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

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

Thursday, September 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).

Wednesday, September 29, 2021

A new framework for the psychology of norms

Westra, E., & Andrews, K. (2021, July 9).


Social Norms – rules that dictate which behaviors are appropriate, permissible, or obligatory in different situations for members of a given community – permeate all aspects of human life. Many researchers have sought to explain the ubiquity of social norms in human life in terms of the psychological mechanisms underlying their acquisition, conformity, and enforcement. Existing theories of the psychology of social norms appeal to a variety of constructs, from prediction-error minimization, to reinforcement learning, to shared intentionality, to evolved psychological adaptations. However, most of these accounts share what we call the psychological unity assumption, which holds that there is something psychologically distinctive about social norms, and that social norm adherence is driven by a single system or process. We argue that this assumption is mistaken. In this paper, we propose a methodological and conceptual framework for the cognitive science of social norms that we call normative pluralism. According to this framework, we should treat norms first and foremost as a community-level pattern of social behavior that might be realized by a variety of different cognitive, motivational, and ecological mechanisms. Norm psychologists should not presuppose that social norms are underpinned by a unified set of processes, nor that there is anything particularly distinctive about normative cognition as such. We argue that this pluralistic approach offers a methodologically sound point of departure for a fruitful and rigorous science of norms.


The central thesis of this paper –what we’ve called normative pluralism–is that we should not take the psychological unity of social norms for granted.Social norms might be underpinned by a domain-specific norm system or by a single type of cognitive process, but they might also be the product of many different processes. In our methodological proposal, we outlined a novel, non-psychological conception of social norms –what we’ve called normative regularities –and defined the core components of a psychology of norms in light of this construct. In our empirical proposal, we argued that thus defined, social norms emerge from a heterogeneous set of cognitive, affective, and ecological mechanisms.

Thinking about social norms in this way will undoubtedly make the cognitive science of norms more complex and messy. If we are correct, however, then this will simply be a reflection of the complexity and messiness of social norms themselves. Taking a pluralistic approach to social norms allows us to explore the potential variability inherent to norm-governed behavior, which can help us to better understand how social norms shape our lives, and how they manifest themselves throughout the natural world.

Tuesday, September 28, 2021

Moral Injury During the CDOVID-19 Pandemic

Borges LM, Barnes SM,  et al. 
Psychol Trauma. 2020 Aug;12(S1):S138-S140. 
doi: 10.1037/tra0000698. Epub 2020 Jun 4. PMID: 32496101.

Here is an excerpt:

Moral injury in COVID-19 may be related to, but is distinct from: 1) burnout, 2) adjustment disorders, 3)
depression, 4) traumatic stress/PTSD, 5) moral injury in the military, and 6) moral distress. Moral injury
may be a contributing factor to burnout, adjustment disorders, or depression, but they are not equivalent. The diagnosis of PTSD requires a qualifying exposure to a traumatic stressor, whereas experiencing a moral injury does not. Moral injury in the military has been addressed in a different population and particularly after deployment, and its lessons may not be generalizable to moral injury during COVID-19, which we are seeing acutely among healthcare workers. Finally, moral distress may be a precursor to moral injury, but the terms are not interchangeable. Previous literature has noted that moral distress signals a need for systemic change because it is generated by systemic issues. Thus, moral distress can serve as a guide for healthcare improvement, and rapid systemic interventions to address moral distress may help to prevent and mitigate the impact of moral injury.

While not a mental disorder itself, moral injury undermines core capacities for well-being, including a
sense of ongoing value-laden actions, competence to face and meet challenges, and feelings of belonging and meaning. Moral injury is associated with strong feelings of shame and guilt and with intense self-condemnation and a shattered core sense of self. Clinical observations suggest that uncertainty in decision-making may increase the likelihood or intensity of moral injury.

In the context of a public health disaster such as the COVID-19 pandemic, acknowledgement of the need
to transition from ordinary standards of care to crisis standards of care can be both necessary and helpful to 1) provide a framework upon which to make difficult and ethically fraught decisions and 2) alleviate some of moral distress and indeed moral injury that may otherwise be experienced in the absence of such guidance. The pandemic forces us to confront challenging questions for which there are no clear answers, and to make “lose-lose” choices in which no one involved ends up feeling satisfied or even comfortable. 

Monday, September 27, 2021

An African Theory of Moral Status: A Relational Alternative to Individualism and Holism.

Metz, T. (2012).
Ethic Theory Moral Prac 15, 387–402. 


The dominant conceptions of moral status in the English-speaking literature are either holist or individualist, neither of which accounts well for widespread judgments that: animals and humans both have moral status that is of the same kind but different in degree; even a severely mentally incapacitated human being has a greater moral status than an animal with identical internal properties; and a newborn infant has a greater moral status than a mid-to-late stage foetus. Holists accord no moral status to any of these beings, assigning it only to groups to which they belong, while individualists such as welfarists grant an equal moral status to humans and many animals, and Kantians accord no moral status either to animals or severely mentally incapacitated humans. I argue that an underexplored, modal-relational perspective does a better job of accounting for degrees of moral status. According to modal-relationalism, something has moral status insofar as it capable of having a certain causal or intensional connection with another being. I articulate a novel instance of modal-relationalism grounded in salient sub-Saharan moral views, roughly according to which the greater a being's capacity to be part of a communal relationship with us, the greater its moral status. I then demonstrate that this new, African-based theory entails and plausibly explains the above judgments, among others, in a unified way.

From the end of the article:

Those deeply committed to holism and individualism, or even a combination of them, may well not be convinced by this discussion. Diehard holists will reject the idea that anything other than a group can ground moral status, while pure individualists will reject the recurrent suggestion that two beings that are internally identical (foetus v neonate, severely mentally incapacitated human v animal) could differ in their moral status. However, my aim has not been to convince anyone to change her mind, or even to provide a complete justification for doing so. My goals have instead been the more limited ones of articulating a new, modal-relational account of moral status grounded in sub-Saharan moral philosophy, demonstrating that it avoids the severe parochialism facing existing relational accounts, and showing that it accounts better than standard Western theories for a variety of widely shared intuitions about what has moral status and to what degree. Many of these intuitions are captured by neither holism nor individualism and have lacked a firm philosophical foundation up to now. Of importance here is the African theory’s promise to underwrite the ideas that humans and animals have a moral status grounded in the same property that differs in degree, that severely mentally incapacitated humans have a greater moral status than animals with the same internal properties, and that a human’s moral status increases as it develops from the embryonic to foetal to neo-natal stages.

Sunday, September 26, 2021

Better the Two Devils You Know, Than the One You Don’t: Predictability Influences Moral Judgments of Immoral Actors

Walker, A. C.,  et al. 
(2020, March 24).


