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

Tuesday, August 31, 2021

What Causes Unethical Behavior? A Meta-Analysis to Set an Agenda for Public Administration Research

Nicola Belle & Paola Cantarelli
Public Administration Review,
Vol. 77, Iss. 3, pp. 327–339


This article uses meta-analysis to synthesize 137 experiments in 73 articles on the causes of unethical behavior. Results show that exposure to in-group members who misbehave or to others who benefit from unethical actions, greed, egocentrism, self-justification, exposure to incremental dishonesty, loss aversion, challenging performance goals, or time pressure increase unethical behavior. In contrast, monitoring of employees, moral reminders, and individuals’ willingness to maintain a positive self-view decrease unethical conduct. Findings on the effect of self-control depletion on unethical behavior are mixed. Results also present subgroup analyses and several measures of study heterogeneity and likelihood of publication bias. The implications are of interest to both scholars and practitioners. The article concludes by discussing which of the factors analyzed should gain prominence in public administration research and uncovering several unexplored causes of unethical behavior.

From the Discussion

Among the factors that our meta-analyses identified as determinants of unethical behavior, the following may be elevated to prominence for public administration research and practice. First, results from the meta-analyses on social influences suggest that being exposed to corrupted colleagues may enhance the likelihood that one engages in unethical conduct. These findings are particularly relevant because “[c]orruption in the public sector hampers the efficiency of public services, undermines confidence in public institutions and increases the cost of public transactions” (OECD 2015 ). Moreover, corruption “may distort government ’ s public resource allocations” (Liu and Mikesell 2014 , 346). 

Monday, August 30, 2021

Generosity pays: Selfish people have fewer children and earn less money.

Eriksson, K., Vartanova, I., et al.
(2020). Journal of Personality and Social 
Psychology, 118(3), 532–544. 


Does selfishness pay in the long term? Previous research has indicated that being prosocial (or otherish) rather than selfish has positive consequences for psychological well-being, physical health, and relationships. Here we instead examine the consequences for individuals’ incomes and number of children, as these are the currencies that matter most in theories that emphasize the power of self-interest, namely economics and evolutionary thinking. Drawing on both cross-sectional (Studies 1 and 2) and panel data (Studies 3 and 4), we find that prosocial individuals tend to have more children and higher income than selfish individuals. An additional survey (Study 5) of lay beliefs about how self-interest impacts income and fertility suggests one reason selfish people may persist in their behavior even though it leads to poorer outcomes: people generally expect selfish individuals to have higher incomes. Our findings have implications for lay decisions about the allocation of scarce resources, as well as for economic and evolutionary theories of human behavior. 

From the General Discussion

Our findings also speak to theories of the evolutionary history of otherishness in humans. It is often assumed that evolution promotes selfishness unless group selection acts as a counter-force (Sober & Wilson, 1999), possibly combined with a punishment mechanism to offset the advantage of being selfish (Henrich & Boyd, 2001). The finding that otherishness is associated with greater fertility within populations indicates that selfishness is not necessarily advantageous in the first place. Our datasets are limited to Europe and the United States, but if the mechanisms we sketched above are correct then we should also expect a similarly positive effect of otherishness on fertility in other parts of the world.

Our results paint a more complex picture for income, compared to fertility. Whereas otherish people tended to show the largest increases in incomes over time, the majority of our studies indicated that the highest absolute levels of income were associated with moderate otherishness. There are several ways in which otherishness may influence income levels and income trajectories. As noted earlier, otherish people tend to have stronger relations and social networks, and social networks are a key source of information about job opportunities (Granovetter, 1995).

Why a Virtual Assistant for Moral Enhancement When We Could have a Socrates?

Lara, F. 
Sci Eng Ethics 27, 42 (2021). 


Can Artificial Intelligence (AI) be more effective than human instruction for the moral enhancement of people? The author argues that it only would be if the use of this technology were aimed at increasing the individual's capacity to reflectively decide for themselves, rather than at directly influencing behaviour. To support this, it is shown how a disregard for personal autonomy, in particular, invalidates the main proposals for applying new technologies, both biomedical and AI-based, to moral enhancement. As an alternative to these proposals, this article proposes a virtual assistant that, through dialogue, neutrality and virtual reality technologies, can teach users to make better moral decisions on their own. The author concludes that, as long as certain precautions are taken in its design, such an assistant could do this better than a human instructor adopting the same educational methodology.

From the Conclusion

The key in moral education is that it be pursued while respecting and promoting personal autonomy. Educators should avoid the mistake of limiting the capacities of individuals to freely and reflectively determine their own values by attempting to enhance their behaviour directly. On the contrary, they must do what they can to ensure that those being educated, at least at an advanced age, actively participate in this process in order to assume the values that will define them and give meaning to their lives. The problem with current proposals for moral enhancement through new technologies is that they treat the subject of their interventions as a "passive recipient". Moral bioenhancement does so because it aims to change the motivation of the individual by bypassing the reflection and gradual assimilation of values that should accompany any adoption of new identity traits. This constitutes a passivity that would also occur in proposals for moral AIenhancement based on ethical machines that either replace humans in decision-making, or surreptitiously direct them to do the right thing, or simply advise them based on their own supposedly undisputed values.

Sunday, August 29, 2021

A New Era of Designer Babies May Be Based on Overhyped Science

Laura Hercher
Scientific American
Originally published 12 July 21

Here is an excerpt:

Current polygenic risk scores have limited predictive strength and reflect the shortcomings of genetic databases, which are overwhelmingly Eurocentric. Alicia Martin, an instructor at Massachusetts General Hospital and the Broad Institute of the Massachusetts Institute of Technology and Harvard University, says her research examining polygenic risk scores suggests “they don’t transfer well to other populations that have been understudied.” In fact, the National Institutes of Health announced in mid-June that it will be giving out $38 million in grants over five years to find ways to enhance disease prediction in diverse populations using polygenic risk scores. Speaking of Orchid, Martin says, “I think it is premature to try to roll this out.”

In an interview about embryo screening and ethics featured on the company’s Web site, Jonathan Anomaly, a University of Pennsylvania bioethicist, suggested the current biases are a problem to be solved by getting customers and doing the testing. “As I understand it,” he said, “Orchid is actively building statistical models to improve ancestry adaptation and adjustments for genetic risk scores, which will increase accessibility of the product to all individuals.”

Still, better data sets will not allay all concerns about embryo selection. The combined expense of testing and IVF means that unequal access to these technologies will continue to be an issue. In her Mendelspod interview, Siddiqui insisted, “We think that everyone who wants to have a baby should be able to, and we want our technology to be as accessible to everyone who wants it,” adding that the lack of insurance coverage for IVF is a major problem that needs to be addressed in the U.S.

