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

Sunday, December 31, 2023

Problems with the interjurisdictional regulation of psychological practice

Taube, D. O., Shapiro, D. L., et al. (2023).
Professional Psychology: Research and Practice,
54(6), 389–402.

Abstract

The U.S. Constitutional structure creates ethical conflicts for the cross-jurisdictional practice of professional psychology. The profession has chosen to seek interstate agreements to overcome such barriers, and such agreements now include almost 80% of American jurisdictions. Although an improvement over a patchwork of state laws regarding practice, the structure of this agreement and the exclusion of the remaining states continue to pose barriers to the principles of beneficence and nonmaleficence. It creates a system that is extraordinarily difficult to change and places an unrealistic burden on professionals to know, address, and act under complex legal mandates. As psychological services have moved increasingly to remote platforms, cross-jurisdictional business models, and a nationwide mental health crisis emerged alongside the pandemic, it is time to consider a national professional licensing system more seriously, both to further reduce barriers to care and complexity and permit the best interests of patients to prevail.

Impact Statement

Access to and the ability to continue receiving mental health care across jurisdictions and nations has become increasingly urgent in the wake of the COVID-19 pandemic This Ethics in Motion section highlights legal barriers to providing ethical care across jurisdictions, how those challenges developed, and strengths and limitations of current approaches and potential solutions.


My summary: 

The current system of interjurisdictional regulation of psychological practice in the United States is problematic because it creates ethical conflicts for psychologists and places an unrealistic burden on them to comply with complex legal mandates. The system is also extraordinarily difficult to change, and it excludes psychologists in states that have not joined the interstate agreement. As a result, the current system does not adequately protect the interests of patients.

A national professional licensing system would be a more effective way to regulate the practice of psychology across state lines. Such a system would eliminate the need for psychologists to comply with multiple state laws, and it would make it easier for them to provide care to patients who live in different states. A national system would also be more equitable, as it would ensure that all psychologists are held to the same standards.

Saturday, December 30, 2023

The ethics of doing human enhancement ethics

Rueda, J. (2023). 
Futures, 153, 103236.

Abstract

Human enhancement is one of the leading research topics in contemporary applied ethics. Interestingly, the widespread attention to the ethical aspects of future enhancement applications has generated misgivings. Are researchers who spend their time investigating the ethics of futuristic human enhancement scenarios acting in an ethically suboptimal manner? Are the methods they use to analyze future technological developments appropriate? Are institutions wasting resources by funding such research? In this article, I address the ethics of doing human enhancement ethics focusing on two main concerns. The Methodological Problem refers to the question of how we should methodologically address the moral aspects of future enhancement applications. The Normative Problem refers to what is the normative justification for investigating and funding the research on the ethical aspects of future human enhancement. This article aims to give a satisfactory response to both meta-questions in order to ethically justify the inquiry into the ethical aspects of emerging enhancement technologies.

Highlights

• Formulates second-order problems neglected in the literature on the ethics of future enhancement technologies.

• Discusses speculative ethics and anticipatory ethics methodologies for analyzing emerging enhancement innovations.

• Evaluates the main objections to engaging in research into the ethical aspects of future scenarios of human enhancement.

• Shows that methodological and normative meta-questions are key to advance the ethical debate on human enhancement.

Friday, December 29, 2023

A Hybrid Account of Harm

Unruh, C. F. (2022).
Australasian Journal of Philosophy, 1–14.
https://doi.org/10.1080/00048402.2022.2048401

Abstract

When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm.


Here's my take:

Charlotte Unruh proposes a new way of thinking about harm. Unruh argues that neither the traditional comparative account nor the non-comparative account of harm can adequately explain all cases of harm. The comparative account says that harm consists in being worse off than one would have been had some event not occurred. The non-comparative account says that harm consists in being in a bad state, regardless of how one would have fared otherwise.

Unruh proposes a hybrid account of harm that combines elements of both the comparative and non-comparative accounts. She says that an agent suffers harm if and only if either (i) the agent suffers ill-being or (ii) the agent's well-being is lower than it was before. This hybrid account is able to explain cases of harm that cannot be explained by either the comparative or non-comparative account alone. For example, the hybrid account explains why it is harmful to prevent someone from achieving a good that they would have otherwise achieved, even if the person is still in a good state overall.

Unruh's hybrid account of harm has a number of advantages over other accounts of harm. It is extensionally adequate, meaning that it correctly classifies all cases of harm as harmful and all cases of non-harm as non-harmful. It is also normatively plausible, meaning that it accords with our intuitions about what counts as harm. Additionally, the hybrid account is able to explain a number of different phenomena related to harm, such as the severity of harm, the distribution of harm, and the compensation for harm.

Thursday, December 28, 2023

The Relative Importance of Target and Judge Characteristics in Shaping the Moral Circle

Jaeger, B., & Wilks, M. (2021). 
Cognitive Science. 

Abstract

People's treatment of others (humans, nonhuman animals, or other entities) often depends on whether they think the entity is worthy of moral concern. Recent work has begun to investigate which entities are included in a person's moral circle, examining how certain target characteristics (e.g., species category, perceived intelligence) and judge characteristics (e.g., empathy, political orientation) shape moral inclusion. However, the relative importance of target and judge characteristics in predicting moral inclusion remains unclear. When predicting whether a person will deem an entity worthy of moral consideration, how important is it to know who is making the judgment (i.e., characteristics of the judge), who is being judged (i.e., characteristics of the target), and potential interactions between the two factors? Here, we address this foundational question by conducting a variance component analysis of the moral circle. In two studies with participants from the Netherlands, the United States, the United Kingdom, and Australia (N = 836), we test how much variance in judgments of moral concern is explained by between-target differences, between-judge differences, and by the interaction between the two factors. We consistently find that all three components explain substantial amounts of variance in judgments of moral concern. Our findings provide two important insights. First, an increased focus on interactions between target and judge characteristics is needed, as these interactions explain as much variance as target and judge characteristics separately. Second, any theoretical account that aims to provide an accurate description of moral inclusion needs to consider target characteristics, judge characteristics, and their interaction.

Here is my take:

The authors begin by reviewing the literature on the moral circle, which is the group of beings that people believe are worthy of moral consideration. They note that both target characteristics (e.g., species category, perceived intelligence) and judge characteristics (e.g., empathy, political orientation) have been shown to influence moral inclusion. However, the relative importance of these two types of characteristics remains unclear.

To address this question, the authors conducted two studies with participants from the Netherlands, the United States, the United Kingdom, and Australia. In each study, participants were asked to rate how much moral concern they felt for a variety of targets, including humans, animals, and robots. Participants were also asked to complete a questionnaire about their own moral values and beliefs.

