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 Community Beneficence. Show all posts
Showing posts with label Community Beneficence. Show all posts

Friday, February 5, 2016

Lawyer told police of client's alleged plot after speaking with ethics hotline

By Debra Cassens Weiss
American Bar Association Journal
Originally published January 12,2016

A Pennsylvania lawyer revealed his client’s alleged plot “take back” the home of his ex-girlfriend using an AR-15 rifle and body armor after consulting with the state bar’s ethics hotline, police say.

Revelations by the lawyer, Seamus Dubbs of York, likely saved lives, police say. The York Daily Record has a story.

The client, Howard Timothy Cofflin Jr., told police after his arrest that he planned to kill the ex-girlfriend as well as anyone who tried to stop him, according to court records cited by the York Daily Report. Charging documents said he planned to decapitate the ex-girlfriend and to go to war with state police, Pennlive.com reports. He also had a plan to bomb state police barracks, police said.

The article is here.

Wednesday, October 14, 2015

Generation XXX

The Economist
Originally published September 26, 2015

Here is an excerpt:

Whenever pornography becomes more available, it sparks a moral panic. After the advent of girlie magazines in the 1950s, and X-rated rental films in the 1980s, campaigners claimed that porn would dent women’s status, stoke sexual violence and lead men to abandon the search for a mate in favour of private pleasures. Disquiet about the effects of online pornography is once more rising (see article). Most of it is now free. As commercial producers fight over scarce revenue, their wares are becoming more extreme. Because of smartphones, tablets and laptops, hardcore material can be accessed privately by anyone. The result is that many teenagers today have seen a greater number and variety of sex acts than the most debauched Mughal emperor managed in a lifetime.

The entire article is here.

Thursday, September 3, 2015

Blaming Mental Illness for Gun Violence

BY Alex Yablon
The Trace
Originally posted September 1, 2015

Here is an excerpt:

Add it all up, and the “mental health” post-shooting playbook looks as calculated to ensure political inaction as it is the appearance of sensitivity. The general public would hardly disagree with statements by Trump, Bush, and others that the severely mentally ill pose a danger; in fact, surveys show that more Americans blame failures of the mental health system for mass shootings than any other factor. Meanwhile the Republican base — not to mention mental health professionals — would hardly countenance any action to expand the reach of background checks to block gun purchases by people with personality disorders or other mental health issues that are not quite so debilitating as conditions that require hospitalization, like schizophrenia or psychosis. So politicians can make statements like “The common thread we see in many of these cases is a failure in the system to help someone who is suffering from mental illness” (Scott Walker, the day after the WDBJ shooting), knowing full well they will not result in any action that could anger their pro-gun supporters.

In fact, framing incidents of gun violence as the product of unsettled perpetrators, versus firearms risks, may influence support for given solutions among the general public. An NPR article published on August 31 describes a psychiatric study in which two groups of subjects were given hypothetical news articles about a mass shooting, slightly altered to emphasize different underlying causes. Readers of the version emphasizing the need to “keep dangerous guns off our streets” were more likely to support limits on gun magazine capacity.

The irony of the psychiatric turn in debate on new gun law is that, for the most part, a body of research shows the severely mentally ill are among the least of our worries when it comes to violent crime, especially when compared to other risk factors. Alcohol, for example, is a factor in 40 percent of all violent acts committed in the United States today, according to the National Council on Alcoholism and Drug Dependence.

The entire article is here.

The full title is: The Political Strategy Behind the GOP’s Post-Shooting ‘Mental Health’ Playbook

Saturday, August 1, 2015

Dilemma 33: Breaking Bad (or Good)

Dr. Jesse Pinkman has been working with a 26-year-old professional for about a year, Ms. Skyler White. They have been working on managing her symptoms of depression and anxiety.  The patient smokes marijuana regularly, which has been a concern for Dr. Pinkman.

Skyler arrives late to her appointment, looking frazzled.  She explained her friend overdosed on heroin the prior evening.  She has been in the ER for the past 12 hours.  Her friend will likely survive, but she may have residual cognitive problems.