Across six studies (N = 2,646), we demonstrate the role that perceptions of predictability play in judgments of moral character, finding that people demonstrate a moral preference for more predictable immoral actors. Participants judged agents performing an immoral action (e.g., assault) for an unintelligible reason as less predictable and less moral than agents performing the same immoral action, along with an additional immoral action (e.g., theft), for a well-understood immoral reason (Studies 1-4). Additionally, agents performing an immoral action for an unintelligible reason were judged as less predictable and less moral compared to agents performing the same immoral act for an unstated reason (Studies 3-5). This moral preference persisted when participants viewed video footage of each agent’s immoral action (Study 5). Finally, agents performing immoral actions in an unusual way were judged as less predictable and less moral than those performing the same actions in a more common manner (Study 6). The present research demonstrates how immoral actions performed without a clear motive or in an unpredictable way are perceived to be especially indicative of poor moral character. In revealing peoples’ moral preference for predictable immoral actors, we propose that perceptions of predictability play an important, yet overlooked, role in judgments of moral character. Furthermore, we propose that predictability influences judgments of moral character for its ultimate role in reducing social uncertainty and facilitating cooperation with trustworthy individuals and discuss how these findings may be accommodated by person-centered theories of moral judgment and theories of morality-as-cooperation.

From the Discussion

From traditional act-based perspectives (e.g., deontology and utilitarianism; Kant, 1785/1959; Mill, 1861/1998) this moral preference may appear puzzling, as participants judged actors causing more harm and violating more moral rules as more moral. Nevertheless, recent work suggests that people view actions not as the endpoint of moral evaluation, but as a source of information for assessing the moral character of those who perform them(Tannenbaum et al., 2011; Uhlmannet al., 2013). Fromthis person-centered perspective(Pizarro & Tannenbaum, 2011; Uhlmann et al., 2015), a moral preference for more predictable immoral actors can be understood as participants judging the same immoral action (e.g., assault) as more indicative of negative character traits (e.g., a lack of empathy)when performed without an intelligible motive. That is, a person assaulting a stranger seemingly without reason or in an unusual manner (e.g., with a frozen fish) may be viewed as a more inherently unstable, violent, and immoral person compared to an individual performing an identical assault for a well-understood reason (e.g., to escape punishment for a crime in-progress). Such negative character assessments may lead unpredictable immoral actors to be considered a greater risk for causing future harms of uncertain severity to potentially random victims. Consistent with these claims, past work has shown that people judge those performing harmless-but-offensive acts (e.g., masturbating inside a dead chicken), as not only possessing more negative character traits compared to others performing more harmful acts (e.g., theft), but also as likely to engage in more harmful actions in the future(Chakroff et al., 2017; Uhlmann& Zhu, 2014).

Saturday, September 25, 2021

The prefrontal cortex and (uniquely) human cooperation: a comparative perspective

Zoh, Y., Chang, S.W.C. & Crockett, M.J.
Neuropsychopharmacol. (2021). 


Humans have an exceptional ability to cooperate relative to many other species. We review the neural mechanisms supporting human cooperation, focusing on the prefrontal cortex. One key feature of human social life is the prevalence of cooperative norms that guide social behavior and prescribe punishment for noncompliance. Taking a comparative approach, we consider shared and unique aspects of cooperative behaviors in humans relative to nonhuman primates, as well as divergences in brain structure that might support uniquely human aspects of cooperation. We highlight a medial prefrontal network common to nonhuman primates and humans supporting a foundational process in cooperative decision-making: valuing outcomes for oneself and others. This medial prefrontal network interacts with lateral prefrontal areas that are thought to represent cooperative norms and modulate value representations to guide behavior appropriate to the local social context. Finally, we propose that more recently evolved anterior regions of prefrontal cortex play a role in arbitrating between cooperative norms across social contexts, and suggest how future research might fruitfully examine the neural basis of norm arbitration.


The prefrontal cortex, in particular its more anterior regions, has expanded dramatically over the course of human evolution. In tandem, the scale and scope of human cooperation has dramatically outpaced its counterparts in nonhuman primate species, manifesting as complex systems of moral codes that guide normative behaviors even in the absence of punishment or repeated interactions. Here, we provided a selective review of the neural basis of human cooperation, taking a comparative approach to identify the brain systems and social behaviors that are thought to be unique to humans. Humans and nonhuman primates alike cooperate on the basis of kinship and reciprocity, but humans are unique in their abilities to represent shared goals and self-regulate to comply with and enforce cooperative norms on a broad scale. We highlight three prefrontal networks that contribute to cooperative behavior in humans: a medial prefrontal network, common to humans and nonhuman primates, that values outcomes for self and others; a lateral prefrontal network that guides cooperative goal pursuit by modulating value representations in the context of local norms; and an anterior prefrontal network that we propose serves uniquely human abilities to reflect on one’s own behavior, commit to shared social contracts, and arbitrate between cooperative norms across diverse social contexts. We suggest future avenues for investigating cooperative norm arbitration and how it is implemented in prefrontal networks.

Friday, September 24, 2021

Hanlon’s Razor

N. Ballantyne and P. H. Ditto
Midwest Studies in Philosophy
August 2021


“Never attribute to malice that which is adequately explained by stupidity” – so says Hanlon’s Razor. This principle is designed to curb the human tendency toward explaining other people’s behavior by moralizing it. In this article, we ask whether Hanlon’s Razor is good or bad advice. After offering a nuanced interpretation of the principle, we critically evaluate two strategies purporting to show it is good advice. Our discussion highlights important, unsettled questions about an idea that has the potential to infuse greater humility and civility into discourse and debate.

From the Conclusion

Is Hanlon’s Razor good or bad advice? In this essay, we criticized two proposals in favor of the Razor.  One sees the benefits of the principle in terms of making us more accurate. The other sees benefits in terms of making us more charitable. Our discussion has been preliminary, but we hope careful empirical investigation can illuminate when and why the Razor is beneficial, if it is. For the time being, what else can we say about the Razor?

The Razor attempts to address the problem of detecting facts that explain opponents’ mistakes. Why do our opponents screw up? For hypermoralists, detecting stupidity in the noise of malice can be difficult: we are too eager to attribute bad motives and unsavory character to people who disagree with us. When we try to explain their mistakes, we are subject to two distinct errors:

Misidentifying-stupidity error: attributing an error to malice that is due to stupidity

Misidentifying-malice error: attributing an error to stupidity that is due to malice 

The idea driving the Razor is simple enough. People make misidentifying-stupidity errors too frequently and they should minimize those errors by risking misidentifying-malice errors. The Razor attempts to adjust our criterion for detecting the source of opponents’ mistakes. People should see stupidity more often in their opponents, even if that means they sometimes see stupidity where there is in fact malice. 