The authors' analysis revealed that both target and judge characteristics explained significant amounts of variance in judgments of moral concern. However, they also found that the interaction between target and judge characteristics was just as important as target and judge characteristics separately. This means that the moral circle is not simply a function of either target or judge characteristics, but rather of the complex interaction between the two.

The authors' findings have important implications for our understanding of the moral circle. They show that moral inclusion is not simply a matter of whether or not a target possesses certain characteristics (e.g., sentience, intelligence). Rather, it also depends on the characteristics of the judge, as well as the interaction between the two.

The authors' findings also have important implications for applied ethics. For example, they suggest that ethicists should be careful to avoid making generalizations about the moral status of entire groups of beings. Instead, they should consider the individual characteristics of both the target and the judge when making moral judgments.

Wednesday, December 27, 2023

This algorithm could predict your health, income, and chance of premature death

Holly Barker
Science.org
Originally published 18 DEC 23

Here is an excerpt:

The researchers trained the model, called “life2vec,” on every individual’s life story between 2008 to 2016, and the model sought patterns in these stories. Next, they used the algorithm to predict whether someone on the Danish national registers had died by 2020.

The model’s predictions were accurate 78% of the time. It identified several factors that favored a greater risk of premature death, including having a low income, having a mental health diagnosis, and being male. The model’s misses were typically caused by accidents or heart attacks, which are difficult to predict.

Although the results are intriguing—if a bit grim—some scientists caution that the patterns might not hold true for non-Danish populations. “It would be fascinating to see the model adapted using cohort data from other countries, potentially unveiling universal patterns, or highlighting unique cultural nuances,” says Youyou Wu, a psychologist at University College London.

Biases in the data could also confound its predictions, she adds. (The overdiagnosis of schizophrenia among Black people could cause algorithms to mistakenly label them at a higher risk of premature death, for example.) That could have ramifications for things such as insurance premiums or hiring decisions, Wu adds.


Here is my summary:

A new algorithm, trained on a mountain of Danish life stories, can peer into your future with unsettling precision. It can predict your health, income, and even your odds of an early demise. This, achieved by analyzing the sequence of life events, like getting a job or falling ill, raises both possibilities and ethical concerns.

On one hand, imagine the potential for good: nudges towards healthier habits or financial foresight, tailored to your personal narrative. On the other, anxieties around bias and discrimination loom. We must ensure this powerful tool is used wisely, for the benefit of all, lest it exacerbate existing inequalities or create new ones. The algorithm’s gaze into the future, while remarkable, is just that – a glimpse, not a script. 

Tuesday, December 26, 2023

Who did it? Moral wrongness for us and them in the UK, US, and Brazil

Paulo Sérgio Boggio, et al. (2023) 
Philosophical Psychology
DOI: 10.1080/09515089.2023.2278637

Abstract

Morality has traditionally been described in terms of an impartial and objective “moral law”, and moral psychological research has largely followed in this vein, focusing on abstract moral judgments. But might our moral judgments be shaped not just by what the action is, but who is doing it? We looked at ratings of moral wrongness, manipulating whether the person doing the action was a friend, a refugee, or a stranger. We looked at these ratings across various moral foundations, and conducted the study in Brazil, US, and UK samples. Our most robust and consistent findings are that purity violations were judged more harshly when committed by ingroup members and less harshly when committed by the refugees in comparison to the unspecified agents, the difference between refugee and unspecified agents decays from liberals to conservatives, i.e., conservatives judge them more harshly than liberals do, and Brazilians participants are harsher than the US and UK participants. Our results suggest that purity violations are judged differently according to who committed them and according to the political ideology of the judges. We discuss the findings in light of various theories of groups dynamics, such as moral hypocrisy, moral disengagement, and the black sheep effect.


Here is my summary:

The study explores how moral judgments vary depending on both the agent committing the act and the nationality of the person making the judgment. The study's findings challenge the notion that moral judgments are universal and instead suggest that they are influenced by cultural and national factors.

The researchers investigated how participants from the UK, US, and Brazil judged moral violations committed by different agents: friends, strangers, refugees, and unspecified individuals. They found that participants from all three countries generally judged violations committed by friends more harshly than violations committed by other agents. However, there were also significant cultural differences in the severity of judgments. Brazilians tended to judge violations of purity as less wrong than Americans, but judged violations of care, liberty, and fairness as more wrong than Americans.

The study's findings suggest that moral judgments are not simply based on the severity of the act itself, but also on factors such as the relationship between the agent and the victim, and the cultural background of the person making the judgment. These findings have implications for understanding cross-cultural moral conflicts and for developing more effective moral education programs.

Monday, December 25, 2023

Pope Francis approves Catholic blessings for same-sex couples, but not for marriage

Becky Sullivan
npr.org
Originally posted 18 Dec 23

Pope Francis has granted his formal approval allowing Catholic priests to bless same-sex couples so long as they do not appear to endorse their marriage, marking the church's most permissive decree yet on the issue of same-sex couples.

The declaration, published Monday in a new document titled "Fiducia Supplicans: On the Pastoral Meaning of Blessings," marks a major departure for the Vatican, which only two years ago had said God "cannot bless sin" in a controversial 2021 decision about same-sex couples. Monday's document was approved by Pope Francis.

Still, the Vatican stressed that marriage remains exclusively between a man and a woman, and any priests granting a blessing to a same-sex couple must "avoid any form of confusion or scandal" that could suggest otherwise.

Francis, 87, has made liberalization toward LGBTQ Catholics a hallmark of his papacy. Since he became pope in 2013, he has urged the decriminalization of homosexuality. When asked in 2013 about gay priests, he famously replied: "If someone is gay and he searches for the Lord and has good will, who am I to judge?"

Monday's declaration is a "major step forward" for the church in regards to LGBTQ people, said the Rev. James Martin, an American Jesuit priest who has advocated for the LGBTQ Catholic community.

The declaration "recognizes the deep desire in many Catholic same-sex couples for God's presence in their loving relationships," Martin wrote on the social media site X, formerly known as Twitter. "In short, yesterday, as a priest, I was forbidden to bless same-sex couples at all. Today, with some limitations, I can."

What the declaration says about blessings for same-sex couples

In the document, the Vatican draws a distinction between what it described as "ritual and liturgical" blessings and those that are more informal and spontaneous.

"This Declaration remains firm on the traditional doctrine of the Church about marriage, not allowing any type of liturgical rite or blessing similar to a liturgical rite that can create confusion," wrote prefect Cardinal Victor Manuel Fernández in an introduction to the document.


The moral arc of the universe is long and complicated, and we hope it bends toward justice.

-paraphrasing Theodore Parker and Martin Luther King Jr.

