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

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

Friday, May 20, 2022

Copy the In-group: Group Membership Trumps Perceived Reliability, Warmth, and Competence in a Social-Learning Task

Montrey, M., & Shultz, T. R. (2022). 
Psychological Science, 33(1), 165–174.


Surprisingly little is known about how social groups influence social learning. Although several studies have shown that people prefer to copy in-group members, these studies have failed to resolve whether group membership genuinely affects who is copied or whether group membership merely correlates with other known factors, such as similarity and familiarity. Using the minimal-group paradigm, we disentangled these effects in an online social-learning game. In a sample of 540 adults, we found a robust in-group-copying bias that (a) was bolstered by a preference for observing in-group members; (b) overrode perceived reliability, warmth, and competence; (c) grew stronger when social information was scarce; and (d) even caused cultural divergence between intermixed groups. These results suggest that people genuinely employ a copy-the-in-group social-learning strategy, which could help explain how inefficient behaviors spread through social learning and how humans maintain the cultural diversity needed for cumulative cultural evolution.


Although previous studies have found an apparent in-group bias in social learning, they have failed to resolve whether this constitutes a genuine social-learning strategy or a mere confluence of other factors (Buttelmann et al., 2013; Howard et al., 2015). Our study disentangled group membership from similarity and familiarity by assigning group membership at random. We found that rather than eliminating the preference for in-group members, this approach resulted in a robust in-group-copying bias, which (a) was bolstered by a tendency to observe in-group members, (b) overrode participants’ stated beliefs, (c) grew stronger when social information was scarce, and (d) even caused cultural divergence between intermixed groups. Taken together, our findings suggest that people genuinely employ a copy-the-in-group strategy and that group membership has both a direct and indirect effect on copying.

Why might a copy-the-in-group strategy have evolved in the first place? One reason could be that it allowed humans to rapidly adopt and vigorously maintain group norms that enhance coordination (McElreath et al., 2003) or promote cooperation (Boyd & Richerson, 2009). Another reason could be that social learning is useful only to the extent that adopting other people’s behavior yields similar payoffs (Laland, 2004). For example, copying out-group members could be less efficient or even counterproductive if groups differ in terms of what behavior is punished or rewarded. Finally, such a strategy could also have evolved because it minimized the risk of deception. Because social learning is essentially information scrounging (Kameda & Nakanishi, 2002), in which the copier benefits from other people’s knowledge without incurring the same costs, knowledgeable individuals have an incentive to mislead others. However, this incentive is minimized when observed individuals have a vested interest in the copier’s success. This holds true in kin relationships (Laland, 2004) and likely generalizes to other settings, such as intergroup competition.

Thursday, May 19, 2022

“Google Told Me So!” On the Bent Testimony of Search Engine Algorithms.

Narayanan, D., De Cremer, D.
Philos. Technol. 35, 22 (2022).


Search engines are important contemporary sources of information and contribute to shaping our beliefs about the world. Each time they are consulted, various algorithms filter and order content to show us relevant results for the inputted search query. Because these search engines are frequently and widely consulted, it is necessary to have a clear understanding of the distinctively epistemic role that these algorithms play in the background of our online experiences. To aid in such understanding, this paper argues that search engine algorithms are providers of “bent testimony”—that, within certain contexts of interactions, users act as if these algorithms provide us with testimony—and acquire or alter beliefs on that basis. Specifically, we treat search engine algorithms as if they were asserting as true the content ordered at the top of a search results page—which has interesting parallels with how we might treat an ordinary testifier. As such, existing discussions in the philosophy of testimony can help us better understand and, in turn, improve our interactions with search engines. By explicating the mechanisms by which we come to accept this “bent testimony,” our paper discusses methods to help us control our epistemic reliance on search engine algorithms and clarifies the normative expectations one ought to place on the search engines that deploy these algorithms.


We have argued here that search engine algorithms provide us with a kind of testimony when they bring to fore some pieces of content for us to engage with and push behind others. This testimony is “bent,” because: 

(1) We treat these algorithms as if they are recommending to us the content that they feature at the top of a search results list, trusting that this content is more likely to contain true claims.

(2) There are disputed norms of communication about whether the recommendation of a piece of content counts as an assertion of its claims.

An understanding of this mechanism of bent testimony shows us how to control our reliance on it, if we so desired. Decreasing our reliance on this bent testimony entails decreasing our credence in the belief that the content ordered at the top of a search engine is any likelier to contain true claims. Further, we have argued that we ought to treat search engines as if they were testifiers. By having comparable expectations between search engines and ordinary testifiers, we would be able to pursue policy and legal interventions that befit the outsized role that these search engines seem to play when we acquire beliefs online.

Wednesday, May 18, 2022

Tragic Choices and the Virtue of Techno-Responsibility Gaps

John Danaher
Philosophy and Technology 
35 (2):1-26 (2022)


There is a concern that the widespread deployment of autonomous machines will open up a number of ‘responsibility gaps’ throughout society. Various articulations of such techno-responsibility gaps have been proposed over the years, along with several potential solutions. Most of these solutions focus on ‘plugging’ or ‘dissolving’ the gaps. This paper offers an alternative perspective. It argues that techno-responsibility gaps are, sometimes, to be welcomed and that one of the advantages of autonomous machines is that they enable us to embrace certain kinds of responsibility gap. The argument is based on the idea that human morality is often tragic. We frequently confront situations in which competing moral considerations pull in different directions and it is impossible to perfectly balance these considerations. This heightens the burden of responsibility associated with our choices. We cope with the tragedy of moral choice in different ways. Sometimes we delude ourselves into thinking the choices we make were not tragic ; sometimes we delegate the tragic choice to others ; sometimes we make the choice ourselves and bear the psychological consequences. Each of these strategies has its benefits and costs. One potential advantage of autonomous machines is that they enable a reduced cost form of delegation. However, we only gain the advantage of this reduced cost if we accept that some techno-responsibility gaps are virtuous.


In summary, in this article I have defended an alternative perspective on techno-responsibility gaps. Although the prevailing wisdom seems to be against such gaps, and the policy proposals tend to try to find ways to plug or dissolve such gaps, I have argued that there may be reasons to welcome them. Tragic choices — moral conflicts that leave ineliminable moral remainders — are endemic in human life and there is no easy way to deal with them. We tend to cycle between different responses: illusionism, delegation and responsibilisation. Each of these responses has its own mix of benefits and costs. None of them is perfect. That said, one potential advantage of advanced autonomous machines is that they enable a form of delegation with reduced moral and psychological costs. Thus they can shift the balance of strategies in favour of delegation and away from responsibilisation. This is only true, however, if we embrace the resultant techno-responsibility gaps. I am fully aware that this position goes against the grain and is contrary to emerging law and policy on autonomous systems. I offer it as a moderate corrective to the current consensus.  Responsibility gaps are not always a bad thing. Delegation to machines, particularly in the case of difficult tragic choices, might sometimes be a good thing.

Tuesday, May 17, 2022

Why it’s so damn hard to make AI fair and unbiased

Sigal Samuel
Originally posted 19 APR 2022

Here is an excerpt:

So what do big players in the tech space mean, really, when they say they care about making AI that’s fair and unbiased? Major organizations like Google, Microsoft, even the Department of Defense periodically release value statements signaling their commitment to these goals. But they tend to elide a fundamental reality: Even AI developers with the best intentions may face inherent trade-offs, where maximizing one type of fairness necessarily means sacrificing another.

