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
Showing posts with label Character. Show all posts
Showing posts with label Character. Show all posts

Tuesday, March 5, 2024

You could lie to a health chatbot – but it might change how you perceive yourself

Dominic Wilkinson
The Conversation
Originally posted 8 FEB 24

Here is an excerpt:

The ethics of lying

There are different ways that we can think about the ethics of lying.

Lying can be bad because it causes harm to other people. Lies can be deeply hurtful to another person. They can cause someone to act on false information, or to be falsely reassured.

Sometimes, lies can harm because they undermine someone else’s trust in people more generally. But those reasons will often not apply to the chatbot.

Lies can wrong another person, even if they do not cause harm. If we willingly deceive another person, we potentially fail to respect their rational agency, or use them as a means to an end. But it is not clear that we can deceive or wrong a chatbot, since they don’t have a mind or ability to reason.

Lying can be bad for us because it undermines our credibility. Communication with other people is important. But when we knowingly make false utterances, we diminish the value, in other people’s eyes, of our testimony.

For the person who repeatedly expresses falsehoods, everything that they say then falls into question. This is part of the reason we care about lying and our social image. But unless our interactions with the chatbot are recorded and communicated (for example, to humans), our chatbot lies aren’t going to have that effect.

Lying is also bad for us because it can lead to others being untruthful to us in turn. (Why should people be honest with us if we won’t be honest with them?)

But again, that is unlikely to be a consequence of lying to a chatbot. On the contrary, this type of effect could be partly an incentive to lie to a chatbot, since people may be conscious of the reported tendency of ChatGPT and similar agents to confabulate.

Here is my summary:

The article discusses the potential consequences of lying to a health chatbot, even though it might seem tempting. It highlights a situation where someone frustrated with a wait for surgery considers exaggerating their symptoms to a chatbot screening them.

While lying might offer short-term benefits like quicker attention, the author argues it could have unintended consequences:

Impact on healthcare:
  • Inaccurate information can hinder proper diagnosis and treatment.
  • It contributes to an already strained healthcare system.
  • Repeatedly lying, even to a machine, can erode honesty and integrity.
  • It reinforces unhealthy avoidance of seeking professional help.
The article encourages readers to be truthful with chatbots for better healthcare outcomes and self-awareness. It acknowledges the frustration with healthcare systems but emphasizes the importance of transparency for both individual and collective well-being.

Friday, June 2, 2023

Is it good to feel bad about littering? Conflict between moral beliefs and behaviors for everyday transgressions

Schwartz, Stephanie A. and Inbar, Yoel
Originally posted 22 June 22


People sometimes do things that they think are morally wrong. We investigate how actor’s perceptions of the morality of their own behaviors affects observers’ evaluations. In Study 1 (n = 302), we presented participants with six different descriptions of actors who routinely engaged in a morally questionable behavior and varied whether the actors thought the behavior was morally wrong. Actors who believed their behavior was wrong were seen as having better moral character, but their behavior was rated as more wrong. In Study 2 (n = 391) we investigated whether perceptions of actor metadesires were responsible for the effects of actor beliefs on judgments. We used the same stimuli and measures as in Study 1 but added a measure of the actor’s perceived desires to engage in the behaviors. As predicted, the effect of actors’ moral beliefs on judgments of their behavior and moral character was mediated by perceived metadesires.

General Discussion

In two studies, we find that actors’ beliefs about their own everyday immoral behaviors affect both how the acts and the actors are evaluated—albeit in opposite directions. An actor’s belief that his or her act is morally wrong causes observers to see the act itself as less morally acceptable, while, at the same time, it leads to more positive character judgments of the actor. In Study 2, we find that these differences in character judgments are mediated by people’s perceptions of the actor’s metadesires. Actors who see their behavior as morally wrong are presumed to have a desire not to engage in it, and this in turn leads to more positive evaluations of their character. These results suggest that one benefit of believing one’s own behavior to be immoral is that others—if they know this—will evaluate one’s character more positively.


