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 Choice. Show all posts
Showing posts with label Choice. Show all posts

Thursday, November 1, 2018

Lesion network localization of free will

R. Ryan Darby, Juho Joutsa, Matthew J. Burke, and Michael D. Fox
PNAS
First published October 1, 2018

Abstract

Our perception of free will is composed of a desire to act (volition) and a sense of responsibility for our actions (agency). Brain damage can disrupt these processes, but which regions are most important for free will perception remains unclear. Here, we study focal brain lesions that disrupt volition, causing akinetic mutism (n = 28), or disrupt agency, causing alien limb syndrome (n = 50), to better localize these processes in the human brain. Lesion locations causing either syndrome were highly heterogeneous, occurring in a variety of different brain locations. We next used a recently validated technique termed lesion network mapping to determine whether these heterogeneous lesion locations localized to specific brain networks. Lesion locations causing akinetic mutism all fell within one network, defined by connectivity to the anterior cingulate cortex. Lesion locations causing alien limb fell within a separate network, defined by connectivity to the precuneus. Both findings were specific for these syndromes compared with brain lesions causing similar physical impairments but without disordered free will. Finally, our lesion-based localization matched network localization for brain stimulation locations that disrupt free will and neuroimaging abnormalities in patients with psychiatric disorders of free will without overt brain lesions. Collectively, our results demonstrate that lesions in different locations causing disordered volition and agency localize to unique brain networks, lending insight into the neuroanatomical substrate of free will perception.

The article is here.

How much control do you really have over your actions?

Michael Price
Sciencemag.org
Originally posted October 1, 2018

Here is an excerpt:

Philosophers have wrestled with questions of free will—that is, whether we are active drivers or passive observers of our decisions—for millennia. Neuroscientists tap-dance around it, asking instead why most of us feel like we have free will. They do this by looking at rare cases in which people seem to have lost it.

Patients with both alien limb syndrome and akinetic mutism have lesions in their brains, but there doesn’t seem to be a consistent pattern. So Darby and his colleagues turned to a relatively new technique known as lesion network mapping.

They combed the literature for brain imaging studies of both types of patients and mapped out all of their reported brain lesions. Then they plotted those lesions onto maps of brain regions that reliably activate together at the same time, better known as brain networks. Although the individual lesions in patients with the rare movement disorders appeared to occur without rhyme or reason, the team found, those seemingly arbitrary locations fell within distinct brain networks.

The researchers compared their results with those from people who lost some voluntary movement after receiving temporary brain stimulation, which uses low-voltage electrodes or targeted magnetic fields to temporarily “knock offline” brain regions.

The networks that caused loss of voluntary movement or agency in those studies matched Darby and colleagues’ new lesion networks. This suggests these networks are involved in voluntary movement and the perception that we’re in control of, and responsible for, our actions, the researchers report today in the Proceedings of the National Academy of Sciences.

The info is here.

Thursday, February 8, 2018

How can groups make good decisions? Deliberation & Diversity

Mariano Sigman and Dan Ariely
TED Talk
Originally recorded April 2017

We all know that when we make decisions in groups, they don't always go right -- and sometimes they go very wrong. How can groups make good decisions? With his colleague Dan Ariely, neuroscientist Mariano Sigman has been inquiring into how we interact to reach decisions by performing experiments with live crowds around the world. In this fun, fact-filled explainer, he shares some intriguing results -- as well as some implications for how it might impact our political system. In a time when people seem to be more polarized than ever, Sigman says, better understanding how groups interact and reach conclusions might spark interesting new ways to construct a healthier democracy.

Saturday, January 6, 2018

The Myth of Responsibility

Raoul Martinez
RSA.org
Originally posted December 7, 2017

Are we wholly responsible for our actions? We don’t choose our brains, our genetic inheritance, our circumstances, our milieu – so how much control do we really have over our lives? Philosopher Raoul Martinez argues that no one is truly blameworthy.  Our most visionary scientists, psychologists and philosophers have agreed that we have far less free will than we think, and yet most of society’s systems are structured around the opposite principle – that we are all on a level playing field, and we all get what we deserve.

4 minutes video is worth watching.....

Tuesday, January 2, 2018

The Neuroscience of Changing Your Mind

 Bret Stetka
Scientific American
Originally published on December 7, 2017

Here are two excerpts:

Scientists have long accepted that our ability to abruptly stop or modify a planned behavior is controlled via a single region within the brain’s prefrontal cortex, an area involved in planning and other higher mental functions. By studying other parts of the brain in both humans and monkeys, however, a team from Johns Hopkins University has now concluded that last-minute decision-making is a lot more complicated than previously known, involving complex neural coordination among multiple brain areas. The revelations may help scientists unravel certain aspects of addictive behaviors and understand why accidents like falls grow increasingly common as we age, according to the Johns Hopkins team.