The public can’t afford to ignore that conundrum. It’s a trap door beneath the technologies that are shaping our everyday lives, from lending algorithms to facial recognition. And there’s currently a policy vacuum when it comes to how companies should handle issues around fairness and bias.

“There are industries that are held accountable,” such as the pharmaceutical industry, said Timnit Gebru, a leading AI ethics researcher who was reportedly pushed out of Google in 2020 and who has since started a new institute for AI research. “Before you go to market, you have to prove to us that you don’t do X, Y, Z. There’s no such thing for these [tech] companies. So they can just put it out there.”

That makes it all the more important to understand — and potentially regulate — the algorithms that affect our lives. So let’s walk through three real-world examples to illustrate why fairness trade-offs arise, and then explore some possible solutions.

How would you decide who should get a loan?

Here’s another thought experiment. Let’s say you’re a bank officer, and part of your job is to give out loans. You use an algorithm to help you figure out whom you should loan money to, based on a predictive model — chiefly taking into account their FICO credit score — about how likely they are to repay. Most people with a FICO score above 600 get a loan; most of those below that score don’t.

One type of fairness, termed procedural fairness, would hold that an algorithm is fair if the procedure it uses to make decisions is fair. That means it would judge all applicants based on the same relevant facts, like their payment history; given the same set of facts, everyone will get the same treatment regardless of individual traits like race. By that measure, your algorithm is doing just fine.

But let’s say members of one racial group are statistically much more likely to have a FICO score above 600 and members of another are much less likely — a disparity that can have its roots in historical and policy inequities like redlining that your algorithm does nothing to take into account.

Another conception of fairness, known as distributive fairness, says that an algorithm is fair if it leads to fair outcomes. By this measure, your algorithm is failing, because its recommendations have a disparate impact on one racial group versus another.

Monday, May 16, 2022

Exploring the Association between Character Strengths and Moral Functioning

Han, H., Dawson, K. J., et al. 
(2022, April 6). PsyArXiv


We explored the relationship between 24 character strengths measured by the Global Assessment of Character Strengths (GACS), which was revised from the original VIA instrument, and moral functioning comprising postconventional moral reasoning, empathic traits and moral identity. Bayesian Model Averaging (BMA) was employed to explore the best models, which were more parsimonious than full regression models estimated through frequentist regression, predicting moral functioning indicators with the 24 candidate character strength predictors. Our exploration was conducted with a dataset collected from 666 college students at a public university in the Southern United States. Results showed that character strengths as measured by GACS partially predicted relevant moral functioning indicators. Performance evaluation results demonstrated that the best models identified by BMA performed significantly better than the full models estimated by frequentist regression in terms of AIC, BIC, and cross-validation accuracy. We discuss theoretical and methodological implications of the findings for future studies addressing character strengths and moral functioning.

From the Discussion

Although the postconventional reasoning was relatively weakly associated with character strengths, several character strengths were still significantly associated with it. We were able to discover its association with several character strengths, particularly those within the domain of intellectual ability.One possible explanation is that intellectual strengths enable people to evaluate moral issues from diverse perspectives and appreciate moral values and principles beyond existing conventions and norms (Kohlberg, 1968). Having such intellectual strengths can thus allow them to engage in sophisticated moral reasoning. For instance, wisdom, judgment, and curiosity demonstrated positive correlation with postconventional reasoning as Han (2019) proposed.  Another possible explanation is that the DIT focuses on hypothetical, abstract moral reasoning, instead of decision making in concrete situations (Rest et al., 1999b). Therefore, the emergence of positive association between intellectual strengths and postconventional moral reasoning in the current study is plausible.

The trend of positive relationships between character strengths and moral functioning indicators was also reported from best model exploration through BMA.  First, postconventional reasoning was best predicted by intellectual strengths, curiosity, and wisdom, plus kindness. Second, EC was positively predicted by love, kindness, and gratitude. Third, PT was positively associated with wisdom and gratitude in the best model. Fourth, moral internalization was positively predicted by kindness and gratitude.

Sunday, May 15, 2022

A False Sense of Security: Rapid Improvement as a Red Flag for Death by Suicide

Rufino, K., Beyene, H., et al.
Journal of Consulting and Clinical Psychology. 
Advance online publication.

Postdischarge from inpatient psychiatry is the highest risk period for suicide, thus better understanding the predictors of death by suicide during this time is critical for improving mortality rates after inpatient psychiatric treatment. As such, we sought to determine whether there were predictable patterns in suicide ideation in hospitalized psychiatric patients. 

We examined a sample of 2,970 adult’s ages 18–87 admitted to an extended length of stay (LOS) inpatient psychiatric hospital. We used group-based trajectory modeling via the SAS macro PROC TRAJ to quantitatively determine four suicide ideation groups: nonresponders (i.e., high suicide ideation throughout treatment), responders (i.e., steady improvement in suicide ideation across treatment), resolvers (i.e., rapid improvement in suicide ideation across treatment), and no-suicide ideation (i.e., never significant suicide ideation in treatment). Next, we compared groups to clinical and suicide-specific outcomes, including death by suicide. 

Resolvers were the most likely to die by suicide postdischarge relative to all other suicide ideation groups. Resolvers also demonstrated significant improvement in all clinical outcomes from admission to discharge. 

There are essential inpatient psychiatry clinical implications from this work, including that clinical providers should not be lulled into a false sense of security when hospitalized adults rapidly improve in terms of suicide ideation. Instead, inpatient psychiatric treatment teams should increase caution regarding the patient’s risk level and postdischarge treatment planning.

Impact Statement

As postdischarge from inpatient psychiatry is the highest risk period for suicide, better understanding the predictors of death by suicide during this time is critical for improving mortality rates after inpatient psychiatric treatment. Clinical providers should not be lulled into a false sense of security when hospitalized adults rapidly improve in terms of suicide ideation, instead, increasing vigilance regarding the patient’s risk level and postdischarge treatment planning. 

Saturday, May 14, 2022

Suicides of Psychologists and Other Health Professionals: National Violent Death Reporting System Data, 2003–2018

Li, T., Petrik, M. L., Freese, R. L., & Robiner, W. N.
(2022). American Psychologist. 
Advance online publication.


Suicide is a prevalent problem among health professionals, with suicide rates often described as exceeding that of the general population. The literature addressing suicide of psychologists is limited, including its epidemiological estimates. This study explored suicide rates in psychologists by examining the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention’s data set of U.S. violent deaths. Data were examined from participating states from 2003 to 2018. Trends in suicide deaths longitudinally were examined. Suicide decedents were characterized by examining demographics, region of residence, method of suicide, mental health, suicidal ideation, and suicidal behavior histories. Psychologists’ suicide rates are compared to those of other health professionals. Since its inception, the NVDRS identified 159 cases of psychologist suicide. Males comprised 64% of decedents. Average age was 56.3 years. Factors, circumstances, and trends related to psychologist suicides are presented. In 2018, psychologist suicide deaths were estimated to account for 4.9% of suicides among 10 selected health professions. As the NVDRS expands to include data from all 50 states, it will become increasingly valuable in delineating the epidemiology of suicide for psychologists and other health professionals and designing prevention strategies. 

