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 Dignity. Show all posts
Showing posts with label Dignity. Show all posts

Tuesday, August 23, 2022

Tackling Implicit Bias in Health Care

J. A. Sabin
N Engl J Med 2022; 387:105-107
DOI: 10.1056/NEJMp2201180

Implicit and explicit biases are among many factors that contribute to disparities in health and health care. Explicit biases, the attitudes and assumptions that we acknowledge as part of our personal belief systems, can be assessed directly by means of self-report. Explicit, overtly racist, sexist, and homophobic attitudes often underpin discriminatory actions. Implicit biases, by contrast, are attitudes and beliefs about race, ethnicity, age, ability, gender, or other characteristics that operate outside our conscious awareness and can be measured only indirectly. Implicit biases surreptitiously influence judgment and can, without intent, contribute to discriminatory behavior. A person can hold explicit egalitarian beliefs while harboring implicit attitudes and stereotypes that contradict their conscious beliefs.

Moreover, our individual biases operate within larger social, cultural, and economic structures whose biased policies and practices perpetuate systemic racism, sexism, and other forms of discrimination. In medicine, bias-driven discriminatory practices and policies not only negatively affect patient care and the medical training environment, but also limit the diversity of the health care workforce, lead to inequitable distribution of research funding, and can hinder career advancement.

A review of studies involving physicians, nurses, and other medical professionals found that health care providers’ implicit racial bias is associated with diagnostic uncertainty and, for Black patients, negative ratings of their clinical interactions, less patient-centeredness, poor provider communication, undertreatment of pain, views of Black patients as less medically adherent than White patients, and other ill effects.1 These biases are learned from cultural exposure and internalized over time: in one study, 48.7% of U.S. medical students surveyed reported having been exposed to negative comments about Black patients by attending or resident physicians, and those students demonstrated significantly greater implicit racial bias in year 4 than they had in year 1.

A review of the literature on reducing implicit bias, which examined evidence on many approaches and strategies, revealed that methods such as exposure to counterstereotypical exemplars, recognizing and understanding others’ perspectives, and appeals to egalitarian values have not resulted in reduction of implicit biases.2 Indeed, no interventions for reducing implicit biases have been shown to have enduring effects. Therefore, it makes sense for health care organizations to forgo bias-reduction interventions and focus instead on eliminating discriminatory behavior and other harms caused by implicit bias.

Though pervasive, implicit bias is hidden and difficult to recognize, especially in oneself. It can be assumed that we all hold implicit biases, but both individual and organizational actions can combat the harms caused by these attitudes and beliefs. Awareness of bias is one step toward behavior change. There are various ways to increase our awareness of personal biases, including taking the Harvard Implicit Association Tests, paying close attention to our own mistaken assumptions, and critically reflecting on biased behavior that we engage in or experience. Gonzalez and colleagues offer 12 tips for teaching recognition and management of implicit bias; these include creating a safe environment, presenting the science of implicit bias and evidence of its influence on clinical care, using critical reflection exercises, and engaging learners in skill-building exercises and activities in which they must embrace their discomfort.

Tuesday, May 31, 2022

Artificial Intelligence, Humanistic Ethics

John Tasioulas
AI & Society
Spring 2022


Ethics is concerned with what it is to live a flourishing life and what it is we morally owe to others. The optimizing mindset prevalent among computer scientists and economists, among other powerful actors, has led to an approach focused on maximizing the fulfillment of human preferences, an approach that has acquired considerable influence in the ethics of AI. But this preference-based utilitarianism is open to serious objections. This essay sketches an alternative, “humanistic” ethics for AI that is sensitive to aspects of human engagement with the ethical often missed by the dominant approach. Three elements of this humanistic approach are outlined: its commitment to a plurality of values, its stress on the importance of the procedures we adopt, not just the outcomes they yield, and the centrality it accords to individual and collective participation in our understanding of human well-being and morality. The essay concludes with thoughts on how the prospect of artificial general intelligence bears on this humanistic outlook.