Thursday, September 23, 2021

The Execution Hypothesis for the Evolution of a Morality of Fairness

R. Wrangham
Ethics & Politics
XXIII, 2021, 261-282


Humans are both the only species known to have a morality of fairness, and the only species in which the social hierarchy is headed by an alliance (a ‘reverse dominance hierarchy’). I present evidence in support of the argument by Boehm (1999, 2012) that these two features are causally linked. The reverse dominance hierarchy is detectable in the fossil record around 300,000 years ago with the
origin of Homo sapiens. From then onwards, according to the execution hypothesis, an alliance of adult males held the power of life and death over all members of the social group, and they used this power to advance their interests. The result was an intense selective pressure against antisocial behaviour and in favour of prosociality, cooperation and conformity to group norms, whether the norms were beneficial for the group as a whole or merely for the male alliance. The execution hypothesis thus argues that group dynamics have operated for at least 12,000 generations to favour the evolution of moral emotions, many of which are designed to protect individuals from the threat of severe punishment or death at the hands of a dominant alliance of males. 


The Persistent Importance of Moral Enforcement

Ever since Durkheim (1902), hunter-gatherers and others living in small-scale, acephalous bands have been known to live by a set of norms that categorize numerous behaviours as right or wrong.  Morally circumscribed behaviors concern food, sharing, sexuality, marriage partners, emotional expression, disrespect, secret societies and much else, and are the topic of much daily conversation. To judge from one detailed study of Ju/’hoansi Bushmen hunter-gatherers, moral enforcement comes more from punishment than reward, with males being sanctioned more than females (Wiessner, 2005).

Wednesday, September 22, 2021

COVID Medical Coverage is Over: Insurers are restoring deductibles and co-pays, leaving patients with big bills

Christopher Rowland
The Washington Post
Originally posted 18 Sept 21

Here is an excerpt:

But this year, most insurers have reinstated co-pays and deductibles for covid patients, in many cases even before vaccines became widely available. The companies imposed the costs as industry profits remained strong or grew in 2020, with insurers paying out less to cover elective procedures that hospitals suspended during the crisis.

Now the financial burden of covid is falling unevenly on patients across the country, varying widely by health-care plan and geography, according to a survey of the two largest health plans in every state by the nonprofit and nonpartisan Kaiser Family Foundation.

If you’re fortunate enough to live in Vermont or New Mexico, for instance, state mandates require insurance companies to cover 100 percent of treatment. But most Americans with covid are now exposed to the uncertainty, confusion and expense of business-as-usual medical billing and insurance practices — joining those with cancer, diabetes and other serious, costly illnesses.

(Insurers continue to waive costs associated with vaccinations and testing, a pandemic benefit the federal government requires.)

A widow with no children, Azar, 57, is part of the unlucky majority. Her experience is a sign of what to expect if covid, as most scientists fear, becomes endemic: a permanent, regular health threat.

Tuesday, September 21, 2021

White Evangelicals Shun Morality for Power

Charles Blow
The New York Times - Opinion
Originally published 19 Sept 21

Here is an excerpt:

I had hoped that there were more white evangelicals who embraced the same teachings, who would not abide by the message the Grahams of the world were advancing, who would stand on principle.

But I was wrong. A report for the Pew Research Center published last week found that, contrary to an onslaught of press coverage about evangelicals who had left the church, disgusted by its embrace of the president, “There is solid evidence that white Americans who viewed Trump favorably and did not identify as evangelicals in 2016 were much more likely than white Trump skeptics to begin identifying as born-again or evangelical Protestants by 2020.”

That’s right, the lying, philandering, thrice-married Trump, who has been accused by dozens of women of sexual misconduct or assault, may actually have grown the ranks of white evangelicals rather than shrunk them.

To get some perspective on this, I reached out to an expert, Anthea Butler, a professor of religious studies and Africana studies and the chair of the religious studies department at the University of Pennsylvania. She is also the author of the recently released book “White Evangelical Racism.”

As Professor Butler told me, the reason that some people might be surprised by these findings is that “they believed the hype.” For years, evangelicals had claimed that they were upholding morality and fighting injustice. But what the movement has really been since the 1970s, said Butler, is “a political arm of the Republican Party.” As Butler put it, evangelicals now “use moral issues as a wedge to get political power.”

Butler concluded, “We need to quit coddling evangelicals and allowing them to use these moral issues to hide behind, because it’s very clear that that’s not what the issue is. The issue is that they believe in anti-vaxxing, they believe in racism, they believe in anti-immigration, they believe that only Republicans should run the country and they believe in white supremacy.”

Monday, September 20, 2021

Intergroup preference, not dehumanization, explains social biases in emotion attribution

F. Enoch, S. P. Tipper, & H. Over
Volume 216, November 2021, 104865


Psychological models can only help improve intergroup relations if they accurately characterise the mechanisms underlying social biases. The claim that outgroups suffer dehumanization is near ubiquitous in the social sciences. We challenge the most prominent psychological model of dehumanization - infrahumanization theory - which holds outgroup members are subtly dehumanized by being denied human emotions. We examine the theory across seven intergroup contexts in thirteen pre-registered and highly powered experiments (N = 1690). We find outgroup members are not denied uniquely human emotions relative to ingroup members. Rather, they are ascribed prosocial emotions to a lesser extent but antisocial emotions to a greater extent. Apparent evidence for infrahumanization is better explained by ingroup preference, outgroup derogation and stereotyping. Infrahumanization theory may obscure more than it reveals about intergroup bias.


• Infrahumanization theory predicts outgroups are often denied uniquely human emotions.

• However, to date, antisocial uniquely human emotions have not been investigated.

• We test attributions of prosocial and antisocial emotions to social groups.

• Attributions of antisocial human emotions were stronger for outgroups than ingroups.

• We find no support for the predictions of infrahumanization theory.

From the General Discussion

Our results dovetail with recent empirical work that challenges the predictions made by Haslam's (2006) dual model of dehumanization (Enock et al., 2021). This research showed that when undesirable human-specific characteristics (such as ‘corrupt’ and ‘selfish’) are included in overall measures of humanness, there is no evidence for either animalistic or mechanistic dehumanization of outgroups as characterised by the dual model. Rather, desirable human qualities are more strongly attributed to ingroup members and undesirable human qualities to outgroup members. The present work extends these findings by further demonstrating the importance of considering sociality confounds when measuring psychological processes of ‘dehumanization’, this time through another highly prominent framework within the field.

