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

Monday, October 31, 2022

Longest Strike Ends: California Mental Health Care Workers Win Big

Cal Wilslow
Originally posted 24 OCT 22

Two thousand mental health clinicians have won; Kaiser Permanente has lost. The 10- week strike has ended in near total victory for the National Union of Healthcare Workers (NUHW). The therapists, walked out on August 15; it became the longest mental health care workers’ strike recorded.

Two issues dominated negotiations from the start: workload for Kaiser therapists and wait time for Kaiser patients. The strikers won on both, forcing concessions until now all but unheard of. The strikers won break through provisions to retain staff, reduce wait times for patients and a plan to collaborate on transforming Kaiser’s model for providing mental health care. The new four-year contract is retroactive to September 2021 and expires in September 2025. Darrell Steinberg, Mayor of Sacramento served as a mediator. Members of the NUHW voted 1561 to 36 to ratify it.

Braving three- digit heat, strikers walked picket lines throughout Northern California and the Central Valley. They picketed, marched and rallied at Kaiser hospitals – in a strike that caught the attention of mental health care advocates everywhere. “Our strike was difficult and draining, but it was worth it,” said Natalie Rogers, a therapist for Kaiser in Santa Rosa. We stood up to the biggest nonprofit in the nation, and we made gains that will help better serve our patients and will advance the cause of mental health parity throughout the country.”

The mental health clinicians I’ve met are almost universally modest and careful in their choice of words, and here is an example. To say that that Kaiser is “the biggest non-profit” is an understatement to say the least – its revenues are in the billions, and its managers make millions while this giant among giants, typically in the world of corporate health care, oversees its empire as if it were making cars and trucks.

I’ve seen NUHW rallies well-attended by patients themselves, also family members and supporters who are angry, bitter. Where frequently they carry signs to the effect that the issues here are life and death, rallies where speakers break down in tears, where placards tell us that suicide can be the outcome of care denied – “Stop the Suicides!” It’s a wonder more therapists don’t move on. The world of pain of the mental health patient can be just as acute as that of the medical patient. Ask a therapist. It’s not that the clinicians don’t want to tell us this.; it’s that, in their own way, they are telling us. It’s why they fight so hard.

Sunday, October 30, 2022

The uselessness of AI ethics

Munn, L. The uselessness of AI ethics.
AI Ethics (2022).


As the awareness of AI’s power and danger has risen, the dominant response has been a turn to ethical principles. A flood of AI guidelines and codes of ethics have been released in both the public and private sector in the last several years. However, these are meaningless principles which are contested or incoherent, making them difficult to apply; they are isolated principles situated in an industry and education system which largely ignores ethics; and they are toothless principles which lack consequences and adhere to corporate agendas. For these reasons, I argue that AI ethical principles are useless, failing to mitigate the racial, social, and environmental damages of AI technologies in any meaningful sense. The result is a gap between high-minded principles and technological practice. Even when this gap is acknowledged and principles seek to be “operationalized,” the translation from complex social concepts to technical rulesets is non-trivial. In a zero-sum world, the dominant turn to AI principles is not just fruitless but a dangerous distraction, diverting immense financial and human resources away from potentially more effective activity. I conclude by highlighting alternative approaches to AI justice that go beyond ethical principles: thinking more broadly about systems of oppression and more narrowly about accuracy and auditing.


Meaningless principles

The deluge of AI codes of ethics, frameworks, and guidelines in recent years has produced a corresponding raft of principles. Indeed, there are now regular meta-surveys which attempt to collate and summarize these principles. However, these principles are highly abstract and ambiguous, becoming incoherent. Mittelstadt suggests that work on AI ethics has largely produced “vague, high-level principles, and value statements which promise to be action-guiding, but in practice provide few specific recommendations and fail to address fundamental normative and political tensions embedded in key concepts.” The point here is not to debate the merits of any one value over another, but to highlight the fundamental lack of consensus around key terms. Commendable values like “fairness” and “privacy” break down when subjected to scrutiny, leading to disparate visions and deeply incompatible goals.

What are some common AI principles? Despite the mushrooming of ethical statements, Floridi and Cowls suggest many values recur frequently and can be condensed into five core principles: beneficence, non-maleficence, autonomy, justice, and explicability. These ideals sound wonderful. After all, who could be against beneficence? However, problems immediately arise when we start to define what beneficence means. In the Montreal principles for instance, “well-being” is the term used, suggesting that AI development should promote the “well-being of all sentient creatures.” While laudable, clearly there are tensions to consider here. We might think, for instance, of how information technologies support certain conceptions of human flourishing by enabling communication and business transactions—while simultaneously contributing to carbon emissions, environmental degradation, and the climate crisis. In other words, AI promotes the well-being of some creatures (humans) while actively undermining the well-being of others.

The same issue occurs with the Statement on Artificial Intelligence, Robotics, and Autonomous Systems. In this Statement, beneficence is gestured to through the concept of “sustainability,” asserting that AI must promote the basic preconditions for life on the planet. Few would argue directly against such a commendable aim. However, there are clearly wildly divergent views on how this goal should be achieved. Proponents of neoliberal interventions (free trade, globalization, deregulation) would argue that these interventions contribute to economic prosperity and in that sense sustain life on the planet. In fact, even the oil and gas industry champions the use of AI under the auspices of promoting sustainability. Sustainability, then, is a highly ambiguous or even intellectually empty term that is wrapped around disparate activities and ideologies. In a sense, sustainability can mean whatever you need it to mean. Indeed, even one of the members of the European group denounced the guidelines as “lukewarm” and “deliberately vague,” stating they “glossed over difficult problems” like explainability with rhetoric.

Saturday, October 29, 2022

A Call to Surrender: A Human Dignity Approach to Russian Citizens Kidnapped to Serve

From Ukraine's Department of Defense

Sleep loss leads to the withdrawal of human helping across individuals, groups, and large-scale societies

Ben Simon E, Vallat R, Rossi A, Walker MP (2022) 
PLoS Biol 20(8): e3001733.


Humans help each other. This fundamental feature of homo sapiens has been one of the most powerful forces sculpting the advent of modern civilizations. But what determines whether humans choose to help one another? Across 3 replicating studies, here, we demonstrate that sleep loss represents one previously unrecognized factor dictating whether humans choose to help each other, observed at 3 different scales (within individuals, across individuals, and across societies). First, at an individual level, 1 night of sleep loss triggers the withdrawal of help from one individual to another. Moreover, fMRI findings revealed that the withdrawal of human helping is associated with deactivation of key nodes within the social cognition brain network that facilitates prosociality. Second, at a group level, ecological night-to-night reductions in sleep across several nights predict corresponding next-day reductions in the choice to help others during day-to-day interactions. Third, at a large-scale national level, we demonstrate that 1 h of lost sleep opportunity, inflicted by the transition to Daylight Saving Time, reduces real-world altruistic helping through the act of donation giving, established through the analysis of over 3 million charitable donations. Therefore, inadequate sleep represents a significant influential force determining whether humans choose to help one another, observable across micro- and macroscopic levels of civilized interaction. The implications of this effect may be non-trivial when considering the essentiality of human helping in the maintenance of cooperative, civil society, combined with the reported decline in sufficient sleep in many first-world nations.