I have mainly focused on narrow AI, conceived as AI-powered technology that can perform limited tasks (such as facial recognition or medical diagnosis) that typically require intelligence when performed by humans. This is partly because serious doubt surrounds the likelihood of artificial general intelligence emerging within any realistically foreseeable time frame, partly because the operative notion of “intelligence” in discussions of AGI (artificial general intelligence) is problematic, and partly because a focus on AGI often distracts us from the more immediate questions of narrow AI.

With these caveats in place, however, one can admit that thought experiments about AGI can help bring into focus two questions fundamental to any humanistic ethic: What is the ultimate source of human dignity, understood as the inherent value attaching to each and every human being? And how can we relate human dignity to the value inhering in nonhuman beings? Toward the end of Kazuo Ishiguro’s novel Klara and the Sun, the eponymous narrator, an “Artificial Friend,” speculates that human dignity–the “human heart” that “makes each of us special and individual”–has its source not in something within us, but in the love of others for us. But a threat of circularity looms for this boot-strapping humanism, for how can the love of others endow us with value unless those others already have value? Moreover, if the source of human dignity is contingent on the varying attitudes of others, how can it apply equally to every human being? Are the unloved bereft of the “human heart”?

Tuesday, November 9, 2021

Louisiana woman learns WWII vet husband’s cadaver dissected at pay-per-view event

Peter Aitken
Originally published 7 NOV 21

The family of a deceased Louisiana man found out that his body ended up in a ticketed live human dissection as part of a traveling expo.

David Saunders, a World War II and Korean War veteran who lived in Baker, died at the age of 98 from COVID-19 complications in August. His family donated his remains to science – or so they thought: Instead, his wife, Elsie Saunders, discovered that his body had ended up in an "Oddities and Curiosities Expo" in Oregon.

The expo, organized by DeathScience.org, was set up at the Portland Marriot Downtown Waterfront. People could watch a live human dissection on Oct. 17 for the cost of up to $500 a seat, KING-TV reported.

"From the external body exam to the removal of vital organs including the brain, we will find new perspectives on how the human body can tell a story," an online event description says. "There will be several opportunities for attendees to get an up-close and personal look at the cadaver."

The Seattle-based station sent an undercover reporter to the expo and noted David Saunders’ name on a bracelet he was wearing. The reporter was able to contact Elsie Saunders and let her know what had happened.

She was, understandably, horrified.

"It’s horrible what has happened to my husband," Elsie Saunders told NBC News. "I didn’t know he was going to be … put on display like a performing bear or something. I only consented to body donation or scientific purposes."

"That’s the way my husband wanted it," she explained. "To say the least, I’m upset."

Wednesday, September 8, 2021

America Runs on ‘Dirty Work’ and Moral Inequality

Eyal Press
The New York Times
Originally posted 13 Aug 21

Here is an excerpt:

“Dirty work” can refer to any unpleasant job, but among social scientists, the term has a more pointed meaning. In 1962, Everett Hughes, an American sociologist, published an essay titled “Good People and Dirty Work” that drew on conversations he’d had in postwar Germany about the mass atrocities of the Nazi era. Mr. Hughes argued that the persecution of Jews proceeded with the unspoken assent of many supposedly enlightened Germans, who refrained from asking too many questions because, on some level, they were not entirely displeased.

This was the nature of dirty work as Mr. Hughes conceived of it: unethical activity that was delegated to certain agents and then disavowed by society, even though the perpetrators had an “unconscious mandate” from their fellow citizens. As extreme as the Nazi example was, this dynamic existed in every society, Mr. Hughes wrote, enabling respectable citizens to distance themselves from the morally troubling things being done in their name. The dirty workers were not rogue actors but “agents” of “good people” who passively stood by.