Sunday, December 24, 2023

Dual character concepts and the normative dimension of conceptual representation

Knobe, J., Prasada, S., & Newman, G. E. (2013).
Cognition, 127(2), 242–257. 

Abstract

Five experiments provide evidence for a class of ‘dual character concepts.’ Dual character concepts characterize their members in terms of both (a) a set of concrete features and (b) the abstract values that these features serve to realize. As such, these concepts provide two bases for evaluating category members and two different criteria for category membership. Experiment 1 provides support for the notion that dual character concepts have two bases for evaluation. Experiments 2–4 explore the claim that dual character concepts have two different criteria for category membership. The results show that when an object possesses the appropriate concrete features, but does not fulfill the appropriate abstract value, it is judged to be a category member in one sense but not in another. Finally, Experiment 5 uses the theory developed here to construct artificial dual character concepts and examines whether participants react to these artificial concepts in the same way as naturally occurring dual character concepts. The present studies serve to define the nature of dual character concepts and distinguish them from other types of concepts (e.g., natural kind concepts), which share some, but not all of the properties of dual character concepts. More broadly, these phenomena suggest a normative dimension in everyday conceptual representation.

Here is my summary of the research, which has its current critics:

This research challenged traditional understandings of categorization and evaluation. Dual character concepts, exemplified by terms like "artist," "scientist," and "teacher," possess two distinct dimensions:

Concrete Features: These are the observable, physical attributes or characteristics that members of the category share.

Abstract Values: These are the underlying goals, ideals, or purposes that the concrete features serve to realize.

Unlike other types of concepts, dual character concepts allow for two distinct bases for evaluation:

Good/Bad Evaluation: This assessment is based on how well the concrete features of an entity align with the expected characteristics of a category member.

True/False Evaluation: This judgment is based on whether the abstract values embedded in the concept are fulfilled by the concrete features of an entity.

This dual-pronged evaluation process leads to intriguing consequences for categorization and judgment. An object may be deemed a "good" category member based on its concrete features, yet not a "true" member if it fails to uphold the abstract values associated with the concept.

The researchers provide compelling evidence for the existence of dual character concepts through a series of experiments. These studies demonstrate that people have two distinct ways of characterizing category members and that dual character concepts influence judgments of category membership.

The concept of dual character concepts highlights the normative dimension of conceptual representation, suggesting that our concepts not only reflect the world but also embody our values and beliefs. This normative dimension shapes how we categorize objects, evaluate entities, and make decisions in our daily lives.

Saturday, December 23, 2023

Folk Psychological Attributions of Consciousness to Large Language Models

Colombatto, C., & Fleming, S. M.
(2023, November 22). PsyArXiv

Abstract

Technological advances raise new puzzles and challenges for cognitive science and the study of how humans think about and interact with artificial intelligence (AI). For example, the advent of Large Language Models and their human-like linguistic abilities has raised substantial debate regarding whether or not AI could be conscious. Here we consider the question of whether AI could have subjective experiences such as feelings and sensations (“phenomenological consciousness”). While experts from many fieldshave weighed in on this issue in academic and public discourse, it remains unknown how the general population attributes phenomenology to AI. We surveyed a sample of US residents (N=300) and found that a majority of participants were willing to attribute phenomenological consciousness to LLMs. These attributions were robust, as they predicted attributions of mental states typically associated with phenomenology –but also flexible, as they were sensitive to individual differences such as usage frequency. Overall, these results show how folk intuitions about AI consciousness can diverge from expert intuitions –with important implications for the legal and ethical status of AI.


My summary:

The results of the study show that people are generally more likely to attribute consciousness to LLMs than to other non-human entities, such as animals, plants, and robots. However, the level of consciousness attributed to LLMs is still relatively low, with most participants rating them as less conscious than humans. The authors argue that these findings reflect the influence of folk psychology, which is the tendency to explain the behavior of others in terms of mental states.

The authors also found that people's attributions of consciousness to LLMs were influenced by their beliefs about the nature of consciousness and their familiarity with LLMs. Participants who were more familiar with LLMs were more likely to attribute consciousness to them, and participants who believed that consciousness is a product of complex computation were also more likely to attribute consciousness to LLMs.

Overall, the study suggests that people are generally open to the possibility that LLMs may be conscious, but they also recognize that LLMs are not as conscious as humans. These findings have implications for the development and use of LLMs, as they suggest that people may be more willing to trust and interact with LLMs that they believe are conscious.

Friday, December 22, 2023

Differential cortical network engagement during states of un/consciousness in humans

Zelmann, R., Paulk, A., et al. (2023).
Neuron. Volume 111, (21)

Summary

What happens in the human brain when we are unconscious? Despite substantial work, we are still unsure which brain regions are involved and how they are impacted when consciousness is disrupted. Using intracranial recordings and direct electrical stimulation, we mapped global, network, and regional involvement during wake vs. arousable unconsciousness (sleep) vs. non-arousable unconsciousness (propofol-induced general anesthesia). Information integration and complex processing we`re reduced, while variability increased in any type of unconscious state. These changes were more pronounced during anesthesia than sleep and involved different cortical engagement. During sleep, changes were mostly uniformly distributed across the brain, whereas during anesthesia, the prefrontal cortex was the most disrupted, suggesting that the lack of arousability during anesthesia results not from just altered overall physiology but from a disconnection between the prefrontal and other brain areas. These findings provide direct evidence for different neural dynamics during loss of consciousness compared with loss of arousability.

Highlights

• Decreased complexity and connectivity, with increased variability when unconscious
• Changes were more pronounced during propofol-induced general anesthesia than sleep
• During sleep, changes were homogeneously distributed across the human brain
• During anesthesia, substantial prefrontal disconnection is related to lack of arousability


Here is my summary:

State-Dependent Cortical Network Engagement

The human brain undergoes significant changes in its functional organization during different states of consciousness, including wakefulness, sleep, and general anesthesia. This study investigated the neural underpinnings of these state-dependent changes by comparing cortical network engagement during wakefulness, sleep, and propofol-induced general anesthesia.

Prefrontal Cortex Disruption during Anesthesia

The findings revealed that loss of consciousness, whether due to sleep or anesthesia, resulted in reduced information integration and increased response variability compared to wakefulness. However, these changes were more pronounced during anesthesia than sleep. Notably, anesthesia was associated with a specific disruption of the prefrontal cortex (PFC), a brain region crucial for higher-order cognitive functions such as decision-making and self-awareness.

Implications for Understanding Consciousness

These findings suggest that the PFC plays a critical role in maintaining consciousness and that its disruption contributes to the loss of consciousness during anesthesia. The study also highlights the distinct neural mechanisms underlying sleep and anesthesia, suggesting that these states involve different modes of brain function.

