effort to reduce aggressive outbursts. Research shows that antipsychotic-treated youths with ADHD often have clinical characteristics associated with aggression. However, few youths with ADHD who were treated with antipsychotics received the evidence-indicated trial doses of 2 stimulants before an antipsychotic.

The info is here.

Thursday, July 30, 2020

Structural Competency Meets Structural Racism: Race, Politics, and the Structure of Medical Knowledge

Jonathan M. Metzl and Dorothy E. Roberts
Virtual Mentor. 2014;16(9):674-690.
doi: 10.1001/virtualmentor.2014.16.9.spec1-1409.

Here is an excerpt:

The Clinical Implications of Addressing Race from a Structural Perspective

These brief case examples illustrate the complex ways that seemingly clinically relevant “cultural” characteristics and attitudes also reflect structural inequities, medical politics, legal codes, invisible discrimination, and socioeconomic disparities. Black men who appeared schizophrenic to medical practitioners did so in part because of the framing of new diagnostic codes. Lower-income persons who “refused” to eat well or exercise lived in neighborhoods without grocery stores or sidewalks. Black women who seemed to be uniquely harming their children by using crack cocaine while pregnant were victims of racial stereotyping, as well as of a selection bias in which decisions about which patients were reported to law enforcement depended on the racial and economic segregation of prenatal care. In this sense, approaches that attempt to address issues—such as the misdiagnosis of schizophrenia in black men, perceived diet “noncompliance” in minority populations, or the punishment of “crack mothers”—through a heuristic aimed solely at enhancing cross-cultural communication between doctors and patients, though surely well intentioned, will overlook the potentially pathologizing impact of structural factors set in motion long before patients or doctors enter exam rooms.

Structural factors impact majority populations as well as minority ones, and structures of privilege or opulence also influence expressions of illness and health. For instance, in the United States, research suggests that pediatricians disproportionately overdiagnose ADHD in white school-aged children. Until recently, medical researchers in many global locales assumed, wrongly, that eating disorders afflicted only affluent persons.

Yet of late, medicine and medical education have struggled most with addressing ways that structural forces impact and disadvantage communities of color. As sociologist Hannah Bradby rightly explains it, hypothesizing mechanisms that include the micro-processes of interactions between patients and professionals and the macro-processes of population-level inequalities is a missing step in our reasoning at present…. [A]s long as we see the solution to racism lying only in educating the individual, we fail to address the complexity of racism and risk alienating patients and physicians alike.

The info is here.

Wednesday, July 29, 2020

Survival of the Friendliest: Homo sapiens Evolved via Selection for Prosociality

Brian Hare
Annu. Rev. Psychol. 2017.68:155-186.


The challenge of studying human cognitive evolution is identifying unique features of our intelligence while explaining the processes by which they arose. Comparisons with nonhuman apes point to our early-emerging cooperative-communicative abilities as crucial to the evolution of all forms of human cultural cognition, including language. The human self-domestication hypothesis proposes that these early-emerging social skills evolved when natural selection favored increased in-group prosociality over aggression in late human evolution. As a by-product of this selection, humans are predicted to show traits of the domestication syndrome observed in other domestic animals. In reviewing comparative, developmental, neurobiological, and paleoanthropological research, compelling evidence emerges for the predicted relationship between unique human mentalizing abilities, tolerance, and the domestication syndrome in humans. This synthesis includes a review of the first a priori test of the self-domestication hypothesis as well as predictions for future tests.

A pdf can be downloaded from here.

Tuesday, July 28, 2020

Does encouraging a belief in determinism increase cheating?

Nadelhoffer, T., and others
(2019, May 3).


A key source of support for the view that challenging people’s beliefs about free will may undermine moral behavior is two classic studies by Vohs and Schooler (2008). These authors reported that exposure to certain prompts suggesting that free will is an illusion increased cheating behavior. In the present paper, we report several attempts to replicate this influential and widely cited work. Over a series of five studies (sample sizes of N = 162, N = 283, N = 268, N = 804, N = 982) (four preregistered) we tested the relationship between (1) anti-free-will prompts and free will beliefs and (2) free will beliefs and immoral behavior. Our primary task was to closely replicate the findings from Vohs and Schooler (2008) using the same or highly similar manipulations and measurements as the ones used in their original studies. Our efforts were largely unsuccessful. We suggest that manipulating free will beliefs in a robust way is more difficult than has been implied by prior work, and that the proposed link with immoral behavior may not be as consistent as previous work suggests.

Monday, July 27, 2020

Most Americans don’t believe they need God to be good: poll

Leonardo Blair
Originally posted 22 July 20

Here is an excerpt:

While 70% of Americans still believe that religion is either “somewhat important” or “very important” in their lives, more than half (54%) of Americans said they believe God is “not necessary to be moral or have good values.”

Meanwhile, 44% of American respondents said they believe God is necessary to “be moral and have good values.”

Respondents on the ideological right were found to be significantly more likely to say it is necessary to believe in God to be a moral person and have good values compared to those on the political left in 15 of the 34 countries surveyed.

The largest gap between the ideological right and left exists in the United States.

While only 24% of American respondents who identified themselves as leaning more to the left politically said it is necessary to believe in God to be moral and have good values, 37% of centrists agreed.

But when it comes to respondents who lean to the right politically, more than twice the percentage of those on the left (63%) agreed that it is necessary to believe in God to be moral and have good values.

The info is here.

Doctors are seen as Godlike: Moral typecasting in medicine

A. Goranson, P. Sheeran, J. Katz, & K. Gray
Social Science & Medicine
Available online 25 May 2020, 113008


Doctors are generally thought of as very intelligent and capable. This perception has upsides—doctors are afforded respect and esteem—but it may also have downsides, such as neglecting the mental and physical health of physicians. Two studies examine how Americans “typecast” doctors as Godlike “thinkers” who help others, rather than as vulnerable “feelers” who might themselves need help.


• Americans view doctors as godlike and invulnerable.

• Doctors are seen as more agentic than other working professionals.