But should insurance companies pay for fertile couples to embryo-shop? This issue is complicated, especially in light of the fact that polygenic risk scores can generate predictions for more than just heart disease and cancer. They can be devised for any trait with a heritable component, and existing models offer predictions for educational attainment, neuroticism and same-sex sexual behavior, all with the same caveats and limitations as Orchid’s current tests for major diseases. To be clear, tests for these behavioral traits are not part of Orchid’s current genetic panel. But when talking about tests the company does offer, Siddiqui suggested that the ultimate decision makers should be the parents-to-be. “I think at the end of the day, you have to respect patient autonomy,” she said.

Saturday, August 28, 2021

Understanding Suicide Risk Among Children and Preteens: A Synthesis Workshop

National Institute of Mental Health
June 15, 2021

NIMH convened a four-part virtual research roundtable series, “Risk, Resilience, & Trajectories in Preteen Suicide.” The roundtables took place between January and April 2021, and culminated in a synthesis meeting in June, 2021. The series brought together a diverse group of expert panelists to assess the state of the science and short- and longer-term research priorities related to preteen suicide risk and risk trajectories. Panelists’ expertise was wide ranging and included youth suicide risk assessment and preventive interventions, developmental psychopathology, child and adolescent mood and anxiety disorders, family and peer relationships, how social and cultural contexts influence youth’s trajectories, biostatistical and computational methods, multilevel modeling, and longitudinal data analysis. 

Friday, August 27, 2021

It’s hard to be a moral person. Technology is making it harder.

Sigal Samuel
Originally posted 3 Aug 21

Here is an excerpt:

People who point out the dangers of digital tech are often met with a couple of common critiques. The first one goes like this: It’s not the tech companies’ fault. It’s users’ responsibility to manage their own intake. We need to stop being so paternalistic!

This would be a fair critique if there were symmetrical power between users and tech companies. But as the documentary The Social Dilemma illustrates, the companies understand us better than we understand them — or ourselves. They’ve got supercomputers testing precisely which colors, sounds, and other design elements are best at exploiting our psychological weaknesses (many of which we’re not even conscious of) in the name of holding our attention. Compared to their artificial intelligence, we’re all children, Harris says in the documentary. And children need protection.

Another critique suggests: Technology may have caused some problems — but it can also fix them. Why don’t we build tech that enhances moral attention?

“Thus far, much of the intervention in the digital sphere to enhance that has not worked out so well,” says Tenzin Priyadarshi, the director of the Dalai Lama Center for Ethics and Transformative Values at MIT.

It’s not for lack of trying. Priyadarshi and designers affiliated with the center have tried creating an app, 20 Day Stranger, that gives continuous updates on what another person is doing and feeling. You get to know where they are, but never find out who they are. The idea is that this anonymous yet intimate connection might make you more curious or empathetic toward the strangers you pass every day.

They also designed an app called Mitra. Inspired by Buddhist notions of a “virtuous friend” (kalyāṇa-mitra), it prompts you to identify your core values and track how much you acted in line with them each day. The goal is to heighten your self-awareness, transforming your mind into “a better friend and ally.”

I tried out this app, choosing family, kindness, and creativity as the three values I wanted to track. For a few days, it worked great. Being primed with a reminder that I value family gave me the extra nudge I needed to call my grandmother more often. But despite my initial excitement, I soon forgot all about the app.

Thursday, August 26, 2021

Social Workers’ Perceptions of Their Peers’ Unprofessional Behavior

Gricus, M., & Wysiekierski, L. (2021).
Journal of Social Work. 

This article explores social workers’ perceptions of their colleagues’ professional mistakes, and the influences of those opinions. Vignettes in a factorial survey helped to determine whether certain variables related to the social worker or the situation influenced the perception of others’ professional errors and ethical violations. The changed variables included personal characteristics of the offending social worker such as perceived race, gender, and sexual orientation of the social worker, and characteristics of the situation, such as the length of time involved in unprofessional behavior.

Licensed social workers in six U.S. states (n = 5596) read vignettes based on real cases brought before licensing boards (n = 22,127) and assigned levels of seriousness and importance to discipline. The vignettes rated most highly involved perceived harm to a client or other vulnerable individual. Those on the lower end of seriousness and importance to discipline were those violations against the profession of social work. Analysis of changed variables indicated respondents’ ratings were influenced by several situational factors, but not by personal characteristics of the social worker involved in the vignette.

Our findings provide some insight into the decision-making factors important to social workers. The results may be helpful to licensing boards considering the contextual factors of unprofessional behavior and whether to discipline certain actions.

From the article:

The availability heuristic proposes that people make judgments based only on the information available at the time (Croskerry, 2002; Shah & Oppenheimer, 2008). The representativeness heuristic allows people to judge whether an example belongs to a given category (Bowes et al., 2020). In clinical settings, this heuristic can play out in diagnosing similar, but not identical, clinical presentations with the same diagnosis. The representativeness heuristic can also cause people to make judgments based on race and gender stereotypes (Bowes et al., 2020). Bisking et al. (2003) (as cited in Salvador, 2019) found that when individuals are involved in enacting sanctions on someone perceived to have engaged in misconduct, their decisions are influenced by characteristics of the offender such as gender. The anchoring and adjustment heuristic, also known as focalism or priming, reveals that people form judgments largely based on the first piece of information they receive and weigh it against all other information (Bowes et al., 2020). Focalism can help to explain why misinformation can be difficult to disprove.

Wednesday, August 25, 2021

As a doctor in a COVID unit, I’m running out of compassion for the unvaccinated. Get the shot

Anita Sircar
The Los Angeles Times
Originally published 17 Aug 21

Here is an excerpt:

The burden of this pandemic now rests on the shoulders of the unvaccinated. On those who are eligible to get vaccinated but choose not to, a decision they defend by declaring, “Vaccination is a deeply personal choice.” But perhaps never in history has anyone’s personal choice affected the world as a whole as it does right now. When hundreds and thousands of people continue to die — when the most vulnerable members of society, our children, cannot be vaccinated — the luxury of choice ceases to exist.

If you believe the pandemic is almost over and I can ride it out, without getting vaccinated, you could not be more wrong. This virus will find you.


If you believe if I get infected I’ll just go to the hospital and get treated, there is no guarantee we can save your life, nor even a promise we’ll have a bed for you.

If you believe I’m pregnant and I don’t want the vaccine to affect me, my baby or my future fertility, it matters little if you’re not alive to see your newborn.

If you believe I won’t get my children vaccinated because I don’t know what the long-term effects will be, it matters little if they don’t live long enough for you to find out.

If you believe I’ll just let everyone else get vaccinated around me so I don’t have to, there are 93 million eligible, unvaccinated people in the “herd” who think the same way you do and are getting in the way of ending this pandemic.