Contemporary America runs on dirty work. Some of the people who do this work are our agents by virtue of the fact that they perform public functions, such as running the world’s largest penal system. Others qualify as such by catering to our consumption habits — the food we eat, the fossil fuels we burn, which are drilled and fracked by dirty workers in places like the Gulf of Mexico. The high-tech gadgets in our pockets rely on yet another form of dirty work — the mining of cobalt — that has been outsourced to workers in Africa and to foreign subcontractors that often brutally exploit them.

Like the essential jobs performed by grocery clerks and other low-wage workers during the Covid-19 pandemic, this work sustains our lifestyles and undergirds the prevailing social order, but privileged people are generally spared from having to think about it. One reason is that the dirty work occurs far away from them, in isolated institutions — prisons, slaughterhouses — that are closed to the public. Another reason is that the privileged rarely have to do it. Although there is no shortage of it to go around, dirty work in America is not randomly distributed. 

Thursday, January 28, 2021

Automation, work and the achievement gap

Danaher, J., Nyholm, S. 
AI Ethics (2020). 


Rapid advances in AI-based automation have led to a number of existential and economic concerns. In particular, as automating technologies develop enhanced competency, they seem to threaten the values associated with meaningful work. In this article, we focus on one such value: the value of achievement. We argue that achievement is a key part of what makes work meaningful and that advances in AI and automation give rise to a number achievement gaps in the workplace. This could limit people’s ability to participate in meaningful forms of work. Achievement gaps are interesting, in part, because they are the inverse of the (negative) responsibility gaps already widely discussed in the literature on AI ethics. Having described and explained the problem of achievement gaps, the article concludes by identifying four possible policy responses to the problem.



Achievement is an important part of the well-lived life. It is the positive side of responsibility. Where we blame ourselves and others for doing bad things, we also praise ourselves for achieving positive (or value neutral) things. Achievement is particularly important when it comes to meaningful work. One of the problems with widespread automation is that it threatens to undermine at least three of the four main conditions for achievement in the workplace: it can reduce the value of work tasks; reduce the cost of committing to those work tasks; and sever the causal connection between human effort and workplace outcome. This opens up ‘achievement gaps’ in the workplace. There are, however, some potential ways to manage the threat of achievement gaps: we can focus on other aspects of meaningful work; we can find some ways to retain the human touch in the production of workplace outputs; we can emphasise the importance of teamwork in producing valuable outputs; and we can find outlets for achievement outside of the workplace.

Tuesday, March 31, 2020

Pregnant and shackled: why inmates are still giving birth cuffed and bound

23 states do not have laws against shackling of incarcerated pregnant women.Lori Teresa Yearwood
Originally posted 24 Feb 20

Here is an excerpt:

To convolute matters more, the federal government does not require prisons or jails to collect data on pregnancy and childbirth among female inmates. A bill introduced in September 2018 would have required such data collection. However, no action was taken on the bill.

Even the definition of shackling varies. Some states, such as Maryland and New York, ban all restraints immediately before and after birth, though there are exceptions in extraordinary circumstances. Other states, such as Ohio, allow pregnant women to be handcuffed in the front of their bodies, as opposed to behind their bodies, which is thought to be more destabilizing.

Then there is the delineation between shackling during pregnancy, active delivery and postpartum. Individual state laws are filled with nuances. As of 2017, Rhode Island is the only state that has what is called “a private right of action”, an enforcement mechanism allowing the illegally shackled woman to sue for monetary compensation.

The one constant: the acute psychological trauma that shackling inflicts.

“Women subjected to restraint during childbirth report severe mental distress, depression, anguish, and trauma,” states a 2017 report from the American Psychological Association.

“Women who get locked up, tend on average to have suffered many more childhood traumas, says Terry Kupers, MD, a psychiatrist and the author of the book Solitary: The Inside Story of Supermax Isolation and How We Can Abolish It. He implores prison staffs “to be very careful that we do not re-traumatize them. Because re-traumatization makes conditions like post-traumatic stress disorder much worse.”