• Doctors are seen as able to ignore mental and physical health problems.

• Moral typecasting in medicine leads people to neglect doctors' suffering.

From the Discussion

Indeed, doctors are seen as equal to God in their capacity to think, exert self-control, remember details, and plan for the future (see Figure 1). Past work reveals that people typecast those who help others both high in agency and low in experience—which makes them invulnerable to injury and insult, and relatively incapable of suffering (K. Gray & Wegner, 2009). Our results confirm the existence of moral typecasting in medicine: compared to other working adults, people see doctors as less sensitive to pain, fear, embarrassment, and hunger (see Figure 2). We further find that these perceptions of super-human doctors extend outside of work and into global perceptions of physicians’ traits and abilities. This work adds to other research arguing that people do not want to acknowledge the feelings of healthcare providers, because this would make providers less capable of serving our health-related goals (Schroeder & Fishbach, 2015).

A pdf of the research is here.

Sunday, July 26, 2020

The trolley problem problem

James Wilson
Originally posted 20 May 20

Here is an excerpt:

Some philosophers think that ethical thought experiments either are, or have a strong affinity with, scientific experiments. On such a view, thought experiments, like other experiments, when well-designed can allow knowledge to be built via rigorous and unbiased testing of hypotheses. Just as in the randomised controlled trials in which new pharmaceuticals are tested, the circumstances and the types of control in thought experiments could be such as to make the situation very unlike everyday situations, but that is a virtue rather than a vice, insofar as it allows ethical hypotheses to be tested cleanly and rigorously.

If thought experiments are – literally – experiments, this helps to explain how they might provide insights into the way the world is. But it would also mean that thought experiments would inherit the two methodological challenges that attend to experiments more generally, known as internal and external validity. Internal validity relates to the extent to which an experiment succeeds in providing an unbiased test of the variable or hypothesis in question. External validity relates to the extent to which the results in the controlled environment translate to other contexts, and in particular to our own. External validity is a major challenge, as the very features that make an environment controlled and suitable to obtain internal validity often make it problematically different from the uncontrolled environments in which interventions need to be applied.

There are significant challenges with both the internal and the external validity of thought experiments. It is useful to compare the kind of care with which medical researchers or psychologists design experiments – including validation of questionnaires, double-blinding of trials, placebo control, power calculations to determine the cohort size required and so on – with the typically rather more casual approach taken by philosophers. Until recently, there has been little systematic attempt within normative ethics to test variations of different phrasing of thought experiments, or to think about framing effects, or sample sizes; or the extent to which the results from the thought experiment are supposed to be universal or could be affected by variables such as gender, class or culture. A central ambiguity has been whether the implied readers of ethical thought experiments should be just anyone, or other philosophers; and, as a corollary, whether judgments elicited are supposed to be expert judgments, or the judgments of ordinary human beings. As the vast majority of ethical thought experiments in fact remain confined to academic journals, and are tested only informally on other philosophers, de facto they are tested only on those with expertise in the construction of ethical theories, rather than more generally representative samples or those with expertise in the contexts that the thought experiments purport to describe.

The info is here.

Saturday, July 25, 2020

America’s Schools Are a Moral and Medical Catastrophe

Laurie Garrett
Originally posted 24 July 20

After U.S. President Donald Trump demanded last week that schools nationwide reopen this fall, regardless of the status of their community’s COVID-19 epidemic status, his Secretary of Education Betsy DeVos was asked how this could safely be accomplished. She offered no guidelines, nor financial support to strapped school districts. Her reply was that school districts nationwide needed to create their own safety schemes and realize that the federal government will cut off funds if schools fail to reopen. “I think the go-to needs to be kids in school, in person, in the classroom,” she said in an interview on CNN on July 12.

This is nothing short of moral bankruptcy. The Trump administration is effectively demanding schools bend to its will, without offering a hint of expert guidance on how to do so safely, much less the necessary financing.

I can’t correct for the latter failure, of course. But here’s some information that will be of use to the many rightfully concerned parents and educators across the United States.

1. Should a national-scale school reopening be considered, at all?

Emphatically, no. The state of Florida’s data shows that 13 percent of children who have been tested for the novel coronavirus were found to be infected, and there’s a gradient of infection downward with age: Only 16 percent of these positive cases are in children 1 to 4 years old, whereas 29 percent are in those 15 to 17 years old. In Nueces County, Texas, 85 children under age 2 have tested positive for the coronavirus since March, killing one of them. The infections were likely caught from parents or older siblings. A South Korean government survey of 60,000 households discovered that adults living in households that had an infected child aged 10 to 19 years had the highest rate of catching the coronavirus—more so than when an infected adult was present. Nearly 19 percent of people living with an infected teenager went on to test positive for the virus within 10 days. A Kaiser Family Foundation study says some 3.3 million adults over 65 in the United States live in a home with at least one school-aged child, putting the elders at special risk.

The info is here.

Friday, July 24, 2020

These Evangelical Women Are Abandoning Trump and the Church

Sara Stankorb
Originally posted 23 July 20

Here is an excerpt:

In exit polls from the 2016 election, 80% of white evangelicals and the majority of self-identified Christians said they voted for Donald Trump. The thrice-married, profane, biblically illiterate, sexually predacious candidate mirrored no beatitudes. While some believers rejected Trump for lack of decency, for many Christian voters, his personal failings were not disqualifying — here, at last, was a president who could muscle forward their political interests.

In her 2019 book, Red State Christians, journalist and Lutheran pastor Angela Denker describes traveling across the country after the election, talking to Christian voters and trying to understand their relationship with Donald Trump. Denker argues Trump may not know much about the Bible or evangelical Christianity, but his rhetoric resonated with a civic religion common in many Evangelical churches, especially in the South, “with its unique blend of nostalgia, plus a little misogyny and dog-whistle race politics on the side.” There’s a degree to which many churches have adopted a Christian nationalism that has wrapped faith tightly in patriotism and relies, in some cases, less on the gospel and more on “God, guns, and country.”