If you believe vaccinated people are getting infected anyway, so what’s the point?, the vaccine was built to prevent hospitalizations and deaths from severe illness. Instead of fatal pneumonia, those with breakthrough infections have a short, bad cold, so the vaccine has already proved itself. The vaccinated are not dying of COVID-19.

SARS-CoV-2, the virus that causes COVID-19, has mutated countless times during this pandemic, adapting to survive. Stacked up against a human race that has resisted change every step of the way — including wearing masks, social distancing, quarantining and now refusing lifesaving vaccines — it is easy to see who will win this war if human behavior fails to change quickly.

Tuesday, August 24, 2021

Reducing the uncanny valley by dehumanizing humanoid robots

Yam, K.C., Bigman, Y., & Gray, K.
Computers in Human Behavior
Volume 125, December 2021, 106945


Humanoid robots are often experienced as unnerving, a psychological phenomenon called the “uncanny valley.” Past work reveals that humanlike robots are unnerving in part because they are ascribed humanlike feelings. We leverage this past work to provide a potential solution to the uncanny valley. Three studies reveal that “dehumanizing” humanoid robots—stripping robots of their apparent capacity for feelings—can significantly reduce the uncanny valley. Participants high on trait dehumanization (Study 1) or experimentally instructed to dehumanize (Study 2) reported lower feelings of uncanniness when viewing a humanoid robot, an effect mediated by reduced perceptions of feelings. We replicate these effects in an experimental field study where hotel guests interacted with real humanoid robots in Japan, and reveal that dehumanization reduces the uncanny valley without decreasing customers’ satisfaction (Study 3).


• The uncanny valley can be mitigated by a dehumanization manipulation.

• This effect is mediated by reduced experience perceptions.

• This simple manipulation can improve user experience of humanoid robots.

Monday, August 23, 2021

Deconstructing Moral Character Judgments

Hartman, R., Blakey, W., & Gray, K.
Current Opinions in Psychology


People often make judgments of others' moral character-an inferred moral essence that presumably predicts moral behavior. We first define moral character and explore why people make character judgments before outlining three key elements that drive character judgments: behavior (good vs. bad, norm violations, and deliberation), mind (intentions, explanations, capacities), and identity (appearance, social groups, and warmth). We also provide a taxonomy of moral character that goes beyond simply good vs. evil. Drawing from the Theory of Dyadic Morality, we outline a two-dimensional triangular space of character judgments (valence and strength/agency), with three key corners-heroes, villains, and victims. Varieties of perceived moral character include saints and demons, strivers/sinners and opportunists, the non-moral, virtuous and culpable victims, and pure victims.


It seems obvious that people make summary judgments of others’ moral character, but less obvious is how exactly that make those judgments. We suggest that people rely upon behavior, identity, and perceived mind when inferring the moral essence of others. We acknowledge that this list is certainly incomplete and will be expanded with future research. One key area of expansion explored here is the importance of perceived strength/agency in character judgments, which helps provide a taxonomy of character types. Whatever the exact varieties and drivers of moral character judgments, these judgments are clearly an important foundation of social life.

Sunday, August 22, 2021

America’s long history of anti-science has dangerously undermined the COVID vaccine

Peter Hotez
The Dallas Morning News
Originally published 15 Aug 21

Here is an excerpt:

America’s full-throated enthusiasm for vaccines lasted until the early 2000s. The 1998 Lancet publication of a paper from Andrew Wakefield and his colleagues, which wrongly asserted that the measles virus in the MMR vaccine replicated in the colons of children to cause pervasive developmental disorder (autism), ushered in a new era of distrust for vaccine.

It also resulted in distrust for the U.S. Health and Human Services agencies promoting vaccinations. The early response from the Centers for Disease Control and Prevention was to dismiss growing American discontent for vaccines as a fringe element, until eventually in the 2010s anti-vaccine sentiment spread across the internet.

The anti-vaccine movement eventually adopted medical freedom and used it to gain strength and accelerate in size, internet presence and external funding. Rising out of the American West, anti-vaccine proponents insisted that only parents could make vaccine choices and they were prepared to resist government requirements for school entry or attendance.

In California, the notion of vaccine choice gained strength in the 2010s, leading to widespread philosophical exemptions to childhood MMR vaccines and other immunizations. Vaccine exemptions reached critical mass, ultimately culminating in a 2014–2015 measles epidemic in Orange County.

The outbreak prompted state government intervention through the introduction of California Senate Bill 277 that eliminated these exemptions and prevented further epidemics, but it also triggered aggressive opposition. Anti-vaccine health freedom groups harassed members of the Legislature and labeled prominent scientists as pharma shills. They touted pseudoscience, claiming that vaccines were toxic, or that natural immunity acquired from the illness was superior and more durable than vaccine-induced immunity.

Health freedom then expanded through newly established anti-vaccine political action committees in Texas and Oklahoma in the Southwest, Oregon in the Pacific Northwest, and Michigan and Ohio in the Midwest, while additional anti-vaccine organizations formed in almost every state.

These groups lobbied state legislatures to promote or protect vaccine exemptions, while working to cloak or obscure classroom or schoolwide disclosures of vaccine exemptions. They also introduced menacing consent forms to portray vaccines as harmful or toxic.

The Texans for Vaccine Choice PAC formed in 2015, helping to accelerate personal belief immunization exemptions to a point where today approximately 72,000 Texas schoolchildren miss vaccines required for school entry and attendance.

Saturday, August 21, 2021

The relational logic of moral inference

Crockett, M., Everett, J. A. C., Gill, M., & Siegel, J. 
(2021, July 9). https://doi.org/10.31234/osf.io/82c6y


How do we make inferences about the moral character of others? Here we review recent work on the cognitive mechanisms of moral inference and impression updating. We show that moral inference follows basic principles of Bayesian inference, but also departs from the standard Bayesian model in ways that may facilitate the maintenance of social relationships. Moral inference is not only sensitive to whether people make moral decisions, but also to features of decisions that reveal their suitability as a relational partner. Together these findings suggest that moral inference follows a relational logic: people form and update moral impressions in ways that are responsive to the demands of ongoing social relationships and particular social roles. We discuss implications of these findings for theories of moral cognition and identify new directions for research on human morality and person perception.