From the Discussion

Between 2003 and 2018, 159 cases of psychologist death by suicide were identified in the NVDRS, providing a basis for examining the phenomenon rather than clarifying its true incidence. Suicide deaths spanned all U.S. regions, with the South accounting for the most (35.8%) cases, followed by the West (24.5%), Midwest (20.1%), and Northeast (19.5%). It is unclear whether this is due to the South and West actually having higher suicide rates among psychologists or if these regions have greater representation due to inclusion of more reporting states. It should also be noted that these regions make up different proportions of the population for the entire United States. According to the U.S. Census Bureau (n.d.), the proportion of each region’s population as compared to the entire U.S. population for the year 2019 was South (38.3%), West (23.9%), Midwest (20.8%), and Northeast (17.1%). This could have affected the number of cases seen within each region, as could other factors, such as the trend for gun ownership to be more than twice as common in the South than in the Northeast (Pew Research Center, 2017). The 2003–2018 psychologist suicide deaths were more than 13 times higher than NVDRS-identified psychologist homicide deaths (n = 12) for that same period (Robiner & Li, 2022).

The number of psychologist suicides identified in the NVDRS generally increased longitudinally. It is not clear whether this might signal an actual increasing incidence, and if so what factors may be contributing, or how much it is an artifact of the increasing number of NVDRS-reporting states. Starting in 2020, the data will more clearly reveal temporal patterns, with variation reflecting changes in suicide incidence rather than how many states reported. In the future, we anticipate longitudinal trends will not be confounded by variation in the number of reporting states.

Most psychologist suicide decedents were White (92.5%). Smaller percentages were Black, Indigenous, and People of Color (BIPOC): Black (2.5%), Asian or Pacific Islander (1.9%), and two or more races (3.1%). These proportions align largely with the racial/ethnic makeup of the psychologist workforce in APA’s Survey of Psychology Health Service Providers for White (87.8%), Black (2.6%), Asian (2.5%), and multiracial/multiethnic psychologists (1.7%; Hamp et al., 2016). The data are generally consistent with earlier findings of psychologist suicide (Phillips, 1999) that most psychologist suicide decedents are White and reveal slightly greater diversification within the field. CDC data from 2019 reveals rates in the general population of suicide per 100,000 are greatest in Whites (29.8 male, 8 female), followed by Blacks (12.4 male, 2.9 female), Asians (11.2 male, 4.0 female), and Hispanics (11.3 male, 3.0 female; NIMH, 2021). There were no cases of Hispanic psychologist suicide in this sample, which is generally consistent with the relatively lower numbers of suicides reported for Hispanics by the CDC. The relatively small numbers of suicides within subgroups limit the certainty of inferences that can be drawn about the association of ethnicity, and potentially other demographics, and suicide incidence. As the demographic composition of the field diversifies, the durability of the present findings for subgroups remains to be seen.

Friday, May 13, 2022

How Other- and Self-Compassion Reduce Burnout through Resource Replenishment

Kira Schabram and Yu Tse Heng
Academy of Management Journal, Vol. 65, No. 2


The average employee feels burnt out, a multidimensional state of depletion likely to persist without intervention. In this paper, we consider compassion as an agentic action by which employees may replenish their own depleted resources and thereby recover. We draw on conservation of resources theory to examine the resource-generating power of two distinct expressions of compassion (self- and other-directed) on three dimensions of burnout (exhaustion, cynicism, inefficacy). Utilizing two complementary designs—a longitudinal field survey of 130 social service providers and an experiential sampling methodology with 100 business students across 10 days—we find a complex pattern of results indicating that both compassion expressions have the potential to generate salutogenic resources (self-control, belonging, self-esteem) that replenish different dimensions of burnout. Specifically, self-compassion remedies exhaustion and other-compassion remedies cynicism—directly or indirectly through resources—while the effects of self- and other-compassion on inefficacy vary. Our key takeaway is that compassion can indeed contribute to human sustainability in organizations, but only when the type of compassion provided generates resources that fit the idiosyncratic experience of burnout.

From the Discussion Section

Our work suggests a more immediate benefit, namely that giving compassion can serve an important resource generative function for the self. Indeed, in neither of our studies did we find either compassion expression to ever have a deleterious effect. While this is in line with the broader literature on self-compassion (Neff, 2011), it is somewhat surprising when it comes to other-compassion. Hobfoll (1989) speculated that when people find themselves depleted, giving support to others should sap them further and such personal costs have been identified in previously cited research on prosocial gestures (Bolino & Grant, 2016; Lanaj et al., 2016; Uy et al., 2017). Why then did other-compassion serve a singularly restorative function? As we noted in our literature review, compassion is distinguished among the family of prosocial behaviors by its principal attendance to human needs (Tsui, 2013) rather than organizational effectiveness, and this may offer an explanation. Perhaps, there is something fundamentally more beneficial for actors about engaging in acts of kindness and care (e.g. taking someone who is having a hard time out for coffee) than in providing instrumental support (e.g. exerting oneself to provide a friendly review). We further note that our study also did not find any evidence of ‘compassion fatigue’ (Figley, 2013), identified frequently by practitioners among the social service employees that comprised our first sample. In line with the ‘desperation corollary’ of COR (Hobfoll et al., 2018), which suggests that individuals can reach a state of extreme depletion characterized by maladaptive coping, it may be that there exists a tipping point after which compassion ceases to offer benefits. If there is, however, it must be quite high to not have registered in either the longitudinal or diary designs. 

Thursday, May 12, 2022

Human Vision Reconstructs Time to Satisfy Causal Constraints

Bechlivanidis, C., Buehner, M. J., et al.
Psychological Science, 33(2), 224–235.


The goal of perception is to infer the most plausible source of sensory stimulation. Unisensory perception of temporal order, however, appears to require no inference, because the order of events can be uniquely determined from the order in which sensory signals arrive. Here, we demonstrate a novel perceptual illusion that casts doubt on this intuition: In three experiments (N = 607), the experienced event timings were determined by causality in real time. Adult participants viewed a simple three-item sequence, ACB, which is typically remembered as ABC in line with principles of causality. When asked to indicate the time at which events B and C occurred, participants’ points of subjective simultaneity shifted so that the assumed cause B appeared earlier and the assumed effect C later, despite participants’ full attention and repeated viewings. This first demonstration of causality reversing perceived temporal order cannot be explained by postperceptual distortion, lapsed attention, or saccades.

Statement of Relevance

There are two sources of information on the temporal order of events: the order in which we experience them and their causal relationships, because causes precede their effects. Intuitively, direct experience of order is far more dependable than causal inference. Here, we showed participants events that looked like collisions, but the collided-on object started moving before the collision occurred. Surprisingly, participants indicated in real time that they saw events happening significantly earlier or later than they actually did, at timings compatible with causal interpretations (as if there were indeed a collision). This is evidence that perceived order is not the passive registration of the sequence of signals arriving at the observer but an active interpretation informed by rich assumptions.