During the review process, it was put to us that because dimensions of valence and sociality correlate highly in our pretest, the two constructs are “indistinguishable”, thus rendering our critique obsolete. We believe this represents a misunderstanding. Height and weight are strongly positively correlated, yet they are distinct constructs. Similarly, even though emotions that are generally perceived as prosocial may also perceived as positive to experience, and emotions that are generally perceived as antisocial may also be perceived as negative to experience, the two constructs are clearly conceptually distinct. While sadness is negative to experience, it is not inherently antisocial in character. Schadenfreude on the other hand is, by definition, positive to experience but antisocial in character.

Sunday, September 19, 2021

How Does Cost-Effectiveness Analysis Inform Health Care Decisions?

David D. Kim & Anirban Basu
AMA J Ethics. 2021;23(8):E639-647. 
doi: 10.1001/amajethics.2021.639.


Cost-effectiveness analysis (CEA) provides a formal assessment of trade-offs involving benefits, harms, and costs inherent in alternative options. CEA has been increasingly used to inform public and private organizations’ reimbursement decisions, benefit designs, and price negotiations worldwide. Despite the lack of centralized efforts to promote CEA in the United States, the demand for CEA is growing. This article briefly reviews the history of CEA in the United States, highlights advances in practice guidelines, and discusses CEA’s ethical challenges. It also offers a way forward to inform health care decisions.


Ethical Considerations

There have been a few criticisms on ethical grounds of CEA’s use for decision making. These include (1) controversies associated with the use of QALYs, (2) distributive justice, and (3) incomplete valuation. We discuss each of them in detail here. However, it is worth pointing out that cost-effectiveness evidence is only one of many factors considered in resource allocation decisions. We have found that none of the international HTA bodies bases its decisions solely on cost-effectiveness evidence. Therefore, much of CEA’s criticisms, fair or not, can be addressed through deliberative processes.

QALYs. The lower health utility, or health-related quality of life, assigned to patients with worse health (because of more severe disease, disability, age, and so on) raises distributional issues in using QALYs for resource allocation decisions. For example, because patients with disabilities have a lower overall health utility weight, any extension of their lives by reducing the health burden from one disease “would not generate as many QALYs as a similar extension of life for otherwise healthy people.” This distributional limitation arises because of the multiplicative nature of QALYs, which are a product of life-years and health utility weight. Consequently, the National Council on Disability has strongly denounced the use of QALYs.

Alternatives to QALYs have been proposed. The Institute for Clinical and Economic Review has started using the equal value of life-years gained metric, a modified version of the equal value of life (EVL) metric, to supplement QALYs. In EVL calculations, any life-year gained is valued at a weight of 1 QALY, irrespective of individuals’ health status during the extra year. EVL, however, “has had limited traction among academics and decision-making bodies” because it undervalues interventions that extend life-years by the same amount as other interventions but that substantially improve quality of life. More recently, a health-years-in-total metric was proposed to overcome the limitations of both QALYs and EVL, but more work is needed to fully understand its theoretical foundations.

Saturday, September 18, 2021

Fraudulent data raise questions about superstar honesty researcher

Cathleen O'Grady
Originally posted 24 Aug 21

Here is an excerpt:

Some time later, a group of anonymous researchers downloaded those data, according to last week’s post on Data Colada. A simple look at the participants’ mileage distribution revealed something very suspicious. Other data sets of people’s driving distances show a bell curve, with some people driving a lot, a few very little, and most somewhere in the middle. In the 2012 study, there was an unusually equal spread: Roughly the same number of people drove every distance between 0 and 50,000 miles. “I was flabbergasted,” says the researcher who made the discovery. (They spoke to Science on condition of anonymity because of fears for their career.)

Worrying that PNAS would not investigate the issue thoroughly, the whistleblower contacted the Data Colada bloggers instead, who conducted a follow-up review that convinced them the field study results were statistically impossible.

For example, a set of odometer readings provided by customers when they first signed up for insurance, apparently real, was duplicated to suggest the study had twice as many participants, with random numbers between one and 1000 added to the original mileages to disguise the deceit. In the spreadsheet, the original figures appeared in the font Calibri, but each had a close twin in another font, Cambria, with the same number of cars listed on the policy, and odometer readings within 1000 miles of the original. In 1 million simulated versions of the experiment, the same kind of similarity appeared not a single time, Simmons, Nelson, and Simonsohn found. “These data are not just excessively similar,” they write. “They are impossibly similar.”

Ariely calls the analysis “damning” and “clear beyond doubt.” He says he has requested a retraction, as have his co-authors, separately. “We are aware of the situation and are in communication with the authors,” PNAS Editorial Ethics Manager Yael Fitzpatrick said in a statement to Science.

Three of the authors say they were only involved in the two lab studies reported in the paper; a fourth, Boston University behavioral economist Nina Mazar, forwarded the Data Colada investigators a 16 February 2011 email from Ariely with an attached Excel file that contains the problems identified in the blog post. Its metadata suggest Ariely had created the file 3 days earlier.

Ariely tells Science he made a mistake in not checking the data he received from the insurance company, and that he no longer has the company’s original file. He says Duke’s integrity office told him the university’s IT department does not have email records from that long ago. His contacts at the insurance company no longer work there, Ariely adds, but he is seeking someone at the company who could find archived emails or files that could clear his name. His publication of the full data set last year showed he was unaware of any problems with it, he says: “I’m not an idiot. This is a very easy fraud to catch.”

Friday, September 17, 2021

The Case Against Non-Moral Blame

Matheson, B., & Milam, P.E.
Forthcoming in the Oxford Studies 
in Normative Ethics 11


Non-moral blame seems to be widespread and widely accepted in everyday life—tolerated at least, but often embraced. We blame athletes for poor performance, artists for bad or boring art, scientists for faulty research, and voters for flawed reasoning. This paper argues that non-moral blame is never justified—i.e. it’s never a morally permissible response to a non-moral failure. Having explained what blame is and how non-moral blame differs from moral blame, the paper presents the argument in four steps. First, it argues that many (perhaps most) apparent cases of non-moral blame are actually cases of moral blame. Second, it argues that even if non-moral blame is pro tanto permissible—because its target is blameworthy for their substandard performance—it often (perhaps usually) fails to meet other permissibility conditions, such as fairness or standing. Third, it goes further and challenges the claim that non-moral blame is ever even pro tanto permissible. Finally, it considers a number of arguments in support of non-moral obligations and argues that none of them succeed.

This philosophical piece highlights, in part, the Fundamental Attribution Error in context of moral judgment.