Honest Hypocrites 

In research on moral judgments of hypocrites, Jordan et al. (2017) found that people who publicly espouse a moral standard that they privately violate are judged particularly negatively.  However, they also found that “honest hypocrites” (those who publicly condemn a behavior while admitting they engage in it themselves) are judged more positively than traditional hypocrites and equivalently to control transgressors (people who simply engage in the negative behavior without taking a public stand on its acceptability). This might seem to contradict our findings in the current studies, where people who transgressed despite thinking that the behavior was morally wrong were judged more positively than those who simply transgressed. We believe the key distinction that explains the difference between Jordan et al.’s results and ours is that in their paradigm, hypocrites publicly condemned others for engaging in the behavior in question.  As Jordan et al. show, public condemnation is interpreted as a strong signal that someone is unlikely to engage in that behavior themselves; hypocrites therefore are disliked both for
engaging in a negative behavior and for falsely signaling (by their public condemnation) that they wouldn’t. Honest hypocrites, who explicitly state that they engage in the negative behavior, are not falsely signaling. However, Jordan et al.’s scenarios imply to participants that honest hypocrites do condemn others—something that may strike people as unfair coming from a person who engages in the behavior themselves. Thus, honest hypocrites may be penalized for public condemnation, even as they are credited for more positive metadesires. In contrast, in our studies participants were told that the scenario protagonists thought the behavior was morally wrong but not that they publicly condemned anyone else for engaging in it. This may have allowed protagonists to benefit from more positive perceived metadesires without being penalized for public condemnation. This explanation is admittedly speculative but could be tested in future research that we outline below.

Suppose you do something bad. Will people blame you more if you knew it was wrong? Or will they blame you less?

The answer seems to be: They will think your act is more wrong, but your character is less bad.

Friday, July 15, 2022

How inferred motives shape moral judgements

Carlson, R.W., Bigman, Y.E., Gray, K. et al. 
Nat Rev Psychol (2022).


When people judge acts of kindness or cruelty, they often look beyond the act itself to infer the agent’s motives. These inferences, in turn, can powerfully influence moral judgements. The mere possibility of self-interested motives can taint otherwise helpful acts, whereas morally principled motives can exonerate those behind harmful acts. In this Review, we survey research showcasing the importance of inferred motives for moral judgements, and show how motive inferences are connected to judgements of actions, intentions and character. This work suggests that the inferences observers draw about peoples’ motives are sufficient for moral judgement (they drive character judgements even without actions) and functional (they effectively aid observers in predicting peoples’ future behaviour). Research that directly probes when and how people infer motives, and how motive properties guide those inferences, can deepen our understanding of the role of inferred motives in moral life.

From Summary and future directions

Moral psychology has long emphasized the importance of actions and character in moral judgements. However, observers frequently go beyond judging actions and seek to understand peoples’ motives. Moral psychology paradigms often feature cues to motives which carry moral weight, such as an agent’s desire to harm others physically, or their lack of motivation to pre-vent harm to others. The inferences people draw about others’ motives are crucial for moral judgement in two respects. First, the mere presence of certain motives can drive moral judgements of character, even in the absence of any action. Second, inferred motives shape what an agent’s actions reveal about their character to observers, and thereby allow observers to better pre-dict others’ future actions. To integrate past work and guide future research in moral psychology, we reviewed research connecting motives with actions, character and other key constructs. These insights can enrich our understanding of moral judgement, and shed light on emerging social phenomena that are relevant to moral psychology (see Box 1). The motive properties reviewed (motive strength, direction and conflict), as well as motive and action multiplicity, offer a guide for future work.

From Box 1

Motives and emerging social challenges researchers and ethicists are expressing growing concern about autonomous technologies and their rapidly increasing role in human life. robots and other artificial agents are perceived as less driven by motives than humans. these agents are increasingly tasked with decisions that have moral implications, such as allocating scarce medical resources, informing parole decisions and guiding autonomous vehicles. understanding the influence of motives in moral judgement can shed light on how the motiveless existence of artificial agents influences how people respond to the decisions of such artificial agents. On the one hand, people are averse to having artificial agents make morally relevant decisions, which can be explained by people perceiving robots as lacking helpful motives. On the other hand, people see artificial agents as less capable of discrimination, and are less outraged when they do discriminate, which can be explained by people perceiving robots as lacking harmful motives, such as prejudice.