There is growing evidence that people infer moral character from behaviors that are not explicitly moral. The data so far suggest that people who are patient, hard-working, tolerant of ambiguity, risk-averse, and actively open-minded are seen as more moral and trustworthy. While at first blush this collection of preferences may seem arbitrary, considering moral inference from a relational perspective reveals a coherent logic. All of these preferences are correlated with cooperative behavior, and comprise traits that are desirable for long-term relationship partners. Reaping the benefits of long-term relationships requires patience and a tolerance for ambiguity: sometime people make mistakes despite good intentions. Erring on the side of caution and actively seeking evidence to inform decision-making in social situations not only helps prevent harmful outcomes (Kappes et al., 2019), but also signals respect: social life is fraught with uncertainty (FeldmanHall & Shenhav, 2019; Kappes et al., 2019), and assuming we know what’s best for another person can have bad consequences, even when our intentions are good.  If evidence continues to suggest that certain types of non-moral preferences are preferred in social partners, partner choice mechanisms may explain the prevalence of those preferences in the broader population.

Friday, August 20, 2021

Would I Give Aducanumab to My Mother?

Dena S. Davis
The Hastings Center
Originally published 11 June 21

Here is an excerpt:

First, it is not at all clear that the drug works, in terms of affecting cognition and slowing decline. As Jason Karlawish explains in an incisive piece in STAT, crucial scientific steps were missed, and the current data are inconclusive and contradictory. 

Side effects include possible brain swelling and bleeds (which appear to be severe in about 6% of patients), headache, falls, diarrhea, and what Biogen describes as “confusion/delirium/altered mental status/disorientation.”  Wait a minute!  I thought the reason to take this drug was that one already had altered mental status and confusion.

Before someone is even considered eligible for aducanumab, they must take a PET scan to ascertain that they have elevated levels of amyloid and then an MRI to make sure they don’t already have brain swelling. MRIs have to be repeated regularly while people are on the drug. I know perfectly competent adults who are freaked out by MRI’s.  How do you explain this to someone with dementia?  Or do you sedate them, thus adding to the risk? Furthermore, the drug itself is not a pill, but a monthly infusion. 

Put that all together, and it just doesn’t add up. How would my mother’s life change for the better? There is little evidence of the drug’s efficacy. Meanwhile, her peaceful life in her rural home with her dedicated caregiver would now be punctuated by trips to the hospital for MRI’s, and monthly struggles to start infusions in her 90-year-old body, with its tiny veins and paper-thin skin. Aducanumab is apparently best suited to people in the early stages of Alzheimer’s, but even in the earliest stage my mother refused to accept that she had a problem. I cannot imagine successfully explaining that we were taking these measures in the faint hope of combatting a problem she insisted she didn’t have. And in the absence of an explanation she could understand, surely the frequent hospital trips would feel to her like unpleasant, even scary, invasions.

Thursday, August 19, 2021

A simple definition of ‘intentionally’

Quillien, T., & German, T. C.
Volume 214, September 2021, 104806


Cognitive scientists have been debating how the folk concept of intentional action works. We suggest a simple account: people consider that an agent did X intentionally to the extent that X was causally dependent on how much the agent wanted X to happen (or not to happen). Combined with recent models of human causal cognition, this definition provides a good account of the way people use the concept of intentional action, and offers natural explanations for puzzling phenomena such as the side-effect effect. We provide empirical support for our theory, in studies where we show that people's causation and intentionality judgments track each other closely, in everyday situations as well as in scenarios with unusual causal structures. Study 5 additionally shows that the effect of norm violations on intentionality judgments depends on the causal structure of the situation, in a way uniquely predicted by our theory. Taken together, these results suggest that the folk concept of intentional action has been difficult to define because it is made of cognitive building blocks, such as our intuitive concept of causation, whose logic cognitive scientists are just starting to understand.

From the end

People can use the word “intentionally” in very strange ways. Our intuitions about whether something is intentional are swayed by moral considerations, are pulled one way or another depending on the amount
of control an agent exerts, and are influenced by how circuitous the causal chain between the agent and the outcome is. Intentionality requires a relevant belief, but the latter can be present in very small doses.
Norm-violating actions are judged as more intentional than norm-conforming actions – except when they are judged as less intentional.

These seemingly erratic intuitions can be anxiety-inducing. One might conclude that our commonsense psychology is fundamentally moralistic; that linguistic meaning is hopelessly entangled in its context;
or that motivational and pragmatic factors constantly warp our intuitions about the proper extension of words.

We think such anxiety might be misplaced. Instead, we view the strangeness of “intentionally” as emerging naturally from the core structure of the concept. The way people use the concept of intentional
action offers a fascinating window on some of the building blocks that make up human thought: it lets us glimpse into our implicit causal model of the mind, and the algorithms with which we assign causes to events.

Wednesday, August 18, 2021

The Shape of Blame: How statistical norms impact judgments of blame and praise

Bostyn, D. H., & Knobe, J. (2020, April 24). 


For many types of behaviors, whether a specific instance of that behavior is either blame or praiseworthy depends on how much of the behavior is done or how people go about doing it. For instance, for a behavior such as “replying quickly to emails”, whether a specific reply is blame or praiseworthy will depend on the timeliness of that reply. Such behaviors lie on a continuum in which part of the continuum is praiseworthy (replying quickly) and another part of the continuum is blameworthy (replying late). As praise shifts towards blame along such behavioral continua, the resulting blame-praise curve must have a specific shape. A number of questions therefore arise. What determines the shape of that curve? And what determines “the neutral point”, i.e., the point along a behavioral continuum at which people neither blame nor praise? Seven studies explore these issues, focusing specifically on the impact of statistical information, and provide evidence for a hypothesis we call the “asymmetric frequency hypothesis.”

From the Discussion

Asymmetric frequency and moral cognition

The results obtained here appear to support the asymmetric frequency hypothesis. So far, we have summarized this hypothesis as “People tend perceive frequent behaviors as not blameworthy.” But how exactly is this hypothesis best understood?Importantly, the asymmetric frequency effect does not imply that whenever a behavior becomes more frequent, the associated moral judgment will shift towards the neutral. Behaviors that are considered to be praiseworthy do not appear to become more neutral simply because they become more frequent. The effect of frequency only appears to occur when a behavior is blameworthy, which is why we dubbed it an asymmetric effect.An enlightening historical example in this regard is perhaps the “gay revolution” (Faderman, 2015). As knowledge of the rate of homosexuality has spread across society and people have become more familiar with homosexuality within their own communities, moral norms surrounding homosexuality have shifted from hostility to increasing acceptance (Gallup 2019). Crucially, however, those who already lauded others for having a loving homosexual relation did not shift their judgment towards neutral indifference over the same time period. While frequency mitigates blameworthiness, it does not cause a general shift towards neutrality. Even when everyone does the right thing, it does not lose its moral shine.