Many Southern Baptist churches celebrate the Sundays closest to the Fourth of July and Veterans Day with as much fervor as Easter, with services that might feature the Pledge of Allegiance, “The Star-Spangled Banner,” sermons on American exceptionalism, and video montages of war veterans. It’s a church-country linkage popularized during the Cold War, a perceived battle against threats to “Christian America” rooted in a dominionist theology that portrays the white European settlement of America as a fulfillment of God’s promise. Winning the culture wars and “restoring” Christian political primacy became a spiritual mandate, a restoration of God’s promise. By the time Obama’s administration championed same-sex marriage and birth control coverage, “Democrats sounded like foreigners to Red State Christians across the South and rural America,” writes Dennker.

The info is here.

Developing judgments about peers' obligation to intervene

Marshall, J., Mermin-Bunnell, K, & Bloom, P.
Volume 201, August 2020, 104215


In some contexts, punishment is seen as an obligation limited to authority figures. In others, it is also a responsibility of ordinary citizens. In two studies with 4- to 7-year-olds (n = 232) and adults (n = 76), we examined developing judgments about whether certain individuals, either authority figures or peers, are obligated to intervene (Study 1) or to punish (Study 2) after witnessing an antisocial action. In both studies, children and adults judged authority figures as obligated to act, but only younger children judged ordinary individuals as also obligated to do so. Taken together, the present findings suggest that younger children, at least in the United States, start off viewing norm enforcement as a universal responsibility, entrusting even ordinary citizens with a duty to intervene in response to antisocial individuals. Older children and adults, though, see obligations as role-dependent—only authority figures are obligated to intervene.

The research is here.

Thursday, July 23, 2020

“Feeling superior is a bipartisan issue: Extremity (not direction) of political views predicts perceived belief superiority”

Harris, E. A., & Van Bavel, J. J. (2020, May 20).


There is currently a debate in political psychology about whether dogmatism and belief superiority are symmetric or asymmetric across the ideological spectrum. One study found that dogmatism was higher amongst conservatives than liberals, but both conservatives and liberals with extreme attitudes reported higher perceived superiority of beliefs (Toner et al., 2013). In the current study, we conducted a pre-registered direct and conceptual replication of this previous research using a large nationally representative sample. Consistent with prior research, we found that conservatives had higher dogmatism scores than liberals while both conservative and liberal extreme attitudes were associated with higher belief superiority compared to more moderate attitudes. As in the prior research we also found that whether conservative or liberal attitudes were associated with higher belief superiority was topic dependent. Different from prior research, we found that ideologically extreme individuals had higher dogmatism. Implications of these results for theoretical debates in political psychology are discussed.


The current work provides further evidence that conservatives have higher dogmatism scores than liberals while both conservative and liberal extreme attitudes are associated with higher belief superiority (and dogmatism). However, ideological differences in belief superiority vary by topic. Therefore, to assess general differences between liberals and conservatives it is necessary to look across many diverse topics and model the data appropriately. If scholars instead choose to study one topic at a time, any ideological differences they find may say more about the topic than about innate differences between liberals and conservatives.

Wednesday, July 22, 2020

FCC Approves 988 as Suicide Hotline Number

Jennifer Weaver
Originally posted 16 July 20

A three-digit number to connect to suicide prevention and mental health crisis counselors has been approved.

The Federal Communications Commission voted unanimously Thursday to make 988 the number people can call to be connected directly to the National Suicide Prevention Hotline.

Phone service providers have until July 2022 to implement the new number. The 10-digit number is currently 1-800-273-8255 (TALK).

Inference from explanation.

Kirfel, L., Icard, T., & Gerstenberg, T.
(2020, May 22).


What do we learn from a causal explanation? Upon being told that "The fire occurred because a lit match was dropped", we learn that both of these events occurred, and that there is a causal relationship between them. However, causal explanations of the kind "E because C" typically disclose much more than what is explicitly stated. Here, we offer a communication-theoretic account of causal explanations and show specifically that explanations can provide information about the extent to which a cited cause is normal or abnormal, and about the causal structure of the situation. In Experiment 1, we demonstrate that people infer the normality of a cause from an explanation when they know the underlying causal structure. In Experiment 2, we show that people infer the causal structure from an explanation if they know the normality of the cited cause. We find these patterns both for scenarios that manipulate the statistical and prescriptive normality of events. Finally, we consider how the communicative function of explanations, as highlighted in this series of experiments, may help to elucidate the distinctive roles that normality and causal structure play in causal explanation.


In this paper, we investigate the communicative dimensions of explanation, revealing some of the rich and subtle inferences people draw from them. We find that people are able to infer additional information from a causal explanation beyond what was explicitly communicated, such as causal structure and normality of the causes.  Our studies show that people make these inferences in part by appeal to what they themselves would judge reasonable to say across different possible scenarios. The overall pattern of judgments and inferences brings us closer to a full understanding of how causal explanations function inhuman discourse and behavior, while also raising new questions concerning the prominent role of norms in causal judgment and the function of causal explanation more broadly.

Editor's Note: This research has significant implications for psychotherapy.

Tuesday, July 21, 2020

College Football’s Brand At Stake, Ethics Expert Says

Penn State football seniors deserved a bigger crowd in final game ...Ray Glier
Originally posted 16 July 20

Here is an excerpt:

“What is the potential harm vs potential good? This the core ethical question,” Etzel said.

The caretakers of college athletics insist it is too early to be making decisions about canceling football this fall. They are allowing players to work out, coaches to scheme, and fans to dream until the last possible moment before they have to pull the plug. Their runway is growing short.

“To be certain—rigid in what is important—is very risky,” Etzel said in an email response to the ethical dilemma facing college administrators. “Decisions and potential mistakes of this magnitude have not been made in the past, so those running and influencing the show have no benchmarks.

“Presidents and other leaders need to responsibly step in to decide on their own—consistent with their job descriptions—just what the most useful, compassionate path is for each organization.”