Monday, November 15, 2021

On Defining Moral Enhancement: A Clarificatory Taxonomy

Carl Jago
Journal of Experimental Social Psychology
Volume 95, July 2021, 104145


In a series of studies, we ask whether and to what extent the base rate of a behavior influences associated moral judgment. Previous research aimed at answering different but related questions are suggestive of such an effect. However, these other investigations involve injunctive norms and special reference groups which are inappropriate for an examination of the effects of base rates per se. Across five studies, we find that, when properly isolated, base rates do indeed influence moral judgment, but they do so with only very small effect sizes. In another study, we test the possibility that the very limited influence of base rates on moral judgment could be a result of a general phenomenon such as the fundamental attribution error, which is not specific to moral judgment. The results suggest that moral judgment may be uniquely resilient to the influence of base rates. In a final pair of studies, we test secondary hypotheses that injunctive norms and special reference groups would inflate any influence on moral judgments relative to base rates alone. The results supported those hypotheses.

From the General Discussion

In multiple experiments aimed at examining the influence of base rates per se, we found that base rates do indeed influence judgments, but the size of the effect we observed was very small. We considered that, in
discovering moral judgments’ resilience to influence from base rates, we may have only rediscovered a general tendency, such as the fundamental attribution error, whereby people discount situational factors. If
so, this tendency would then also apply broadly to non-moral scenarios. We therefore conducted another study in which our experimental materials were modified so as to remove the moral components. We found a substantial base-rate effect on participants’ judgments of performance regarding non-moral behavior. This finding suggests that the resilience to base rates observed in the preceding studies is unlikely the result of amore general tendency, and may instead be unique to moral judgment.

The main reasons why we concluded that the results from the most closely related extant research could not answer the present research question were the involvement in those studies of injunctive norms and
special reference groups. To confirm that these factors could inflate any influence of base rates on moral judgment, in the final pair of studies, we modified our experiments so as to include them. Specifically, in one study, we crossed prescriptive and proscriptive injunctive norms with high and low base rates and found that the impact of an injunctive norm outweighs any impact of the base rate. In the other study, we found that simply mentioning, for example, that there were some good people among those who engaged in a high base-rate behavior resulted in a large effect on moral judgment; not only on judgments of the target’s character, but also on judgments of blame and wrongness. 

Tuesday, April 13, 2021

Can Clinical Empathy Survive? Distress, Burnout, and Malignant Duty in the Age of Covid‐19

A. Anzaldua & J. Halpern
Hastings Report
Jan-Feb 2021 22-27.


The Covid‐19 crisis has accelerated a trend toward burnout in health care workers, making starkly clear that burnout is especially likely when providing health care is not only stressful and sad but emotionally alienating; in such situations, there is no mental space for clinicians to experience authentic clinical empathy. Engaged curiosity toward each patient is a source of meaning and connection for health care providers, and it protects against sympathetic distress and burnout. In a prolonged crisis like Covid‐19, clinicians provide care out of a sense of duty, especially the duty of nonabandonment. We argue that when duty alone is relied on too heavily, with fear and frustration continually suppressed, the risk of burnout is dramatically increased. Even before Covid‐19, clinicians often worked under dehumanizing and unjust conditions, and rates of burnout were 50 percent for physicians and 33 percent for nurses. The Covid‐19 intensification of burnout can serve as a wake‐up call that the structure of health care needs to be improved if we are to prevent the loss of a whole generation of empathic clinicians.


The Dynamics of Clinical Empathy

Clinical empathy, a specific form of empathy that has therapeutic impact in the medical setting and is professionally sustainable, was first conceptualized by one of us, Jodi Halpern, as emotionally engaged curiosity. Her work challenged the expectation that physicians should limit themselves to detached cognitive empathy, showing how affective resonance, when redirected into curiosity about the patient, is essential for therapeutic impact. Halpern's interactive model of affective and cognitive empathy has been supported by empirical research, including findings regarding improved diagnosis, treatment adherence, and coping as well as studies of specific diseases (for example, about improved diabetes outcomes), though more research is needed to precisely identify the specific ways that affective resonance and cognitive curiosity contribute to meeting specific clinical needs. This model is also supported by neuroscientific findings showing how affective attunement improves cognitive empathy.