General Discussion

Collectively, our findings constitute the first demonstration of a unisensory perceptual illusion of temporal order induced by causal impressions, indicating that the visual system generates the experienced order through a process of interpretation (Grush, 2016; Holcombe, 2015).  Participants were given precise instructions and sufficient time to repeatedly view the sequences, they attended to the critical events using the same modality, and they synchronized object motion with a nonlocalized flash.  We can thus confidently rule out alternative explanations based on inattentional blindness, multimodal integration, flash lag, and motion aftereffects. Because stimulus presentation was free and unconstrained relative to the time of saccades, our results cannot be accounted for by transient perisaccadic mislocalization, either (Kresevic et al., 2016; Morrone et al., 2005). Although in this case we examined the effect only with an adult population recruited from a crowdsourcing platform, previous research suggests that children as young as 4 years old are also susceptible to causal reordering, at least when asked to make post hoc reports (Tecwyn et al., 2020).  More research needs to be carried out to study the degree of perceptual shift and, more broadly, the generalizability of the current results.

Wednesday, May 11, 2022

Bias in mental health diagnosis gets in the way of treatment

Howard N. Garb
Originally posted 2 MAR 22

Here is an excerpt:

What about race-related bias? 

Research conducted in the US indicates that race bias is a serious problem for the diagnosis of adult mental disorders – including for the diagnosis of PTSD, depression and schizophrenia. Preliminary data also suggest that eating disorders are underdiagnosed in Black teens compared with white and Hispanic teens.

The misdiagnosis of PTSD can have significant economic consequences, in addition to its implications for treatment. In order for a US military veteran to receive disability compensation for PTSD from the Veterans Benefits Administration, a clinician has to diagnose the veteran. To learn if race bias is present in this process, a research team compared its own systematic diagnoses of veterans with diagnoses made by clinicians during disability exams. Though most clinicians will make accurate diagnoses, the research diagnoses can be considered more accurate, as the mental health professionals who made them were trained to adhere to diagnostic criteria and use extensive information. When veterans received a research diagnosis of PTSD, they should have also gotten a clinician’s diagnosis of PTSD – but this occurred only about 70 per cent of the time.

More troubling is that, in cases where research diagnoses of PTSD were made, Black veterans were less likely than white veterans to receive a clinician’s diagnosis of PTSD during their disability exams. There was one set of cases where bias was not evident, however. In roughly 25 per cent of the evaluations, clinicians administered a formal PTSD symptom checklist or a psychological test to help them make a diagnosis – and if this additional information was collected, race bias was not observed. This is an important finding. Clinicians will sometimes form a first impression of a patient’s condition and then ask questions that can confirm – but not refute – their subjective impression. By obtaining good-quality objective information, clinicians might be less inclined to depend on their subjective impressions alone.

Race bias has also been found for other forms of mental illness. Historically, research indicated that Black patients and sometimes Hispanic patients were more likely than white patients to be given incorrect diagnoses of schizophrenia, while white patients were more often given correct diagnoses of major depression and bipolar disorder. During the past 20 years, this appears to have changed somewhat, with the most accurate diagnoses being made for Latino patients, the least accurate for Black patients, and the results for white patients somewhere in between.

Tuesday, May 10, 2022

Consciousness Semanticism: A Precise Eliminativist Theory of Consciousness

Anthis, J.R. (2022). 
In: Klimov, V.V., Kelley, D.J. (eds) Biologically 
Inspired Cognitive Architectures 2021. BICA 2021. 
Studies in Computational Intelligence, vol 1032. 
Springer, Cham. 


Many philosophers and scientists claim that there is a ‘hard problem of consciousness’, that qualia, phenomenology, or subjective experience cannot be fully understood with reductive methods of neuroscience and psychology, and that there is a fact of the matter as to ‘what it is like’ to be conscious and which entities are conscious. Eliminativism and related views such as illusionism argue against this. They claim that consciousness does not exist in the ways implied by everyday or scholarly language. However, this debate has largely consisted of each side jousting analogies and intuitions against the other. Both sides remain unconvinced. To break through this impasse, I present consciousness semanticism, a novel eliminativist theory that sidesteps analogy and intuition. Instead, it is based on a direct, formal argument drawing from the tension between the vague semantics in definitions of consciousness such as ‘what it is like’ to be an entity and the precise meaning implied by questions such as, ‘Is this entity conscious?’ I argue that semanticism naturally extends to erode realist notions of other philosophical concepts, such as morality and free will. Formal argumentation from precise semantics exposes these as pseudo-problems and eliminates their apparent mysteriousness and intractability.

From Implications and Concluding Remarks

Perhaps even more importantly, humanity seems to be rapidly developing the capacity to create vastly more intelligent beings than currently exist. Scientists and engineers have already built artificial intelligences from chess bots to sex bots.  Some projects are already aimed at the organic creation of intelligence, growing increasingly large sections of human brains in the laboratory. Such minds could have something we want to call consciousness, and they could exist in astronomically large numbers. Consider if creating a new conscious being becomes as easy as copying and pasting a computer program or building a new robot in a factory. How will we determine when these creations become conscious or sentient?  When do they deserve legal protection or rights? These are important motivators for the study of consciousness, particularly for the attempt to escape the intellectual quagmire that may have grown from notions such as the ‘hard problem’ and ‘problem of other minds’. Andreotta (2020) argues that the project of ‘AI rights’,  including artificial intelligences in the moral circle, is ‘beset by an epistemic problem that threatens to impede its progress—namely, a lack of a solution to the “Hard Problem” of consciousness’. While the extent of the impediment is unclear, a resolution of the ‘hard problem’ such as the one I have presented could make it easier to extend moral concern to artificial intelligences.

Monday, May 9, 2022

C.I.A. Captive Was Too Small for Waterboard, Interrogator Testifies

Carol Rosenberg
The New York Times
Originally posted 3 MAY 22

The psychologist who for the C.I.A. waterboarded a prisoner accused of plotting the U.S.S. Cole bombing testified this week that the Saudi man broke quickly and became so compliant that he would crawl into a cramped crate even before guards ordered him inside.

The psychologist, James E. Mitchell, also told a military judge that the prisoner, Abd al-Rahim al-Nashiri, was so scrawny that Dr. Mitchell and his interrogation partner, [psychologist] John Bruce Jessen, stopped waterboarding him after the third session at a secret site in Thailand in 2002 because they feared he might be hurt.

In that instance, they put him in a neck brace and strapped him to a gurney that served as the board. But when they tilted the board up to let him breathe after a “40-second pour,” the 5-foot-5, 120-pound prisoner nearly slid out of the straps to the floor, Dr. Mitchell said.

“He was snorting and blowing water out of his nose,” Dr. Mitchell testified. 

A former career military psychologist..., Dr. Mitchell said the waterboarding episodes were so long ago that he could not recall whether the prisoner actually cried.

Defense lawyers for Mr. Nashiri questioned Dr. Mitchell on Monday and Tuesday about what went on for several weeks in the black site in November 2002. 

His testimony was meant to offer an account of what may have been on videotapes that senior C.I.A. leaders destroyed at a time when the Senate Intelligence Committee was investigating the black site activities.


For Mr. Nashiri, it was the fourth stop on what would become a four-year odyssey of C.I.A. detention through 10 secret overseas sites.