Amy Ard, executive director of Motherhood Beyond Bars, a not-for-profit in Georgia, worries that the trauma of shackling takes a toll on the self-image of new mothers. Inevitably, this question looms in the minds of the women Ard works with: if I am someone who needs to be chained, how can I expect to also see myself as someone capable of protecting my child?

The info is here.

Friday, February 28, 2020

Lon Fuller and the Moral Value of the Rule of Law

Murphy, Colleen
Law and Philosophy,
Vol. 24, 2005.
Available at SSRN

It is often argued that the rule of law is only instrumentally morally valuable, valuable when and to the extent that a legal system is used to purse morally valuable ends. In this paper, I defend Lon Fuller’s view that the rule of law has conditional non-instrumental as well as instrumental moral value. I argue, along Fullerian lines, that the rule of law is conditionally non-instrumentally valuable in virtue of the way a legal system structures political relationships. The rule of law specifies a set of requirements which lawmakers must respect if they are to govern legally. As such, the rule of law restricts the illegal or extra-legal use of power. When a society rules by law, there are clear rules articulating the behavior appropriate for citizens and officials. Such rules ideally determine the particular contours political relationships will take. When the requirements of the rule of law are respected, the political relationships structured by the legal system constitutively express the moral values of reciprocity and respect for autonomy. The rule of law is instrumentally valuable, I argue, because in practice the rule of law limits the kind of injustice which governments pursue. There is in practice a deeper connection between ruling by law and the pursuit of moral ends than advocates
of the standard view recognize.

The next part of this paper outlines Lon Fuller’s conception of the rule of law and his explanation of its moral value. The third section illustrates how the Fullerian analysis draws attention to the impact that state-sanctioned atrocities can have upon the institutional functioning of the legal system, and so to their impact on the relationships between officials and citizens that are structured by that institution. The fourth section considers two objections to this account. According to the first, Razian objection, while the Fullerian analysis accurately describes the nature of the requirements of the rule of law, it offers a mistaken account of its moral value. Against my assertion that the rule of law has non-instrumental value, this objection argues that the rule of law is only instrumentally valuable. The second objection grants that the rule of law has non-instrumental moral value but claims that the Fullerian account of the requirements of the rule of law is incomplete.

Friday, October 11, 2019

Dying is a Moral Event. NJ Law Caught Up With Morality

T. Patrick Hill
Star-Ledge Guest Column
Originally posted September 9, 2019

New Jersey’s Medical-Aid-in-Dying legislation authorizes physicians to issue a prescription to end the lives of their patients who have been diagnosed with a terminal illness, are expected to die within six months, and have requested their physicians to help them do so. While the legislation does not require physicians to issue the prescription, it does require them to transfer a patient’s medical records to another physician who has agreed to prescribe the lethal medication.


The Medical Aid in Dying Act goes even further, concluding that its passage serves the public’s interests, even as it endorses the “right of a qualified terminally ill patient …to obtain medication that the patient may choose to self-administer in order to bring about the patient’s humane and dignified death.”

The info is here.

Tuesday, August 6, 2019

Ethics and automation: What to do when workers are displaced

Tracy Mayor
MIT School of Management
Originally published July 8, 2019

As companies embrace automation and artificial intelligence, some jobs will be created or enhanced, but many more are likely to go away. What obligation do organizations have to displaced workers in such situations? Is there an ethical way for business leaders to usher their workforces through digital disruption?

Researchers wrestled with those questions recently at MIT Technology Review’s EmTech Next conference. Their conclusion: Company leaders need to better understand the negative repercussions of the technologies they adopt and commit to building systems that drive economic growth and social cohesion.

Pramod Khargonekar, vice chancellor for research at University of California, Irvine, and Meera Sampath, associate vice chancellor for research at the State University of New York, presented findings from their paper, “Socially Responsible Automation: A Framework for Shaping the Future.”

The research makes the case that “humans will and should remain critical and central to the workplace of the future, controlling, complementing and augmenting the strengths of technological solutions.” In this scenario, automation, artificial intelligence, and related technologies are tools that should be used to enrich human lives and livelihoods.