Models of compassion in medical care add valuable practices of mindfulness but do not emphasize an individualized appreciation of each patient's predicament. We thus work with Halpern's model, which emphasizes using emotional resonance to inform imagining the world from each patient's perspective. Halpern defines the cognitive aim of imagining each patient's perspective as “curiosity” because the practice of clinical empathy as engaged curiosity is founded on the recognition that each patient brings their own distinct world, with a unique set of values and needs that the physician cannot presume to know. This is a subtle but vital point. 

Friday, February 14, 2020

The Moral Self and Moral Duties

J. Everett, J. Skorburg, and J. Savulescu
Created on 6 Jan 20


Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity.

The research is here.

Monday, January 27, 2020

The Character of Causation: Investigating the Impact of Character, Knowledge, and Desire on Causal Attributions

Justin Sytsma
(2019) Preprint


There is a growing consensus that norms matter for ordinary causal attributions. This has important implications for philosophical debates over actual causation. Many hold that theories of actual causation should coincide with ordinary causal attributions, yet those attributions often diverge from the theories when norms are involved. There remains substantive debate about why norms matter for causal attributions, however. In this paper, I consider two competing explanations—Alicke’s bias view, which holds that the impact of norms reflects systematic error (suggesting that ordinary causal attributions should be ignored in the philosophical debates), and our responsibility view, which holds that the impact of norms reflects the appropriate application of the ordinary concept of causation (suggesting that philosophical accounts are not analyzing the ordinary concept). I investigate one key difference between these views: the bias view, but not the responsibility view, predicts that “peripheral features” of the agents in causal scenarios—features that are irrelevant to appropriately assessing responsibility for an outcome, such as general character—will also impact ordinary causal attributions. These competing predictions are tested for two different types of scenarios. I find that information about an agent’s character does not impact causal attributions on its own. Rather, when character shows an effect it works through inferences to relevant features of the agent. In one scenario this involves inferences to the agent’s knowledge of the likely result of her action and her desire to bring about that result, with information about knowledge and desire each showing an independent effect on causal attributions.

From the Conclusion:

Alicke’s bias view holds that not only do features of the agent’s mental states matter, such as her knowledge and desires concerning the norm and the outcome, but also peripheral features of the agent whose impact could only reasonably be explained in terms of bias. In contrast, our responsibility view holds that the impact of norms does not reflect bias, but rather that ordinary causal attributions issue from the appropriate application of a concept with a normative component. As such, we predict that while judgments about the agent’s mental states that are relevant to adjudicating responsibility will matter, peripheral features of the agent will only matter insofar as they warrant an inference to other features of the agent that are relevant.

 In line with the responsibility view and against the bias view, the results of the studies presented in this paper suggest that information relevant to assessing an agent’s character matters but only when it warrants an inference to a non-peripheral feature, such as the agent’s negligence in the situation or her knowledge and desire with regard to the outcome. Further, the results indicate that information about an agent’s knowledge and desire both impact ordinary causal attributions in the scenario tested. This raises an important methodological issue for empirical work on ordinary causal attributions: researchers need to carefully consider and control for the inferences that participants might draw concerning the agents’ mental states and motivations.

The research is here.

Wednesday, November 27, 2019

Corruption Is Contagious: Dishonesty begets dishonesty, rapidly spreading unethical behavior through a society

Dan Ariely & Ximena Garcia-Rada
Scientific American
September 2019

Here is an excerpt:

This is because social norms—the patterns of behavior that are accepted as normal—impact how people will behave in many situations, including those involving ethical dilemmas. In 1991 psychologists Robert B. Cialdini, Carl A. Kallgren and Raymond R. Reno drew the important distinction between descriptive norms—the perception of what most people do—and injunctive norms—the perception of what most people approve or disapprove of. We argue that both types of norms influence bribery.

Simply put, knowing that others are paying bribes to obtain preferential treatment (a descriptive norm) makes people feel that it is more acceptable to pay a bribe themselves.

Similarly, thinking that others believe that paying a bribe is acceptable (an injunctive norm) will make people feel more comfortable when accepting a bribe request. Bribery becomes normative, affecting people's moral character.