(cut)

Tracking these eye movements and neural action let the researchers resolve the very confusing question of what brain areas are involved in these split-second decisions, says Vanderbilt University neuroscientist Jeffrey Schall, who was not involved in the research. “By combining human functional brain imaging with nonhuman primate neurophysiology, [the investigators] weave together threads of research that have too long been separate strands,” he says. “If we can understand how the brain stops or prevents an action, we may gain ability to enhance that stopping process to afford individuals more control over their choices.”

The article is here.

Monday, November 13, 2017

Medical Evidence Debated

Ralph Bartholdt
Coeur d’Alene Press 
Originally posted October 27, 2017

Here is an excerpt:

“The point of this is not that he had a choice,” he said. “But what’s been loaded into his system, what’s he’s making the choices with.”

Thursday’s expert witness, psychologist Richard Adler, further developed the argument that Renfro suffered from a brain disorder evidenced by a series of photograph-like images of Renfro’s brain that showed points of trauma. He pointed out degeneration of white matter responsible for transmitting information from the front to the back of the brain, and shrunken portions on one side of the brain that were not symmetrical with their mirror images on the other side.

Physical evidence coinciding with the findings include Renfro’s choppy speech patterns and mannerisms as well inabilities to make cognitive connections, and his lack of social skills, Adler said.

Defense attorney Jay Logsdon asked if the images were obtained through a discredited method, one that has “been attacked as junk science?”

The method, called QEEG, for quantitative electroencephalogram, which uses electrical patterns that show electrical activity inside the brain’s cortex to determine impairment, was attacked in an article in 1997. The article’s criticism still stands today, Adler said.

Throughout the morning and into the afternoon, Adler reiterated findings, linking them to the defendant’s actions, and dovetailing them into other test results, psychological and cognitive, that have been conducted while Renfro has been incarcerated in the Kootenai County Jail.

The article is here.

Wednesday, October 11, 2017

The guide psychologists gave carmakers to convince us it’s safe to buy self-driving cars

Olivia Goldhill
Quartz.com
Originally published September 17, 2017

Driverless cars sound great in theory. They have the potential to save lives, because humans are erratic, distracted, and often bad drivers. Once the technology is perfected, machines will be far better at driving safely.

But in practice, the notion of putting your life into the hands of an autonomous machine—let alone facing one as a pedestrian—is highly unnerving. Three out of four Americans are afraid to get into a self-driving car, an American Automobile Association survey found earlier this year.

Carmakers working to counter those fears and get driverless cars on the road have found an ally in psychologists. In a paper published this week in Nature Human Behavior, three professors from MIT Media Lab, Toulouse School of Economics, and the University of California at Irvine discuss widespread concerns and suggest psychological techniques to help allay them:

Who wants to ride in a car that would kill them to save pedestrians?

First, they address the knotty problem of how self-driving cars will be programmed to respond if they’re in a situation where they must either put their own passenger or a pedestrian at risk. This is a real world version of an ethical dilemma called “The Trolley Problem.”

The article is here.

Wednesday, September 27, 2017

New York’s Highest Court Rules Against Physician-Assisted Suicide

Jacob Gershman
The Wall Street Journal
Originally posted September 7, 2017

New York’s highest court on Thursday ruled that physician-assisted suicide isn’t a fundamental right, rejecting a legal effort by terminally ill patients to decriminalize doctor-assisted suicide through the courts.

The state Court of Appeals, though, said it wouldn’t stand in the way if New York’s legislature were to decide that assisted suicide could be “effectively regulated” and pass legislation allowing terminally ill and suffering patients to kill themselves.

Physician-assisted suicide is illegal in most of the country. But advocates who support loosening the laws have been making gains. Doctor-assisted dying has been legalized in several states, most recently in California and Colorado, the former by legislation and the latter by a ballot measure approved by voters in November. Oregon, Vermont and Washington have enacted similar “end-of-life” measures. Washington, D.C., also passed an “assisted-dying” law last year.

Montana’s highest court in 2009 ruled that physicians who provide “aid in dying” are shielded from liability.

No state court has recognized “aid in dying” as a fundamental right.

The article is here.