Skyler reported feeling horribly guilty because she introduced her friend to her next door neighbor, who is the drug dealer.  Her friend always stops by to see Skyler first, before purchasing drugs. Skyler purchases her marijuana from the same dealer.

After processing the events of the previous evening, Skyler stated she will move away from the drug dealer.  She no longer wants to be this close or indirectly cause harm to someone else.  The police are actively investigating, but Skyler does not want to divulge any information.  She does not want to get involved.  Skyler makes an appointment for next week, and then leaves feeling somewhat better.

Dr. Pinkman becomes preoccupied about what Skyler reported.  Dr. Pinkman knows the dealer’s name from previous sessions and can figure out the address of dealer, based on his patient’s address.

Dr. Pinkman is contemplating calling in an anonymous tip to the police.  Dr. Pinkman is aware of the increase in heroin use in his community.  He also recognizes his struggle with moral outrage and sense of injustice in this situation.  Struggling with the emotions to report or not report anonymously, Dr. Pinkman calls you for a consultation.

What are the competing ethical principles in this situation?

How would you feel if you were Dr. Pinkman?

What are some of the positive and negative consequences about Dr. Pinkman making the anonymous report?

How do your own professional values and personal morals influence how you would respond to Dr. Pinkman?

How would you respond to Dr. Pinkman’s moral outrage?

Would your answers differ if the friend died?

Would your answers differ if the patient was of low socio-economic status?

Would your answers differ if Skyler were a teenager?

Monday, March 16, 2015

Measles, Vaccination, and the Tragedy of the Commons

By Katharine Brown
Bioethics Forum
Originally published on February 25, 2015

Here is an excerpt:

To understand why, think of vaccination and the quest for herd immunity as a collective action problem. Garrett Hardin’s “tragedy of the commons” illustrates the basic logic of collective action problems. Imagine that 50 farmers share common land (“the commons”) upon which they graze their sheep. The commons are lush, and so each farmer can easily allow four sheep to graze at a given time without depleting the resource. But imagine that each farmer seeks to maximize his own good (what economic theory refers to as “rational” behavior) and it is better for him to graze more sheep than fewer. The farmers will, in effect, be “free-riding” – in this case, taking more than their fair share of the common resource while benefitting from the restraint of others. The trouble is that, while adding one more sheep to the commons does not deplete the resource, adding 50 does. The combined actions of each farmer, acting rationally, leads to an outcome that is worse for all.

The tragedy of the commons reveals that what is good for the individual is at odds with what is good for all. This is the basic logic of collective action problems. We see a similar logic in the case of vaccines. If most get vaccinated, then everyone will be better off. But it would be best for any particular individual if all others got vaccinated and he or she did not.

The entire article is here.

Saturday, January 31, 2015

To Protect His Son, A Father Asks School To Bar Unvaccinated Children

By Lisa Aliferis
NPR
Originally posted January 27, 2015

Here are two excerpts:

Rhett cannot be vaccinated, because his immune system is still rebuilding. It may be months more before his body is healthy enough to get all his immunizations. Until then, he depends on everyone around him for protection — what's known as herd immunity.

(cut)

Carl Krawitt has had just about enough. "It's very emotional for me," he said. "If you choose not to immunize your own child and your own child dies because they get measles, OK, that's your responsibility, that's your choice. But if your child gets sick and gets my child sick and my child dies, then ... your action has harmed my child."

The entire article is here.

Thursday, January 22, 2015

Private acts and public interests

By Pedro Molina
Philly.com
Originally published December 28, 2014

Theorists of public morality - from the ancient Greek philosophers and Roman jurists on - have noticed that apparently private acts of vice, when they multiply and become widespread, can imperil important public interests. This fact embarrasses philosophical efforts to draw a sharp line between "private" morality, which is not subject to law, and public actions that may rightly be subjected to legal regulation.