The episodes Dr. Mitchell described included:
  • A member of an interrogation team used a belt to strap Mr. Nashiri’s arms behind his back and lift him up from behind to “his tiptoes,” Dr. Mitchell said. The prisoner howled, and Dr. Mitchell said he protested, fearing Mr. Nashiri’s shoulders would be dislocated. The treatment continued.
  • Guards forced a shackled Mr. Nashiri onto his knees then bent him backward, with a broomstick placed behind the prisoner’s knees.
  • The chief interrogator, ostensibly seeking to train Mr. Nashiri to address him as “sir,” used a stiff bristle brush to give Mr. Nashiri a cold-water bath, then scraped the brush from the prisoner’s anus to his face and mouth.
Dr. Mitchell said he learned only in recent days — from case prosecutors — that Mr. Nashiri had been subjected to “rectal feeding,” a procedure he said was mostly handled by C.I.A. doctors for medical reasons, except when the chief interrogator in Afghanistan chose to use it.

Sunday, May 8, 2022

MAID Without Borders? Oregon Drops the Residency Requirement

Nancy Berlinger
The Hastings Center: Bioethics
Originally posted 1 APR 22

Oregon, which legalized medical aid-in-dying (MAID) in 1997, has dropped the requirement that had limited MAID access to residents of the state. Under a settlement of a lawsuit filed in federal court by the advocacy group Compassion & Choices, Oregon public health officials will no longer apply or enforce this requirement as part of eligibility criteria for MAID.  The lawsuit was filed on behalf of an Oregon physician who challenged the state’s residency requirement and its consequences for his patients in neighboring Washington State.

In Oregon and in nine other jurisdictions – California, Colorado, the District of Columbia, Hawaii, Maine, New Jersey, New Mexico, Vermont, and Washington – with Oregon-type provisions (Montana has related but distinct case law), MAID eligibility criteria include being an adult with a life expectancy of six months or less; the capacity to make a voluntary medical decision; and the ability to self-administer lethal medication prescribed by a physician for the purpose of ending life. Because hospice eligibility criteria also include a six-month prognosis, all people who are eligible for MAID are already hospice-eligible, and most people who seek to use a provision are enrolled in hospice.

The legal and practical implications of this policy change are not yet known and are potentially complex. Advocates have called attention to potential legal risks associated with traveling to Oregon to gain access to MAID. For example, a family member or friend who accompanies a terminally ill person to Oregon could be liable under the laws of their state of residence for “assisting a suicide.”

What are the ethical and social implications of this policy change? Here are some preliminary thoughts:

First, it is unlikely that many people will travel to Oregon from states without MAID provisions. MAID is used by extremely small numbers of terminally ill people, and Oregon’s removal of its residency requirement did not change the multistep evaluation process to determine eligibility. To relocate to another state for the weeks that this process takes would not be practicable or financially feasible for many terminally ill, usually older, adults who are already receiving hospice care.

Saturday, May 7, 2022

Mathematical model offers clear-cut answers to how morals will change over time

The Institute for Future Studies
Originally posted 13 APR 2022

Researchers at the Institute for Futures Studies in Stockholm, Sweden, have created a mathematical model to predict changes in moral opinion. It predicts that values about corporal punishment of children, abortion-rights and how parental leave should be shared between parents, will all move in liberal directions in the U.S. Results from a first test of the model using data from large opinion surveys continuously conducted in the U.S. are promising.

Corporal punishment of children, such as spanking or paddling, is still widely accepted in the U.S. But public opinion is changing rapidly, and in the United States and elsewhere around the world, this norm will soon become a marginal position. The right to abortion is currently being threatened through a series of court cases—but though change is slow, the view of abortion as a right will eventually come to dominate. A majority of Americans today reject the claim that parental leave should be equally shared between parents, but within 15 years, public opinion will flip, and a majority will support an equal division.

"Almost all moral issues are moving in the liberal direction. Our model is based on large opinion surveys continuously conducted in the U.S., but our method for analyzing the dynamics of moral arguments to predict changing public opinion on moral issues can be applied anywhere," says social norm researcher Pontus Strimling, a research leader at the Institute for Futures Studies, who together with mathematician Kimmo Eriksson and statistician Irina Vartanova conducted the study that will be published in the journal Royal Society Open Science on Wednesday, April 13th.

From the Discussion

Overall, this study shows that moral opinion change can to some extent be predicted, even under unusually volatile circumstances. Note that the prediction method used in this paper is quite rudimentary. Specifically, the method is only based on a very simple survey measure of each opinion's argument advantage and the use of historical opinion data to calibrate a parameter for converting such measures to predicted change rates. Given that the direction is predicted completely based on surveys about argument advantage it is remarkable that the direction was correctly predicted in two-thirds of the cases (three-quarters if the issues related to singular events were excluded). Even so, the method can probably be improved.

Predicting how the U.S. public opinion on moral issues will change from 2018 to 2020 and beyond, Royal Society Open Science (2022).

Friday, May 6, 2022

Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system

A. Carter, A. Butler, et al. (2022)
The Lancet, Vol 44, 101266



People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system.


Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult.

Research in context

Evidence before this study

One previous review had synthesised the literature regarding the effectiveness of interventions during incarceration, but no studies had investigated the effectiveness of interventions to prevent suicidal thoughts and/or behaviours among people in contact with the multiple other settings in the criminal justice system. We searched Embase, PsycINFO, and MEDLINE on 1 June 2021 using variants and combinations of search terms relating to suicide, self-harm, prevention, and criminal justice system involvement (suicide, self-injury, ideation, intervention, trial, prison, probation, criminal justice).
 Added value of this study

Our review identified gaps in the evidence base, including a dearth of robust evidence regarding the effectiveness of interventions across non-custodial criminal justice settings and from low- and middle-income countries. We identified the need for studies examining suicide prevention initiatives for people who were detained in police custody, on bail, or on parole/license, those serving non-custodial sentences, and those after release from incarceration. Furthermore, our findings suggested an absence of interventions which considered specific population groups with diverse needs, such as women, First Nations people, and young people.

Thursday, May 5, 2022

USS George Washington sailors detail difficult working conditions after string of suicides

Melissa Chan
Originally posted 28 APR 22

Here are two excerpts:

Crisostomo and several other George Washington sailors said their struggles were directly related to a culture where seeking help is not met with the necessary resources, as well as nearly uninhabitable living conditions aboard the ship, including constant construction noise that made sleeping impossible and a lack of hot water and electricity. 

Since Crisostomo’s attempt, at least five of her shipmates on the George Washington have died by suicide, including three within a span of a week this April, military officials said. The latest cluster of suicides is under investigation by the Navy and has drawn concern from the Pentagon and Rep. Elaine Luria, D-Va., who served in the Navy for two decades.

On April 15, Master-at-Arms Seaman Recruit Xavier Hunter Sandor died by suicide onboard the George Washington, according to the Navy and the state chief medical examiner’s office. He had been working on the warship for about three months, his family said.

His death came five days after Natasha Huffman, an interior communications electrician, died by suicide off-base in Hampton, officials said.

The day before, Retail Services Specialist 3rd Class Mika’il Rayshawn Sharp also died by suicide off-base in Portsmouth, said his mother, Natalie Jefferson. 