In 2009 Ariely, with behavioral researchers Francesca Gino and Shahar Ayal, published a study showing how powerful social norms can be in shaping dishonest behavior. In two lab studies, they assessed the circumstances in which exposure to others' unethical behavior would change someone's ethical decision-making. Group membership turned out to have a significant effect: When individuals observed an in-group member behaving dishonestly (a student with a T-shirt suggesting he or she was from the same school cheating in a test), they, too, behaved dishonestly. In contrast, when the person behaving dishonestly was an out-group member (a student with a T-shirt from the rival school), observers acted more honestly.

But social norms also vary from culture to culture: What is acceptable in one culture might not be acceptable in another. For example, in some societies giving gifts to clients or public officials demonstrates respect for a business relationship, whereas in other cultures it is considered bribery. Similarly, gifts for individuals in business relationships can be regarded either as lubricants of business negotiations, in the words of behavioral economists Michel André Maréchal and Christian Thöni, or as questionable business practices. And these expectations and rules about what is accepted are learned and reinforced by observation of others in the same group. Thus, in countries where individuals regularly learn that others are paying bribes to obtain preferential treatment, they determine that paying bribes is socially acceptable. Over time the line between ethical and unethical behavior becomes blurry, and dishonesty becomes the “way of doing business.”

The info is here.

Wednesday, January 30, 2019

Trump Has Officially Made ‘Conservative Ethics’ an Oxymoron

Jonathan Chait
New York Magazine

The conservative intelligentsia initially greeted the rise of Donald Trump with revulsion. After some of them peeled off, a minority remained within the party tent on the grounds that they could support Trump’s policy goals without endorsing his grotesque character. Mitt Romney’s op-ed attacking Trump’s lack of virtue, however, has put this question squarely on the table. And the conservative response seems clear: Republicans will not abide attacks on Trump’s character, either.

A couple of recent columns nakedly illustrate the moral depravity into which conservatives have descended. It would be easy to mock some blow-dried Fox News bobblehead, but I’m going to focus on two samples from a pair of the more esteemed intellectuals the conservative movement has produced. The first is a column by Roger Kimball, and the second by Henry Olsen.

Kimball is an esteemed, long-standing conservative critic, who writes for a wide array of literary, scholarly, and pseudo-scholarly journals, and is frequently photographed in a bow tie. Like many conservative intellectuals, Kimball once devoted himself to the evils of moral relativism. “What a relativist really believes (or believes he believes) is that 1) there is no such thing as value and 2) there is no such thing as truth,” he wrote in one such essay, in 2009. Kimball explained that by attacking fixed truths, relativism allows the strongman to impose his own values. “Relativism and tyranny, far from being in opposition, are in fact regular collaborators,” he wrote. And also: “Relativism, which begins with a beckoning promise of liberation from ‘oppressive’ moral constraints, so often end in the embrace of immoral constraints that are politically obnoxious.”

The info is here.

Tuesday, November 6, 2018

Bringing back professionalism in the practice of law is key

Samuel C. Stretton
The Legal Intelligencer
Originally published October 4, 2018

Here is an excerpt:

All lawyers ought to review the Pennsylvania Rules of Civility. Although these rules do not have disciplinary consequences, they set forth the aspirations all lawyers should achieve in the legal profession. Perhaps lawyers have to understand what it means to be a professional. To have the privilege of being admitted to practice law in a state is a wonderful opportunity. The lawyer being admitted becomes part of the legal profession which has a long and historic presence. The legal profession can take great credit for the evolving law and for the democratic institutions which populate this country. Lawyers through vigorous advocacy and through much involvement in the community and in the political offices have help to create a society by law where fairness and justice are the ideals. Once admitted to practice, each and every lawyer becomes part of this wonderful profession and has a duty to uphold the ideals not only in terms of representing clients as vigorously and as honestly as they can, but also in terms of insuring involvement in the community and in society. Each generation of lawyers help to reinterpret the constitution and make it a living document to adjust to the modern problems of every generation. It is a wonderful and great honor to be part of this profession and perhaps one of the greatest privileges any lawyer can have. This privilege allows a lawyer to participate fully in the third branch of public. This privilege allows a lawyer to become part of the public life of their community and of the country in terms of representation and in terms of legal and judicial changes.