Considered as isolated acts, someone's recreational use of narcotics, for example, may affect the public weal negligibly, if at all. But an epidemic of drug abuse, though constituted by private acts of drug-taking, damages the common good in myriad ways. This does not by itself settle the question whether drug prohibition is a prudent or effective policy. It does, however, undermine the belief that the recreational use of drugs is a matter of purely private choice.

The entire article is here.

Saturday, December 27, 2014

Coaxing better behavior

Behavioral science is playing a pivotal role in research and policymaking that seeks to gently steer us toward better decisions.

By Tori DeAngelis
The Monitor on Psychology
December 2014, Vol 45, No. 11
Print version: page 62

Here is an excerpt:

But social psychology has probably never held as much potential to change global outcomes as it does now. Governments and other organizations are applying "nudge principles" — psychologists' findings about the human propensities that influence our decisions and actions — to collect unpaid taxes, reduce child mortality, and help people choose healthier foods and make better environmental choices. In one line of study, for example, researchers found that people recycled much more when their trash bin lids featured cut-out shapes of the objects to be recycled, be they circles for cans and bottles or slits for paper.

The entire article is here.

Wednesday, August 13, 2014

Doing their duty: An empirical analysis of the unintended effect of Tarasoff

By Griffin Sims Edwards
Journal of Law and Economics, Vol. 57, 2014
Emory Law and Economics Research Paper No. 10-61

Abstract

The seminal ruling of Tarasoff v. Regents enacted a duty that required mental health providers to warn potential victims of any real threat to life made by a patient. Many have theorized that this required breach of confidentiality may have adverse effects on effective psychological treatment - but the question remains unanswered empirically. Due to the presence of duty to warn laws, patients might forego mental health treatment that leads them to violence. Using a fixed effects model and exploiting the variation in the timing and style of duty to warn laws across states, I find that mandatory duty to warn laws cause an increase in homicides of 5%. These results are robust to model specifications, falsification tests, and help to clarify the true effect of state duty to warn laws.

The entire article is here.

Wednesday, July 2, 2014

What Do We Owe to Child Migrants?

By Rachel Fabi and Mohini Banerjee
Bioethics Forum
Originally posted June 26, 2014

From October 1, 2013, through June 15, 2014, more than 52,000 child migrants crossed the U.S.-Mexico border in South Texas, overwhelming the U.S. Customs and Border Patrol and the Department of Homeland Security (DHS). The Obama administration has declared this an “urgent humanitarian situation” and has authorized DHS to establish a Unified Coordinating Group led by the Federal Emergency Management Agency (FEMA) to provide for the children’s humanitarian needs. While the recent upsurge, and the myths circulating among migrants that there is a window of opportunity for children seeking asylum (or for women with young children), have caught the attention of policy-makers and the media, a May 2014 report by the United Nations High Commissioner for Refugees (UNHCR) concludes that this pattern of “mixed” migration, which includes children fleeing violent home countries, in addition to more typical economic migrants, began in 2009.

What do we owe these children?  What is an appropriate ethical and legal framework for exploring and articulating our obligations, both in terms of immediate humanitarian aid and beyond?

The entire article is here.

Tuesday, May 6, 2014

Beijing shuts down thousands of websites in online pornography purge

By Tom Paine
The Independent
Originally published April 21, 2014

The Chinese government has shut down thousands of websites and social media sites in a bid to purge the internet of online pornography, it was revealed today.

The nation’s state media services announced the progress of its ‘Cleaning the Web 2014’ campaign today, which has resulted in the closure of 110 websites and more than 3,300 accounts containing ‘obscene’ material since January.

The entire article is here.

Monday, August 12, 2013

The Charitable-Industrial Complex

By PETER BUFFETT
The New York Times - Opinionator
Published: July 26, 2013

Here are some excerpts:

Because of who my father is, I’ve been able to occupy some seats I never expected to sit in. Inside any important philanthropy meeting, you witness heads of state meeting with investment managers and corporate leaders. All are searching for answers with their right hand to problems that others in the room have created with their left. There are plenty of statistics that tell us that inequality is continually rising. At the same time, according to the Urban Institute, the nonprofit sector has been steadily growing.