Thursday, December 21, 2023

Chatbot therapy is risky. It’s also not useless

A.W. Ohlheiser
vox.com
Originally posted 14 Dec 23

Here is an excerpt:

So what are the risks of chatbot therapy?

There are some obvious concerns here: Privacy is a big one. That includes the handling of the training data used to make generative AI tools better at mimicking therapy as well as the privacy of the users who end up disclosing sensitive medical information to a chatbot while seeking help. There are also the biases built into many of these systems as they stand today, which often reflect and reinforce the larger systemic inequalities that already exist in society.

But the biggest risk of chatbot therapy — whether it’s poorly conceived or provided by software that was not designed for mental health — is that it could hurt people by not providing good support and care. Therapy is more than a chat transcript and a set of suggestions. Honos-Webb, who uses generative AI tools like ChatGPT to organize her thoughts while writing articles on ADHD but not for her practice as a therapist, noted that therapists pick up on a lot of cues and nuances that AI is not prepared to catch.

Stade, in her working paper, notes that while large language models have a “promising” capacity to conduct some of the skills needed for psychotherapy, there’s a difference between “simulating therapy skills” and “implementing them effectively.” She noted specific concerns around how these systems might handle complex cases, including those involving suicidal thoughts, substance abuse, or specific life events.

Honos-Webb gave the example of an older woman who recently developed an eating disorder. One level of treatment might focus specifically on that behavior: If someone isn’t eating, what might help them eat? But a good therapist will pick up on more of that. Over time, that therapist and patient might make the connection between recent life events: Maybe the patient’s husband recently retired. She’s angry because suddenly he’s home all the time, taking up her space.

“So much of therapy is being responsive to emerging context, what you’re seeing, what you’re noticing,” Honos-Webb explained. And the effectiveness of that work is directly tied to the developing relationship between therapist and patient.


Here is my take:

The promise of AI in mental health care dances on a delicate knife's edge. Chatbot therapy, with its alluring accessibility and anonymity, tempts us with a quick fix for the ever-growing burden of mental illness. Yet, as with any powerful tool, its potential can be both a balm and a poison, demanding a wise touch for its ethical wielding.

On the one hand, imagine a world where everyone, regardless of location or circumstance, can find a non-judgmental ear, a gentle guide through the labyrinth of their own minds. Chatbots, tireless and endlessly patient, could offer a first step of support, a bridge to human therapy when needed. In the hushed hours of isolation, they could remind us we're not alone, providing solace and fostering resilience.

But let us not be lulled into a false sense of ease. Technology, however sophisticated, lacks the warmth of human connection, the nuanced understanding of a shared gaze, the empathy that breathes life into words. We must remember that a chatbot can never replace the irreplaceable – the human relationship at the heart of genuine healing.

Therefore, our embrace of chatbot therapy must be tempered with prudence. We must ensure adequate safeguards, preventing them from masquerading as a panacea, neglecting the complex needs of human beings. Transparency is key – users must be aware of the limitations, of the algorithms whispering behind the chatbot's words. Above all, let us never sacrifice the sacred space of therapy for the cold efficiency of code.

Chatbot therapy can be a bridge, a stepping stone, but never the destination. Let us use technology with wisdom, acknowledging its potential good while holding fast to the irreplaceable value of human connection in the intricate tapestry of healing. Only then can we mental health professionals navigate the ethical tightrope and make technology safe and effective, when and where possible.

Wednesday, December 20, 2023

Dehumanization: Beyond the Intergroup to the Interpersonal

Karantzas, G. C., Simpson, J. A., & Haslam, N. (2023).
Current Directions in Psychological Science, 0(0).

Abstract

Over the past two decades, there has been a significant shift in how dehumanization is conceptualized and studied. This shift has broadened the construct from the blatant denial of humanness to groups to include more subtle dehumanization within people’s interpersonal relationships. In this article, we focus on conceptual and empirical advances in the study of dehumanization in interpersonal relationships, with a particular focus on dehumanizing behaviors. In the first section, we describe the concept of interpersonal dehumanization. In the second section, we review social cognitive and behavioral research into interpersonal dehumanization. Within this section, we place special emphasis on the conceptualization and measurement of dehumanizing behaviors. We then propose a conceptual model of interpersonal dehumanization to guide future research. While doing so, we provide a novel review and integration of cutting-edge research on interpersonal dehumanization.

Conclusion

This review shines a spotlight on interpersonal dehumanization, with a specific emphasis on dehumanizing behaviors. Our review highlights that interpersonal dehumanization is a rapidly expanding and innovative field of research. It provides a clearer understanding of the current and emerging directions of research investigating how even subtle forms of negative behavior may, at times, thwart social connection and human bonding. It also provides a theoretical platform for scholars to launch new streams of research on interpersonal dehumanization processes and outcomes.

My summary

Traditionally, dehumanization has been studied in the context of intergroup conflict and prejudice, where individuals or groups are perceived as less human than others. However, recent research has demonstrated that dehumanization can also manifest in interpersonal interactions, affecting how individuals perceive, treat, and interact with each other.

The article argues that interpersonal dehumanization is a prevalent and impactful phenomenon that can have significant consequences for both individuals and relationships. It can lead to reduced empathy, increased hostility, and justification for aggression and violence.

The authors propose a conceptual model of interpersonal dehumanization that identifies three key components:

Dehumanizing Cognitions & Perceptions: The tendency to view others as less human-like, lacking essential human qualities like emotions, thoughts, and feelings.

Dehumanizing Behaviors: Actions or expressions that convey a disregard for another's humanity, such as insults, mockery, or exclusion.

Dehumanizing Consequences: The negative effects of dehumanization on individuals and relationships, including reduced empathy, increased hostility, and justification for aggression.

By understanding the mechanisms and consequences of interpersonal dehumanization, we can better address its prevalence and mitigate its harmful effects. The article concludes by emphasizing the importance of fostering empathy, promoting inclusive environments, and encouraging respectful interactions to combat dehumanization and promote healthy interpersonal relationships.

Tuesday, December 19, 2023

Human bias in algorithm design

Morewedge, C.K., Mullainathan, S., Naushan, H.F. et al.
Nat Hum Behav 7, 1822–1824 (2023).

Here is how the article starts:

Algorithms are designed to learn user preferences by observing user behaviour. This causes algorithms to fail to reflect user preferences when psychological biases affect user decision making. For algorithms to enhance social welfare, algorithm design needs to be psychologically informed.Many people believe that algorithms are failing to live up to their prom-ise to reflect user preferences and improve social welfare. The problem is not technological. Modern algorithms are sophisticated and accurate. Training algorithms on unrepresentative samples contributes to the problem, but failures happen even when algorithms are trained on the population. Nor is the problem caused only by the profit motive. For-profit firms design algorithms at a cost to users, but even non-profit organizations and governments fall short.