If athletes get sick from the virus in workouts this summer and do not recover, or have permanent damage to their health, the college game will get hit with vitriol nationally like it has never seen before. Millions of people in the U.S. are college football fans, but not everyone worships the U. Coaches and administrators are going to be painted as money-thirsty villains. An athletic director, maybe a coach, is going to be scapegoated, then fired, if an athlete does not recover from the virus.

The info is here.

Collective narcissism predicts the belief and dissemination of conspiracy theories during the COVID-19 pandemic.

Sternisko, A., Cichocka, A., Cislak, A.,
& Van Bavel, J. J. (2020, May 21).


While COVID-19 was quietly spreading across the globe, conspiracy theories were finding loud voices on the internet. What contributes to the spread of these theories? In two national surveys (NTotal = 950) conducted in the United States and the United Kingdom, we identified national narcissism – a belief in the greatness of one’s nation that others do not appreciate – as a risk factor for the spread of conspiracy theories during the COVID-19 pandemic. We found that national narcissism was strongly associated with the proneness to believe and disseminate conspiracy theories related to COVID-19, accounting for up to 22% of the variance. Further, we found preliminary evidence that belief in COVID-19 conspiracy theories and national narcissism was linked to health-related behaviors and attitudes towards public policies to mitigate the spread of COVID-19. Our study expands previous work by illustrating the importance of identity processes in the spread of conspiracy theories during pandemics.


Ultimately, we hope that our studies are not only relevant for researchers but also for practitioners.Yet, little is known about how to increase or decrease the link between collective narcissism and conspiracy theories. Therefore, we urge future research to examine if focusing on the protection of the national image influences the spread of COVID-19 conspiracy theories, and the implications of these associations for public-health communication. For instance, underscoring that the national in-group is in some way disadvantaged in fighting the pandemic might increase the need to assert the image of the group and further fuel conspiracy theories.  Conversely, public-health messages might benefit from stressing that the adherence to health guidelines and policies also helps protect the nation’s image. Exploring such and other interventions could help limit the current ‘infodemic'.

Monday, July 20, 2020

Physicians united: Here’s why pulling out of WHO is a big mistake

Andis Robeznieks
American Medical Association
Originally published 8 July 20

Here is an excerpt:

The joint statement builds on a previous response from the AMA made back in May after the administration announced its intention to withdraw from the WHO.

Withdrawal served “no logical purpose,” made finding a solution to the pandemic more challenging and could have harmful repercussions in worldwide efforts to develop a vaccine and effective COVID-19 treatments, then-AMA President Patrice A. Harris, MD, MA, said at the time.

Defeating COVID-19 “requires the entire world working together,” Dr. Harris added.

In April, Dr. Harris said withdrawing from the WHO would be “a dangerous step in the wrong direction, and noted that “fighting a global pandemic requires international cooperation “

“Cutting funding to the WHO—rather than focusing on solutions—is a dangerous move at a precarious moment for the world,” she added

The message regarding the need for a unified international effort was echoed in the statement from the physician leaders.

"As our nation and the rest of the world face a global health pandemic, a worldwide, coordinated response is more vital than ever,” they said. “This dangerous withdrawal not only impacts the global response against COVID-19, but also undermines efforts to address other major public health threats.”

The info is here.

Seven Tips for Maintaining the Frame in Online Therapy

Clifford Arnold & Thomas Franklin
Psychiatric News
Originally published 25 June 20

While we are in the midst of a pandemic, teleconferencing technology can be a source of both stability and insecurity in the therapeutic relationship; on the one hand, it confers the near-miraculous ability to remain connected at a safe distance, while on the other hand it upends the basic conditions under which therapy takes place, like simply being in the same room together.

When striving for continuity in the transition from in-person to online therapy, a possible pitfall is to conserve the verbal elements of therapy and ignore the rest. This is counterproductive since the nonverbal aspects of therapy have an arguably greater impact on patients, and without them words can be ineffectual. The set of nonverbal conditions that engender trust, confidence, and security in patients and allow the words of therapy to be effective is called the therapeutic frame. The following tips are meant to help maintain the therapeutic frame during this precarious time, specifically in the transition from the office to the screen.

1. Create some distance: One way to preserve a familiar and comfortable frame is to observe personal space online as one would in the office. It would feel awkward, intrusive, and exhausting to sit four feet away from a patient and stare directly into her face for an hour straight in the office, yet we do that regularly online. Perhaps we are compensating for feeling distant in other ways or perhaps we simply can’t see or hear very well. It’s ok to back up, and some technological modifications can help (see tip #3). The extra space might allow both parties to feel less self-conscious and more at ease, less focused on maintaining a perfect affect and more on the therapy.

2. Body language matters: Here’s another reason to back off the camera a bit: Expanding the field of vision to include not just facial expressions but also upper-body language (for example, hand gestures, posture, distance modulation) has been shown to increase empathy measures, according to David T. Nguyen and John Canny in the article “More Than Face-to-Face: Empathy Effects of Video Framing.” Experiment with this. Sit back, expand the visual frame, move, and gesture as you would in person—find what feels connective and go with it. In addition to camera distance, the angle matters too; if the lens is positioned at a height lower than your eyes it may appear to your patients that you are looking down on them. Stack some books under your monitor to avoid the impression of being overbearing or aloof.

The info is here.

Sunday, July 19, 2020

Virtue signalling is virtuous

Neil Levy
Synthese (2020).


The accusation of virtue signalling is typically understood as a serious charge. Those accused usually respond (if not by an admission of fault) by attempting to show that they are doing no such thing. In this paper, I argue that we ought to embrace the charge, rather than angrily reject it. I argue that this response can draw support from cognitive science, on the one hand, and from social epistemology on the other. I claim that we may appropriately concede that what we are doing is (inter alia) virtue signalling, because virtue signalling is morally appropriate. It neither expresses vices, nor is hypocritical, nor does it degrade the quality of public moral discourse. Signalling our commitment to norms is a central and justifiable function of moral discourse, and the same signals provide (higher-order) evidence that is appropriately taken into account in forming moral beliefs.