(cut)

As more lives and communities are destroyed by the system that creates vast amounts of wealth for the few, the more heroic it sounds to “give back.” It’s what I would call “conscience laundering” — feeling better about accumulating more than any one person could possibly need to live on by sprinkling a little around as an act of charity.

(cut)

I’m really not calling for an end to capitalism; I’m calling for humanism.

The entire story is here.

Saturday, August 3, 2013

Ethics, Charity and Overhead

Posted by Mike LaBossiere
Talking Philosophy
Originally posted July 19, 2013

While heading home after a race, I caught a segment on the radio discussing Dan Pallotta’s view of the moral assessment of charities and the notion that our moral intuitions regarding charities are erroneous. Pallotta’s main criticism is that people err in regarding frugality as being equivalent to being moral. So, for example, a charitable event with 5% overhead is regarded as morally superior to one with 70% overhead. This is an error, as he sees it, because what should be focused on is the accomplishments. If, for example, the event with the 5% overhead only raised $100 for charity and the event with 70% overhead raised a million dollars, then the second event would obviously have accomplished a great deal more. Naturally, it is being assumed that the overhead is for legitimate expenses such as salaries, advertising and such.

While I lack Pallotta’s experience and expertise in regards to running charities, I do think it is well worth while to consider some of the ethical issues that his discussion raised.

The entire story is here.

Friday, July 19, 2013

The Morality of Meditation

By David DeSteno
The New York Times - Gray Matter
Originally published July 5, 2013

Here is an excerpt:

Gaining competitive advantage on exams and increasing creativity in business weren’t of the utmost concern to Buddha and other early meditation teachers. As Buddha himself said, “I teach one thing and one only: that is, suffering and the end of suffering.” For Buddha, as for many modern spiritual leaders, the goal of meditation was as simple as that. The heightened control of the mind that meditation offers was supposed to help its practitioners see the world in a new and more compassionate way, allowing them to break free from the categorizations (us/them, self/other) that commonly divide people from one another.

But does meditation work as promised? Is its originally intended effect — the reduction of suffering — empirically demonstrable?

To put the question to the test, my lab, led in this work by the psychologist Paul Condon, joined with the neuroscientist Gaëlle Desbordes and the Buddhist lama Willa Miller to conduct an experiment whose publication is forthcoming in the journal Psychological Science.

The entire story is here.

Friday, July 12, 2013

Diagnosis: Insufficient Outrage

By H. GILBERT WELCH
The New York Times - Op Ed
Published: July 4, 2013

RECENT revelations should lead those of us involved in America’s health care system to ask a hard question about our business: At what point does it become a crime?

I’m not talking about a violation of federal or state statutes, like Medicare or Medicaid fraud, although crime in that sense definitely exists. I’m talking instead about the violation of an ethical standard, of the very “calling” of medicine.

Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufactures — are the ones benefiting.

A number of publications — including this one — have recently published big reports on the exorbitant cost of American health care. In March, Time magazine ran a cover story exposing outrageous hospital prices, from $108 for a tube of bacitracin — the ointment my mother put on the scrapes I got as a kid and that costs $5 at CVS — to $21,000 for a three-hour emergency room evaluation for chest pain caused by indigestion.

The entire story is here.

Saturday, June 15, 2013

UNC-Chapel Hill drops honor court case against student

By Phil Gast
CNN
Originally posted June 7, 2013

The University of North Carolina at Chapel Hill has dropped honor-court proceedings against a student who said the school retaliated against her for a sexual assault allegation.

In an e-mail to faculty and students on Thursday, Chancellor Holden Thorp said an outside review indicated no evidence of retaliation against Landen Gambill, who accused her ex-boyfriend of rape.

Gambill is one of several students who sparked a Department of Education investigation into how the university handles sex assault cases.

Thorp said a section of the honor code pertaining to "disruptive or intimidating behavior" would be suspended pending further review.