Thursday, September 16, 2021

Attorney General James and U.S. Department of Labor Deliver $14 Million to Consumers Who Were Denied Mental Health Care Coverage

Press Release
NY Attorney General
Posted 12 August 21

New York Attorney General Letitia James and the U.S. Department of Labor (USDOL) today announced landmark agreements with UnitedHealthcare (United), the nation’s largest health insurer, to resolve allegations that United unlawfully denied health care coverage for mental health and substance use disorder treatment for thousands of Americans. As a result of these agreements, United will pay approximately $14.3 million in restitution to consumers affected by the policies, including $9 million to more than 20,000 New Yorkers with behavioral health conditions who received denials or reductions in reimbursement. New York and federal law requires health insurance plans to cover mental health and substance use disorder treatment the same way they cover physical health treatment. The agreements — which resolve investigations and litigation — address United’s policies that illegally limited coverage of outpatient psychotherapy, hindering access to these vital services for hundreds of thousands of New Yorkers for whom United administers behavioral health benefits. In addition to the payment to impacted consumers, United will lift the barriers it imposed and pay more than $2 million in penalties, with $1.3 million going to New York state.  

“In the shadow of the most devastating year for overdose deaths and in the face of growing mental health concerns due to the pandemic, access to this care is more critical than ever before,” said Attorney General James. “United’s denial of these vital services was both unlawful and dangerous — putting millions in harm’s way during the darkest of times. There must be no barrier for New Yorkers seeking health care of any kind, which is why I will always fight to protect and expand it. I thank Secretary Walsh for his partnership on this important matter.” 

“Protecting access to mental health and substance use disorder treatment is a priority for the Department of Labor and something I believe in strongly as a person in long-term recovery,” said U.S. Secretary of Labor Marty Walsh. “This settlement provides compensation for many people who were denied full benefits and equitable treatment. We appreciate Attorney General James and her office for their partnership in investigating, identifying, and remedying these violations.” 

New York’s behavioral health parity law — originally enacted as “Timothy’s Law” in 2006 — and the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) require insurance coverage for mental health and substance use disorder treatment to be no more restrictive than insurance coverage for physical health conditions. The agreements are the product of the first joint state-federal enforcement of these laws.  

Wednesday, September 15, 2021

Why Is It So Hard to Be Rational?

Joshua Rothman
The New Yorker
Originally published 16 Aug 21

Here is an excerpt:

Knowing about what you know is Rationality 101. The advanced coursework has to do with changes in your knowledge. Most of us stay informed straightforwardly—by taking in new information. Rationalists do the same, but self-consciously, with an eye to deliberately redrawing their mental maps. The challenge is that news about distant territories drifts in from many sources; fresh facts and opinions aren’t uniformly significant. In recent decades, rationalists confronting this problem have rallied behind the work of Thomas Bayes, an eighteenth-century mathematician and minister. So-called Bayesian reasoning—a particular thinking technique, with its own distinctive jargon—has become de rigueur.

There are many ways to explain Bayesian reasoning—doctors learn it one way and statisticians another—but the basic idea is simple. When new information comes in, you don’t want it to replace old information wholesale. Instead, you want it to modify what you already know to an appropriate degree. The degree of modification depends both on your confidence in your preexisting knowledge and on the value of the new data. Bayesian reasoners begin with what they call the “prior” probability of something being true, and then find out if they need to adjust it.

Consider the example of a patient who has tested positive for breast cancer—a textbook case used by Pinker and many other rationalists. The stipulated facts are simple. The prevalence of breast cancer in the population of women—the “base rate”—is one per cent. When breast cancer is present, the test detects it ninety per cent of the time. The test also has a false-positive rate of nine per cent: that is, nine per cent of the time it delivers a positive result when it shouldn’t. Now, suppose that a woman tests positive. What are the chances that she has cancer?

When actual doctors answer this question, Pinker reports, many say that the woman has a ninety-per-cent chance of having it. In fact, she has about a nine-per-cent chance. The doctors have the answer wrong because they are putting too much weight on the new information (the test results) and not enough on what they knew before the results came in—the fact that breast cancer is a fairly infrequent occurrence. To see this intuitively, it helps to shuffle the order of your facts, so that the new information doesn’t have pride of place. Start by imagining that we’ve tested a group of a thousand women: ten will have breast cancer, and nine will receive positive test results. Of the nine hundred and ninety women who are cancer-free, eighty-nine will receive false positives. Now you can allow yourself to focus on the one woman who has tested positive. To calculate her chances of getting a true positive, we divide the number of positive tests that actually indicate cancer (nine) by the total number of positive tests (ninety-eight). That gives us about nine per cent.

Tuesday, September 14, 2021

Reconstructing the Einstellung effect

Binz, M., & Schulz, E. (2021, August 10).


The Einstellung effect was first described by Abraham Luchins in his doctoral thesis published in 1942. The effect occurs when a repeated solution to old problems is applied to a new problem even though a more appropriate response is available. In Luchins' so-called water jar task, participants had to measure a specific amount of water using three jars of different capacities. Luchins found that subjects kept using methods they had applied in previous trials, even if a more efficient solution for the current trial was available: an Einstellung effect. Moreover, Luchins studied the different conditions that could possibly mediate this effect, including telling participants to pay more attention, changing the number of tasks, alternating between different types of tasks, as well as putting participants under time pressure. In the current work, we reconstruct and reanalyze the data of the various experimental conditions published in Luchins' thesis. We furthermore show that a model of resource-rational decision-making can explain all of the observed effects. This model assumes that people transform prior preferences into a posterior policy to maximize rewards under time constraints. Taken together, our reconstructive and modeling results put the Einstellung effect under the lens of modern-day psychology and show how resource-rational models can explain effects that have historically been seen as deficiencies of human problem-solving.

From the Discussion

It is typically assumed that the best solution for any particular problem is necessarily the shortest, and thus previous research has largely characterized the Einstellung effect as maladaptive behavior.  In the present paper, we have challenged this assumption and provided a resource-rational interpretation of the effect. We did so with the help of an information-theoretic model of decision-making.  The central premise of this  model is to transform prior preferences into posterior policies in a way that trade of expected utility with the time it takes to make a decision. The resulting model incorporates three basic principles: (1) people prefer simple solutions, i.e.,they attempt to spend as little physical effort as possible, (2) they avoid costly computations, i.e., those that require high mental effort, and (3) they adapt to their environment,  i.e., they learn about statistics of the problem they interact with.We found that these simple principles are sufficient to capture the rich characteristics found in Luchins’ data. An additional ablation analysis  confirmed  that  all  of  these  principles  are necessary to reproduce the entire set of phenomena reported in Luchins’ thesis.

Monday, September 13, 2021

What are the obligations of pharmaceutical companies in a global health emergency?

Emanuel, E., et al. 
The Lancet
Originally published 5 August 21

Here is an excerpt:

Principles governing the response to COVID-19

An ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability.