Tuesday, August 17, 2021

One -- but Not the Same

Schwenkler, J. Byrd, N. Lambert, E., & Taylor, M.
Philosophical Studies


Ordinary judgments about personal identity are complicated by the fact that phrases like “same person” and “different person” have multiple uses in ordinary English. This complication calls into question the significance of recent experimental work on this topic. For example, Tobia (2015) found that judgments of personal identity were significantly affected by whether the moral change described in a vignette was for the better or for the worse, while Strohminger and Nichols (2014) found that loss of moral conscience had more of an effect on identity judgments than loss of biographical memory. In each case, however, there are grounds for questioning whether the judgments elicited in these experiments engaged a concept of numerical personal identity at all (cf. Berniūnas and Dranseika 2016; Dranseika 2017; Starmans and Bloom 2018). In two pre-registered studies we validate this criticism while also showing a way to address it: instead of attempting to engage the concept of numerical identity through specialized language or the terms of an imaginary philosophical debate, we should consider instead how the identity of a person is described through the connected use of proper names, definite descriptions, and the personal pronouns “I”, “you”, “he”, and “she”. When the experiments above are revisited in this way, there is no evidence that the differences in question had an effect on ordinary identity judgments.

From the Discussion

Our findings do, however, suggest a promising strategy for the experimental study of how philosophically important concepts are employed by people without formal philosophical training. As we noted above, in philosophy we use phrases like “numerical identity” and “qualitative identity” in a somewhat artificial way, in order thereby to disambiguate between the different meanings a phrase like “same person” can have in ordinary language. But we cannot easily disambiguate things in this way when we wish to investigate how these concepts are understood by non-philosophers: for a question like “Is the man after the accident numerically the same as the man before?” cannot be posed to such a person without first explicating the meaning of the italicized phrase.

Monday, August 16, 2021

Therapist Targeted Googling: Characteristics and Consequences for the Therapeutic Relationship

Cox, K. E., Simonds, L. M., & Moulton-Perkins, A. 
(2021).  Professional Psychology: 
Research and Practice. Advance online publication. 


Therapist-targeted googling (TTG) refers to a patient searching online to find information about their therapist. The present study investigated TTG prevalence and characteristics in a sample of adult psychotherapy clients. Participants (n = 266) who had attended at least one session with a therapist completed an anonymous online survey about TTG prevalence, motivations, and perceived impact on the therapeutic relationship. Two-thirds of the sample had conducted TTG. Those participants who were having therapy privately had worked with more than one therapist, or were having sessions more often than weekly were significantly more likely to conduct TTG; this profile was particularly common among patients who were having psychodynamic psychotherapy. Motivations included wanting to see if the therapist is qualified, curiosity, missing the therapist, and wanting to know them better. Nearly a quarter who undertook TTG thought the findings impacted the therapeutic relationship but only one in five had disclosed TTG to the therapist. TTG beyond common sense consumerism can be conceptualized as a patient’s attempt to attain closeness to the therapist but may result in impacts on trust and ability to be open. Disclosures of TTG may constitute important therapeutic material. 

Impact Statement

This study suggests that there are multiple motivations for clients searching online for information about their therapist. It highlights the need for practitioners to carefully consider the information available about them online and the importance of client searching to the therapeutic relationship.

Here is the conclusion:

In this study, most participants searched for information about their therapist. Curiosity and commonsense consumerism might explain much of this activity. We argue that there is evidence that some of this might be motivated by moments of vulnerability between sessions to regain a connection with the therapist. We also suggest that the discovery of challenging information during vulnerability might represent difficulties for the patient that are not disclosed to the therapist due to feelings of guilt and shame. Further work is needed to understand TTG, the implications on the therapeutic relationship, and how therapists work with disclosures of TTG in a way that does not provoke more shame in the patient, but which also allows therapists to effectively manage therapeutic closeness and their own vulnerability.

Sunday, August 15, 2021

Prosocial Behavior and Reputation: When Does Doing Good Lead to Looking Good?

Berman, J. Z., & Silver, I.
(2021). Current Opinion in Psychology
Available online 9 July 2021


One reason people engage in prosocial behavior is to reap the reputational benefits associated with being seen as generous. Yet, there isn’t a direct connection between doing good deeds and being seen as a good person. Rather, prosocial actors are often met with suspicion, and sometimes castigated as disingenuous braggarts, empty virtue-signalers, or holier-than-thou hypocrites. In this article, we review recent research on how people evaluate those who engage in prosocial behavior and identify key factors that influence whether observers will praise or denigrate a prosocial actor for doing a good deed.


Obligations to Personal Relations

One complicating factor that affects how actors are judged concerns whether they are donating to a cause that benefits a close personal relation. Recent theories of morality suggest that people see others as obligated to help close personal relations over distant strangers.  Despite these obligations, or perhaps because of them, prosocial actors are afforded less credit when they donate to causes that benefit close others: doing so is seen as relatively selfish compared to helping strangers. At the same time, helping a stranger instead of helping a close other is seen as a violation of one’s commitments and obligations, which can also damage one’s reputation. Understanding the role of relationship-specific obligations in judgments of selfless behavior is still nascent and represents an emerging area of research. 

Saturday, August 14, 2021

How does COVID affect the brain? Two neuroscientists explain

T. Kilpatrick & S. Petrou
The Conversation
Originally posted 11 Aug 21

Here is an excerpt:

In a UK-based study released as a pre-print online in June, researchers compared brain images taken of people before and after exposure to COVID. They showed parts of the limbic system had decreased in size compared to people not infected. This could signal a future vulnerability to brain diseases and may play a role in the emergence of long-COVID symptoms.

COVID could also indirectly affect the brain. The virus can damage blood vessels and cause either bleeding or blockages resulting in the disruption of blood, oxygen, or nutrient supply to the brain, particularly to areas responsible for problem solving.

The virus also activates the immune system, and in some people, this triggers the production of toxic molecules which can reduce brain function.

Although research on this is still emerging, the effects of COVID on nerves that control gut function should also be considered. This may impact digestion and the health and composition of gut bacteria, which are known to influence the function of the brain.

The virus could also compromise the function of the pituitary gland. The pituitary gland, often known as the “master gland”, regulates hormone production. This includes cortisol, which governs our response to stress. When cortisol is deficient, this may contribute to long-term fatigue.

Friday, August 13, 2021

Moral dilemmas and trust in leaders during a global health crisis

Everett, J.A.C., Colombatto, C., Awad, E. et al. 
Nat Hum Behav (2021). 


Trust in leaders is central to citizen compliance with public policies. One potential determinant of trust is how leaders resolve conflicts between utilitarian and non-utilitarian ethical principles in moral dilemmas. Past research suggests that utilitarian responses to dilemmas can both erode and enhance trust in leaders: sacrificing some people to save many others (‘instrumental harm’) reduces trust, while maximizing the welfare of everyone equally (‘impartial beneficence’) may increase trust. In a multi-site experiment spanning 22 countries on six continents, participants (N = 23,929) completed self-report (N = 17,591) and behavioural (N = 12,638) measures of trust in leaders who endorsed utilitarian or non-utilitarian principles in dilemmas concerning the COVID-19 pandemic. Across both the self-report and behavioural measures, endorsement of instrumental harm decreased trust, while endorsement of impartial beneficence increased trust. These results show how support for different ethical principles can impact trust in leaders, and inform effective public communication during times of global crisis.