All algorithms are built on a psychological model of what the user is doing. The fundamental constraint on this model is the narrowness of the measurable variables for algorithms to predict. We suggest that algorithms fail to reflect user preferences and enhance their welfare because algorithms rely on revealed preferences to make predictions. Designers build algorithms with the erroneous assumption that user behaviour (revealed preferences) tells us (1) what users rationally prefer (normative preferences) and (2) what will enhance user welfare. Reliance on this 95-year-old economic model, rather than the more realistic assumption that users exhibit bounded rationality, leads designers to train algorithms on user behaviour. Revealed preferences can identify unknown preferences, but revealed preferences are an incomplete — and at times misleading — measure of the normative preferences and values of users. It is ironic that modern algorithms are built on an outmoded and indefensible commitment to revealed preferences.


Here is my summary.

Human biases can be reflected in algorithms, leading to unintended discriminatory outcomes. The authors argue that algorithms are not simply objective tools, but rather embody the values and assumptions of their creators. They highlight the importance of considering psychological factors when designing algorithms, as human behavior is often influenced by biases. To address this issue, the authors propose a framework for developing psychologically informed algorithms that can better capture user preferences and enhance social welfare. They emphasize the need for a more holistic approach to algorithm design that goes beyond technical considerations and takes into account the human element.

Monday, December 18, 2023

Medical Debt Is Disappearing From Americans’ Credit Reports, Lifting Scores

Noam Levey
KFF Health News
Originally published 2 Nove 23

The share of American consumers with medical debt on their credit reports has declined dramatically over the past year as major credit rating agencies removed small unpaid bills and debts that were less than a year old, according to a new analysis from the nonprofit Urban Institute.

At the same time, millions of Americans have seen their credit scores improve, making it easier for many to get a job, rent an apartment, or get a car.

“This is a very significant change,” said Breno Braga, an economist at the Urban Institute and a co-author of the study. “It affects a lot of people.”

For years, medical debt has depressed credit scores, undermining the financial security of tens of millions of patients and their families.

Under mounting pressure from patient advocates and government regulators, the three major credit agencies over the last two years have taken a series of steps to remove some medical debts from credit reports, including unpaid medical bills under $500.

The changes appear to be having an impact. As of August, just 5% of adults with a credit report had a medical debt on their report, down from almost 14% two years earlier.

Urban Institute researchers also found that Americans with a medical debt on their credit report in August 2022 saw their VantageScore credit score improve over the next year from an average of 585 to an average of 615.


Here is my summary:

The article discusses a study conducted by the Urban Institute, focusing on the impact of removing medical debt from credit reports. The study reveals that eliminating medical debt from credit reports can significantly improve individuals' credit scores and financial well-being. The research found that once medical debts were removed, more than two-thirds of affected individuals experienced an increase in their credit scores, with an average rise of 16 points. This is particularly crucial as medical debt is often incurred unexpectedly, and its presence on credit reports can lead to long-lasting financial consequences for individuals, affecting their ability to secure loans or access favorable interest rates.

Furthermore, the study suggests that removing medical debt from credit reports can contribute to reducing racial and ethnic disparities in credit scores. It highlights that individuals from communities of color are disproportionately affected by medical debt and its consequences on creditworthiness. By addressing this issue, there is an opportunity to promote greater financial equity and inclusivity. The findings underscore the potential benefits of policy interventions or industry practices aimed at mitigating the adverse impact of medical debt on individuals' credit histories, thereby fostering a more equitable financial landscape.

Sunday, December 17, 2023

Compassion Fatigue as a Self-Fulfilling Prophecy: Believing Compassion Is Limited Increases Fatigue and Decreases Compassion

Gainsburg, I., & Lee Cunningham, J. (2023). 
Psychological science, 34(11), 1206–1219.

Abstract

People's compassion responses often weaken with repeated exposure to suffering, a phenomenon known as compassion fatigue. Why is it so difficult to continue feeling compassion in response to others' suffering? We propose that people's limited-compassion mindsets-beliefs about compassion as a limited resource and a fatiguing experience-can result in a self-fulfilling prophecy that reinforces compassion fatigue. Across four studies of adults sampled from university students and online participant pools in the United States, we show that there is variability in people's compassion mindsets, that these mindsets can be changed with convincing information, and that limited-compassion mindsets predict lower feelings of compassion, lower-quality social support, and more fatigue. This contributes to our understanding of factors that underlie compassion fatigue and supports the broader idea that people's beliefs about the nature of emotions affect how emotions are experienced. Together, this research contributes to developing a strategy for increasing people's capacity to feel compassion and their social support.

Here is an excerpt:

Compassion and Its (Potential) Limits

Compassion is the feeling of concern for others’ suffering and the accompanying motivation to help (Goetz et al., 2010). Like other psychological capacities (e.g., short-term memory; Cowan, 2016), there may be limits to people’s compassion capacities. Relevant to the present research, compassion can weaken in response to prolonged, repeated exposure to suffering (i.e., compassion fatigue; Figley, 1995). Compassion fatigue was conceptualized as an occupational hazard among healthcare professionals, and it is defined as “a healthcare practitioner’s diminished capacity to care as a consequence of repeated exposure to the suffering of patients, and from the knowledge of their patient’s traumatic experiences” (Cavanagh et al., 2020, p. 640) and “a state of exhaustion . . . as a result of prolonged exposure to compassion stress” (Figley, 1995, p. 253).

Although compassion fatigue often stems from actively caring for patients, the mere knowledge of or exposure to patients’ suffering can also cause compassion fatigue (Cavanagh et al., 2020). Thus, media scholars also theorized about compassion fatigue following people’s repeated exposure to news media depicting the suffering of distant others disconnected from the self (Kinnick et al., 1996; Moeller, 1999). Supporting this idea, one experimental, lab-based study showed that participants who saw many (vs. few) compassion-inducing videos exhibited less empathy and reduced intent to help people in need during an unrelated task (Süssenbach, 2018). Although this context is different from health care, research in both contexts demonstrates the core elements of compassion fatigue: repeated exposure to suffering reduces subsequent compassion.

Why Mindsets May Influence Compassion

Although the capacity to feel sustained compassion in response to ongoing suffering may be limited, it is also possible that believing compassion is limited (i.e., having a limited mindset) contributes to compassion fatigue. In their review of limited willpower mindsets, Bernecker and Job (2019) explain that people with limited mindsets view their willpower as a “limited resource that gets depleted whenever used,” whereas those with nonlimited mindsets “reject this view and rather believe that using their willpower can even activate their mental stamina.” In the present research, people with limited mindsets may believe that feeling compassion depletes their emotional resources, requiring rest and recovery; people with nonlimited mindsets may disagree, and potentially view an initial experience of compassion as emotionally energizing, increasing their ability to feel compassion for others.