These four principles should be taken as a coherent whole, for all companies and applied globally. For instance, ensuring accountability should not undermine optimising production. There are multiple ways to balance these principles. Any decision to give greater weight to some principles rather than others is inherently controversial. Optimising production is obviously necessary to end vaccine scarcity. Fair distribution requires that no segment of the world's population should be unvaccinated because of inability to afford vaccination.5 Importantly, any practical approach should ensure sustainability and companies' continued engagement in addressing COVID-19 and their focus on future infectious diseases and health emergencies.

Additionally, all parties' obligations should be coordinated and mutually consistent. For instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges.

Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others.

Sunday, September 12, 2021

How relationships bias moral reasoning: Neural and self-report evidence

Berg, M. K., Kitayama, S., & Kross, E.
Journal of Experimental Social Psychology
Volume 95, July 2021, 104156


Laws govern society, regulating people's behavior to create social harmony. Yet recent research indicates that when laws are broken by people we know and love, we consistently fail to report their crimes. Here we identify an expectancy-based cognitive mechanism that underlies this phenomenon and illustrate how it interacts with people's motivations to predict their intentions to report crimes. Using a combination of self-report and brain (ERP) measures, we demonstrate that although witnessing any crime violates people's expectations, expectancy violations are stronger when close (vs. distant) others commit crimes. We further employ an experimental-causal-chain design to show that people resolve their expectancy violations in diametrically opposed ways depending on their relationship to the transgressor. When close others commit crimes, people focus more on the individual (vs. the crime), which leads them to protect the transgressor. However, the reverse is true for distant others, which leads them to punish the transgressor. These findings highlight the sensitivity of early attentional processes to information about close relationships. They further demonstrate how these processes interact with motivation to shape moral decisions. Together, they help explain why people stubbornly protect close others, even in the face of severe crimes.


• We used neural and self-report methods to explain people's reluctance to punish close others who act immorally.

• Close others acting immorally, and severe immoral acts, are highly unexpected.

• Expectancy violations interact with motivation to drive attention.

• For close others, people focus on the transgressor, which yields a more lenient response.

• For distant others, people focus on the immoral act, which yields a more punitive response.

Saturday, September 11, 2021

Virtues for Real-World Utilitarians

Schubert, S., & Caviola, L. (2021, August 3)


Utilitarianism says that we should maximize aggregate well-being, impartially considered. But utilitarians that try to apply this principle will encounter many psychological obstacles, ranging from selfishness to moral biases to limits to epistemic and instrumental rationality. In this chapter, we argue that utilitarians should cultivate a number of virtues that allow them to overcome the most important of these obstacles. We select virtues based on two criteria. First, the virtues should be impactful: they should greatly increase your impact (according to utilitarian standards), if you acquire them. Second, the virtues should be acquirable: they should be psychologically realistic to acquire. Using these criteria, we argue that utilitarians should prioritize six virtues: moderate altruism, moral expansiveness, effectiveness-focus, truth-seeking, collaborativeness, and determination. Finally, we discuss how our suggested list of virtues compares with standard conceptions of utilitarianism, as well as with common sense morality.


We have suggested six virtues that utilitarians should cultivate to overcome psychological obstacles to utilitarianism and maximize their impact in the real world: moderate altruism, moral expansiveness, effectiveness-focus,  truth-seeking,  collaborativeness,  and  determination.  To  reiterate,  this  list  is tentative, and should be seen more as a starting point for further research than as a well-consolidated set of findings. It is plausible that some of our suggested virtues should be refined, and that we should add further  virtues  to  the  list.  We  hope  that  it  should  inspire  a  debate  among  philosophers  and psychologists about what virtues utilitarians should prioritize the most.

Friday, September 10, 2021

Why social liberals are not moral relativists

Thomas Hurka
The New Statesman
Originally published 3 March 21

Here is an excerpt:

We tend to think of morality as issuing commands and prohibitions – Moses didn’t give his people the Ten Permissions – but morality also allows things. Trivially, it lets you choose your hairstyle; there’s nothing morally wrong about having a mullet. More seriously, if you could save two strangers’ lives by sacrificing your own, morality permits you to do that, but it also permits you not to. In cases like this morality allows you to care more about your own life and so again frees you to make either of two choices. A progressive private morality simply grants more of these permissions.

And a progressive morality can perfectly well ground public duties, though of a distinctively liberal kind. It can say that whenever someone is permitted to make a choice, others are forbidden to interfere with that choice or prevent them from making it.

Thus rape is wrong in part because it prevents the other person from deciding, as they’re morally permitted to, not to have sex with someone. By the same token, though, if a state criminalises gay sex, that too prevents people from doing something morally permitted and is wrong – hence liberals’ opposition to such laws.

For liberals, everyone has the right to make certain choices in their private lives, and others are required, as a matter of public morality, to respect that right. It’s wrong to force someone to do what they’re permitted not to do. In the liberal view, just as in the conservative view, a universal public duty rests on a universal truth about private morality. But this truth is now one that permits rather than forbids things.

*   *   *   

If all this is true, why do some progressives say relativist-sounding things that invite a charge like Barr’s? They may be making, in a slightly misleading way, several claims that aren’t relativist but can sound as though they are.

By “values are relative”, for example, liberals may mean only to emphasise that people’s beliefs about morality differ, both between cultures and within a single one, and that we should take account of this in our moral thinking. Recognising this plurality can make us less prone to assume, dogmatically, that our particular moral convictions capture the whole of universal moral truth. Maybe some other culture or person has insights we lack; maybe the most adequate moral view combines some elements from ours with some from theirs.

Sometimes the differences between cultures are simply a matter of the conventional ways they express a shared moral value. In one culture people show respect for each other by taking off their hats, while in another they do so by keeping their heads covered. Here it may be true that the “right” thing to do with headgear differs between these cultures, but that’s not a relativist claim because it concerns only the arbitrary specification of a universal value of respect.

Thursday, September 9, 2021

Neurodualism: People Assume that the Brain Affects the Mind more than the Mind Affects the Brain

Valtonen, J., Ahn, W., & Cimpian, A.
Cognitive Science


People commonly think of the mind and the brain as distinct entities that interact, a view known as dualism.  At the same time, the public widely acknowledges that science attributes all mental phenomena to the workings of a material brain, a view at odds with dualism. How do people reconcile these conflicting perspectives? We propose that people distort claims about the brain from the wider culture to fit their dualist belief that minds and brains are distinct, interacting entities: Exposure to cultural discourse about the brain as the physical basis for the mind prompts people to posit that mind–brain interactions are asymmetric, such that the brain is able to affect the mind more than vice versa. We term this hybrid intuitive theory neurodualism. Five studies involving both thought experiments and naturalistic scenarios provided evidence of neurodualism among laypeople and, to some extent, even practicing psychotherapists. For example, lay participants reported that “a change in a person’s brain” is accompanied by “a change in the person’s mind” more often than vice versa. Similarly, when asked to imagine that “future scientists were able to alter exactly 25% of a person’s brain,” participants reported larger corresponding changes in the person’s mind than in the opposite direction. Participants also showed a similarly asymmetric pattern favoring the brain over the mind in naturalistic scenarios.  By uncovering people’s intuitive theories of the mind–brain relation, the results provide insights into societal phenomena such as the allure of neuroscience and common misperceptions of mental health treatments.