From the Discussion section

Taken together, findings across all 3 studies establish insufficient sleep (both quantity and quality) as a degrading force influencing whether or not humans wish to help each other, and do indeed, choose to help each other (through real-world altruistic acts), observable at 3 different societal scales: within individuals, across individuals, and at a nationwide level.

Study 1 established not only the causal impact of sleep loss on the basic desire to help another human being, but further characterised the central underlying brain mechanism associated with this altered phenotype of diminished helping. Specifically, sleep loss significantly and selectively reduced activity throughout key nodes of the social cognition brain network (see Fig 1B) normally associated with prosociality, including perspective taking of others’ mental state, their emotions, and their personal needs. Therefore, impairment of this neural system caused by a lack of sleep represents one novel pathway explaining the associated withdrawal of helping desire and the decisional act to offer such help.

Friday, October 28, 2022

Gender and ethnicity bias in medicine: a text analysis of 1.8 million critical care records

David M Markowitz
PNAS Nexus, Volume 1, Issue 4,
September 2022, pg157


Gender and ethnicity biases are pervasive across many societal domains including politics, employment, and medicine. Such biases will facilitate inequalities until they are revealed and mitigated at scale. To this end, over 1.8 million caregiver notes (502 million words) from a large US hospital were evaluated with natural language processing techniques in search of gender and ethnicity bias indicators. Consistent with nonlinguistic evidence of bias in medicine, physicians focused more on the emotions of women compared to men and focused more on the scientific and bodily diagnoses of men compared to women. Content patterns were relatively consistent across genders. Physicians also attended to fewer emotions for Black/African and Asian patients compared to White patients, and physicians demonstrated the greatest need to work through diagnoses for Black/African women compared to other patients. Content disparities were clearer across ethnicities, as physicians focused less on the pain of Black/African and Asian patients compared to White patients in their critical care notes. This research provides evidence of gender and ethnicity biases in medicine as communicated by physicians in the field and requires the critical examination of institutions that perpetuate bias in social systems.

Significance Statement

Bias manifests in many social systems, including education, policing, and politics. Gender and ethnicity biases are also common in medicine, though empirical investigations are often limited to small-scale, qualitative work that fails to leverage data from actual patient–physician records. The current research evaluated over 1.8 million caregiver notes and observed patterns of gender and ethnicity bias in language. In these notes, physicians focused more on the emotions of women compared to men, and physicians focused less on the emotions of Black/African patients compared to White patients. These patterns are consistent with other work investigating bias in medicine, though this study is among the first to document such disparities at the language level and at a massive scale.

From the Discussion Section

This evidence is important because it establishes a link between communication patterns and bias that is often unobserved or underexamined in medicine. Bias in medicine has been predominantly revealed through procedural differences among ethnic groups, how patients of different ethnicities perceive their medical treatment, and structures that are barriers-to-entry for women and ethnic minorities. The current work revealed that the language found in everyday caregiver notes reflects disparities and indications of bias—new pathways that can complement other approaches to signal physicians who treat patients inequitably. Caregiver notes, based on their private nature, are akin to medical diaries for physicians as they attend to patients, logging the thoughts, feelings, and diagnoses of medical professionals. Caregivers have the herculean task of tending to those in need, though the current evidence suggests bias and language-based disparities are a part of this system. 

Thursday, October 27, 2022

Frequently asked questions about abortion laws and psychology practice

American Psychological Association
Updated 1 SEPT 2022

Since the U.S. Supreme Court issued its decision to overturn Roe v. Wade, many states have proposed, enacted, or resurrected a range of laws to either prohibit, significantly restrict, or protect reproductive rights and health care. Currently, the main targets of these laws appear to be medical providers who provide abortions or individuals seeking to obtain an abortion.

APA and APA Services Inc. are striving to provide psychologists with accurate and adequate information about the potential impact on them of reproductive health care laws. Since psychologists have embraced telehealth and many use technology to provide services across state lines, it’s important to be familiar with the laws governing the jurisdiction(s) where you are licensed as well as the jurisdiction(s) where your patients live.

In addition to this FAQ and other APA resources, psychologists will want to be familiar with guidance issued by federal and state agencies, their state licensing board(s), and their liability carrier. Some frequently asked questions follow.

While the situation is dynamic, good psychological practice remains unchanged. The changing landscape in states regarding access to reproductive health care does not change the fundamental approach to psychological care. Psychologists should continue to prioritize the welfare of their patients, protect confidentiality, and ensure their patients’ safety.

Practicing in states with changing abortion laws

Am I practicing in a state where abortion is, or is soon to be, illegal under all or certain circumstances?

The Supreme Court’s decision to overturn Roe v. Wade has put the regulation of abortion in the hands of states. In anticipation of the ruling, 13 states enacted “trigger laws,” designed to ban or restrict abortion upon the Supreme Court’s reversal of Roe v. Wade. Not all trigger laws immediately kicked in, and some that did were immediately challenged in court, delaying their enforcement.

Staying current on laws affecting the states where you practice is important. For a list of existing abortion bans and restrictions within each state, the Center for Reproductive Rights has provided a map that is updated in real time. The Guttmacher Institute, a well-respected research group that collects information on abortion laws across the United States, also tracks current state abortion-related laws.

Wednesday, October 26, 2022

Moral Injury: Ethical Issues in Context of Trauma-Based Care


Moral Injury Is an Invisible Epidemic That Affects Millions

Elizabeth Svoboda
Scientific American
Originally published 26 SEPT 22

Here are two excerpts:

A 2019 study by researchers at the Salisbury VA Healthcare System in North Carolina reports that moral injury has different brain signatures than PTSD alone: People with moral injury have more activity in the brain’s precuneus area, which helps govern moral judgments, than those who only have PTSD. And after people suffer moral traumas, they display different brain glucose metabolism patterns than those who suffer direct physical threats, according to a 2016 study by researchers at the University of Texas Health Science Center at San Antonio and their colleagues. The results support developing theories that moral injury is a unique biological entity.

As Brock’s Shay Moral Injury Center found its footing, she forged connections with powerful people who could get the word out about moral injury—including Margaret Kibben, the current chaplain at the U.S. House of Representatives. Kibben holds regular events for House members, and one of her recent talks was about moral injury. The event drew about three times more members than usual, Brock reports, “and they all wanted to talk about their experience.” Brock and Kibben’s partnership reflects a growing trend in the study of moral injury: collaboration between scholars and clergy members who aim to chronicle the unspeakable and to help people through it. Moral injury “does really bring together a lot of disciplines,” says psychologist Anna Harwood-Gross of Metiv, the Israel Psychotrauma Center in Jerusalem. “It’s rare to see articles written by chaplains and psychologists together.”

As COVID ravaged the planet from 2020 onward, moral injury research and inquiry took a distinct new turn. Health care workers spoke out about how rationing care was affecting them psychologically, and Dean and her colleagues Breanne Jacobs and Rita Manfredi, both at the George Washington University School of Medicine and Health Sciences, published a journal article that urged employers to monitor moral injury’s effects. “We need time, energy and intellectual capacity to make peace with those specters,” they wrote.