“Three people don’t just decide to kill themselves in a span of days for nothing,” said Crisostomo, who left the Navy in October 2021, on an honorable discharge with a medical condition following her suicide attempt.


When asked about mental-health resources, Smith told sailors that the Navy would put more chaplains on smaller ships for the first time, but that it’s not easy to hire more psychologists, psychiatrists, and other mental health care workers, because they’re not “out there in abundance.”

“You can’t just snap your fingers and grow a psychiatrist,” he said, adding that the sailors should be “each other’s counselors.”

Myers said a larger Navy team is being built to assess quality-of-life conditions on aircraft carriers undergoing overhauls. 

“Their recommendations will inform potential future action, identify areas for improvements, and propose mitigation strategies to optimize [quality of life],” he said.

In 2020, the most recent year for which full data is available, 580 military members died by suicide, a 16 percent increase from 2019, when 498 died by suicide, according to the Defense Department. Nineteen out of every 100,000 sailors died by suicide in 2020, compared to members of the Army, which had the highest rate, at about 36 per 100,000, Pentagon statistics show.

Wednesday, May 4, 2022

Why nurses are raging and quitting after the RaDonda Vaught verdict

B. Kelman & H. Norman
Originally published 5 APR 22

Emma Moore felt cornered. At a community health clinic in Portland, Ore., the 29-year-old nurse practitioner said she felt overwhelmed and undertrained. Coronavirus patients flooded the clinic for two years, and Moore struggled to keep up.

Then the stakes became clear. On March 25, about 2,400 miles away in a Tennessee courtroom, former nurse RaDonda Vaught was convicted of two felonies and now faces eight years in prison for a fatal medication mistake.

Like many nurses, Moore wondered if that could be her. She'd made medication errors before, although none so grievous. But what about the next one? In the pressure cooker of pandemic-era health care, another mistake felt inevitable.

Four days after Vaught's verdict, Moore quit. She said the verdict contributed to her decision.

"It's not worth the possibility or the likelihood that this will happen," Moore said, "if I'm in a situation where I'm set up to fail." In the wake of Vaught's trial ― an extremely rare case of a health care worker being criminally prosecuted for a medical error ― nurses and nursing organizations have condemned the verdict through tens of thousands of social media posts, shares, comments and videos. They warn that the fallout will ripple through their profession, demoralizing and depleting the ranks of nurses already stretched thin by the pandemic. Ultimately, they say, it will worsen health care for all.

Statements from the American Nurses Association, the American Association of Critical-Care Nurses, and the National Medical Association each said Vaught's conviction set a "dangerous precedent." Linda Aiken, a nursing and sociology professor at the University of Pennsylvania, said that although Vaught's case is an "outlier," it will make nurses less forthcoming about mistakes.

"One thing that everybody agrees on is it's going to have a dampening effect on the reporting of errors or near misses, which then has a detrimental effect on safety," Aiken said. "The only way you can really learn about errors in these complicated systems is to have people say, 'Oh, I almost gave the wrong drug because ...'"

"Well, nobody is going to say that now."

Tuesday, May 3, 2022

The Mystifying Rise of Child Suicide

Andrew Solomon
The New Yorker
Originally posted 4 APR 22

Here are two excerpts:

Every suicide creates a vacuum. Those left behind fill it with stories that aspire to rationalize their ultimately unfathomable plight. People may blame themselves or others, cling to small crumbs of comfort, or engage in pitiless self-laceration; many do all this and more. In a year of interviewing the people closest to Trevor, I saw all of these reactions and experienced some of them myself. I came to feel a love for Trevor, which I hadn’t felt when he was alive. The more I understood the depths of his vulnerability, the more I wished that I had encouraged my son, whose relationship with Trevor was often antagonistic, to befriend him. As I interviewed Trevor’s parents, my relationship with them changed. The need to write objectively without increasing their suffering made it more fraught—but it also became deeper and more loving. As the April 6th anniversary of Trevor’s death approached, I started to share their hope that this article would be a kind of memorial to him.

Angela was right that a larger issue is at stake. The average age of suicides has been falling for a long time while the rate of youth suicide has been rising. Between 1950 and 1988, the proportion of adolescents aged between fifteen and nineteen who killed themselves quadrupled. Between 2007 and 2017, the number of children aged ten to fourteen who did so more than doubled. It is extremely difficult to generalize about youth suicide, because the available data are so much sparser and more fragmentary than for adult mental illness, let alone in the broader field of developmental psychology. What studies there are have such varied parameters—of age range, sample size, and a host of demographic factors—as to make collating the information all but impossible. The blizzard of conflicting statistics points to our collective ignorance about an area in which more and better studies are urgently needed. Still, in 2020, according to the Centers for Disease Control and Prevention, in the United States suicide claimed the lives of more than five hundred children between the ages of ten and fourteen, and of six thousand young adults between fifteen and twenty-four. In the former group, it was the second leading cause of death (behind unintentional injury). This makes it as common a cause of death as car crashes.


Perhaps the most unsettling aspect of child suicide is its unpredictability. A recent study published in the Journal of Affective Disorders found that about a third of child suicides occur seemingly without warning and without any predictive signs, such as a mental-health diagnosis, though sometimes a retrospective analysis points to signs that were simply missed. Jimmy Potash, the chair of the psychiatry department at Johns Hopkins, told me that a boy who survived a suicide attempt described the suddenness of the impulse: seeing a knife in the kitchen, he thought, I could stab myself with that, and had done so before he had time to think about it. When I spoke to Christine Yu Moutier, who is the chief medical officer at the American Foundation for Suicide Prevention, she told me that, in children, “the moment of acute suicidal urge is very short-lived. It’s almost like the brain can’t keep up that rigid state of narrowed cognition for long.” This may explain why access to means is so important; children living in homes with guns have suicide rates more than four times higher than those of other children.

Monday, May 2, 2022

Mormon Leader Reaffirms Faith's Stance on Same-Sex Marriage

Sam Metz
Associated Press
Originally published 3 APR 22

A top leader in The Church of Jesus Christ of Latter-day Saints reaffirmed the faith’s opposition to same-sex marriage and “changes that confuse or alter gender” as debates over gender and sexuality reemerge throughout the United States.

Dallin H. Oaks, the second-highest-ranking leader of the faith known widely as the Mormon Church, told thousands of listeners gathered at a conference center at the church’s Salt Lake City headquarters that what he called “social and legal pressures” wouldn’t compel the church to alter its stances on same-sex marriage or matters of gender identity that he did not specify.

The highest level of salvation, Oaks said, “can only be attained through faithfulness to the covenants of an eternal marriage between a man and a woman. That divine doctrine is why we teach that gender is an essential characteristic of individual pre-mortal, mortal, and eternal identity and purpose.”

Oaks also said church doctrine “opposed changes that confuse or alter gender or homogenize the differences between men and women” and warned that “confusing gender, distorting marriage, and discouraging childbearing” was the devil’s work.

He also implored members of the faith to live peacefully and respect those with beliefs different than their own.

Oaks’ remarks reaffirm the faith’s long-held position on same-sex marriage that it has held to steadfastly even as its softened its policies on other LGTBQ matters, including allowing the children of same-sex couples to be baptized.