From the General Discussion

In all experiments and across several different tasks involving both thought experiments and naturalistic scenarios, untrained participants believed that interventions acting on the brain would affect the mind more than interventions acting on the mind would affect the brain, supporting our proposal. This causal asymmetry was strong and replicated reliably with untrained participants. Moreover, the extent to which participants endorsed popular dualism was only weakly correlated with their endorsement of neurodualism, supporting our proposal that a more complex set of beliefs is involved. In the last study, professional psychotherapists also showed evidence of endorsing neurodualism—albeit to a weaker degree—despite their scientific training and their stronger reluctance, relative to lay participants, to believe that psychiatric medications affect the mind.

Our results both corroborate and extend prior findings regarding intuitive reasoning about minds and brains. Our results corroborate prior findings by showing, once again, that both lay people and trained mental health professionals commonly hold dualistic beliefs. If their reasoning had been based on (folk versions of) a physicalist model such as identity theory or supervenience, participants should not have expected mental events to occur in the absence of neural events. However, both lay participants and professional psychotherapists did consistently report that mental changes can occur (at least sometimes) even in situations in which no neural changes occur. (Underline inserted for emphasis.)

Wednesday, September 8, 2021

America Runs on ‘Dirty Work’ and Moral Inequality

Eyal Press
The New York Times
Originally posted 13 Aug 21

Here is an excerpt:

“Dirty work” can refer to any unpleasant job, but among social scientists, the term has a more pointed meaning. In 1962, Everett Hughes, an American sociologist, published an essay titled “Good People and Dirty Work” that drew on conversations he’d had in postwar Germany about the mass atrocities of the Nazi era. Mr. Hughes argued that the persecution of Jews proceeded with the unspoken assent of many supposedly enlightened Germans, who refrained from asking too many questions because, on some level, they were not entirely displeased.

This was the nature of dirty work as Mr. Hughes conceived of it: unethical activity that was delegated to certain agents and then disavowed by society, even though the perpetrators had an “unconscious mandate” from their fellow citizens. As extreme as the Nazi example was, this dynamic existed in every society, Mr. Hughes wrote, enabling respectable citizens to distance themselves from the morally troubling things being done in their name. The dirty workers were not rogue actors but “agents” of “good people” who passively stood by.

Contemporary America runs on dirty work. Some of the people who do this work are our agents by virtue of the fact that they perform public functions, such as running the world’s largest penal system. Others qualify as such by catering to our consumption habits — the food we eat, the fossil fuels we burn, which are drilled and fracked by dirty workers in places like the Gulf of Mexico. The high-tech gadgets in our pockets rely on yet another form of dirty work — the mining of cobalt — that has been outsourced to workers in Africa and to foreign subcontractors that often brutally exploit them.

Like the essential jobs performed by grocery clerks and other low-wage workers during the Covid-19 pandemic, this work sustains our lifestyles and undergirds the prevailing social order, but privileged people are generally spared from having to think about it. One reason is that the dirty work occurs far away from them, in isolated institutions — prisons, slaughterhouses — that are closed to the public. Another reason is that the privileged rarely have to do it. Although there is no shortage of it to go around, dirty work in America is not randomly distributed. 

Tuesday, September 7, 2021

Vaccination as a social contract

L. Korn, et al.
PNASJun 2020, 117 (26) 
DOI: 10.1073/pnas.1919666117


Most vaccines protect both the vaccinated individual and the society by reducing the transmission of infectious diseases. In order to eliminate infectious diseases, individuals need to consider social welfare beyond mere self-interest—regardless of ethnic, religious, or national group borders. It has therefore been proposed that vaccination poses a social contract in which individuals are morally obliged to get vaccinated. However, little is known about whether individuals indeed act upon this social contract. If so, vaccinated individuals should reciprocate by being more generous to a vaccinated other. On the contrary, if the other doesn’t vaccinate and violates the social contract, generosity should decline. Three preregistered experiments investigated how a person’s own vaccination behavior, others’ vaccination behavior, and others’ group membership influenced a person’s generosity toward respective others. The experiments consistently showed that especially compliant (i.e., vaccinated) individuals showed less generosity toward nonvaccinated individuals. This effect was independent of the others’ group membership, suggesting an unconditional moral principle. An internal metaanalysis (n = 1,032) confirmed the overall social contract effect. In a fourth experiment (n = 1,212), this pattern was especially pronounced among vaccinated individuals who perceived vaccination as a moral obligation. It is concluded that vaccination is a social contract in which cooperation is the morally right choice. Individuals act upon the social contract, and more so the stronger they perceive it as a moral obligation. Emphasizing the social contract could be a promising intervention to increase vaccine uptake, prevent free riding, and, eventually, support the elimination of infectious diseases.


Vaccines support controlling and eliminating infectious diseases. As most vaccines protect both vaccinated individuals and the society, vaccination is a prosocial act. Its success relies on a large number of contributing individuals. We study whether vaccination is a social contract where individuals reciprocate and reward others who comply with the contract and punish those who don’t. Four preregistered experiments demonstrate that vaccinated individuals indeed show less generosity toward nonvaccinated individuals who violate the social contract. This effect is independent of whether the individuals are members of the same or different social groups. Thus, individuals’ behavior follows the rules of a social contract, which provides a valuable basis for future interventions aiming at increasing vaccine uptake by emphasizing this social contract.

Monday, September 6, 2021

Paranoia and belief updating during the COVID-19 crisis

Suthaharan, P., Reed, E.J., Leptourgos, P. et al. 
Nat Hum Behav (2021). 


The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals’ paranoia and made their belief updating more erratic. A proactive lockdown made people’s belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour.


The COVID-19 pandemic has been associated with increased paranoia. The increase was less pronounced in states that enforced a more proactive lockdown and more pronounced at reopening in states that mandated mask-wearing. Win-switch behaviour and volatility priors tracked these changes in paranoia with policy. We explored cultural variations in rule following (CTL) as a possible contributor to the increased paranoia that we observed. State tightness may originate in response to threats such as natural disasters, disease, territorial and ideological conflict. Tighter states typically evince more coordinated threat responses. They have also experienced greater mortality from pneumonia and influenza throughout their history. However, paranoia was highest in tight states with a mandate, with lower mask adherence during reopening. It may be that societies that adhere rigidly to rules are less able to adapt to unpredictable change. Alternatively, these societies may prioritize protection from ideological and economic threats over a public health crisis or perhaps view the disease burden as less threatening.