From the Conclusion

The charge that someone is engaged in virtue signalling is widely felt to be a serious one. It is an accusation that stings. I hope we can now see that it should sting very much less. Virtue signalling is not an ir- or arational influence on belief formation. Rather, it provides (higher-order) evidence, which serves as an input into rational deliberation. Moreover, signalling is not a perversion of the central function of moral discourse. Independently of the role it plays in deliberation, signalling is a central function of public moral discourse, with an important role to play in enabling cooperation. Virtue signallers are not, in the main, hypocritical in their motivations and we have some grounds for thinking they are not dishonest in the signals they send.

Saturday, July 18, 2020

Making Decisions in a COVID-19 World

Baruch Fischoff
JAMA. 2020;324(2):139-140.

Here are two excerpts:

Individuals must answer complementary questions. When is it safe enough to visit a physician’s office, get a dental check-up, shop for clothing, ride the bus, visit an aging or incarcerated relative, or go to the gym? What does it mean that some places are open but not others and in one state, but not in a bordering one? How do individuals make sense of conflicting advice about face masks, fomites, and foodstuffs?

Risk analysis translates technical knowledge into terms that people can use. Done to a publication standard, risk analysis requires advanced training and substantial resources. However, even back-of-the-envelope calculations can help individuals make sense of otherwise bewildering choices. Combined with behavioral research, risk analysis can help explain why reasonable people sometimes make different decisions. Why do some people wear face masks and crowd on the beach, while others do not? Do they perceive the risks differently or are they concerned about different risks?


Second, risk analyses are needed to apply that knowledge. However solid the science on basic physical, biological, and behavioral processes, applying it requires knowledge of specific settings. How do air and people circulate? What objects and surfaces do people and viruses touch? How sustainable are physical barriers and behavioral practices? Risk analysts derive such estimates by consulting with scientists who know the processes and decision makers who know the settings.3 Boundary organizations are needed to bring the relevant parties together in each sector (medicine, sports, schools, movie production, etc) to produce estimates informed by the science and by people who know how that sector works.

The info is here.

Friday, July 17, 2020

Ivanka Trump's love for Goya beans violates ethics rules, say US rights groups

ImageAssociated Press
Originally posted 15 July 2020

The White House has defended Ivanka Trump tweeting a photo of herself holding up a can of Goya beans to buck up a Hispanic-owned business that she says has been unfairly treated, arguing she had “every right” to publicly express her support.

Government watchdogs countered that President Donald Trump’s daughter and senior adviser doesn’t have the right to violate ethics rules that bar government officials from using their public office to endorse specific products or groups.

These groups contend Ivanka Trump’s action also highlights broader concerns about how the president and those around him often blur the line between politics and governing. The White House would be responsible for disciplining Ivanka Trump for any ethics violation but chose not to in a similar case involving White House counselor Kellyanne Conway in 2017.

Goya became the target of a consumer boycott after CEO Robert Unanue praised the president at a Hispanic event at the White House on Thursday last week.

Trump tweeted the next day about his “love” for Goya, and his daughter followed up late Tuesday by tweeting a photo of herself holding a can of Goya black beans with a caption that read, “If it’s Goya, it has to be good,” in English and Spanish.

The info is here.

Immunity to Covid-19 could be lost in months, UK study suggests

Ian Sample
The Guardian
Originally posted 12 July 20

People who have recovered from Covid-19 may lose their immunity to the disease within months, according to research suggesting the virus could reinfect people year after year, like common colds.

In the first longitudinal study of its kind, scientists analysed the immune response of more than 90 patients and healthcare workers at Guy’s and St Thomas’ NHS foundation trust and found levels of antibodies that can destroy the virus peaked about three weeks after the onset of symptoms then swiftly declined.

Blood tests revealed that while 60% of people marshalled a “potent” antibody response at the height of their battle with the virus, only 17% retained the same potency three months later. Antibody levels fell as much as 23-fold over the period. In some cases, they became undetectable.

“People are producing a reasonable antibody response to the virus, but it’s waning over a short period of time and depending on how high your peak is, that determines how long the antibodies are staying around,” said Dr Katie Doores, lead author on the study at King’s College London.

The study has implications for the development of a vaccine, and for the pursuit of “herd immunity” in the community over time.

The immune system has multiple ways to fight the coronavirus but if antibodies are the main line of defence, the findings suggested people could become reinfected in seasonal waves and that vaccines may not protect them for long.

The info is here.

Thursday, July 16, 2020

At Stake in Reopening Schools: ‘The Future of the Country’

Matt Peterson
Originally posted 10 July 20

Here is an excerpt:

We do have to think about this longer-term. We also have to think about it from an ethics standpoint, acknowledging the following. At least right now, the primary motivation behind closing schools—having children not be educated in school buildings—is because of a belief that keeping schools physically open with children congregating poses a risk to community transmission. Either to teachers directly or back to households and the wider community. Whether it’s bad for kids themselves or how risky it is for kids themselves remains an open question. We’re worried about multisymptom inflammatory syndrome. But at least, right now, the evidence continues to suggest children are not themselves a particularly high risk group for serious Covid disease.

From an ethics point of view, when one group is being burdened primarily to benefit other groups, that puts a very special onus on justifying that it is ethically OK. If we conclude it is the right thing to do ethically because of what’s at stake for the community, we have both to make sure that it’s justified, this disproportionate burden on children, and that we do everything we can to mitigate those burdens.

The info is here.

Cognitive Bias and Public Health Policy During the COVID-19 Pandemic

Halpern SD, Truog RD, and Miller FG.
Published online June 29, 2020.

Here is an excerpt:

These cognitive errors, which distract leaders from optimal policy making and citizens from taking steps to promote their own and others’ interests, cannot merely be ascribed to repudiations of science. Rather, these biases are pervasive and may have been evolutionarily selected. Even at academic medical centers, where a premium is placed on having science guide policy, COVID-19 action plans prioritized expanding critical care capacity at the outset, and many clinicians treated seriously ill patients with drugs with little evidence of effectiveness, often before these institutions and clinicians enacted strategies to prevent spread of disease.