Critically, research suggests that limited mindsets can produce mindset-consistent experiences: Job and colleagues (2010) showed variability in limited versus nonlimited mindsets, the malleability of mindsets in response to information, and effects of limited mindsets on self-control and mental fatigue. Subsequent research suggests that these effects may be due to mindsets influencing people’s task-specific expectations and interpretations of mental experiences when exerting willpower (Chow et al., 2015; Francis & Job, 2018). Similarly, we propose that limited mindsets for compassion increases compassion fatigue via increased expectations of compassion fatigue in contexts eliciting ongoing compassion.

Saturday, December 16, 2023

Older people are perceived as more moral than younger people: data from seven culturally diverse countries

Piotr Sorokowski, et al. (2023)
Ethics & Behavior,
DOI: 10.1080/10508422.2023.2248327

Abstract

Given the adage “older and wiser,” it seems justified to assume that older people may be stereotyped as more moral than younger people. We aimed to study whether assessments of a person’s morality differ depending on their age. We asked 661 individuals from seven societies (Australians, Britons, Burusho of Pakistan, Canadians, Dani of Papua, New Zealanders, and Poles) whether younger (~20-year-old), middle-aged (~40-year-old), or older (~60-year-old) people were more likely to behave morally and have a sense of right and wrong. We observed that older people were perceived as more moral than younger people. The effect was particularly salient when comparing 20-year-olds to either 40- or 60-year-olds and was culturally universal, as we found it in both WEIRD (i.e. Western, Educated, Industrialized, Rich, Democratic) and non-WEIRD societies.


Here is my summary:

The researchers found that older people were rated as more moral than younger people, and this effect was particularly strong when comparing 20-year-olds to either 40- or 60-year-olds. The effect was also consistent across cultures, suggesting that it is a universal phenomenon.

The researchers suggest that there are a few possible explanations for this finding. One possibility is that older people are simply seen as having more life experience and wisdom, which are both associated with morality. Another possibility is that older people are more likely to conform to social norms, which are often seen as being moral. Finally, it is also possible that people simply have a positive bias towards older people, which leads them to perceive them as being more moral.

Whatever the explanation, the finding that older people are perceived as more moral than younger people has a number of implications. For example, it suggests that older people may be more likely to be trusted and respected, and they may also be more likely to be seen as leaders. Additionally, the finding suggests that ageism may be a form of prejudice, as it involves making negative assumptions about people based on their age.

Friday, December 15, 2023

Clinical documentation of patient identities in the electronic health record: Ethical principles to consider

Decker, S. E., et al. (2023). 
Psychological Services.
Advance online publication.

Abstract

The American Psychological Association’s multicultural guidelines encourage psychologists to use language sensitive to the lived experiences of the individuals they serve. In organized care settings, psychologists have important decisions to make about the language they use in the electronic health record (EHR), which may be accessible to both the patient and other health care providers. Language about patient identities (including but not limited to race, ethnicity, gender, and sexual orientation) is especially important, but little guidance exists for psychologists on how and when to document these identities in the EHR. Moreover, organizational mandates, patient preferences, fluid identities, and shifting language may suggest different documentation approaches, posing ethical dilemmas for psychologists to navigate. In this article, we review the purposes of documentation in organized care settings, review how each of the five American Psychological Association Code of Ethics’ General Principles relates to identity language in EHR documentation, and propose a set of questions for psychologists to ask themselves and their patients when making choices about documenting identity variables in the EHR.

Impact Statement

Psychologists in organized care settings may face ethical dilemmas about what language to use when documenting patient identities (race, ethnicity, gender, sexual orientation, and so on) in the electronic health record. This article provides a framework for considering how to navigate these decisions based on the American Psychological Association Code of Ethics’ five General Principles. To guide psychologists in decision making, questions to ask self and patient are included, as well as suggestions for further study.

Here is my summary:

The authors emphasize the lack of clear guidelines for psychologists on how and when to document these identity variables in EHRs. They acknowledge the complexities arising from organizational mandates, patient preferences, fluid identities, and evolving language, which can lead to ethical dilemmas for psychologists.

To address these challenges, the article proposes a framework based on the five General Principles of the American Psychological Association (APA) Code of Ethics:
  1. Fidelity and Responsibility: Psychologists must prioritize patient welfare and act in their best interests. This includes respecting their privacy and self-determination when documenting identity variables.
  2. Competence: Psychologists should possess the necessary knowledge and skills to accurately and sensitively document patient identities. This may involve ongoing training and staying abreast of evolving language and cultural norms.
  3. Integrity: Psychologists must maintain ethical standards and avoid misrepresenting or misusing patient identity information. This includes being transparent about the purposes of documentation and seeking patient consent when appropriate.
  4. Respect for Human Rights and Dignity: Psychologists must respect the inherent dignity and worth of all individuals, regardless of their identity. This includes avoiding discriminatory or stigmatizing language in EHR documentation.
  5. Social Justice and Public Interest: Psychologists should contribute to the promotion of social justice and the elimination of discrimination. This includes being mindful of how identity documentation can impact patients' access to care and their overall well-being.
To aid psychologists in making informed decisions about identity documentation, the authors propose a set of questions to consider:
  1. What is the purpose of documenting this identity variable?
  2. Is this information necessary for providing appropriate care or fulfilling legal/regulatory requirements?
  3. How will this information be used?
  4. What are the potential risks and benefits of documenting this information?
  5. What are the patient's preferences regarding the documentation of their identity?
By carefully considering these questions, psychologists can make ethically sound decisions that protect patient privacy and promote their well-being.

Thursday, December 14, 2023

Ethical Reasoning vs. Empathic Bias: A False Dichotomy?

Law, K. F., Amormino, P. et al.
(2023, September 5).

Abstract

Does empathy necessarily impede equity in altruism? Emerging findings from cognitive and affective science suggest that rationality and empathy are mutually compatible, contradicting some earlier, prominent arguments that empathy impedes equitable giving. We propose alternative conceptualizations of relationships among empathy, rationality, and equity, drawing on interdisciplinary advances in altruism research.

Here is my summary: 

This article discusses the relationship between ethical reasoning and empathic bias. Ethical reasoning is the process of using logic and reason to make moral decisions. Empathic bias is the tendency to make moral decisions that are influenced by our emotions and our personal relationships with the people involved.

The article argues that these two concepts are often seen as being in opposition to each other, but that this is a false dichotomy. Both ethical reasoning and empathic bias are important for making moral decisions. Ethical reasoning allows us to think about the broader implications of our decisions, while empathic bias allows us to connect with the individuals who are affected by our decisions.