The moral injury Dean sees in health care often doesn’t stem from one-time, cataclysmic events. Many providers are suffering what she calls “death by a thousand cuts”—the constant, stultifying knowledge that they have to give people subpar care or none at all. “They think they suck. They think they’re inadequate,” says trauma surgeon Gregory Peck of New Jersey’s Rutgers Robert Wood Johnson Medical School. “No one’s putting their finger on ‘You don’t suck. This is moral injury you’re suffering.’” 


But one sticking point with CBT is that it focuses on correcting clients’ distorted thought patterns. For people with moral injury who’ve experienced wrenching events that upend their entire value system, ethical distress is genuine, not the product of distorted thinking, Harwood-Gross says . If people with moral injury simply try to retrain their thoughts, they may be left unsatisfied and unhealed.

Therapies for PTSD can likewise fall short for morally injured patients, in Harwood-Gross’s experience. PTSD-focused approaches teach clients to adapt to traumatic triggers, such as fireworks that sound like gunshots, but this exposure approach doesn’t really help them resolve deep ethical conflicts. Effective moral injury counseling is “more about the processing,” Harwood-Gross says. “There has to be that movement: ‘How do I see it for what it is and, from there, develop something more meaningful?’ It’s a more spiritual approach.”

Recognizing moral injury’s unique challenges, psychologists such as Litz have been creating therapies that more directly address clients’ needs. Litz and other providers have pioneered a moral injury treatment called adaptive disclosure. Researchers at Australia’s La Trobe University and University of Queensland have developed a similar approach called pastoral narrative disclosure. The latter involves discussing moral issues with a chaplain or other spiritual adviser rather than a doctor.

These therapies stress the importance of moral reckoning. They encourage clients to accept uncomfortable truths: “I led that attack on Iraqi civilians”; “I sent that suffering patient home without treatment.” Then, with clients’ input, counselors can help them develop strategies for making amends or pursuing closure—say, apologizing to a family whose child they injured.

Early evidence suggests these approaches make headway where others can’t. In Litz’s initial trial of adaptive disclosure on 44 Marines, participants’ negative beliefs about both themselves and the world diminished. Most also said the therapy helped resolve their moral struggles.

Tuesday, October 25, 2022

More than a quarter of U.S. adults say they’re so stressed they can’t function

American Psychological Association
Press Release
Originally posted 19 OCT 22

Americans are struggling with multiple external stressors that are out of their personal control, with 27% reporting that most days they are so stressed they cannot function, according to a poll conducted for the American Psychological Association.

A majority of adults cited inflation (83%), violence and crime (75%), the current political climate (66%), and the racial climate (62%) as significant sources of stress.

The nationwide survey, fielded by The Harris Poll on behalf of APA, revealed that 70% of adults reported they do not think people in the government care about them, and 64% said they felt their rights are under attack. Further, nearly half of adults (45%) said they do not feel protected by the laws in the United States. More than a third (38%) said the state of the nation has made them consider moving to a different country.

More than three-quarters of adults (76%) said that the future of our nation is a significant source of stress in their lives, while 68% said this is the lowest point in our nation’s history that they can remember.

Various disparities in stressors emerged among population subgroups. For example, 72% of the members of the LGBTQIA+ community reported feeling as if their rights are under attack, which is a higher proportion than non-LGBTQIA+ adults (64%). Younger adult women (ages 18 to 34) were more likely to report that most days their stress is completely overwhelming, in comparison with older women (62% vs. 48% 35–44; 27% 45–64; 9% 65+) and men ages 35 or older (62% vs. 48% 35–44; 21% 45–64; 8% 65+). Seventy-five percent of Black adults said that the racial climate in the U.S. is a significant source of stress, while 70% of Latino/a adults, 69% of Asian adults and 56% of white adults reported the same.

Furthermore, Latinas were most likely, among racial/ethnic groups, to cite significant sources of stress related to violence, including violence and crime (89% Latinas; 80% Black women; 79% Asian women; 77% Latinos; 75% Black men; 73% white women; 72% white men; 70% Asian men), mass shootings (89% Latinas; 78% Latinos; 77% Black women; 77% Asian women; 73% white women; 71% Black men; 67% Asian men; 66% white men) and gun violence (87% Latinas; 83% Black women; 77% Asian women; 76% Latinos; 75% Black men; 69% white women; 68% white men; 63% Asian men).

“It’s clear that the impacts of uncontrollable stressors are profound for most Americans, but psychological science shows us that there are effective ways to talk about and cope with this type of stress,” said Arthur C. Evans Jr., PhD, APA’s chief executive officer. “Focusing on accomplishing goals that are in our control can help prevent our minds from getting overwhelmed by the many uncertainties in life. From using our breathing to slow racing thoughts, to intentionally limiting our social media consumption, or exercising our right to vote, action can be extremely empowering.”

Adults reported that stress has had an impact on their health; 76% of adults reported they had experienced at least one symptom in the last month as a result of stress—such as headache (38%), fatigue (35%), feeling nervous or anxious (34%) and feeling depressed or sad (33%). Seven in 10 adults (72%) experienced additional symptoms in the last month, including feeling overwhelmed (33%), experiencing changes in sleeping habits (32%), and/or worrying constantly (30%).

Monday, October 24, 2022

Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

Fusar-Poli, P., Manchia, M., et al. (2022, October). 
European Neuropsychopharmacology, 63, 17–34.


Precision psychiatry is an emerging field with transformative opportunities for mental health. However, the use of clinical prediction models carries unprecedented ethical challenges, which must be addressed before accessing the potential benefits of precision psychiatry. This critical review covers multidisciplinary areas, including psychiatry, ethics, statistics and machine-learning, healthcare and academia, as well as input from people with lived experience of mental disorders, their family, and carers. We aimed to identify core ethical considerations for precision psychiatry and mitigate concerns by designing a roadmap for research and clinical practice. We identified priorities: learning from somatic medicine; identifying precision psychiatry use cases; enhancing transparency and generalizability; fostering implementation; promoting mental health literacy; communicating risk estimates; data protection and privacy; and fostering the equitable distribution of mental health care. We hope this blueprint will advance research and practice and enable people with mental health problems to benefit from precision psychiatry.

From the Results section

3.1. Ethics of precision psychiatry: Key concepts

Broadly speaking, ethical issues concern the development of ‘practical ought claims’ (Sheehan and Dunn, 2013) (i.e. normative claims that are practical in nature), which arise when we face ethical uncertainty in precision psychiatry. These practical claims come schematically like this: how should somebody or a group of people act in relation to a particular issue when they face certain circumstances? For example, how should researchers inform patients about their individualised risk estimates after running a novel clinical prediction model? To address these questions, four overarching ethical principles have been suggested (by Beauchamp and Childress) (Beauchamp and Childress, 2019), which include autonomy, beneficence, non-maleficence and justice. These can be applied to precision psychiatry, complemented by an extra principle of “explainability/interpretability” (Panel 1) which has been specifically introduced for artificial intelligence (Floridi et al., 2018) (for a more detailed discussion of ethical platforms for big data analytics see eSupplementary 1).