The information is here.

Monday, July 9, 2018

Learning from moral failure

Matthew Cashman & Fiery Cushman
In press: Becoming Someone New: Essays on Transformative Experience, Choice, and Change


Pedagogical environments are often designed to minimize the chance of people acting wrongly; surely this is a sensible approach. But could it ever be useful to design pedagogical environments to permit, or even encourage, moral failure? If so, what are the circumstances where moral failure can be beneficial?  What types of moral failure are helpful for learning, and by what mechanisms? We consider the possibility that moral failure can be an especially effective tool in fostering learning. We also consider the obvious costs and potential risks of allowing or fostering moral failure. We conclude by suggesting research directions that would help to establish whether, when and how moral pedagogy might be facilitated by letting students learn from moral failure.



Errors are an important source of learning, and educators often exploit this fact.  Failing helps to tune our sense of balance; Newtonian mechanics sticks better when we witness the failure of our folk physics. We consider the possibility that moral failure may also prompt especially strong or distinctive forms of learning.  First, and with greatest certainty, humans are designed to learn from moral failure through the feeling of guilt.  Second, and more speculatively, humans may be designed to experience moral failures by “testing limits” in a way that ultimately fosters an adaptive moral character.  Third—and highly speculatively—there may be ways to harness learning by moral failure in pedagogical contexts. Minimally, this might occur by imagination, observational learning, or the exploitation of spontaneous wrongful acts as “teachable moments”.

The book chapter is here.

Friday, February 9, 2018

Benjamin Franklin built his character around 13 virtues

Trent Hamm
The Simple Dollar - Business Insider
Originally published January 13, 2018

Here are two excerpts:

One of the things that has really stood out to me each time I've read his autobiography is the fact that he attributed most of his success (beyond that of luck) to practicing 13 core life virtues, to the best of his ability. He believed that by living those virtues, he had done everything he could to put himself in a position to be on the good side of the unexpected events of life.


Once you've defined a set of virtues or specific skills that you want to work on in your life and integrate into your normal behaviors, take it a step further and copy Franklin's entire system, using your desired virtues and skills as the basis for your practice.

You can start by making a set of cards for the virtues you want to practice. It's pretty simple to design a small table, with rows for each thing you want to improve and columns for each day of the week, in your preferred word processing program. Just design a size that prints easily on a blank 4″ by 6″ index card and print them yourself. If you prefer, you can also design them by hand using a ruler and a pen.

On each card, simply write the days of the week at the top of each column and an abbreviation of the skill or virtue you want to practice to the left of each row.

Consider designing a set of these cards, one with each virtue or skill you want to practice at the top with a brief description, so that you have a particular virtue or skill to focus on that week. Print off (or make) the entire set at once, cycle through all of them, and then make a new set and start from scratch.

The article is here.

Wednesday, December 6, 2017

Disturbing allegations against psychologist at VT treatment center

Jennifer Costa
Originally published November 17, 2017

Here is an excerpt:

Simonds is accused making comments about female patients, calling them "whores" or saying they look "sexy" and asking inappropriate details about their sex lives. Staff members allege he showed young women favoritism, made promises about drug treatment and bypassed waiting lists to get them help ahead of others.

He's accused of yelling and physically intimidating patients. Some refused to file complaints fearing he would pull their treatment opportunities.

Staffers go on to paint a nasty picture of their work environment, telling the state Simonds routinely threatened, cursed and yelled at them, calling them derogatory names like "retarded," "monkeys," "fat and lazy," and threatening to fire them at will while sexually harassing female subordinates.

Co-workers claim Simonds banned them from referring residential patients to facilities closer to their homes, instructed them to alter referrals to keep them in the Maple Leaf system and fired a clinician who refused to follow these orders. He is also accused of telling staff members to lie to the state about staffing to maintain funding and of directing clinicians to keep patients longer than necessary to drum up revenue.

The article is here.