Tuesday, August 29, 2017

The Influence of (Dis)belief in Free Will on Immoral Behavior

Caspar, E. A., Vuillaume, L., Magalhães De Saldanha da Gama, P. A. and Cleeremans, A.
Frontiers in Psychology, 17 January 2017

Abstract

One of the hallmarks of human existence is that we all hold beliefs that determine how we act. Amongst such beliefs, the idea that we are endowed with free will appears to be linked to prosocial behaviors, probably by enhancing the feeling of responsibility of individuals over their own actions. However, such effects appear to be more complex that one might have initially thought. Here, we aimed at exploring how induced disbeliefs in free will impact the sense of agency over the consequences of one’s own actions in a paradigm that engages morality. To do so, we asked participants to choose to inflict or to refrain from inflicting an electric shock to another participant in exchange of a small financial benefit. Our results show that participants who were primed with a text defending neural determinism – the idea that humans are a mere bunch of neurons guided by their biology – administered fewer shocks and were less vindictive toward the other participant. Importantly, this finding only held for female participants. These results show the complex interaction between gender, (dis)beliefs in free will and moral behavior.

From the Conclusion:

To conclude, we observed that disbelief in free will had a positive impact on the morality of decisions toward others. The present work extends previous research by showing that additional factors, such as gender, could influence the impact of (dis)belief in free will on prosocial and antisocial behaviors. Our results also showed that previous results relative to the (moral) context underlying the paradigm in use are not always replicated.

The research is here.

Monday, August 28, 2017

Sometimes giving a person a choice is an act of terrible cruelty

Lisa Tessman
aeon.com
Originally posted August 9, 2017

It is not always good to have the opportunity to make a choice. When we must decide to take one action rather than another, we also, ordinarily, become at least partly responsible for what we choose to do. Usually this is appropriate; it’s what makes us the kinds of creatures who can be expected to abide by moral norms. 

Sometimes, making a choice works well. For instance, imagine that while leaving the supermarket parking lot you accidentally back into another car, visibly denting it. No one else is around, nor do you think there are any surveillance cameras. You face a choice: you could drive away, fairly confident that no one will ever find out that you damaged someone’s property, or you could leave a note on the dented car’s windshield, explaining what happened and giving contact information, so that you can compensate the car’s owner.

Obviously, the right thing to do is to leave a note. If you don’t do this, you’ve committed a wrongdoing that you could have avoided just by making a different choice. Even though you might not like having to take responsibility – and paying up – it’s good to be in the position of being able to do the right thing.

Yet sometimes, having a choice means deciding to commit one bad act or another. Imagine being a doctor or nurse caught in the following fictionalised version of real events at a hospital in New Orleans in the aftermath of Hurricane Katrina in 2005. Due to a tremendous level of flooding after the hurricane, the hospital must be evacuated. The medical staff have been ordered to get everyone out by the end of the day, but not all patients can be removed. As time runs out, it becomes clear that you have a choice, but it’s a choice between two horrifying options: euthanise the remaining patients without consent (because many of them are in a condition that renders them unable to give it) or abandon them to suffer a slow, painful and terrifying death alone. Even if you’re anguished at the thought of making either choice, you might be confident that one action – let’s say administering a lethal dose of drugs – is better than the other. Nevertheless, you might have the sense that no matter which action you perform, you’ll be violating a moral requirement.

Wednesday, August 16, 2017

What Does Patient Autonomy Mean for Doctors and Drug Makers?

Christina Sandefur
The Conversation
Originally published July 26, 2017

Here is an excerpt:

Although Bateman-House fears that deferring to patients comes at the expense of physician autonomy, she also laments that physicians currently abuse the freedom they have, failing to spend enough time with their patients, which she says undermines a patient’s ability to make informed medical decisions.

Even if it’s true that physician consultations aren’t as thorough as they once were, patients today have better access to health care information than ever before. According to the Pew Research Center, two-thirds of U.S. adults have broadband internet in their homes, and 13 percent who lack it can access the internet through a smartphone. Pew reports that more than half of adult internet users go online to get information on medical conditions, 43 percent on treatments, and 16 percent on drug safety. Yet despite their desire to research these issues online, 70 percent still sought out additional information from a doctor or other professional.

In other words, people are making greater efforts to learn about health care on their own. True, not all such information on the internet is accurate. But encouraging patients to seek out information from multiple sources is a good thing. In fact, requiring government approval of treatments may lull patients into a false sense of security. As Connor Boyack, president of the Libertas Institute, points out, “Instead of doing their own due diligence and research, the overwhelming majority of people simply concern themselves with whether or not the FDA says a certain product is okay to use.” But blind reliance on a government bureaucracy is rarely a good idea.

The article can be found here.

Monday, July 17, 2017

The ethics of brain implants and ‘brainjacking’

Chelsey Ballarte
Geek Wire
Originally published June 29, 2017

Here is an excerpt:

Fetz and the report’s other authors say we should regard advancements in machine learning and artificial intelligence with the same measure of caution we use when we consider accountability for self-driving cars and privacy for smartphones.