The Latter-day Saints’ reaffirmation of their stances comes as debates rage throughout the nation over transgender youth and what kids should learn about gender and sexuality. Officials in Texas have fought to classify gender confirmation surgeries as child abuse and Florida has outlawed instruction on sexual orientation and gender identity in kindergarten through third grade.

Sunday, May 1, 2022

Why So Many Middle-Aged Women Are on Antidepressants—Scientists are gaining a better understanding of women’s midlife depression

Andrea Petersen
The Wall Street Journal
Originally posted 2 APR 22

For years, middle-aged women have had some of the country’s highest rates of antidepressant use. Now, scientists are starting to better understand why—and to develop more targeted treatments for women’s midlife depression.

About one in five women ages 40 to 59 and nearly one in four women ages 60 and over used antidepressants in the last 30 days during 2015 to 2018, according to the latest data from the National Center for Health Statistics. 

Among women ages 18 to 39, the figure was about one in 10. 

Among men, 8.4% of those ages 40 to 59 and 12.8% of those 60 and older used antidepressants in the last 30 days, according to the NCHS data.

The figures are drawing increasing attention from scientists and doctors. Many are alarmed at how high depression rates were among midlife women even before the pandemic, now that the past two years have exacerbated mental-health issues for many Americans. 


Researchers at NIMH who have been following 90 women since 1988 have found that the incidence of women’s midlife depression is concentrated in the two years before and after the last menstrual period, says Dr. Schmidt. 

The quality of women’s midlife depression is distinct, too, Dr. Schmidt says, in that it often involves intense anxiety, irritability and sleep problems along with the more typical sadness and loss of pleasure in once-enjoyed activities.

Doctors speculate that antidepressant use among middle-aged women is being driven in part by the reluctance of women—and many of their physicians—in recent decades to use hormone-replacement therapy for menopausal symptoms. In 2002, a large study, the Women’s Health Initiative, was stopped after women taking hormone therapy had an increased risk of breast cancer, heart attacks and strokes. 

Later analyses found that the risks were largely concentrated among women who were older when they started hormone therapy. For women in their 50s, hormone therapy actually reduced the risk of heart disease and death from any cause. 

Hormone therapy, either estrogen alone or combined with a progestogen, is the most effective treatment for hot flashes and night sweats, according to the North American Menopause Society and the American College of Obstetricians and Gynecologists. 

Some research has found that it can also improve mood.

Saturday, April 30, 2022

Which moral exemplars inspire prosociality?

Han, H., Workman, C. I., May, J., et al.
(2022, January 16). PsyArXiv


Some stories of moral exemplars motivate us to emulate their admirable attitudes and behaviors, but why do some exemplars motivate us more than others? We systematically studied how motivation to emulate is influenced by the similarity between a reader and an exemplar in social or cultural background (Relatability) and how personally costly or demanding the exemplar’s actions are (Attainability). Study 1 found that university students reported more inspiration and related feelings after reading true stories about the good deeds of a recent fellow alum, compared to a famous moral exemplar from decades past. Study 2A developed a battery of short moral exemplar stories that more systematically varied Relatability and Attainability, along with a set of non-moral exemplar stories for comparison. Studies 2B and 2C examined the path from the story type to relatively low stakes altruism (donating to charity and intentions to volunteer) through perceived attainability and relatability, as well as elevation and pleasantness. Together, our studies suggest that it is primarily the relatability of the moral exemplars, not the attainability of their actions, that inspires more prosocial motivation, at least regarding acts that help others at a relatively low cost to oneself.

General Discussion

Stories can describe moral exemplars who are more or less similar to the reader (relatability) and who engage in acts that are more or less difficult to emulate (attainability). The overarching aim of this research was to address whether prosocial motivation is increased by greater attainability, relatability, or both. Overall, as predicted, more relatable and attainable exemplar stories generate greater inspiration (Study 1) and emulation of prosociality on some measures (Study 2), with perceived relatability being most influential. We developed a battery of ecologically valid exemplar stories that systematically varied attainability and relatability. Although differences in our story types did not produce detectable changes in prosocial behavior, perceived attainability and relatability are highly relative to the individual and thus difficult to systematically manipulate for all or even most participants. For instance, the average American might relate little to a Russian retiree, while others in our studies might do so easily (e.g., if their parents grew up in the Soviet Union). Similarly, donating $50 USD to charity is a major sacrifice for some Americans but not others. So, it was important for us to directly examine the effects of perceived attainability and relatability on prosociality.

The path analyses conducted in Studies 2B and 2C suggest in particular that the perceived relatability—not attainability—of a moral exemplar tends to increase emulation among readers.  The more attainable stories and perceived attainability did not positively predict emotional and behavioral outcomes, but the more relatable stories and perceived relatability did. This suggests that the relatability of exemplars is more fundamental in motivating people compared with the attainability of their acts. Another possibility is that highly attainable moral actions require little personal sacrifice, such as donating $1 to a charity, which is not particularly inspiring and in some cases is perhaps even seen as insulting (compare Thomson and Siegel 2013). Further research could explore these possibilities.

Friday, April 29, 2022

Navy Deputizes Psychologists to Enforce Drug Rules Even for Those Seeking Mental Health Help

Konstantin Toropin
Originally posted 18 APR 22

In the wake of reports that a Navy psychologist played an active role in convicting for drug use a sailor who had reached out for mental health assistance, the service is standing by its policy, which does not provide patients with confidentiality and could mean that seeking help has consequences for service members.

The case highlights a set of military regulations that, in vaguely defined circumstances, requires doctors to inform commanding officers of certain medical details, including drug tests, even if those tests are conducted for legitimate medical reasons necessary for adequate care. Allowing punishment when service members are looking for help could act as a deterrent in a community where mental health is still a taboo topic among many, despite recent leadership attempts to more openly discuss getting assistance.

On April 11, Military.com reported the story of a sailor and his wife who alleged that the sailor's command, the destroyer USS Farragut, was retaliating against him for seeking mental health help.

Jatzael Alvarado Perez went to a military hospital to get help for his mental health struggles. As part of his treatment, he was given a drug test that came back positive for cannabinoids -- the family of drugs associated with marijuana. Perez denies having used any substances, but the test resulted in a referral to the ship's chief corpsman.

Perez's wife, Carli Alvarado, shared documents with Military.com that were evidence in the sailor's subsequent nonjudicial punishment, showing that the Farragut found out about the results because the psychologist emailed the ship's medical staff directly, according to a copy of the email.

"I'm not sure if you've been tracking, but OS2 Alvarado Perez popped positive for cannabis while inpatient," read the email, written to the ship's medical chief. Navy policy prohibits punishment for a positive drug test when administered as part of regular medical care.

The email goes on to describe efforts by the psychologist to assist in obtaining a second test -- one that could be used to punish Perez.

"We are working to get him a command directed urinalysis through [our command] today," it added.