Sunday, September 5, 2021

A Just Standard: The Ethical Management of Incidental Findings in Brain Imaging Research

Graham, M., Hallowell, N., & Savulescu, J. (2021). 
Journal of Law, Medicine & Ethics, 49(2), 269-281. 


Neuroimaging research regularly yields “incidental findings”: observations of potential clinical significance in healthy volunteers or patients, but which are unrelated to the purpose or variables of the study.

From the Conclusion

Appealing to considerations of distributive justice provides an answer for these difficult cases. Data about a patient’s brain that may be generated by a neuroimaging scan in a research context is not something a healthy participant is entitled to as a matter of basic care. Accordingly, a researcher has no obligation to generate this information by performing additional scans (i.e., to “look” for incidental findings). Similarly, if a researcher discovers an incidental finding of unknown or uncertain clinical significance, they are not required to refer a participant for follow-up. Screening for brain abnormalities is not a requirement of basic care, and the burdens of follow-up on the health system (given the potential benefits) are inconsistent with distributive justice. This approach thus avoids the problem of trying to determine whether disclosure (is likely to) promote autonomy or benefit the patient. Rather, it requires researchers to ensure that participants are not deprived of anything to which they are entitled as a matter of distributive justice. This includes all of the protections to which participants in research are normally entitled, as well as the disclosure of clinically significant incidental findings.

Saturday, September 4, 2021

Dilemma 39: Pills, Chills, but No Thrills

Dr. Janssen has been treating Eli Lily for the past year.  During a recent session, Mr. Lily stated that he had been having financial problems.  When queried by Dr. Janssen, Mr. Lily detailed that he can sell his medication to co-workers and neighbors.  Dr. Janssen asked a few other questions, then Mr. Lily changed the subject.  While writing notes, Dr. Janssen reviewed note from the initial intake.  Mr. Lily takes a variety of controlled substances, including Adderall for ADHD and Ambien for insomnia.  Mr. Lily receives these prescriptions for Adderall and Ambien, as well as other medication, from his physician’s associate (PA). 

At the next session, Dr. Janssen asked more questions about the medications he had been selling.  Mr. Lily reported he sells Adderall and Ambien intermittently.  However, Mr. Lily has had a medical marijuana card and has being selling various forms of medical marijuana on a regular basis to friends and family.  Mr. Lily obtained a medical marijuana card through a process independent of the PA, and indicated the PA does not know about the medical marijuana.

Dr. Janssen in clearly concerned about these legal and clinical issues.  Dr. Janssen wants to just forget he asked these questions, but calls you for a consultation.

What are the ethical issues involved in this case?

What are the clinical issues involved in this situation?

What are the ramifications about the therapeutic relationship?

What courses of action would you suggest to Dr. Janssen?

Friday, September 3, 2021

What is consciousness, and could machines have it?

S. Dahaene, H. Lau, & S. Kouider
Science  27 Oct 2017:
Vol. 358, Issue 6362, pp. 486-492


The controversial question of whether machines may ever be conscious must be based on a careful consideration of how consciousness arises in the only physical system that undoubtedly possesses it: the human brain. We suggest that the word “consciousness” conflates two different types of information-processing computations in the brain: the selection of information for global broadcasting, thus making it flexibly available for computation and report (C1, consciousness in the first sense), and the self-monitoring of those computations, leading to a subjective sense of certainty or error (C2, consciousness in the second sense). We argue that despite their recent successes, current machines are still mostly implementing computations that reflect unconscious processing (C0) in the human brain. We review the psychological and neural science of unconscious (C0) and conscious computations (C1 and C2) and outline how they may inspire novel machine architectures.

From Concluding remarks

Our stance is based on a simple hypothesis: What we call “consciousness” results from specific types of information-processing computations, physically realized by the hardware of the brain. It differs from other theories in being resolutely computational; we surmise that mere information-theoretic quantities do not suffice to define consciousness unless one also considers the nature and depth of the information being processed.

We contend that a machine endowed with C1 and C2 would behave as though it were conscious; for instance, it would know that it is seeing something, would express confidence in it, would report it to others, could suffer hallucinations when its monitoring mechanisms break down, and may even experience the same perceptual illusions as humans. Still, such a purely functional definition of consciousness may leave some readers unsatisfied. Are we “over-intellectualizing” consciousness, by assuming that some high-level cognitive functions are necessarily tied to consciousness? Are we leaving aside the experiential component (“what it is like” to be conscious)? Does subjective experience escape a computational definition?

Although those philosophical questions lie beyond the scope of the present paper, we close by noting that empirically, in humans the loss of C1 and C2 computations covaries with a loss of subjective experience. 

Thursday, September 2, 2021

Reconciling scientific and commonsense values to improve reasoning

C. Cusimano & T. Lombrozo
Trends in Cognitive Sciences
Available online July 2021


Scientific reasoning is characterized by commitments to evidence and objectivity. New research suggests that under some conditions, people are prone to reject these commitments, and instead sanction motivated reasoning and bias. Moreover, people’s tendency to devalue scientific reasoning likely explains the emergence and persistence of many biased beliefs. However, recent work in epistemology has identified ways in which bias might be legitimately incorporated into belief formation. Researchers can leverage these insights to evaluate when commonsense affirmation of bias is justified and when it is unjustified and therefore a good target for intervention.

  • People espouse a ‘lay ethics of belief’ that defines standards for how beliefs should be evaluated and formed.
  • People vary in the extent to which they endorse scientific norms of reasoning, such as evidentialism and impartiality, in their own norms of belief. In some cases, people sanction motivated or biased thinking.
  • Variation in endorsement of scientific norms predicts belief accuracy, suggesting that interventions that target norms could lead to more accurate beliefs.
  • Normative theories in epistemology vary in whether, and how, they regard reasoning and belief formation as legitimately impacted by moral or pragmatic considerations.
  • Psychologists can leverage knowledge of people’s lay ethics of belief, and normative arguments about when and whether bias is appropriate, to develop interventions to improve reasoning that are both ethical and effective.

Concluding remarks

It is no secret that humans are biased reasoners. Recent work suggests that these departures from scientific reasoning are not simply the result of unconscious bias, but are also a consequence of endorsing norms for belief that place personal, moral, or social good above truth.  The link between devaluing the ‘scientific ethos’ and holding biased beliefs suggests that, in some cases, interventions on the perceived value of scientific reasoning could lead to better reasoning and to better outcomes. In this spirit, we have offered a strategy for value debiasing.