Although these four principles have become the cornerstones of biomedical ethics in healthcare practice, they have been criticised as they are often conflicting with no clear hierarchy and are not very specific (i.e. these principles are somewhat implicit, representing general moral values), leading to “imprecise ethics” that may not fit the needs of precision psychiatry (Table 1). Rather we should ask ourselves “why” a certain act may be harmful or beneficial. For example, let's imagine having a risk assessment; what would that mean for the individual, their family planning, workplace, choosing their studies, or their period of life? Alternatively, let's imagine that the risk assessment is not performed; what would be the results in a few years’ time? To address these sorts of questions, this study will consider ethical values in a broader sense, for example, by taking into account some of the different principles present in the charter of fundamental rights of the European Union – starting from dignity, freedom, equality, solidarity, citizens’ rights and justice (Table 1) (European Union, 2012; Hallinan, 2021). In particular, human dignity and human flourishing are the most crucial elements from an ethical point of view that are tightly linked to autonomy and self-determination (which is modulated by several factors such as physical health, psychological state, sociocultural environment, as well as values and beliefs). The loss of insight associated with some psychiatric disorders may incapacitate the individual to make autonomous decisions. For example, autonomy emerged as the driving decision component for undergoing risk prediction testing among young populations (Mantell et al., 2021a), regardless of whether a person would decide for or against risk profiling. Finally, it is important to highlight that unique ethical considerations may be associated with the historically complex socio-political perceptions and attitudes towards severe mental disorders and psychiatry (Ball et al., 2020a; Manchia et al., 2020a).

Sunday, October 23, 2022

Advancing theorizing about fast-and-slow thinking

De Neys, W. (2022). 
Behavioral and Brain Sciences, 1-68. 


Human reasoning is often conceived as an interplay between a more intuitive and deliberate thought process. In the last 50 years, influential fast-and-slow dual process models that capitalize on this distinction have been used to account for numerous phenomena—from logical reasoning biases, over prosocial behavior, to moral decision-making. The present paper clarifies that despite the popularity, critical assumptions are poorly conceived. My critique focuses on two interconnected foundational issues: the exclusivity and switch feature. The exclusivity feature refers to the tendency to conceive intuition and deliberation as generating unique responses such that one type of response is assumed to be beyond the capability of the fast-intuitive processing mode. I review the empirical evidence in key fields and show that there is no solid ground for such exclusivity. The switch feature concerns the mechanism by which a reasoner can decide to shift between more intuitive and deliberate processing. I present an overview of leading switch accounts and show that they are conceptually problematic—precisely because they presuppose exclusivity. I build on these insights to sketch the groundwork for a more viable dual process architecture and illustrate how it can set a new research agenda to advance the field in the coming years.


In the last 50 years dual process models of thinking have moved to the center stage in research on human reasoning. These models have been instrumental for the initial exploration of human thinking in the cognitive sciences and related fields (Chater, 2018; De Neys, 2021). However, it is time to rethink foundational assumptions. Traditional dual process models have typically conceived intuition and deliberation as generating unique responses such that one type of response is exclusively tied to deliberation and is assumed to be beyond the reach of the intuitive system. I reviewed empirical evidence from key dual process applications that argued against this exclusivity feature. I also showed how exclusivity leads to conceptual complications when trying to explain how a reasoner switches between intuitive and deliberate reasoning. To avoid these complications, I sketched an elementary non-exclusive working model in which it is the activation strength of competing intuitions within System 1 that determines System 2 engagement. 

It will be clear that the working model is a starting point that will need to be further developed and specified. However, by avoiding the conceptual paradoxes that plague the traditional model, it presents a more viable basic architecture that can serve as theoretical groundwork to build future dual process models in various fields. In addition, it should at the very least force dual process theorists to specify more explicitly how they address the switch issue. In the absence of such specification, dual process models might continue to provide an appealing narrative but will do little to advance our understanding of the interaction between intuitive and deliberate— fast and slow—thinking. It is in this sense that I hope that the present paper can help to sketch the building blocks of a more judicious dual process future. 

Saturday, October 22, 2022

Sexuality Training in Counseling Psychology: A Mixed-Methods Study of Student Perspectives

Abbott, D. M., Vargas, J. E., & Santiago, H. J. (2022).
Journal of Counseling Psychology. 
Advance online publication.


Counseling psychologists are a cogent fit to lead the movement toward a sex-positive professional psychology (Burnes et al., 2017a). Though centralizing training in human sexuality (HS; Mollen & Abbott, 2021) and sexual and reproductive health (Grzanka & Frantell, 2017) is congruent with counseling psychologists’ values, training programs rarely require or integrate comprehensive sexuality training for their students (Mollen et al., 2020). We employed a critical mixed-methods design in the interest of centering the missing voices of doctoral-level graduate students in counseling psychology in the discussion of the importance of human sexuality competence for counseling psychologists. Using focus groups to ascertain students’ perspectives on their human sexuality training (HST) in counseling psychology, responses yielded five themes: (a) HST is integral to counseling psychology training, (b) few opportunities to gain human sexuality competence, (c) inconsistent training and self-directed learning, (d) varying levels of human sexuality comfort and competence, and (e) desire for integration of HST. Survey responses suggested students were trained on the vast majority of human sexuality topics at low levels, consistent with prior studies surveying training directors in counseling psychology and at internship training sites (Abbott et al., 2021; Mollen et al., 2020). Taken together, results suggested students see HST as aligned with the social justice emphasis in counseling psychology but found their current training was inconsistent, incidental rather than intentional, and lacked depth. Recommendations, contextualized within counseling psychology values, are offered to increase opportunities for and strengthen HST in counseling psychology training programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Impact Statement

The present study suggests that counseling psychology graduate students perceive human sexuality training (HST) as valuable to their professional development and congruent with counseling psychology values. Findings support the integration of consistent, comprehensive, sex-positive HST in doctoral counseling psychology training programs. 


Comprehensive training in human sexuality represents a notable omission from counseling psychology training, particularly in light of the discipline’s values including emphases on diversity, social justice, and contextual, holistic perspectives. In the present study, the first to explore counseling psychology student perceptions of sexuality training, participants outlined the importance of HST to counseling psychology training, specifically, and providing psychotherapeutic services, broadly, outlined the current nature of their training, or lack thereof, and conveyed their desire for HST including recommendations for how programs may successfully implement HST in ways that benefitted students and the public they serve. Therefore, we call on faculty in counseling psychology training programs to reevaluate their commitment to developing sexuality competence among their students, invest in their own sexuality training as needed, and invoke creative strategies to make HST accessible and comprehensive in their programs.

Friday, October 21, 2022

“Everybody’s doing it”: Exploring the consequences of intergroup contact norms

Boss, H., Buliga, E., & MacInnis, C. C. (2022). 
Group Processes & Intergroup Relations.