Fetz recalled the time security researchers proved they could hack into a Jeep Cherokee over the internet and disable it as it drove on the freeway. He said that in the world of prosthetics, a hacker could conceivably take over someone’s arm.

“The hack could override the signals,” he said. It could even override a veto, and that’s the danger. The strategy to head off that scenario would have to be to make sure the system can’t be influenced from the outside.

Study co-author John Donoghue, a director of the Wyss Center for Bio and Neuroengineering in Geneva, said these are just a few things we would have to think about if these mechanisms became the norm.

“We must carefully consider the consequences of living alongside semi-intelligent, brain-controlled machines, and we should be ready with mechanisms to ensure their safe and ethical use,” he said in a news release.

Donoghue said that as technology advances, we need to be ready to think about how our current laws would apply. “Our aim is to ensure that appropriate legislation keeps pace with this rapidly progressing field,” he said.

The article is here.

Wednesday, May 24, 2017

Roger Penrose On Why Consciousness Does Not Compute

Steve Paulson
Nautilus
Originally posted May 4, 2017

Here is an excerpt:

As we probed the deeper implications of Penrose’s theory about consciousness, it wasn’t always clear where to draw the line between the scientific and philosophical dimensions of his thinking. Consider, for example, superposition in quantum theory. How could Schrödinger’s cat be both dead and alive before we open the box? “An element of proto-consciousness takes place whenever a decision is made in the universe,” he said. “I’m not talking about the brain. I’m talking about an object which is put into a superposition of two places. Say it’s a speck of dust that you put into two locations at once. Now, in a small fraction of a second, it will become one or the other. Which does it become? Well, that’s a choice. Is it a choice made by the universe? Does the speck of dust make this choice? Maybe it’s a free choice. I have no idea.”

I wondered if Penrose’s theory has any bearing on the long-running philosophical argument between free will and determinism. Many neuroscientists believe decisions are caused by neural processes that aren’t ruled by conscious thought, rendering the whole idea of free will obsolete. But the indeterminacy that’s intrinsic to quantum theory would suggest that causal connections break down in the conscious brain. Is Penrose making the case for free will?

“Not quite, though at this stage, it looks like it,” he said. “It does look like these choices would be random. But free will, is that random?” Like much of his thinking, there’s a “yes, but” here. His claims are provocative, but they’re often provisional. And so it is with his ideas about free will. “I’ve certainly grown up thinking the universe is deterministic. Then I evolved into saying, ‘Well, maybe it’s deterministic but it’s not computable.’ But is it something more subtle than that? Is it several layers deeper? If it’s something we use for our conscious understanding, it’s going to be a lot deeper than even straightforward, non-computable deterministic physics. It’s a kind of delicate borderline between completely deterministic behavior and something which is completely free.”

Thursday, May 11, 2017

The Implications of Libertarianism for Compulsory Vaccination

Justin Bernstein
BMJ Blogs
Originally posted April 24, 2017

Here is an excerpt:

Some libertarians, however, attempt to avoid the controversial conclusion that libertarianism is incompatible with compulsory vaccination. In my recent paper, “The Case Against Libertarian Arguments for Compulsory Vaccination,” I argue that such attempts are unsuccessful, and so libertarians must either develop new arguments, or join Senator Paul in opposing compulsory vaccination.

How might a libertarian try to defend compulsory vaccination? One argument is that going unvaccinated exposes others to risk, and this violates their rights. Since the state is permitted to use coercive measures to protect rights, the state may require parents to vaccinate their children. But for libertarians, this argument has two shortcomings. First, there are other, far riskier activities that the libertarian prohibits the government from regulating. For instance, owning and using automobiles or firearms imposes far more significant risk than going unvaccinated, but libertarians defend our rights to own and use automobiles and firearms. Second, one individual going unvaccinated poses very little risk; the risk eventuates only if many collectively go unvaccinated, thereby endangering herd immunity. Imposing such an independently small risk hardly seems to be a rights violation.

The entire blog post is here.

Is There a Duty to Use Moral Neurointerventions?

Michelle Ciurria
Topoi (2017).
doi:10.1007/s11245-017-9486-4

Abstract

Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer (Neuroethics 8(2):139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject’s brain, without her active participation, unlike ‘active’ interventions. Some neurointerventions, however, appear to be relatively unproblematic, and some appear to preserve the agent’s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: (i) pass pre-clinical and clinical trials, (ii) fare well in post-clinical studies, and (iii) be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention.

The article is here.