The COVID-19 pandemic has raised a number of moral dilemmas that engender conflicts between utilitarian and non-utilitarian ethical principles. Building on past work on utilitarianism and trust, we tested the hypothesis that endorsement of utilitarian solutions to pandemic dilemmas would impact trust in leaders. Specifically, in line with suggestions from previous work and case studies of public communications during the early stages of the pandemic, we predicted that endorsing instrumental harm would decrease trust in leaders, while endorsing impartial beneficence would increase trust.

Thursday, August 12, 2021

Partisan Schadenfreude and the Demand for Candidate Cruelty

Webster, S.W., Glynn, A.N., & Motta, M. P.
Unpublished Manuscript
July 2021


We establish the prevalence of partisan schadenfreude—that is, taking “joy in the suffering” of partisan others. Analyzing attitudes on health care, taxation, climate change, and the coronavirus pandemic, we find that a sizable portion of the American mass public engages in partisan schadenfreude and that these attitudes are most commonly expressed by the most ideologically extreme Americans. Additionally, we provide evidence of the demand for candidate cruelty, finding a sizable portion of the American public to be more likely than not to vote for candidates who promise to pass policies that “disproportionately harm” supporters of the opposing political party. Finally, we demonstrate that partisan schadenfreude is highly predictive of this likelihood to vote for cruel candidates and much more predictive of this likelihood than strong partisanship or ideological extremity. In sum, our results suggest that partisan schadenfreude is widespread and has disturbing implications for American political behavior.


American politics is increasingly divisive. While such a claim is relatively undisputed, few have attempted to study how those divisions psychologically motivate extreme and punitive forms of political participation. In this study we have taken an important first step in this regard. Utilizing a series of novel datasets measuring the political attitudes of thousands of Americans, we have shown that a significant portion of the mass public is prone to engaging in what we have called partisan schadenfreude, or taking “joy in the suffering” of partisan others.

We have also demonstrated that Americans express a preference for candidate cruelty. Specifically, our results suggest that a significant portion—over one-third—of the mass public is willing to vote for a candidate of unknown ideological leanings who promises to pass policies that “disproportionately harm” supporters of the opposing political party. Together, these findings help resolve uncertainty about whether the public passively accepts politicians who espouse punitive policies and rhetoric, or actively demands them. We find that Americans actively demand candidate cruelty, and that this demand is highest among those who exhibit the greatest amount of partisan schadenfreude.

Wednesday, August 11, 2021

The sympathetic plot, its psychological origins, and implications for the evolution of fiction

Singh, M. (2021). 
Emotion Review, 13(3), 183–198.


For over a century, scholars have compared stories and proposed universal narrative patterns. Despite their diversity, nearly all of these projects converged on a common structure: the sympathetic plot. The sympathetic plot describes how a goal-directed protagonist confronts obstacles, overcomes them, and wins rewards. Stories with these features frequently exhibit other common elements, including an adventure and an orphaned main character. Here, I identify and aim to explain the sympathetic plot. I argue that the sympathetic plot is a technology for entertainment that works by engaging two sets of psychological mechanisms. First, it triggers mechanisms for learning about obstacles and how to overcome them. It builds interest by confronting a protagonist with a problem and induces satisfaction when the problem is solved. Second, it evokes sympathetic joy. It establishes the protagonist as an ideal cooperative partner pursuing a justifiable goal, convincing audiences that they should assist the character. When the protagonist succeeds, they receive rewards, and audiences feel sympathetic joy, an emotion normally triggered when cooperative partners triumph. The psychological capacities underlying the sympathetic plot are not story-specific adaptations. Instead, they evolved for purposes like learning and cooperation before being co-opted for entertainment by storytellers and cultural evolution.


Why do people everywhere tell stories about abused stepdaughters who marry royalty and revel in awarded riches? Whence all the virtuous orphans? The answer, I have argued, is entertainment.Tales in which a likable main character overcomes difficulty and reaps rewards create a compelling cognitive dreamscape. They twiddle psychological mechanisms involved in learning and cooperation, narrowing attention and inducing sympathetic joy. Story imitates life, or at least the elements of life to which we’ve evolved pleasurable responses.

Note: Many times, our patients narrate stories of their lives.  Narrative patterns may help psychologists understand internal motivations of our patients, how they view their life trajectories, and how we can help them alter their storylines for improved mental health.

Tuesday, August 10, 2021

The irrationality of transhumanists

Susan B. Levin
iai.tv Issue 9
Originally posted 11 Jan 21

Bioenhancement is among the hottest topics in bioethics today. The most contentious area of debate here is advocacy of “radical” enhancement (aka transhumanism). Because transhumanists urge us to categorically heighten select capacities, above all, rationality, it would be incorrect to say that the possessors of these abilities were human beings: to signal, unmistakably, the transcendent status of these beings, transhumanists call them “posthuman,” “godlike,” and “divine.” For many, the idea of humanity’s technological self-transcendence has a strong initial appeal; that appeal, intensified by transhumanists’ relentless confidence that radical bioenhancement will occur if only we commit adequate resources to the endeavor, yields a viscerally potent combination. On this of all topics, however, we should not let ourselves be ruled by viscera. 

Transhumanists present themselves as the sole rational parties to the debate over radical bioenhancement: merely questioning a dedication to skyrocketing rational capacity or lifespan testifies to one’s irrationality. Scientifically, for this charge of irrationality not to be intellectually perverse, the evidence on transhumanists’ side would have to be overwhelming.


Transhumanists are committed to extreme rational essentialism: they treasure the limitless augmentation of rational capacity, treating affect as irrelevant or targeting it (at minimum, the so-called negative variety) for elimination. Further disrupting transhumanists’ fixation with radical cognitive bioenhancement, therefore, is the finding that pharmacological boosts, such as they are, may not be entirely or even mainly cognitive. Motivation may be strengthened, with resulting boosts to subjects’ informational facility. What’s more, being in a “positive” (i.e., happy) mood can impair cognitive performance, while being in a “negative” (i.e., sad) one can strengthen it by, for instance, making subjects more disposed to reject stereotypes. 