Newcomers to a country can strongly benefit from having positive intergroup contact with host country residents. Often, however, such contact does not occur. Norms surrounding intergroup contact between newcomers and host country residents were explored over three studies. Correlational relationships among positive perceived contact norms, positive attitudes, and behavioural intentions supporting contact were demonstrated over multiple studies. Further, an experimental manipulation indicating higher (vs. lower and control) contact between host country residents and newcomers predicted behavioural intentions toward future intergroup contact through heightened intergroup contact norms and more positive attitudes toward newcomers. Implications of using norms as a means to impact intergroup relations are discussed.

From General Discussion

Across studies, we demonstrated that perceived norms surrounding contact between Canadians and newcomers can influence attitudes toward newcomers, and one’s willingness to engage in contact with them. These findings are consistent with the theory of planned behaviour (Ajzen, 1991), such that perceived ingroup norms and attitudes are important predictors of behavioural intentions. Our findings were also consistent with group norms theory (Sherif & Sherif, 1953), such that perceived norms were strong predictors of attitudes toward newcomers. A manipulation involving reading a single newspaper article had clear implications for the perceived norms of participants in Studies 2–3. This has implications for discussions of newcomers in the media. For example, newcomer-serving organizations seeking to attract volunteers should be careful with how requests are framed. Projecting perceptions of ingroup disinterest in or disengagement from outgroups may damage attitudes and contact intentions among individuals who might otherwise be desired volunteers. As such, it may be ideal for newcomer-serving agencies to focus on the contact that is occurring rather than on the lack of contact when seeking to attract new volunteers.


We provide evidence that perceived social norms surrounding contact between ingroup and outgroup members can play an important role in attitudes toward outgroups and intentions to interact with these individuals in the future. Our findings are specific to the context of contact between Canadians and newcomers to Canada but may generalize to similar contexts. Our findings suggest that norm-based interventions can be a means to promote positive intergroup relations. Promoting positive norms about intergroup contact to the dominant group may be a valuable tool for increasing contact with newcomers, an important outcome given that intergroup contact can facilitate positive integration for new immigrants and refugees.

Thursday, October 20, 2022

The Age Trajectory of Happiness

Kratz, F., & Brüderl, J. (2021, April 18).


A large interdisciplinary literature on the relationship between age and subjective well-being (happiness) has produced very mixed evidence. Virtually every conceivable age-happiness trajectory has been supported by empirical evidence and theoretical arguments. Sceptics may conclude that the social science of happiness can only produce arbitrary results. In this paper we argue that this conclusion is premature. Instead, the methodological toolbox that has been developed by the modern literature on causal inference gives scholars everything they need to arrive at valid conclusions: the causal inference toolbox only must be applied by happiness researchers. We identify four potential sources of bias that may distort the assessment of the age-happiness relationship. By causal reasoning we derive a model specification that avoids these  biases.  For  an  empirical  illustration,  we  use  the  longest  running  panel  study  with information on happiness, the German Socio-Economic Panel (1984-2017; N persons=70,922; N person-years =565,703). With these data we demonstrate the relevance of the four biases and how combinations of different biases can reproduce almost any finding from the literature. Most biases tend to produce a spuriously U-shaped age trajectory, the most prominent finding from the literature. In contrast, with our specification we find a (nearly monotonic) declining age-happiness trajectory.

Summary and Conclusions

How aging affects happiness is an important research question for the social and behavioral sciences. Our literature review demonstrates that many conflicting age trajectories have been reported in the literature. As this state of research is quite unsettling for the science of happiness, we  discuss—informed  by  recent  advances  in  the  methodology  of  causal  analysis—model specifications used by researchers in this field. Altogether, we identify four main biases that may distort the age trajectory of happiness. By using the German SOEP data, we show that distortions may be huge producing even qualitatively different conclusions. We demonstrate that by using different combinations of mis-specifications it is possible to generate (almost) every trajectory that has been reported in the literature. With a model specification that avoids these four biases, we find an age-happiness trajectory that declines slowly over adulthood (altogether about half a scale point). The decline comes to a halt and we observe even a small increase (about one tenth of a scale point) during the golden ages. Afterwards, in old age a very steep decline in happiness sets in.

Wednesday, October 19, 2022

Technology and moral change: the transformation of truth and trust

Danaher, J., Sætra, H.S. 
Ethics Inf Technol 24, 35 (2022).


Technologies can have profound effects on social moral systems. Is there any way to systematically investigate and anticipate these potential effects? This paper aims to contribute to this emerging field on inquiry through a case study method. It focuses on two core human values—truth and trust—describes their structural properties and conceptualisations, and then considers various mechanisms through which technology is changing and can change our perspective on those values. In brief, the paper argues that technology is transforming these values by changing the costs/benefits of accessing them; allowing us to substitute those values for other, closely-related ones; increasing their perceived scarcity/abundance; and disrupting traditional value-gatekeepers. This has implications for how we study other, technologically-mediated, value changes.


Conclusion: lessons learned

Having examined our two case studies, it remains to consider whether or not there are similarities in how technology affects trust and truth, and if there are general lessons to be learned here about how technology may impact values in the future.

The two values we have considered are structurally similar and interrelated. They are both intrinsically and instrumentally valuable. They are both epistemic and practical in nature: we value truth and trust (at least in part) because they give us access to knowledge and help us to resolve the decision problems we face on a daily basis. We also see, in both case studies, similar mechanisms of value change at work. The most interesting, to our minds, are the following:
  • Technology changes the costs associated with accessing certain values, making them less or more important as a result Digital disinformation technology increases the cost of finding out the truth, but reduces the cost of finding and reinforcing a shared identity community; reliable AI and robotics gives us an (often cheaper and more efficient) substitute for trust in humans, while still giving us access to useful cognitive, emotional and physical assistance.
  • Technology makes it easier, or more attractive to trade off or substitute some values against others Digital disinformation technology allows us to obviate the need for finding out the truth and focus on other values instead; reliable machines allow us to substitute the value of reliability for the value of trust. This is a function of the plural nature of values, their scarcity, and the changing cost structure of values caused by technology.
  • Technology can make some values seem more scarce (rare, difficult to obtain), thereby increasing their perceived intrinsic value Digital disinformation makes truth more elusive, thereby increasing its perceived value which, in turn, encourages some moral communities to increase their fixation on it; robots and AI make trust in humans less instrumentally necessary, thereby increasing the expressive value of trust in others.
  • Technology can disrupt power networks, thereby altering the social gatekeepers to value to the extent that we still care about truth, digital disinformation increases the power of the epistemic elites that can help us to access the truth; trust-free or trust-alternative technologies can disrupt the power of traditional trusted third parties (professionals, experts etc.) and redistribute power onto technology or a technological elite.