Identifiable Lives and Optimism Bias

The first error that thwarts effective policy making during crises stems from what economists have called the “identifiable victim effect.” Humans respond more aggressively to threats to identifiable lives, ie, those that an individual can easily imagine being their own or belonging to people they care about (such as family members) or care for (such as a clinician’s patients) than to the hidden, “statistical” deaths reported in accounts of the population-level tolls of the crisis. Similarly, psychologists have described efforts to rescue endangered lives as an inviolable goal, such that immediate efforts to save visible lives cannot be abandoned even if more lives would be saved through alternative responses.

Some may view the focus on saving immediately threatened lives as rational because doing so entails less uncertainty than policies designed to save invisible lives that are not yet imminently threatened. Individuals who harbor such instincts may feel vindicated knowing that during the present pandemic, few if any patients in the US who could have benefited from a ventilator were denied one.

Yet such views represent a second reason for the broad endorsement of policies that prioritize saving visible, immediately jeopardized lives: that humans are imbued with a strong and neurally mediated3 tendency to predict outcomes that are systematically more optimistic than observed outcomes. Early pandemic prediction models provided best-case, worst-case, and most-likely estimates, fully depicting the intrinsic uncertainty.4 Sound policy would have attempted to minimize mortality by doing everything possible to prevent the worst case, but human optimism bias led many to act as if the best case was in fact the most likely.

The info is here.

Wednesday, July 15, 2020

COVID-19 is more than a public health challenge: it's a moral test

Thomas Reese
Originally published 10 July 20

The time is already past to admit that the coronavirus pandemic in the United States is a moral crisis, not simply a public health and economic crisis.

While a certain amount of confusion back in February at the beginning of the crisis is understandable, today it is unforgivable. Bad leadership has cost thousands of lives and millions of jobs.

A large part of the failure has been in separating the economic crisis from the public health crisis when in fact they are intimately related. Until consumers and workers feel safe, the economy cannot revive. Nor should we take the stock market as the key measure of the country’s health, rather than the lives of ordinary people.

It can be difficult to see this as a moral crisis because what is needed is not heroic action, but simple acts that everyone must do. People simply need to wear masks, keep social distance and wash their hands. Employers need to provide working conditions where that is possible.

These are practices that public health experts have taught for decades. Too many in the United States have ignored them. Warnings about masks, for example, have been ignored.

For its part, government needs to enforce these measures, expand testing on a massive scale, do contact tracing and help people isolate themselves if they test positive. Instead, government, especially at the federal level, has failed. Businesses, especially bars, restaurants and entertainment venues, have remained open or been reopened too soon.

That it is possible to do the right thing and control the virus is obvious from the examples of South Korea, Thailand, New Zealand, China, Vietnam, most of Europe, New York, Massachusetts and Connecticut.

There is also the sin of presumption of those who trust in God to protect them from the virus while doing nothing themselves. Those who left it to the Lord forgot that “God helps those who help themselves.” There is also an arrogance in seeing ourselves as different from other mortals like us. Areas where people insisted they were somehow immune to this “blue” big-city virus have now been hit with comparable or worse infection rates.

The info is here.

Empathy is both a trait and a skill. Here's how to strengthen it.

Kristen Rogers
Originally posted 24 June 20

Here is an excerpt:

Types of empathy

Empathy is more about looking for a common humanity, while sympathy entails feeling pity for someone's pain or suffering, Konrath said.

"Whereas empathy is the ability to perceive accurately what another person is feeling, sympathy is compassion or concern stimulated by the distress of another," Lerner said. "A common example of empathy is accurately detecting when your child is afraid and needs encouragement. A common example of sympathy is feeling sorry for someone who has lost a loved one."


A "common mistake is to leap into sympathy before empathically understanding what another person is feeling," Lerner said. Two types of empathy can prevent that relationship blunder.

Emotional empathy, sometimes called compassion, is more intuitive and involves care and concern for others.

Cognitive empathy requires effort and more systematic thinking, so it may lead to more empathic accuracy, Lerner said.  It entails considering others' and their perspectives and imagining what it's like to be them, Konrath added.

Some work managers and colleagues, for example, have had to practice empathy for parents juggling remote work with child care and virtual learning duties, said David Anderson, senior director of national programs and outreach at the Child Mind Institute….   But since the outset of the pandemic in March, that empathy has faded — reflecting the notion that cognitive empathy does take effort.

It takes work to interpret what someone is feeling by all of his cues: facial expressions, tones of voice, posture, words and more. Then you have to connect those cues with what you know about him and the situation in order to accurately infer his feelings.

"This kind of inference is a highly complex social-cognitive task" that might involve a variation of mental processes, Lerner said.

The info is here.

Tuesday, July 14, 2020

The Pandemic Experts Are Not Okay

Ed Yong
The Atlantic
Originally posted 7 July 20

Here is an excerpt:

The field of public health demands a particular way of thinking. Unlike medicine, which is about saving individual patients, public health is about protecting the well-being of entire communities. Its problems, from malnutrition to addiction to epidemics, are broader in scope. Its successes come incrementally, slowly, and through the sustained efforts of large groups of people. As Natalie Dean, a biostatistician at the University of Florida, told me, “The pandemic is a huge problem, but I’m not afraid of huge problems.”

The more successful public health is, however, the more people take it for granted. Funding has dwindled since the 2008 recession. Many jobs have disappeared. Now that the entire country needs public-health advice, there aren’t enough people qualified to offer it. The number of epidemiologists who specialize in pandemic-level infectious threats is small enough that “I think I know them all,” says Caitlin Rivers, who studies outbreaks at the Johns Hopkins Center for Health Security.

The people doing this work have had to recalibrate their lives. From March to May, Colin Carlson, a research professor at Georgetown University who specializes in infectious diseases, spent most of his time traversing the short gap between his bed and his desk. He worked relentlessly and knocked back coffee, even though it exacerbates his severe anxiety: The cost was worth it, he felt, when the United States still seemed to have a chance of controlling COVID-19.

The info is here.