The article concludes by suggesting that we should strive to use both ethical reasoning and empathic bias in our moral decision-making. By doing so, we can make more informed and compassionate decisions.

This article demonstrates that the Ethical Acculturation Model is not widely known by researchers.  The EAM stresses the professional's ability to integrate their own professional obligations and norms with their personal beliefs, values, and morality. Only through blending these important components can individuals resolve complex ethical/moral dilemmas.

Wednesday, December 13, 2023

Science and Ethics of “Curing” Misinformation

Freiling, I., Knause, N.M., & Scheufele, D.A.
AMA J Ethics. 2023;25(3):E228-237. 

Abstract

A growing chorus of academicians, public health officials, and other science communicators have warned of what they see as an ill-informed public making poor personal or electoral decisions. Misinformation is often seen as an urgent new problem, so some members of these communities have pushed for quick but untested solutions without carefully diagnosing ethical pitfalls of rushed interventions. This article argues that attempts to “cure” public opinion that are inconsistent with best available social science evidence not only leave the scientific community vulnerable to long-term reputational damage but also raise significant ethical questions. It also suggests strategies for communicating science and health information equitably, effectively, and ethically to audiences affected by it without undermining affected audiences’ agency over what to do with it.

My summary:

The authors explore the challenges and ethical considerations surrounding efforts to combat misinformation. The authors argue that using the term "curing" to describe these efforts is problematic, as it suggests that misinformation is a disease that can be eradicated. They argue that this approach is overly simplistic and disregards the complex social and psychological factors that contribute to the spread of misinformation.

The authors identify several ethical concerns with current approaches to combating misinformation, including:
  • The potential for censorship and suppression of legitimate dissent.
  • The undermining of public trust in science and expertise.
  • The creation of echo chambers and further polarization of public opinion.
Instead of trying to "cure" misinformation, the authors propose a more nuanced and ethical approach that focuses on promoting critical thinking, media literacy, and civic engagement. They also emphasize the importance of addressing the underlying social and psychological factors that contribute to the spread of misinformation, such as social isolation, distrust of authority, and a desire for simple explanations.

Tuesday, December 12, 2023

Health Insurers Have Been Breaking State Laws for Years

Maya Miller and Robin Fields
ProPublic.org
Originally published 16, NOV 23

Here is an excerpt:

State insurance departments are responsible for enforcing these laws, but many are ill-equipped to do so, researchers, consumer advocates and even some regulators say. These agencies oversee all types of insurance, including plans covering cars, homes and people’s health. Yet they employed less people last year than they did a decade ago. Their first priority is making sure plans remain solvent; protecting consumers from unlawful denials often takes a backseat.

“They just honestly don’t have the resources to do the type of auditing that we would need,” said Sara McMenamin, an associate professor of public health at the University of California, San Diego, who has been studying the implementation of state mandates.

Agencies often don’t investigate health insurance denials unless policyholders or their families complain. But denials can arrive at the worst moments of people’s lives, when they have little energy to wrangle with bureaucracy. People with plans purchased on HealthCare.gov appealed less than 1% of the time, one study found.

ProPublica surveyed every state’s insurance agency and identified just 45 enforcement actions since 2018 involving denials that have violated coverage mandates. Regulators sometimes treat consumer complaints as one-offs, forcing an insurer to pay for that individual’s treatment without addressing whether a broader group has faced similar wrongful denials.

When regulators have decided to dig deeper, they’ve found that a single complaint is emblematic of a systemic issue impacting thousands of people.

In 2017, a woman complained to Maine’s insurance regulator, saying her carrier, Aetna, broke state law by incorrectly processing claims and overcharging her for services related to the birth of her child. After being contacted by the state, Aetna acknowledged the mistake and issued a refund.


Here's my take:

The article explores the ethical issues surrounding health insurance denials and the violation of state laws. The investigation reveals a pattern of health insurance companies systematically denying coverage for medically necessary treatments, even when such denials directly contravene state laws designed to protect patients. The unethical practices extend to various states, indicating a systemic problem within the industry. Patients are often left in precarious situations, facing financial burdens and health risks due to the denial of essential medical services, raising questions about the industry's commitment to prioritizing patient well-being over profit margins.

The article underscores the need for increased regulatory scrutiny and enforcement to hold health insurance companies accountable for violating state laws and compromising patient care. It highlights the ethical imperative for insurers to prioritize their fundamental responsibility to provide coverage for necessary medical treatments and adhere to the legal frameworks in place to safeguard patient rights. The investigation sheds light on the intersection of profit motives and ethical considerations within the health insurance industry, emphasizing the urgency of addressing these systemic issues to ensure that patients receive the care they require without undue financial or health-related consequences.

Monday, December 11, 2023

Many Americans receive too much health care. That may finally be changing

Elsa Pearson Sites
StatNews.com
Originally published 8 Nov 23

The opioid crisis rocked America, bringing addiction and overdose into the spotlight. But it also highlighted the overtreatment of pain: Medical and dental providers alike overprescribed opioids after procedures and for chronic conditions. Out of that overtreatment came an epidemic.

In American health care, overtreatment is common. Recently though, there has been a subtle shift in the opposite direction. It’s possible that “less is more” is catching on.

For many Americans, it can be challenging to even access care: Treatment is expensive, insurance is confusing, and there aren’t enough providers. But ironically, we often use too much care, too.

Now, some providers are asking what the line between necessary and unnecessary really is. The results are encouraging, suggesting that, in some cases, it may be possible to achieve the same health outcomes with less treatment — and fewer side effects, too.

This shift is particularly noticeable in cancer care.


Here is my take:

The article delves into the pervasive issue of overtreatment and overdiagnosis in the healthcare system. It highlights the unintended consequences of modern medical practices, where patients are often subjected to unnecessary tests, procedures, and treatments that may not necessarily improve their health outcomes. The article emphasizes how overtreatment can lead to adverse effects, both physically and financially, for patients, while overdiagnosis can result in the unnecessary burden of managing conditions that may never cause harm. The piece discusses the challenges in striking a balance between providing thorough medical care and avoiding unnecessary interventions, urging a shift toward a more patient-centered and evidence-based approach to reduce harm and improve the overall quality of healthcare.

The author suggests that addressing the issue of overtreatment and overdiagnosis requires a comprehensive reevaluation of medical practices, incorporating shared decision-making between healthcare providers and patients. The article underscores the importance of fostering a healthcare culture that prioritizes the avoidance of unnecessary interventions and aligns treatments with patients' preferences and values. By acknowledging and addressing the challenges associated with overmedicalization, the article advocates for a more thoughtful and personalized approach to healthcare delivery that considers the potential harm of unnecessary treatments and strives to enhance the overall well-being of patients.