Tuesday, October 18, 2022

Underestimating Counterparts’ Learning Goals Impairs Conflictual Conversations

C. Hanne, C. A. Dorison, J. A. Minson, and F. Gino. 
Psychological Science (forthcoming).


Given the many contexts in which people have difficulty engaging with views that disagree with their own—from political discussions to workplace conflicts—it is critical to understand how conflictual conversations can be improved. Whereas previous work has focused on strategies to change individual-level mindsets (e.g., encouraging open-mindedness), the present study investigated the role of partners’ beliefs about their counterparts. Across seven preregistered studies (N = 2,614 adults), people consistently underestimated how willing disagreeing counterparts were to learn about opposing views (compared with how willing participants were themselves and how willing they believed agreeing others would be). Further, this belief strongly predicted greater derogation of attitude opponents and more negative expectations for conflictual conversations. Critically, in both American partisan politics and the Israeli-Palestinian conflict, a short informational intervention that increased beliefs that disagreeing counterparts were willing to learn about one’s views decreased derogation and increased willingness to engage in the future. We built on research recognizing the power of the situation to highlight a fruitful new focus for conflict research.

General Discussion

Across seven pre-registered studies, we document three findings. First, we identify a robust self-other difference, wherein conflict participants believe that counterparts are less willing to learn about their views than vice versa. Second, these beliefs predict how people evaluate counterparts, and their experiences with them. Third, manipulating beliefs about counterpart’s learning goals improves conflict outcomes. In both American partisan politics and the Israeli-Palestinian conflict, counterparts and their arguments were evaluated more positively when participants believed that their counterpart was eager to learn about their perspective. 


Social psychology has a rich history of highlighting the role of situational forces in determining human behavior. In dyadic conflict, the social situation has one overwhelmingly salient feature: the other person. We build on the tradition of recognizing the power of the situation (Ross & Nisbett, 2011) and individual construal in shaping behavior.

Complementing prior work on the importance of individual attributes in determining conflict outcomes—e.g., receptiveness (Minson et al., 2020)—our results highlight the importance of individuals’ beliefs about others. This shift in focus provides a new lens for conflict research. Indeed, the results of Studies 4-5 suggest that clearly signaling learning goals (e.g., “I would be interested to learn what you think about…”) could lead to more productive dialogue.

Editor's note: This research has applications for individual and couples counseling.

Monday, October 17, 2022

The Psychological Origins of Conspiracy Theory Beliefs: Big Events with Small Causes Amplify Conspiratorial Thinking

Vonasch, A., Dore, N., & Felicite, J.
(2022, January 20). 


Three studies supported a new model of conspiracy theory belief: People are most likely to believe conspiracy theories that explain big, socially important events with smaller, intuitively unappealing official explanations. Two experiments (N = 577) used vignettes about fictional conspiracy theories and measured online participants’ beliefs in the official causes of the events and the corresponding conspiracy theories. We experimentally manipulated the size of the event and its official cause. Larger events and small official causes decreased belief in the official cause and this mediated increased belief in the conspiracy theory, even after controlling for individual differences in paranoia and distrust. Study 3 established external validity and generalizability by coding the 78 most popular conspiracy theories on Reddit. Nearly all (96.7%) popular conspiracy theories explain big, socially important events with smaller, intuitively unappealing official explanations. By contrast, events not producing conspiracy theories often have bigger explanations.

General Discussion

Three studies supported the HOSE (heuristic of sufficient explanation) of conspiracy theory belief. Nearly all popular conspiracy theories sampled were about major events with small official causes deemed too small to sufficiently explain the event. Two experiments involving invented conspiracy theories supported the proposed causal mechanism. People were less likely to believe the official explanation was true because it was relatively small and the event was relatively big. People’s beliefs in the conspiracy theory were mediated by their disbelief in the official explanation. Thus, one reason people believe conspiracy theories is because they offer a bigger explanation for a seemingly implausibly large effect of a small cause.

HOSE helps explain why certain conspiracy theories become popular but others do not. Like evolutionarily fit genes are especially likely to spread to subsequent generations, ideas (memes) with certain qualities are most likely to spread and thus become popular (Dawkins, 1976). HOSE explains that conspiracy theories spread widely because people are strongly motivated to learn an explanation for important events (Douglas, et al., 2017; 2019), and are usually unsatisfied with counterintuitively small explanations that seem insufficient to explain things. Conspiracy theories are typically inspired by events that people perceive to be larger than their causes could plausibly produce. Some conspiracy theories may be inevitable because small causes do sometimes counterintuitively cause big events: via the exponential spread of a microscopic virus or the interconnected, chaotic nature of events like the flap of a butterfly’s wings changing weather across the world (Gleick, 2008). Therefore, itmay be impossible to prevent all conspiracy theories from developing.

Sunday, October 16, 2022

A framework for understanding reasoning errors: From fake news to climate change and beyond

Pennycook, G. (2022, August 31).


Humans have the capacity, but perhaps not always the willingness, for great intelligence. From global warming to the spread of misinformation and beyond, our species is facing several major challenges that are the result of the limits of our own reasoning and decision-making. So, why are we so prone to errors during reasoning? In this chapter, I will outline a framework for understanding reasoning errors that is based on a three-stage dual-process model of analytic engagement (intuition, metacognition, and reason). The model has two key implications: 1) That a mere lack of deliberation and analytic thinking is a primary source of errors and 2) That when deliberation is activated, it generally reduces errors (via questioning intuitions and integrating new information) than increasing errors (via rationalization and motivated reasoning). In support of these claims, I review research showing the extensive predictive validity of measures that index individual differences in analytic cognitive style – even beyond explicit errors per se. In particular, analytic thinking is not only predictive of skepticism about a wide range of epistemically suspect beliefs (paranormal, conspiratorial, COVID-19 misperceptions, pseudoscience and alternative medicines) as well as decreased susceptibility to bullshit, fake news, and misinformation, but also important differences in people’s moral judgments and values as well as their religious beliefs (and disbeliefs). Furthermore, in some (but not all cases), there is evidence from experimental paradigms that support a causal role of analytic thinking in determining judgments, beliefs, and behaviors. The findings reviewed here provide some reason for optimism for the future: It may be possible to foster analytic thinking and therefore improve the quality of our decisions.

Evaluating the evidence: Does reason matter?

Thus far, I have prioritized explaining the various alternative frameworks. I will now turn to an in-depth review of some of the key relevant evidence that helps mediate between these accounts. I will organize this review around two key implications that emerge from the framework that I have proposed.

First, the primary difference between the three-stage model (and related dual-process models) and the social-intuitionist models (and related intuitionist models) is that the former argues that people should be able to overcome intuitive errors using deliberation whereas the latter argues that reason is generally infirm and therefore that intuitive errors will simply dominate. Thus, the reviewed research will investigate the apparent role of deliberation in driving people’s choices, beliefs, and behaviors.

Second, the primary difference between the three-stage model (and related dual-process models) and the identity-protective cognition model is that the latter argues that deliberation facilitates biased information processing whereas the former argues that deliberation generally facilitates accuracy. Thus, the reviewed research will also focus on whether deliberation is linked with inaccuracy in politically-charged or identity-relevant contexts.