Saturday, November 18, 2017

For some evangelicals, a choice between Moore and morality

Marc Fisher
The Washington Post
Originally posted November 16, 2017

Here is an excerpt:

What’s happening in the churches of Alabama — a state where half the residents consider themselves evangelical Christians, double the national average, according to a Pew Research study — is nothing less than a battle for the meaning of evangelism, some church leaders say. It is a titanic struggle between those who believe there must be one clear, unalterable moral standard and those who argue that to win the war for the nation’s soul, Christians must accept morally flawed leaders.

Evangelicals are not alone in shifting their view of the role moral character should play in choosing political leaders. Between 2011 and last year, the percentage of Americans who say politicians who commit immoral acts in their private lives can still behave ethically in public office jumped to 61 percent from 44 percent, according to a Public Religion Research Institute/Brookings poll. During the same period, the shift among evangelicals was even more dramatic, moving from to 72 percent from 30 percent, the survey found.

“What you’re seeing here is rank hypocrisy,” said John Fea, an evangelical Christian who teaches history at Messiah College in Mechanicsburg, Pa. “These are evangelicals who have decided that the way to win the culture is now uncoupled from character. Their goal is the same as it was 30 years ago, to restore America to its Christian roots, but the political playbook has changed.

The article is here.

And yes, I live in Mechanicsburg, PA, by I don't know John Fea.

Thursday, November 9, 2017

You Don’t Find Your Purpose — You Build It

John Coleman
Harvard Business Review
Originally published October 20, 2017

Here are two excerpts:

In achieving professional purpose, most of us have to focus as much on making our work meaningful as in taking meaning from it. Put differently, purpose is a thing you build, not a thing you find. Almost any work can possess remarkable purpose. School bus drivers bear enormous responsibility — caring for and keeping safe dozens of children — and are an essential part of assuring our children receive the education they need and deserve. Nurses play an essential role not simply in treating people’s medical conditions but also in guiding them through some of life’s most difficult times. Cashiers can be a friendly, uplifting interaction in someone’s day — often desperately needed — or a forgettable or regrettable one. But in each of these instances, purpose is often primarily derived from focusing on what’s so meaningful and purposeful about the job and on doing it in such a way that that meaning is enhanced and takes center stage. Sure, some jobs more naturally lend themselves to senses of meaning, but many require at least some deliberate effort to invest them with the purpose we seek.


Most of us will have multiple sources of purpose in our lives. For me, I find purpose in my children, my marriage, my faith, my writing, my work, and my community. For almost everyone, there’s no one thing we can find. It’s not purpose but purposes we are looking for — the multiple sources of meaning that help us find value in our work and lives. Professional commitments are only one component of this meaning, and often our work isn’t central to our purpose but a means to helping others, including our families and communities. Acknowledging these multiple sources of purpose takes the pressure off of finding a single thing to give our lives meaning.

The article is here.

Sunday, October 29, 2017

Courage and Compassion: Virtues in Caring for So-Called “Difficult” Patients

Michael Hawking, Farr A. Curlin, and John D. Yoon
AMA Journal of Ethics. April 2017, Volume 19, Number 4: 357-363.


What, if anything, can medical ethics offer to assist in the care of the “difficult” patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the “difficult” patient as an example of a “moral stress test” that especially challenges the physician’s character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of “difficult” patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training.

Here is an excerpt:

To give a concrete example of a virtue that will be familiar to anyone in medicine, consider the virtue of temperance. A temperate person exhibits appropriate self-control or restraint. Aristotle describes temperance as a mean between two extremes—in the case of eating, an extreme lack of temperance can lead to morbid obesity and its excess to anorexia. Intemperance is a hallmark of many of our patients, particularly among those with type 2 diabetes, alcoholism, or cigarette addiction. Clinicians know all too well the importance of temperance because they see the results for human beings who lack it—whether it be amputations and dialysis for the diabetic patient; cirrhosis, varices, and coagulopathy for the alcoholic patient; or chronic obstructive pulmonary disease and lung cancer for the lifelong smoker. In all of these cases, intemperance inhibits a person’s ability to flourish. These character traits do, of course, interact with social, cultural, and genetic factors in impacting an individual’s health, but a more thorough exploration of these factors is outside the scope of this paper.

The article is here.

Friday, October 20, 2017

A virtue ethics approach to moral dilemmas in medicine

P Gardiner
J Med Ethics. 2003 Oct; 29(5): 297–302.


Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.

A pdf download of the article can be found here.

Note from John: This article is interesting for a myriad of reasons. For me, we ethics educators have come a long way in 14 years.

Friday, August 18, 2017

Trump fails morality test on Charlottesville

John Kass
Chicago Tribune
Originally posted on August 16, 2017

After the deadly violence of Charlottesville, Va., the amoral man in the White House failed his morality test. And in doing so, he gave the left a powerful weapon.


So President Trump was faced with a question of morality.

All he had to do was be unequivocal in his condemnation of the alt-right mob.

His brand as an alpha in a sea of political beta males promised he wouldn't be equivocal about anything.

But he failed, miserably, his mouth and tongue transformed into a dollop of lukewarm tapioca, talking in equivocal terms, about the violence on "many sides."

He then he offered another statement, ostensibly to clarify and condemn the mob. But that was followed, predictably, by even more comments, as he desperately tried to publicly litigate his earlier failures.

In doing so, he gave the alt-right all they could dream of.

He said some attending the rally were "fine people."

Fine people don't go to white supremacist rallies to spew hate. Fine people don't remotely associate with the KKK. Fine people at a protest see men in white hoods and leave.

Fine people don't get in a car and in a murderous rage, run others down, including Heather Heyer, who in her death has become a saint of the left.

The article is here.

Thursday, August 17, 2017

Donald Trump has a very clear attitude about morality: He doesn't believe in it

John Harwood | @johnjharwood
Originally published August 16, 2017

The more President Donald Trump reveals his character, the more he isolates himself from the American mainstream.

In a raucous press conference this afternoon, the president again blamed "both sides" for deadly violence in Charlottesville. He equated "Unite the Right" protesters — a collection including white supremacists, neo-Nazis and ex-KKK leader David Duke — with protesters who showed up to counter them.

Earlier he targeted business leaders — specifically, executives from Merck, Under Armour, Intel, and the Alliance for American Manufacturing — who had quit a White House advisory panel over Trump's message. In a tweet, the president called them "grandstanders."

That brought two related conclusions into focus. The president does not share the instinctive moral revulsion most Americans feel toward white supremacists and neo-Nazis. And he feels contempt for those — like the executives — who are motivated to express that revulsion at his expense.

No belief in others' morality

Trump has displayed this character trait repeatedly. It combines indifference to conventional notions of morality or propriety with disbelief that others would be motivated by them.

He dismissed suggestions that it was inappropriate for his son and campaign manager to have met with Russians offering dirt on Hillary Clinton during the presidential campaign. "Most people would have taken the meeting," he said. "Politics isn't the nicest business."

The article is here.

Tuesday, August 15, 2017

Inferences about moral character moderate the impact of consequences on blame and praise

Jenifer Z. Siegel, Molly J.Crockett, and Raymond J. Dolan
Volume 167, October 2017, Pages 201-211


Moral psychology research has highlighted several factors critical for evaluating the morality of another’s choice, including the detection of norm-violating outcomes, the extent to which an agent caused an outcome, and the extent to which the agent intended good or bad consequences, as inferred from observing their decisions. However, person-centered accounts of moral judgment suggest that a motivation to infer the moral character of others can itself impact on an evaluation of their choices. Building on this person-centered account, we examine whether inferences about agents’ moral character shape the sensitivity of moral judgments to the consequences of agents’ choices, and agents’ role in the causation of those consequences. Participants observed and judged sequences of decisions made by agents who were either bad or good, where each decision entailed a trade-off between personal profit and pain for an anonymous victim. Across trials we manipulated the magnitude of profit and pain resulting from the agent’s decision (consequences), and whether the outcome was caused via action or inaction (causation). Consistent with previous findings, we found that moral judgments were sensitive to consequences and causation. Furthermore, we show that the inferred character of an agent moderated the extent to which people were sensitive to consequences in their moral judgments. Specifically, participants were more sensitive to the magnitude of consequences in judgments of bad agents’ choices relative to good agents’ choices. We discuss and interpret these findings within a theoretical framework that views moral judgment as a dynamic process at the intersection of attention and social cognition.

The article is here.