Aspirational, yes, but how do we get there?

The info is here.

Thursday, July 25, 2019

Societal and ethical issues of digitization

Lambèr Royakkers, Jelte Timmer, Linda Kool, & Rinie van Est
Ethics and Information Technology (2018) 20:127–142


In this paper we discuss the social and ethical issues that arise as a result of digitization based on six dominant technologies: Internet of Things, robotics, biometrics, persuasive technology, virtual & augmented reality, and digital platforms. We highlight the many developments in the digitizing society that appear to be at odds with six recurring themes revealing from our analysis of the scientific literature on the dominant technologies: privacy, autonomy, security, human dignity, justice, and balance of power. This study shows that the new wave of digitization is putting pressure on these public values. In order to effectively shape the digital society in a socially and ethically responsible way, stakeholders need to have a clear understand-ing of what such issues might be. Supervision has been developed the most in the areas of privacy and data protection. For other ethical issues concerning digitization such as discrimination, autonomy, human dignity and unequal balance of power, the supervision is not as well organized.

The paper is here.

Friday, July 19, 2019

Revisiting Morality In the Age of Dishonesty

Wim Laven
Originally posted June 27, 2019

If Donald Trump actually follows through on his recently tweeted promise that Immigrations and Customs Enforcement (ICE) “will begin deporting the millions of illegal aliens who have illicitly found their way into the United States … as fast as they come in,” what will you do?

According to the faith I was raised with I hope I would act according to the lessons found in the parable of the Good Samaritan. In the Gospel of Luke Jesus told of a traveler who was beaten, stripped, and left naked waiting for death. People who claimed to have good faith avoided this victim, but it was the Samaritan who stopped and rendered aid—a selfless act of altruism. Charity, compassion, and forgiveness are the highest values I was raised with. I do my best to dedicate myself to their service, and I’m sure I’m not the only one left in a bind: what will I do?

Recent stories tell of modern day Samaritans rendering aid to travelers (some seeking asylum, some trying to immigrate legally, some illegally…) at great risk. The case of Scott Warren in Arizona presents offering humanitarian aid as a crime punishable by up to 20 years in prison; but there is no verdict, the jury is hung. His specific crimes are putting out food and water, and pointing directions (actions consistent with No More Deaths, a part of the Unitarian Universalist Church of Tucson), which appears reflect values just like I was raised with. Do I have the strength to follow my religious convictions, even in the face of criminal prosecution like Warren has?

The info is here.

Thursday, July 18, 2019

Taking Ethics Seriously: Toward Comprehensive Education in Ethics and Human Rights for Psychologists

Duška Franeta
European Psychologist (2019), 24, pp. 125-135.

Education in ethics and professional regulation are not alternatives; education in ethics for psychologists should not be framed merely as instruction regarding current professional regulation, or “ethical training.” This would reduce ethics to essentially a legal perspective, diminish professional responsibility, debase professional ethics, and downplay its primary purpose – the continuous critical reflection of professional identity and professional role. This paper discusses the meaning and function of education in ethics for psychologists and articulates the reasons why comprehensive education in ethics for psychologists should not be substituted by instruction in professional codes. Likewise, human rights education for psychologists should not be downgraded to mere instruction in existing legal norms. Human rights discourse represents an important segment of the comprehensive education in ethics for psychologists. Education in ethics should expose and examine substantial ethical ideas that serve as the framework for the law of human rights as well as the interpretative, multifaceted, evolving, even manipulable character of the human rights narrative. The typically proclaimed duty of psychologists to protect and promote human rights requires a deepening and expounding of the human rights legal framework through elaborate scrutiny of its ethical meaning. The idea of affirming and restoring human dignity – the concept often designated as the legal and ethical basis, essence, and purpose of human rights – represents one approach to framing this duty by which the goals of psychology on the professional and ethical levels become unified.

The info is here.