Saturday, October 15, 2022

Boundary Issues of Concern

Charles Dike
Psychiatric News
Originally posted 25 AUG 22

Here is an excerpt:

There are, of course, less prominent but equally serious boundary violations other than sexual relations with patients or a patients’ relatives. The case of Dr. Jerome Oremland, a prominent California psychiatrist, is one example. According to a report by KQED on October 3, 2016, John Pierce, a patient, alleged that his psychiatrist, Dr. Oremland, induced Mr. Pierce to give him at least 12 works of highly valued art. The psychiatrist argued that the patient had consented to their business dealings and that the art he had received from the patient was given willingly as payment for psychiatric treatment. The patient further alleged that Dr. Oremland used many of their sessions to solicit art, propose financial schemes (including investments), and discuss other subjects unrelated to treatment. Furthermore, the patient allegedly made repairs in Dr. Oremland’s home, offices, and rental units; helped clear out the home of Dr. Oremland’s deceased brother; and cleaned his pool. Mr. Pierce began therapy with Dr. Oremland in 1984 but brought a lawsuit against him in 2015. The court trial began shortly after Dr. Oremland’s death in 2016, and Dr. Oremland’s estate eventually settled with Mr. Pierce. In addition to being a private practitioner, Dr. Oremland had been chief of psychiatry at the Children’s Hospital in San Francisco and a clinical professor of psychiatry at UCSF. He also wrote books on the intersection of art and psychology.


There are less dramatic but still problematic boundary crossings such as when a psychiatrist in private practice agrees that a patient may pay off treatment costs by doing some work for the psychiatrist. Other examples include a psychiatrist hiring a patient, for example, a skilled plumber, to work in the psychiatrist’s office or home at the patient’s going rate or obtaining investment tips from a successful investment banker patient. In these situations, questions arise about the physician-patient relationship. Even when the psychiatrist believes he or she is treating the patient fairly—such as paying the going rate for work done for the psychiatrist—the psychiatrist is clueless regarding how the patient is interpreting the arrangement: Does the patient experience it as exploitative? What are the patient’s unspoken expectations? What if the patient’s work in the psychiatrist’s office is inferior or the investment advice results in a loss? Would these outcomes influence the physician-patient relationship? Even compassionate acts such as writing off the bill of patients who are unable to pay or paying for an indigent patient’s medications should make the psychiatrist pause for thought. To avoid potential misinterpretation of the psychiatrist’s intentions or complaints of inequitable practices or favoritism, the psychiatrist should be ready to do the same for other indigent patients. It would be better to establish neutral policies for all indigent patients than to appear to favor some over others.

Friday, October 14, 2022

9th Circuit Upholds Ban on Conversion Therapy for Minors in First Amendment Challenge

Debra Cassens Weiss
ABA Journal
Originally published 7 SEPT 22

Washington state’s ban on conversion therapy for minors does not violate the First or 14th Amendments, a federal appeals court ruled on Tuesday.

The San Francisco-based 9th U.S. Circuit Court of Appeals upheld the law, which subjects licensed therapists to discipline if they practice therapy that seeks to change the sexual orientation or gender identity of a person under age 18.

The appeals court said the law was intended to prevent psychological harm to LGBTQ minors subjected to conversion therapy, including depression, self-stigma and emotional distress.

The appeals court ruled against Christian marriage and family counselor Brian Tingley, who claimed the ban on conversion therapy for minors violated his free speech and free exercise rights under the First Amendment. He also claimed the Washington state law was unconstitutionally vague under the 14th Amendment.

The appeals court noted its 2014 decision, Pickup v. Brown, upheld a nearly identical law in California. Tingley had argued, however, that the U.S. Supreme Court abrogated the Pickup decision in 2018 when it ruled for anti-abortion crisis pregnancy centers challenging California’s required notice on the availability of state-subsidized abortions.

The Supreme Court held the abortion-notice law was a content-based restriction that was likely unconstitutional. The case was National Institute of Family & Life Advocates v. Becerra.

Thursday, October 13, 2022

This company is about to grow new organs in a person for the first time

Jessica Hamzelou
MIT Technology Review
Originally posted 25 AUG 22

Here is an excerpt:

Livers have a unique ability to regenerate. Cut away half an animal’s liver, and it will grow back. Human livers damaged by toxins or alcohol can usually regrow too. But some diseases can cause extensive damage from which the liver can’t recover. For these diseases, the treatment of choice is usually a liver transplant.

Transplants aren’t always an option for people who are very unwell, however. That’s why Eric Lagasse and his colleagues at LyGenesis have taken this different approach. Lagasse, a stem-cell biologist at the University of Pittsburgh, has spent years researching cell-based treatments for liver disease. Around 10 years ago, he was experimenting with the idea of injecting cells from healthy livers into diseased ones in mice.

It is difficult to access the livers of small, 25-gram mice, which Lagasse was studying, so instead he and his colleagues injected the cells into the spleens of mice with liver disease. They found that the cells were able to migrate from the spleen to the liver. To find out if they could migrate from other organs, Lagasse’s team injected liver cells at various sites in the mice’s bodies.

Only a small number of mice survived. When Lagasse and his colleagues later performed autopsies on those survivors, “I was very surprised,” he recalls. “We had a mini liver present … where the lymph node would be.”

Little incubators

Lymph nodes are small, bean-shaped structures found throughout the body. They play a crucial role in our immune health, making cells that help fight infections. And while Lagasse was initially surprised that liver cells could multiply and grow in lymph nodes, it makes sense, he says. 

Lymph nodes are natural homes for rapidly dividing cells, even if those are usually immune cells. Lymph nodes also have a good blood supply, which can aid the growth of new tissue.

Wednesday, October 12, 2022

Gender-diverse teams produce more novel and higher-impact scientific ideas

Yang, Y., Tian, T. Y., et al. (2022, August 29). 
Proceedings of the National Academy of Sciences, 119(36).


Science’s changing demographics raise new questions about research team diversity and research outcomes. We study mixed-gender research teams, examining 6.6 million papers published across the medical sciences since 2000 and establishing several core findings. First, the fraction of publications by mixed-gender teams has grown rapidly, yet mixed-gender teams continue to be underrepresented compared to the expectations of a null model. Second, despite their underrepresentation, the publications of mixed-gender teams are substantially more novel and impactful than the publications of same-gender teams of equivalent size. Third, the greater the gender balance on a team, the better the team scores on these performance measures. Fourth, these patterns generalize across medical subfields. Finally, the novelty and impact advantages seen with mixed-gender teams persist when considering numerous controls and potential related features, including fixed effects for the individual researchers, team structures, and network positioning, suggesting that a team’s gender balance is an underrecognized yet powerful correlate of novel and impactful scientific discoveries.


Science teams made up of men and women produce papers that are more novel and highly cited than those of all-men or all-women teams. These performance advantages increase the greater the team’s gender balance and appear nearly universal. On average, they hold for small and large teams, the 45 subfields of medicine, and women- or men-led teams and generalize to published papers in all science fields over the last 20 y. Notwithstanding these benefits, gender-diverse teams remain underrepresented in science when compared to what is expected if the teams in the data had been formed without regard to gender. These findings reveal potentially new gender and teamwork synergies that correlate with scientific discoveries and inform diversity, equity, and inclusion (DEI) initiatives.