Friday, April 14, 2017

The moral bioenhancement of psychopaths

Elvio Baccarini and Luca Malatesti
The Journal of Medical Ethics
http://dx.doi.org/10.1136/medethics-2016-103537

Abstract

We argue that the mandatory moral bioenhancement of psychopaths is justified as a prescription of social morality. Moral bioenhancement is legitimate when it is justified on the basis of the reasons of the recipients. Psychopaths expect and prefer that the agents with whom they interact do not have certain psychopathic traits. Particularly, they have reasons to require the moral bioenhancement of psychopaths with whom they must cooperate. By adopting a public reason and a Kantian argument, we conclude that we can justify to a psychopath being the recipient of mandatory moral bioenhancement because he has a reason to require the application of this prescription to other psychopaths.

Friday, April 7, 2017

Informed Patient? Don’t bet on it

Mikkael Sekeres and Timothy Gilligan
The New York Times
Originally posted March 1, 2017

Here is an excerpt:

The secret is that informed consent in health care is commonly not-so-well informed. It might be a document we ask you to sign, at the behest of our lawyers, in case we end up in court if a bad outcome happens. Unfortunately, it’s often not really about informing you. In schools, teachers determine what students know through tests and homework. The standard is not whether the teacher has explained how to add, but instead whether the student can add. If we were truly invested in whether you were informed, we’d give you a quiz, or at least ask you to repeat back to us what you heard so we could assess its accuracy.

The article is here.

Thursday, April 6, 2017

Would You Deliver an Electric Shock in 2015?

Dariusz Doliński, Tomasz Grzyb, Tomasz Grzyb and others
Social Psychological and Personality Science
First Published January 1, 2017

Abstract

In spite of the over 50 years which have passed since the original experiments conducted by Stanley Milgram on obedience, these experiments are still considered a turning point in our thinking about the role of the situation in human behavior. While ethical considerations prevent a full replication of the experiments from being prepared, a certain picture of the level of obedience of participants can be drawn using the procedure proposed by Burger. In our experiment, we have expanded it by controlling for the sex of participants and of the learner. The results achieved show a level of participants’ obedience toward instructions similarly high to that of the original Milgram studies. Results regarding the influence of the sex of participants and of the “learner,” as well as of personality characteristics, do not allow us to unequivocally accept or reject the hypotheses offered.

The article is here.

“After 50 years, it appears nothing has changed,” said social psychologist Tomasz Grzyb, an author of the new study, which appeared this week in the journal Social Psychological and Personality Science.

A Los Angeles Times article summaries the study here.

How to Upgrade Judges with Machine Learning

by Tom Simonite
MIT Press
Originally posted March 6, 2017

Here is an excerpt:

The algorithm assigns defendants a risk score based on data pulled from records for their current case and their rap sheet, for example the offense they are suspected of, when and where they were arrested, and numbers and type of prior convictions. (The only demographic data it uses is age—not race.)

Kleinberg suggests that algorithms could be deployed to help judges without major disruption to the way they currently work in the form of a warning system that flags decisions highly likely to be wrong. Analysis of judges’ performance suggested they have a tendency to occasionally release people who are very likely to fail to show in court, or to commit crime while awaiting trial. An algorithm could catch many of those cases, says Kleinberg.

Richard Berk, a professor of criminology at the University of Pennsylvania, describes the study as “very good work,” and an example of a recent acceleration of interest in applying machine learning to improve criminal justice decisions. The idea has been explored for 20 years, but machine learning has become more powerful, and data to train it more available.

Berk recently tested a system with the Pennsylvania State Parole Board that advises on the risk a person will reoffend, and found evidence it reduced crime. The NBER study is important because it looks at how machine learning can be used pre-sentencing, an area that hasn’t been thoroughly explored, he says.

The article is here.

Editor's Note: I often wonder how much time until machine learning is applied to psychotherapy.

Wednesday, April 5, 2017

Canada passes genetic ‘anti-discrimination’ law

Xavier Symons
BioEdge
Originally published 10 March 2017

Canada’s House of Commons has passed a controversial new law that prevents corporations from demanding genetic information from potential employees or customers.

The law, known as ‘Bill S-201’, makes it illegal for companies to deny someone a job if they refuse a genetic test, and also prevents insurance companies from making new customer policies conditional on the supply of genetic information. Insurance companies will no longer be able to solicit genetic tests so as to determine customer premiums.

Critics of the bill said that insurance premiums would skyrocket, in some cases up to 30 or 50 per cent, if companies are prevented from obtaining genetic data. And Prime Minister Justin Trudeau labelled the proposed legislation “unconstitutional” as it impinges on what he believes should be a matter for individual provinces to regulate.

The article is here.