Monday, August 9, 2021

Health Care in the U.S. Compared to Other High-Income Countries: Worst Outcomes

The Commonwealth Fund
Mirror, Mirror 2021: Reflecting Poorly
Originally posted 4 Aug 21


No two nations are alike when it comes to health care. Over time, each country has settled on a unique mix of policies, service delivery systems, and financing models that work within its resource constraints. Even among high-income nations that have the option to spend more on health care, approaches often vary substantially. These choices affect health system performance in terms of access to care, patients’ experiences with health care, and people’s health outcomes. In this report, we compare the health systems of 11 high-income countries as a means to generate insights about the policies and practices that are associated with superior performance.

With the COVID-19 pandemic imposing an unprecedented stress test on the health care and public health systems of all nations, such a comparison is especially germane. Success in controlling and preventing infection and disease has varied greatly. The same is true of countries’ ability to address the challenges that the pandemic has presented to the workforce, operations, and financial stability of the organizations delivering care. And while the comparisons we draw are based on data collected prior to the pandemic or during the earliest months of the crisis, the prepandemic strengths and weaknesses of each country’s preexisting arrangements for health care and public health have undoubtedly been shaping its experience throughout the crisis.

For our assessment of health care system performance in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States, we used indicators available across five domains:
  • Access to care
  • Care process
  • Administrative efficiency
  • Equity
  • Health care outcomes
For more information on these performance domains and their component measures, see How We Measured Performance. Most of the data were drawn from surveys examining how members of the public and primary care physicians experience health care in their respective countries. These Commonwealth Fund surveys were conducted by SSRS in collaboration with partner organizations in the 10 other countries. Additional data were drawn from the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO).

Sunday, August 8, 2021

Spreading False Vax Info Might Cost You Your Medical License

Ryan Basen
Originally posted 3 Aug 21

Physicians who intentionally spread misinformation or disinformation about the COVID-19 vaccines could be disciplined by state medical boards and may have their licenses suspended or taken away, said the Federation of State Medical Boards (FSMB).

Due "to a dramatic increase in the dissemination of COVID-19 vaccine misinformation and disinformation by physicians and other health care professionals on social media platforms, online and in the media," the FSMB, a national nonprofit representing medical boards that license and discipline allopathic and osteopathic physicians, issued the following statement:
Physicians who willfully generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded and consensus driven for the betterment of public health. Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.

The FSMB is aiming to remind physicians that words matter, that they have a platform, and that misinformation and disinformation -- especially within the context of the pandemic -- can cause harm, said president and CEO Humayun Chaudhry, DO. "I hope that physicians and other licensees get the message," he added.

The info is here.

Saturday, August 7, 2021

Character-Infused Ethical Decision Making

Nguyen, B., Crossan, M. 
J Bus Ethics (2021). 


Despite a growing body of research by management scholars to understand and explain failures in ethical decision making (EDM), misconduct prevails. Scholars have identified character, founded in virtue ethics, as an important perspective that can help to address the gap in organizational misconduct. While character has been offered as a valid perspective in EDM, current theorizing on how it applies to EDM has not been well developed. We thus integrate character, founded in virtue ethics, into Rest’s (1986) EDM model to reveal how shifting attention to the nature of the moral agent provides critical insights into decision making more broadly and EDM specifically. Virtue ethics provides a perspective on EDM that acknowledges and anticipates uncertainties, considers its contextual constraints, and contemplates the development of the moral agent. We thus answer the call by many scholars to integrate character in EDM in order to advance the understanding of the field and suggest propositions for how to move forward. We conclude with implications of a character-infused approach to EDM for future research.

From the Conclusion

As described at the outset, misconduct occurs in every facet of organizational life from the individual to the collective, at a localized and global scale, and covers inappropriate action in the private (2008 financial crisis), public/government (Panama Papers), academic institutions (Varsity Blues Scandal), and even touches not-for-profit organizations (IOC doping scandal). Character highlights the fact that misconduct often arises from “too much of a good thing” (Antonakis et al., 2017); when one or a set of character dimensions are privileged over the others, leading to deficiencies in those undervalued dimensions. For example, those who contributed to the financial crisis and the Panama Paper scandal were likely high on drive but deficient in justice and humanity. Thus, future research could insert character into the equation to better understand the nature of misconduct.

Friday, August 6, 2021

White and minority demographic shifts, intergroup threat, and right-wing extremism

Bai, H., & Federico, C. M.
(2021). Journal of Experimental Social Psychology
Volume 94, May 2021, 104114


We present four studies (one correlational and three experimental) of American Whites that examine relationships between White and minority demographic shifts, intergroup threat, and support for extreme-right groups and actions. We focus in particular on the role of collective existential threat (i.e., a perception that the ingroup will cease to exist), along with three alternative/competing intergroup threats: status threat, symbolic threat, and prototypicality threat. Though no zero-order relationship was found between perceived White population decline and far-right variables, we find evidence that (1) perceived White population decline leads to collective existential threat net of other perceived demographic shifts, (2) collective existential threat is related to far-right support net of other threats, and (3) perceived White decline has a robust indirect relationship with measures of far-right support via collective existential threat.


• Perceived White population decline leads to collective existential threat net of other perceived demographic shifts.

• Existential threat is related to far-right support net of other threats.

• Perceived White population decline has a robust indirect relationship with measures of far-right support via collective existential threat.

Thursday, August 5, 2021

Technological seduction and self-radicalization

Alfano, M., Carter, J., & Cheong, M. (2018). 
Journal of the American Philosophical Association, 
4(3), 298-322. doi:10.1017/apa.2018.27


Many scholars agree that the Internet plays a pivotal role in self-radicalization, which can lead to behaviors ranging from lone-wolf terrorism to participation in white nationalist rallies to mundane bigotry and voting for extremist candidates. However, the mechanisms by which the Internet facilitates self-radicalization are disputed; some fault the individuals who end up self-radicalized, while others lay the blame on the technology itself. In this paper, we explore the role played by technological design decisions in online self-radicalization in its myriad guises, encompassing extreme as well as more mundane forms. We begin by characterizing the phenomenon of technological seduction. Next, we distinguish between top-down seduction and bottom-up seduction. We then situate both forms of technological seduction within the theoretical model of dynamical systems theory. We conclude by articulating strategies for combating online self-radicalization.

Wednesday, August 4, 2021

A taxonomy of conscientious objection in healthcare

Gamble, N., & Saad, T. (2021). 
Clinical Ethics. 


Conscientious Objection (CO) has become a highly contested topic in the bioethics literature and public policy. However, when CO is discussed, it is almost universally referred to as a single entity. Reality reveals a more nuanced picture. Healthcare professionals may object to a given action on numerous grounds. They may oppose an action because of its ends, its means, or because of factors that lay outside of both ends and means. Our paper develops a taxonomy of CO, which makes it possible to describe the refusals of healthcare professional with greater finesse. The application of this development will potentially allow for greater subtlety in public policy and academic discussions – some species of CO could be permitted while others could be prohibited.