Conducting an analysis of 6.6 million published papers from more than 15,000 different medical journals worldwide, we find that mixed-gender teams—teams combining women and men scientists—produce more novel and more highly cited papers than all-women or all-men teams. Mixed-gender teams publish papers that are up to 7% more novel and 14.6% more likely to be upper-tail papers than papers published by same-gender teams, results that are robust to numerous institutional, team, and individual controls and further generalize by subfield. Finally, in exploring gender in science through the lens of teamwork, the results point to a potentially transformative approach for thinking about and capturing the value of gender diversity in science.

Another key finding of this work is that mixed-gender teams are significantly underrepresented compared to what would be expected by chance. This underrepresentation is all the more striking given the findings that gender-diverse teams produce more novel and high-impact research and suggests that gender-diverse teams may have substantial untapped potential for medical research. Nevertheless, the underrepresentation of gender-diverse teams may reflect research showing that women receive less credit for their successes than do men teammates, which in turn inhibits the formation of gender-diverse teams and women’s success in receiving grants, prizes, and promotions.

Tuesday, October 11, 2022

Surprisingly Happy to Have Helped: Underestimating Prosociality Creates a Misplaced Barrier to Asking for Help

Zhao, X., & Epley, N. (2022).
Psychological Science.


Performing acts of kindness increases well-being, yet people can be reluctant to ask for help that would enable others’ kindness. We suggest that people may be overly reluctant because of miscalibrated expectations about others’ prosocial motivation, underestimating how positively others will feel when asked for help. A pretest identified that interest in asking for help was correlated with expectations of how helpers would think and feel, but a series of scenarios, recalled experiences, and live interactions among adult participants in the United States (total N = 2,118) indicated that those needing help consistently underestimated others’ willingness to help, underestimated how positively helpers would feel, and overestimated how inconvenienced helpers would feel. These miscalibrated expectations stemmed from underestimating helpers’ prosocial motivation while overestimating compliance motivation. This research highlights a limitation of construing help-seeking through a lens of compliance by scholars and laypeople alike. Undervaluing prosociality could create a misplaced barrier to asking for help when needed.

From the Discussion section

Prosocial actions, such as performing random acts of kindness, tend to improve well-being for both those who perform prosocial acts as well as for those who receive them. Indeed, those who performed a random act of kindness in our experiments reported feeling significantly more positive than they normally do, and two of the experiments confirmed that performers felt better than participants who were not given the opportunity to perform a random act of kindness. Another found that people performing acts of kindness felt more positive after being kind than they reported feeling at the beginning of the experiment. Being more prosocial did not come at a cost to people’s own well-being; it enhanced it.

Daily life, however, affords many opportunities for engaging in prosocial activities that people may not take. We believe our research suggests one possible reason why: that those performing random acts of kindness undervalue the positive impact they are having on recipients. People’s choices are often guided by either an implicit or explicit calculation of expected value (Becker, 1993). Underestimating how positive a recipient would feel after even a small act of kindness could lead people to engage in prosocial actions less often than might be optimal for both their own and others’ well-being.

Across a variety of different actions, in many different contexts, performers systematically perceived their random act of kindness to be a more minor action than recipients perceived it to be and systematically underestimated how positive recipients would feel afterward. Performers were not confused, of course, that recipients would feel good about their experience. In all cases performers expected recipients to feel more positive than they normally do. Nevertheless, performers were still systematically miscalibrated as recipients felt even better than expected.

Monday, October 10, 2022

7 tell-tale red flags of medical gaslighting

Ashley Laderer
Originally published 29 AUG 2022

Here is an except:

"Medical gaslighting is a term recently used to describe when health care providers dismiss a patient's concerns, feelings, or complaints," says Faith Fletcher, an assistant professor in the Center for Medical Ethics and Health Policy at Baylor College of Medicine and a senior advisor to the Hastings Center, a bioethics research institute. 

Numerous studies over the years have found examples of medical gaslighting, whether it's interrupting a patient or misdiagnosing them based on unconscious biases about race or gender. Gaslighting in the medical field tends to affect marginalized groups the most.

"These interactions don't take place in a vacuum and are rooted in long-standing structural and social injustices such as racism, sexism, and class oppression in the US healthcare system," Fletcher says. 

Here are seven signs your doctor may be gaslighting you and the consequences it can have on your health.

1. They interrupt you
2. They rush you 
3. They won't discuss your symptoms with you
4. They let underlying biases affect diagnosis 
5. They say it's all in your head
6. They question the legitimacy of your medical history 
7. They're uncollaborative on treatment options

Sunday, October 9, 2022

A Normative Approach to Artificial Moral Agency

Behdadi, D., Munthe, C.
Minds & Machines 30, 195–218 (2020).


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

Free will and Autonomy

Several AMA debaters have claimed that free will is necessary for being a moral agent (Himma 2009; Hellström 2012; Friedman and Kahn 1992). Others make a similar (and perhaps related) claim that autonomy is necessary (Lin et al. 2008; Schulzke 2013). In the AMA debate, some argue that artificial entities can never have free will (Bringsjord 1992; Shen 2011; Bringsjord 2007) while others, like James Moor (2006, 2009), are open to the possibility that future machines might acquire free will.Footnote15 Others (Powers 2006; Tonkens 2009) have proposed that the plausibility of a free will condition on moral agency may vary depending on what type of normative ethical theory is assumed, but they have not developed this idea further.

Despite appealing to the concept of free will, this portion of the AMA debate does not engage with key problems in the free will literature, such as the debate about compatibilism and incompatibilism (O’Connor 2016). Those in the AMA debate assume the existence of free will among humans, and ask whether artificial entities can satisfy a source control condition (McKenna et al. 2015). That is, the question is whether or not such entities can be the origins of their actions in a way that allows them to control what they do in the sense assumed of human moral agents.

An exception to this framing of the free will topic in the AMA debate occurs when Johnson writes that ‘… the non-deterministic character of human behavior makes it somewhat mysterious, but it is only because of this mysterious, non-deterministic aspect of moral agency that morality and accountability are coherent’ (Johnson 2006 p. 200). This is a line of reasoning that seems to assume an incompatibilist and libertarian sense of free will, assuming both that it is needed for moral agency and that humans do possess it. This, of course, makes the notion of human moral agents vulnerable to standard objections in the general free will debate (Shaw et al. 2019). Additionally, we note that Johnson’s idea about the presence of a ‘mysterious aspect’ of human moral agents might allow for AMA in the same way as Dreyfus and Hubert’s reference to the subconscious: artificial entities may be built to incorporate this aspect.

The question of sourcehood in the AMA debate connects to the independence argument: For instance, when it is claimed that machines are created for a purpose and therefore are nothing more than advanced tools (Powers 2006; Bryson 2010; Gladden 2016) or prosthetics (Johnson and Miller 2008), this is thought to imply that machines can never be the true or genuine source of their own actions. This argument questions whether the independence required for moral agency (by both functionalists and standardists) can be found in a machine. If a machine’s repertoire of behaviors and responses is the result of elaborate design then it is not independent, the argument goes. Floridi and Sanders question this proposal by referring to the complexity of ‘human programming’, such as genes and arranged environmental factors (e.g. education).