Thursday, April 28, 2022

The State of Florida v. Kelvin Lee Coleman Jr.: the implications of neuroscience in the courtroom through a case study

P. Loizidou, R. E. Wieczorek-Fynn, & J. C. Wu
Psychology, Crime & Law 
Published online: 17 Mar 2022


Neuroscience can provide evidence in some cases of legal matters, despite its tenuous nature. Among others, arguing for diminished capacity, insanity, or pleading for mitigation is the most frequent use of neurological evidence in the courtroom. While there is a plethora of studies discussing the moral and legal matters of the practice, there is a lack of studies examining specific cases and the subsequent applications of brain knowledge. This study details the capital punishment trial of Kelvin Lee Coleman Jr., charged in 2013 with double murder in Tampa, Florida, to illustrate the extent that expert opinions – based on neuroimaging, neurological, and neuropsychiatric examinations – had an impact on the court’s decisions. The defendant was sentenced to life imprisonment without the possibility of parole. According to the comments of the trial’s jury, the most influential reason for not sentencing the defendant to death is the fact that during the incident was that he was under extreme mental and emotional disturbance. Other reasons were evidence of brain abnormalities resulting from neurological insult, fetal alcohol syndrome, and orbitofrontal syndrome contributing to severely abnormal behavior and lack of impulse control.


While this study addresses a single case, similar cases have in the past reached similar rulings. The evasion of death sentences has been especially common after the Hurst v. State decision requiring an anonymous jury vote before sentencing defendants to death. One such case is the State of Florida v. Luis Toledo which took place in 2017. The defendant was not sent to death despite killing his wife and her two children because of the mitigation claims of neurological illness and epilepsy. Similarly, in the case of State of Florida v. Byron Burch in 2015, first-degree murder and burglary charged to a defendant with a lengthy criminal record, did not result in a death sentence due to mitigating evidence of brain damage and presumptive chronic traumatic encephalopathy (CTE). Both cases had PET neuroimaging analyzed by one of the coauthors (JCW). After quantitative electroencephalography was inadmissible to the court, the defense attorney presented PET scans to claim brain damage that hindered impulse control. The jurors decided on a sentence to life in prison without parole which the judge ultimately decided upon.

While evidence on the existence of brain damage seems to suffice in some cases for a sentence to life in prison without parole, it is of interest to examine further the link between brain damage and criminality. This is linked to two questions: First, how common is brain damage among criminals, and second, how much does brain damage impact the likeliness of criminality. Several studies have looked at the prevalence of brain damage and psychiatric disorders among incarcerated individuals. Mental illness is significantly over-represented in death-row samples relative to the general population (Cunningham & Vigen, 2002). TBI is particularly prevalent among criminals, with one study reporting that 82% of the 164 incarcerated individuals interviewed have sustained a TBI, 79% have sustained a TBI with loss of consciousness, and 43% have sustained more than four or more TBIs (Schofield et al., 2006). Other psychiatric conditions like depression, mania, and schizophrenia have reportedly significantly higher prevalence rates among general samples of individuals from jails and specific samples of homicide charged individuals as compared to the rest of the population (Teplin, 1990; Wallace et al., 1998). It is of interest to see that mental disorders are usually accompanied by substance abuse and in many cases substance, especially alcohol abuse was confounded with associations between TBI and criminal offense (Wallace et al., 1998).

Wednesday, April 27, 2022

APA decries Florida guidance calling for withholding treatment for gender non-conforming children

American Psychological Association
Press Release
Originally release 21 APR 22

Warns that Florida document is based on flawed, cherry-picked research

WASHINGTON — Following is a statement by Frank C. Worrell, PhD, president of the American Psychological Association, reacting to new guidance issued by the Florida Department of Health opposing science-based treatment for gender non-conforming children:

“This memo from the Florida Department of Health distorts the psychological science regarding the treatment of gender non-conforming children. Research into the treatment of gender non-conforming individuals has found that withholding evidence-based treatments can be psychologically damaging, especially to children and youths who are struggling with their gender identity. Rates of self-injury, suicidal ideation and suicide attempts are much higher among gender dysphoric youth, ironically attributed to stress associated with non-affirming approaches to these very real issues.   

“The Florida memo relies not on science, but on biased opinion pieces and cherry-picked findings to support a predetermined viewpoint and create a narrative that is not only scientifically inaccurate but also dangerous.  

“The American Psychological Association urges both policymakers and psychological practitioners to follow APA’s carefully researched ‘Guidelines for Psychological Practice With Transgender and Gender Nonconforming People (PDF, 461KB),’ which call for ‘culturally competent, developmentally appropriate, and trans-affirmative psychological practice’ with such individuals, including minors.

Please note: Psychologists are bound by APA's Ethical Principles of Psychologists and Code of Conduct and Practice Guidelines.

Psychologists may want to contemplate the concept of Conscientious Objector status to laws and regulations that conflict with ethical obligations and moral beliefs.

Tuesday, April 26, 2022

Ethical considerations for psychotherapists participating in Alcoholics Anonymous

Kohen, Casey B.,Conlin, William E.
Practice Innovations, Vol 7(1), Mar 2022, 40-52.


Because the demands of professional psychology can be taxing, psychotherapists are not immune to the development of mental health and substance use disorders. One estimate indicates that roughly 30% to 40% of psychologists know of a colleague with a current substance abuse problem (Good et al., 1995). Twelve-step mutual self-help groups, particularly Alcoholics Anonymous (AA), are the most widely used form of treatment for addiction in the United States. AA has empirically demonstrated effectiveness at fostering long-term treatment success and is widely accessible throughout the world. However, psychotherapist participation in AA raises a number of ethical concerns, particularly regarding the potential for extratherapy contact with clients and the development of multiple relationships. This article attempts to review the precarious ethical and practical situations that psychotherapists, either in long-term recovery or newly sober, may find themselves in during AA involvement. Moreover, this article provides suggestions for psychotherapists in AA regarding how to best adhere to both the principles of AA (i.e., the 12 steps and 12 traditions) and the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct

Here is an excerpt:

Recent literature regarding the use of AA or other mutual self-help groups by psychotherapists is scant, but earlier studies suggest its effectiveness. A 1986 survey of 108 members of Psychologists Helping Psychologists (a seemingly defunct support group exclusively for substance dependent doctoral-level psychologists and students) shows that of the 94% of respondents maintaining abstinence, 86% attended AA (Thoreson et al., 1986). A separate study of 70 psychologists in recovery who were members of AA revealed the majority attained sobriety outside of formal treatment or intervention programs (Skorina et al., 1990). 

Because AA appears to be a vital resource for psychotherapists struggling with substance misuse, it is important to consider how to address ethical dilemmas that one might encounter while participating in AA.


Psychotherapists participating in AA may, at times, find that their professional responsibility of adhering to the APA Code of Ethics hinders some aspects of their categorical involvement in AA as defined by AA’s 12 steps and 12 traditions. The psychotherapist in AA may need to adjust their personal AA “program” in comparison with the typical AA member in a manner that attempts to meet the requirements of the profession yet still provides them with enough support to maintain their professional competence. This article discusses reasonable compromises, specifically tailored to the length of the psychotherapist’s sobriety, that minimize the potential for client harm. Ultimately, if the psychotherapist is unable to find an appropriate middle-ground, where the personal needs of recovery can be met without damaging client welfare and respecting the client’s rights, the psychotherapist should refer the client elsewhere. With these recommendations, psychotherapists should feel more comfortable participating in AA (or other mutual self-help groups) while also adhering to the ethical principles of our profession.