The MAD Model of Moral Contagion: The role of motivation, attention and design in the spread of moralized content online

Brady WJ, Crockett MJ, Van Bavel JJ.
Perspect Psychol Sci. 2020;1745691620917336.


With over 3 billion users, online social networks represent an important venue for moral and political discourse and have been used to organize political revolutions, influence elections, and raise awareness of social issues. These examples rely on a common process in order to be effective: the ability to engage users and spread moralized content through online networks. Here, we review evidence that expressions of moral emotion play an important role in the spread of moralized content (a phenomenon we call ‘moral contagion’). Next, we propose a psychological model to explain moral contagion. The ‘MAD’ model of moral contagion argues that people have group identity-based motivations to share moral-emotional content; that such content is especially likely to capture our attention; and that the design of social media platforms amplifies our natural motivational and cognitive tendencies to spread such content. We review each component of the model (as well as interactions between components) and raise several novel, testable hypotheses that can spark progress on the scientific investigation of civic engagement and activism, political polarization, propaganda and disinformation, and other moralized behaviors in the digital age.

A copy of the research can be found here.

Monday, July 13, 2020

Our Minds Aren’t Equipped for This Kind of Reopening

The Atlantic
Originally published 6 July 20

Here is the conclusion:

At the least, government agencies must promulgate clear, explicit norms and rules to facilitate cooperative choices. Most people congregating in tight spaces are telling themselves a story about why what they are doing is okay. Such stories flourish under confusing or ambivalent norms. People are not irrevocably chaotic decision makers; the level of clarity in human thinking depends on how hard a problem is. I know with certainty whether I’m staying home, but the confidence interval around “I am being careful” is really wide. Concrete guidance makes challenges easier to resolve. If masks work, states and communities should require them unequivocally. Cognitive biases are the reason to mark off six-foot spaces on the supermarket floor or circles in the grass at a park.

For social-distancing shaming to be a valuable public-health tool, average citizens should reserve it for overt defiance of clear official directives—failure to wear a mask when one is required—rather than mere cases of flawed judgment. In the meantime, money and power are located in public and private institutions that have access to public-health experts and the ability to propose specific behavioral norms. The bad judgments that really deserve shaming include the failure to facilitate testing, failure to protect essential workers, failure to release larger numbers of prisoners from facilities that have become COVID-19 hot spots, and failure to create the material conditions that permit strict isolation. America’s half-hearted reopening is a psychological morass, a setup for defeat that will be easy to blame on irresponsible individuals while culpable institutions evade scrutiny.

The info is here.

Amazon Halts Police Use Of Its Facial Recognition Technology

Bobby Allyn
Originally posted 10 June 20

Amazon announced on Wednesday a one-year moratorium on police use of its facial-recognition technology, yielding to pressure from police-reform advocates and civil rights groups.

It is unclear how many law enforcement agencies in the U.S. deploy Amazon's artificial intelligence tool, but an official with the Washington County Sheriff's Office in Oregon confirmed that it will be suspending its use of Amazon's facial recognition technology.

Researchers have long criticized the technology for producing inaccurate results for people with darker skin. Studies have also shown that the technology can be biased against women and younger people.

IBM said earlier this week that it would quit the facial-recognition business altogether. In a letter to Congress, chief executive Arvind Krishna condemned software that is used "for mass surveillance, racial profiling, violations of basic human rights and freedoms."

And Microsoft President Brad Smith told The Washington Post during a livestream Thursday morning that his company has not been selling its technology to law enforcement. Smith said he has no plans to until there is a national law.

The info is here.

Sunday, July 12, 2020

Moral Molecules: Morality as a combinatorial system

Curry, O. S., Alfano, M.,
Brandt, M. J., & Pelican, C. (2020, June 9).


Is morality a combinatorial system in which a small number of simple moral ‘elements’ combine to form a large number of complex moral ‘molecules’? According to the theory of morality-as-cooperation, morality is a collection of biological and cultural solutions to the problems of cooperation recurrent in human social life. As evolutionary game theory has shown, there are many types of cooperation; hence, the theory explains many types of morality, including: family values, group loyalty, reciprocity, heroism, deference, fairness and property rights. As with any set of discrete items, these seven ‘elements’ can, in principle, be combined in multiple ways. But are they in practice? In this paper, we show that they are. For each combination of two elements, we hypothesise candidate moral molecules; and we successfully locate examples of them in the professional and popular literature. These molecules include: fraternity, blood revenge, family pride, filial piety, gavelkind, primogeniture, friendship, patriotism, tribute, diplomacy, common ownership, honour, confession, turn taking, restitution, modesty, mercy, munificence, arbitration, mendicancy, and queuing. Thus morality – like many other physical, biological, psychological and cultural systems – is indeed a combinatorial system. And morality-as-cooperation provides a principled and systematic taxonomy that has the potential to explain all moral ideas, possible and actual. Pursuing the many implications of this theory will help to place the study of morality on a more secure scientific footing.

Saturday, July 11, 2020

Why Do People Avoid Facts That Could Help Them?

Francesca Gino
Scientific American
Originally posted 16 June 20

In our information age, an unprecedented amount of data are right at our fingertips. We run genetic tests on our unborn children to prepare for the worst. We get regular cancer screenings and monitor our health on our wrist and our phone. And we can learn about our ancestral ties and genetic predispositions with a simple swab of saliva.

Yet there’s some information that many of us do not want to know. A study of more than 2,000 people in Germany and Spain by Gerd Gigerenzer of the Max Planck Institute for Human Development in Berlin and Rocio Garcia-Retamero of the University of Granada in Spain found that 90 percent of them would not want to find out, if they could, when their partner would die or what the cause would be. And 87 percent also reported not wanting to be aware of the date of their own death. When asked if they’d want to know if, and when, they’d get divorced, more than 86 percent said no.

Related research points to a similar conclusion: We often prefer to avoid learning information that could cause us pain. Investors are less likely to log on to their stock portfolios on days when the market is down. And one laboratory experiment found that subjects who were informed that they were rated less attractive than other participants were willing to pay money not to find out their exact rank.