Sunday, May 26, 2019

Brain science should be making prisons better, not trying to prove innocence

Arielle Baskin-Sommers
Originally posted November 1, 2017

Here is an excerpt:

Unfortunately, when neuroscientific assessments are presented to the court, they can sway juries, regardless of their relevance. Using these techniques to produce expert evidence doesn’t bring the court any closer to truth or justice. And with a single brain scan costing thousands of dollars, plus expert interpretation and testimony, it’s an expensive tool out of reach for many defendants. Rather than helping untangle legal responsibility, neuroscience here causes an even deeper divide between the rich and the poor, based on pseudoscience.

While I remain skeptical about the use of neuroscience in the judicial process, there are a number of places where its findings could help corrections systems develop policies and practices based on evidence.

Solitary confinement harms more than helps

Take, for instance, the use within prisons of solitary confinement as a punishment for disciplinary infractions. In 2015, the Bureau of Justice reported that nearly 20 percent of federal and state prisoners and 18 percent of local jail inmates spent time in solitary.

Research consistently demonstrates that time spent in solitary increases the chances of persistent emotional trauma and distress. Solitary can lead to hallucinations, fantasies and paranoia; it can increase anxiety, depression and apathy as well as difficulties in thinking, concentrating, remembering, paying attention and controlling impulses. People placed in solitary are more likely to engage in self-mutilation as well as exhibit chronic rage, anger and irritability. The term “isolation syndrome” has even been coined to capture the severe and long-lasting effects of solitary.

The info is here.

Monday, October 29, 2018

The dismantling of informed consent is a disaster

David Penner
Originally posted September 26, 2018

Informed consent is the cornerstone of medical ethics. And every physician must defend this sacred principle from every form of evil that would seek to dismantle, degrade and debase it. If informed consent is the sun, then privacy, confidentiality, dignity, and trust are planets that go around it. For without informed consent, the descent of health care into amorality is inevitable, and the doctor-patient relationship is doomed to ruination, oblivion, and despair. It is also important to acknowledge the fact that a lack of informed consent has become endemic to our health care system.

This betrayal of patient trust is inextricably linked to three violations: a rape of the body, a rape of the mind and a rape of the soul. The rape of the mind is anchored in a willful nondisclosure of common long-term side effects associated with powerful drugs, such as opioids and certain types of chemotherapy. When a patient starts a chemotherapy regimen, they are typically briefed by a nurse, who proceeds to educate them regarding common short-term side effects such as mouth sores, constipation, and nausea, while failing to mention any of the typical long-term side effects, such as cognitive difficulties and early menopause. It is the long-term side effects that underscore the tragedy of having to resort to chemotherapy, as they can have a devastating impact on a patient’s quality of life, even long after remission has been attained.

The info is here.

Tuesday, September 18, 2018

Changing the way we communicate about patients

Abraar Karan
BMJ Blog
Originally posted August 29, 2018

Here is an excerpt:

There are many changes that we can make to improve how we communicate about patients. One of the easiest and most critical transformations is how we write our medical notes. One of the best doctors I ever worked with did exactly this, and is famous at the Brigham (our hospital) for doing it. He systematically starts every single note with the person’s social history. Who is this patient? It is not just a lady with abdominal pain. It is a mother of three, a retired teacher, and an active cyclist. That is the first thing we read about her, and so when I enter her room, I can’t help but see her this way rather than as a case of appendicitis.

This matters because patients deserve to be treated as people—a statement that’s so obvious it shouldn’t need to be said, but which physician behaviour doesn’t always reflect. You wouldn’t expect to know the most sensitive and vulnerable aspects of someone before even knowing their most basic background, yet we do this in medicine all the time. This is also important because in many clinical presentations, it provides critical information that helps deduce how they got sick, and why they may get sick again in the same way if we don’t restructure something essential in their life. For instance, if I didn’t know that the 22 year old opioid addict had just been kicked out of his house and is on the street without transportation to get to his suboxone clinic, I will not have truly solved what brought him to the hospital in the first place.

The info is here.