The ethical analysis and framework we have presented demonstrate that conscience is intertwined with practical wisdom and is an intrinsic part of the work of healthcare professionals. The species of CO we have enumerated reveal that morality and values in healthcare are not only related to a few controversial ends, but to all ends and means in medicine, and the relationships between them.

The taxonomy we have presented will feasibly permit a more nuanced discussion of CO, where the issues surrounding and policy solutions for each species of CO can be discussed separately. Such a conversation
is an important task. After all, CO will not go away, even if specific belief systems rise or fall. CO exists
because humans have an innate awareness of the need to seek good and avoid evil, yet still arrive at disparate intellectual conclusions about what is right and wrong. Thus, if tolerant and amicable solutions
are to be developed for CO, conversations on CO in healthcare need to continue with a more integrated
understanding of practical reason and an awareness of broad involvement of conscience in medicine. We
hope our paper contributes to this end.

Tuesday, August 3, 2021

Get lucky: Situationism and circumstantial moral luck

Marcela Herdova & Stephen Kearns 
(2015) Philosophical Explorations, 18:3, 362-377
DOI: 10.1080/13869795.2015.1026923


Situationism is, roughly, the thesis that normatively irrelevant environmental factors have a great impact on our behaviour without our being aware of this influence. Surprisingly, there has been little work done on the connection between situationism and moral luck. Given that it is often a matter of luck what situations we find ourselves in, and that we are greatly influenced by the circumstances we face, it seems also to be a matter of luck whether we are blameworthy or praiseworthy for our actions in those circumstances. We argue that such situationist moral luck, as a variety of circumstantial moral luck, exemplifies a distinct and interesting type of moral luck. Further, there is a case to be made that situationist moral luck is perhaps more worrying than some other well-discussed cases of (supposed) moral luck.

From the Conclusion

Those who insist on the significance of luck to our practices of moral assessment are on somewhat of a tightrope. If we consider agents who differ only in the external results of their actions, and who are faced with normatively similar circumstances, it is difficult to maintain that there is any major difference in the degree of such agents’ moral responsibility. If we consider agents that differ rather significantly, and face normatively distinct situations, then though luck may play a role in what normative circumstances they face, there is much to base a moral assessment on that is either under the agents’ control or distinctive of each agent and their respective responses to their normative circumstances (or both). The role luck plays in our assessments of such agents, then, is arguably small enough that it is unclear that any difference in moral assessment can be properly said to be due  to this luck (at least to an extent that should worry us or that is inconsiderable tension with our usual moral thinking).

Monday, August 2, 2021

Landmark research integrity survey finds questionable practices are surprisingly common

Jop De Vrieze
Science Magazine
Originally posted 7 Jul 21

More than half of Dutch scientists regularly engage in questionable research practices, such as hiding flaws in their research design or selectively citing literature, according to a new study. And one in 12 admitted to committing a more serious form of research misconduct within the past 3 years: the fabrication or falsification of research results.

This rate of 8% for outright fraud was more than double that reported in previous studies. Organizers of the Dutch National Survey on Research Integrity, the largest of its kind to date, took special precautions to guarantee the anonymity of respondents for these sensitive questions, says Gowri Gopalakrishna, the survey’s leader and an epidemiologist at Amsterdam University Medical Center (AUMC). “That method increases the honesty of the answers,” she says. “So we have good reason to believe that our outcome is closer to reality than that of previous studies.” The survey team published results on 6 July in two preprint articles, which also examine factors that contribute to research misconduct, on MetaArxiv.

When the survey began last year, organizers invited more than 60,000 researchers to take part—those working across all fields of research, both science and the humanities, at some 22 Dutch universities and research centers. However, many institutions refused to cooperate for fear of negative publicity, and responses fell short of expectations: Only about 6800 completed surveys were received. Still, that’s more responses than any previous research integrity survey, and the response rate at the participating universities was 21%—in line with previous surveys.

One of the preprints focuses on the prevalence of misbehavior—cases of fraud as well as a less severe category of “questionable research practices,” such as carelessly assessing the work of colleagues, poorly mentoring junior researchers, or selectively citing scientific literature. The other article focuses on responsible behavior; this includes correcting one’s own published errors, sharing research data, and “preregistering” experiments—posting hypotheses and protocols ahead of time to reduce the bias that can arise when these are released after data collection.

Sunday, August 1, 2021

Understanding, explaining, and utilizing medical artificial intelligence

Cadario, R., Longoni, C. & Morewedge, C.K. 
Nat Hum Behav (2021). 


Medical artificial intelligence is cost-effective and scalable and often outperforms human providers, yet people are reluctant to use it. We show that resistance to the utilization of medical artificial intelligence is driven by both the subjective difficulty of understanding algorithms (the perception that they are a ‘black box’) and by an illusory subjective understanding of human medical decision-making. In five pre-registered experiments (1–3B: N = 2,699), we find that people exhibit an illusory understanding of human medical decision-making (study 1). This leads people to believe they better understand decisions made by human than algorithmic healthcare providers (studies 2A,B), which makes them more reluctant to utilize algorithmic than human providers (studies 3A,B). Fortunately, brief interventions that increase subjective understanding of algorithmic decision processes increase willingness to utilize algorithmic healthcare providers (studies 3A,B). A sixth study on Google Ads for an algorithmic skin cancer detection app finds that the effectiveness of such interventions generalizes to field settings (study 4: N = 14,013).

From the Discussion

Utilization of algorithmic-based healthcare services is becoming critical with the rise of telehealth service, the current surge in healthcare demand and long-term goals of providing affordable and high-quality healthcare in developed and developing nations. Our results yield practical insights for reducing reluctance to utilize medical AI. Because the technologies used in algorithmic-based medical applications are complex, providers tend to present AI provider decisions as a ‘black box’. Our results underscore the importance of recent policy recommendations to open this black box to patients and users. A simple one-page visual or sentence that explains the criteria or process used to make medical decisions increased acceptance of an algorithm-based skin cancer diagnostic tool, which could be easily adapted to other domains and procedures.

Given the complexity of the process by which medical AI makes decisions, firms now tend to emphasize the outcomes that algorithms produce in their marketing to consumers, which feature benefits such as accuracy, convenience and rapidity (performance), while providing few details about how algorithms work (process). Indeed, in an ancillary study examining the marketing of skin cancer smartphone applications (Supplementary Appendix 8), we find that performance-related keywords were used to describe 57–64% of the applications, whereas process-related keywords were used to describe 21% of the applications. Improving subjective understanding of how medical AI works may then not only provide beneficent insights for increasing consumer adoption but also for firms seeking to improve their positioning. Indeed, we find increased advertising efficacy for SkinVision, a skin cancer detection app, when advertising included language explaining how it works.