More consequentially, people avoid learning certain information related to their health even if having such knowledge would allow them to identify therapies to manage their symptoms or treatment. As one study found, only 7 percent of people at high risk for Huntington’s disease elect to find out whether they have the condition, despite the availability of a genetic test that is generally paid for by health insurance plans and the clear usefulness of the information for alleviating the chronic disease’s symptoms. Similarly,participants in a laboratory experiment chose to forgo part of their earnings to avoid learning the outcome of a test for a treatable sexually transmitted disease. Such avoidance was even greater when the disease symptoms were more severe.

The info is here.

Friday, July 10, 2020

Aging in an Era of Fake News

Brashier, N. M., & Schacter, D. L. (2020).
Current Directions in 
Psychological Science, 29(3), 316–323.


Misinformation causes serious harm, from sowing doubt in modern medicine to inciting violence. Older adults are especially susceptible—they shared the most fake news during the 2016 U.S. election. The most intuitive explanation for this pattern lays the blame on cognitive deficits. Although older adults forget where they learned information, fluency remains intact, and knowledge accumulated across decades helps them evaluate claims. Thus, cognitive declines cannot fully explain older adults’ engagement with fake news. Late adulthood also involves social changes, including greater trust, difficulty detecting lies, and less emphasis on accuracy when communicating. In addition, older adults are relative newcomers to social media and may struggle to spot sponsored content or manipulated images. In a post-truth world, interventions should account for older adults’ shifting social goals and gaps in their digital literacy.


The focus on “facts” at the expense of long-term trust is one reason why I see news organizations being ineffective in preventing, and in some cases facilitating, the establishment of “alternative narratives”. News reporting, as with any other type of declaration, can be ideologically, politically, and emotionally contested. The key differences in the current environment involve speed and transparency: First, people need to be exposed to the facts before the narrative can be strategically distorted through social media, distracting “leaks”, troll operations, and meme warfare. Second, while technological solutions for “fake news” are a valid effort, platforms policing content through opaque technologies adds yet another disruption in the layer of trust that should be reestablished directly between news organizations and their audiences.

A pdf can be found here.

Thursday, July 9, 2020

Addiction, Identity, Morality

Earp, B.D., Skorburg, J.A. Everett, J. & Savulescu, J.
(2019) AJOB Empirical Bioethics, 10:2, 136-153.
DOI: 10.1080/23294515.2019.1590480

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a “brain disease” versus “moral weakness” model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after becoming addicted.

Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction.

Conclusions: In Study 1, we found that U.S. participants judged an agent who became addicted to drugs as being closer to “a completely different person” than “completely the same person” as the agent who existed prior to the addiction. In Studies 2–6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves.

The research is here.

Wednesday, July 8, 2020

A Normative Approach to Artificial Moral Agency

Behdadi, D., Munthe, C.
Minds & Machines (2020). 


This paper proposes a methodological redirection of the philosophical debate on artificial moral agency (AMA) in view of increasingly pressing practical needs due to technological development. This “normative approach” suggests abandoning theoretical discussions about what conditions may hold for moral agency and to what extent these may be met by artificial entities such as AI systems and robots. Instead, the debate should focus on how and to what extent such entities should be included in human practices normally assuming moral agency and responsibility of participants. The proposal is backed up by an analysis of the AMA debate, which is found to be overly caught in the opposition between so-called standard and functionalist conceptions of moral agency, conceptually confused and practically inert. Additionally, we outline some main themes of research in need of attention in light of the suggested normative approach to AMA.


We have argued that to be able to contribute to pressing practical problems, the debate on AMA should be redirected to address outright normative ethical questions. Specifically, the questions of how and to what extent artificial entities should be involved in human practices where we normally assume moral agency and responsibility. The reason for our proposal is the high degree of conceptual confusion and lack of practical usefulness of the traditional AMA debate. And this reason seems especially strong in light of the current fast development and implementation of advanced, autonomous and self-evolving AI and robotic constructs.

Tuesday, July 7, 2020

Can COVID-19 re-invigorate ethics?

Louise Campbell
BMJ Blogs
Originally posted 26 May 20

The COVID-19 pandemic has catapulted ethics into the spotlight.  Questions previously deliberated about by small numbers of people interested in or affected by particular issues are now being posed with an unprecedented urgency right across the public domain.  One of the interesting facets of this development is the way in which the questions we are asking now draw attention, not just to the importance of ethics in public life, but to the very nature of ethics as practice, namely ethics as it is applied to specific societal and environmental concerns.

Some of these questions which have captured the public imagination were originally debated specifically within healthcare circles and at the level of health policy: what measures must be taken to prevent hospitals from becoming overwhelmed if there is a surge in the number of people requiring hospitalisation?  How will critical care resources such as ventilators be prioritised if need outstrips supply?  In a crisis situation, will older people or people with disabilities have the same opportunities to access scarce resources, even though they may have less chance of survival than people without age-related conditions or disabilities?  What level of risk should healthcare workers be expected to assume when treating patients in situations in which personal protective equipment may be inadequate or unavailable?   Have the rights of patients with chronic conditions been traded off against the need to prepare the health service to meet a demand which to date has not arisen?  Will the response to COVID-19 based on current evidence compromise the capacity of the health system to provide routine outpatient and non-emergency care to patients in the near future?

Other questions relate more broadly to the intersection between health and society: how do we calculate the harms of compelling entire populations to isolate themselves from loved ones and from their communities?  How do we balance these harms against the risks of giving people more autonomy to act responsibly?  What consideration is given to the fact that, in an unequal society, restrictions on liberty will affect certain social groups in disproportionate ways?  What does the catastrophic impact of COVID-19 on residents of nursing homes say about our priorities as a society and to what extent is their plight our collective responsibility?  What steps have been taken to protect marginalised communities who are at greater risk from an outbreak of infectious disease: for example, people who have no choice but to coexist in close proximity with one another in direct provision centres, in prison settings and on halting sites?

The info is here.