"This action is not a challenge to the important role of students in our Honor System, but is intended to protect the free speech rights of our students," the chancellor said in his e-mail. Thorp said the "important issue" will receive further discussion.

Gambill's attorney, Henry Clay Turner, had written a letter to Thorp, saying his client believed the university was retaliating against her because it let the student-run honor court charge her with intimidating her former boyfriend.

Gambill did not file a sexual assault report with police, and her former boyfriend -- who has not been identified publicly -- denied her accusation, according to his attorney.

The entire story is here.


Saturday, June 8, 2013

Ethics Without Borders

By Cynthia Schoeman
The Ethics Monitor

For organisations that strive to be ethical, there are two important criteria for earning and maintaining an ethical status: the continual, consistent application of their values to all their stakeholders and their on-going adherence to all applicable laws and regulations. If a company’s commitment to their values or their compliance with regulations is intermittent or applied selectively, it erodes their ethical standing. The constancy of ethical behaviour reflects the practice of “ethics without borders”.

Borderless ethics necessitates that the organisation has a very inclusive ethical boundary, whereby ethics is exercised beyond self-interest and includes all stakeholders affected by the company’s operations. By contrast, an exclusive ethical boundary, which implies that ethics is exercised only for the organisation’s own benefit and relative to a select few stakeholders (typically shareholders), totally contradicts an approach of ethics without borders. While the exclusion of other stakeholders does not necessarily mean that the company is behaving unethically, it does highlight the fact that the company prioritises their own goals and needs above others’ or that they don’t give equal priority to their various stakeholders – such as communities who are impacted by the company’s operations. Added to that, organisations are rarely obliged - for example, by law - to include all stakeholder groups formally within their ethical boundary. So, although such companies may not be technically behaving unethically or illegally, their limited application of ethics means that they would rarely be regarded as an ethical organisation.

There is a further challenge to following an approach of ethics without borders. This emanates from the recurring discourse in workplace ethics that ethics differs for different people, cultures, countries and situations. This view needs to be addressed not only because it appears to invalidate the possibility for ethics without borders, but also because it undermines the pursuit of common and shared organisational ethics. The globalised nature of the world of work particularly makes for a multitude of differences in the workplace. Yet, ironically, globalisation makes the practice of ethics without borders all the more valuable, not least for the clarity it offers all affected parties and the fairness it embodies by operating in terms of the same ethics globally.

The entire story is here.

Editor's Note: This article has direct connections to individual psychologists in private practice, businesses in general, state psychological associations, and the American Psychological Association.

Sunday, April 21, 2013

Google helps bring hotline to human-trafficking battle

By Yamiche Alcindor
USA Today
Originally posted April 9, 2013

A $3 million grant from Google helped get an anti-human-trafficking hotline up and running today — the latest data-sharing effort aimed at fighting the growing problem.

The Global Human Trafficking Hotline Network, launched with Google's grant, will allow organizations working in the USA, Southeast Asia and Europe to standardize data, identify trends and combine statistics for a more comprehensive look at the issue.

"Right now, most of the hotlines around the world are doing great work but operating in isolation," said Bradley Myles, CEO of Polaris Project, a non-profit group that runs the U.S. human trafficking hotline. "The fight has to be more thoughtful, so collaboration and partnerships in this field can keep up and get ahead of the innovation of traffickers."

Polaris Project, Liberty Asia, a non-profit group that does work in Southeast Asia, and La Strada International, which focuses on parts of Europe, have been jointly awarded a Google Global Impact Award and will work to stitch together their different hotlines.

The entire story is here.

Monday, March 4, 2013

Advocates Seek Mental Health Changes, Including Power to Detain

By BRANDI GRISSOM
The Texas Tribune/The New York Times
Published: February 23, 2013

Here are some excerpts:

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

(cut)

Hospital officials say they face a Catch-22 under current law: if they detain a mentally ill person against his or her will, they face liability because they have no legal authority to do so. If they allow the person to leave and something tragic happens, they risk a lawsuit like the one the Boren family filed.

The entire story is here.