Sunday, December 10, 2023

Personality and prosocial behavior: A theoretical framework and meta-analysis

Thielmann, I., Spadaro, G., & Balliet, D. (2020).
Psychological Bulletin, 146(1), 30–90.

Abstract

Decades of research document individual differences in prosocial behavior using controlled experiments that model social interactions in situations of interdependence. However, theoretical and empirical integration of the vast literature on the predictive validity of personality traits to account for these individual differences is missing. Here, we present a theoretical framework that identifies 4 broad situational affordances across interdependent situations (i.e., exploitation, reciprocity, temporal conflict, and dependence under uncertainty) and more specific subaffordances within certain types of interdependent situations (e.g., possibility to increase equality in outcomes) that can determine when, which, and how personality traits should be expressed in prosocial behavior. To test this framework, we meta-analyzed 770 studies reporting on 3,523 effects of 8 broad and 43 narrow personality traits on prosocial behavior in interdependent situations modeled in 6 commonly studied economic games (Dictator Game, Ultimatum Game, Trust Game, Prisoner’s Dilemma, Public Goods Game, and Commons Dilemma). Overall, meta-analytic correlations ranged between −.18 ≤ ρ̂ ≤ .26, and most traits yielding a significant relation to prosocial behavior had conceptual links to the affordances provided in interdependent situations, most prominently the possibility for exploitation. Moreover, for several traits, correlations within games followed the predicted pattern derived from a theoretical analysis of affordances. On the level of traits, we found that narrow and broad traits alike can account for prosocial behavior, informing the bandwidth-fidelity problem. In sum, the meta-analysis provides a theoretical foundation that can guide future research on prosocial behavior and advance our understanding of individual differences in human prosociality.

Public Significance Statement

This meta-analysis provides a theoretical framework and empirical test identifying when, how, and which of 51 personality traits account for individual variation in prosocial behavior. The meta-analysis shows that the relations between personality traits and prosocial behavior can be understood in terms of a few situational affordances (e.g., a possibility for exploitation, a possibility for reciprocity, dependence on others under uncertainty) that allow specific traits to become expressed in behavior across a variety of interdependent situations. As such, the meta-analysis provides a theoretical basis for understanding individual differences in prosocial behavior in various situations that individuals face in their everyday social interactions.


A massive review of the literature finds that the best predictors of pro-social behavior are:
  1. social value orientation
  2. proneness to feel guilt
  3. humility/honesty

Saturday, December 9, 2023

Physicians’ Refusal to Wear Masks to Protect Vulnerable Patients—An Ethical Dilemma for the Medical Profession

Dorfman D, Raz M, Berger Z.
JAMA Health Forum. 2023;4(11):e233780.
doi:10.1001/jamahealthforum.2023.3780

Here is an excerpt:

In theory, the solution to the problem should be simple: patients who wear masks to protect themselves, as recommended by the CDC, can ask the staff and clinicians to wear a mask as well when seeing them, and the clinicians would oblige given the efficacy masks have shown in reducing the spread of respiratory illnesses. However, disabled patients report physicians and other clinical staff having refused to wear a mask when caring for them. Although it is hard to know how prevalent this phenomenon is, what recourse do patients have? How should health care systems approach clinicians and staff who refuse to mask when treating a disabled patient?

Physicians have a history of antagonism to the idea that they themselves might present a health risk to their patients. Famously, when Hungarian physician Ignaz Semmelweis originally proposed handwashing as a measure to reduce purpureal fever, he was met with ridicule and ostracized from the profession.

Physicians were also historically reluctant to adopt new practices to protect not only patients but also physicians themselves against infection in the midst of the AIDS epidemic. In 1985, the CDC presented its guidance on workplace transmission, instructing physicians to provide care, “regardless of whether HCWs [health care workers] or patients are known to be infected with HTLV-III/LAV [human T-lymphotropic virus type III/lymphadenopathy-associated virus] or HBV [hepatitis B virus].” These CDC guidelines offered universal precautions, common-sense, nonstigmatizing, standardized methods to reduce infection. Yet, some physicians bristled at the idea that they need to take simple, universal public health steps to prevent transmission, even in cases in which infectivity is unknown, and instead advocated for a medicalized approach: testing or masking only in cases when a patient is known to be infected. Such an individualized medicalized approach fails to meet the public health needs of the moment.

Patients are the ones who pay the price for physicians’ objections to changes in practices, whether it is handwashing or the denial of care as an unwarranted HIV precaution. Yet today, with the enactment of disability antidiscrimination law, patients are protected, at least on the books.

As we have written elsewhere, federal law supports the right of a disabled individual to request masking as a reasonable disability accommodation in the workplace and at schools.


Here is my summary:

This article explores the ethical dilemma arising from physicians refusing to wear masks, potentially jeopardizing the protection of vulnerable patients. The author delves into the conflict between personal beliefs and professional responsibilities, questioning the ethical implications of such refusals within the medical profession. The analysis emphasizes the importance of prioritizing patient well-being and public health over individual preferences, calling for a balance between personal freedoms and ethical obligations in healthcare settings.

Friday, December 8, 2023

Professional Judges’ Disbelief in Free Will Does Not Decrease Punishment

Genschow, O., Hawickhorst, H., et al. (2020).
Social Psychological and Personality Science,
12, 357 - 362.

Abstract

There is a debate in psychology and philosophy on the societal consequences of casting doubts about individuals’ belief in free will. Research suggests that experimentally reducing free will beliefs might affect how individuals evaluate others’ behavior. Past research has demonstrated that reduced free will beliefs decrease laypersons’ tendency toward retributive punishment. This finding has been used as an argument for the idea that promoting anti-free will viewpoints in the public media might have severe consequences for the legal system because it may move judges toward softer retributive punishments. However, actual implications for the legal system can only be drawn by investigating professional judges. In the present research, we investigated whether judges (N = 87) are affected by reading anti-free will messages. The results demonstrate that although reading anti-free will texts reduces judges’ belief in free will, their recommended sentences are not influenced by their (manipulated) belief in free will.


Here is my take:

The results showed that the judges who read the anti-free will passage did indeed have a reduced belief in free will. However, there were no differences in the recommended sentences between the two groups of judges. This suggests that judges' disbelief in free will does not lead them to recommend lighter sentences for criminals.

The study's authors suggest that this finding may be due to the fact that judges are trained to uphold the law and to base their sentencing decisions on legal factors, such as the severity of the crime and the defendant's criminal history. They also suggest that judges may be reluctant to reduce sentences based on metaphysical beliefs about free will.

Key findings:
  • Reading anti-free will messages reduces judges' belief in free will.
  • Judges' disbelief in free will does not lead them to recommend lighter sentences for criminals.