Friday, August 17, 2018

Ethical Dimensions of Caring Well for Dying Patients

Ilana Stol
AMA Journal of Ethics

Dying is a uniquely individual yet deeply shared and universal experience; it profoundly impacts perceptions of culture, personhood, and identity. For many Americans, it is also an experience widely discrepant from the one they want and envision for themselves and their loved ones.  Over the past decade, there has been growing awareness of the incongruence between the way Americans say they want to die and how they actually do.  But while most would agree that this reality is not the ideal that clinicians or patients strive for, what is less agreed upon is what the roles of clinicians and patients should be in defining what actually constitutes dying and good care of dying people. What do patients and clinicians need to know about dying and care at the end of life? What barriers exist to accessing and employing this knowledge in the face of difficult decisions?

To best answer these questions, it is useful to examine the social structures and supports already in place for end-of-life care and to understand how they are being utilized. To begin with, hospital palliative care programs are expanding rapidly in order to meet the physical and emotional needs of patients with serious or terminal illness. Robust evidence now exists demonstrating that early palliative care improves the dying experience for both patients and families while generally reducing health care costs and potentially prolonging survival. Despite these facts, there is significant variation in physician practice in the care of patients at the end of life and a general consensus that palliative and hospice care are underutilized by physicians.

The information is here.

Monday, May 28, 2018

This Suicide Pod Dubbed 'the Tesla of Death' Lets You Kill Yourself Peacefully

Loukia Papadopoulos
Interesting Engineering
Originally posted April 27, 2018

A new controversial pod for ending one’s life is on the market and it is being dubbed the Tesla of death and its founder, the Elon Musk of suicide. The pod, developed by euthanasia campaigner Dr. Philip Nitschke, is called the Sarco and it seeks to revolutionize the way we die.

The Sarco's website features a thought-provoking question on its landing page. “What if we had more than mere dignity to look forward to on our last day on this planet?” reads the site.

A description of the pod goes on to explain that “the elegant design was intended to suggest a sense of occasion: of travel to a ‘new destination’, and to dispel the ‘yuk’ factor.” If this sounds like a macabre joke, rest assured it is not.

The article is here.

Friday, May 4, 2018

Will Tech Companies Ever Take Ethics Seriously?

Evan Selinger
Originally published April 9, 2018

Here are two excerpts:

And let’s face it, tech companies are in a structural bind, because they simultaneously serve many masters who can have competing priorities: shareholders, regulators, and consumers. Indeed, while “conscientious capitalism” sounds nice, anyone who takes political economy seriously knows we should be wary of civics being conflated with keeping markets going and companies appealing to ethics as an end-run strategy to avoid robust regulation.

But what if there is reason — even if just a sliver of practical optimism — to be more hopeful? What if the responses to the Cambridge Analytica scandal have already set in motion a reckoning throughout the tech world that’s moving history to a tipping point? What would it take for tech companies to do some real soul searching and embrace Spider-Man’s maxim that great responsibility comes with great power?


Responsibility has many dimensions. But as far as Hartzog is concerned — and the “values in design” literature supports this contention — the three key ideals that tech companies should be prioritizing are: promoting genuine trust (through greater transparency and less manipulation), respecting obscurity (the ability for people to be more selective when sharing personal information in public and semipublic spaces), and treating dignity as sacrosanct (by fostering genuine autonomy and not treating illusions of user control as the real deal). At the very least, embracing these goals means that companies will have to come up with better answers to two fundamental questions: What signals do their design choices send to users about how their products should be perceived and used? What socially significant consequences follow from their design choices lowering transaction costs and making it easier or harder to do things, such as communicate and be observed?

The information is here.

Saturday, March 17, 2018

The Revised Declaration of Geneva

Ramin Walter Parsa-Parsi
JAMA. 2017;318(20):1971-1972.

Here is an excerpt:

The most notable difference between the Declaration of Geneva and other key ethical documents, such as the WMA’s Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects and the Declaration of Taipei on Ethical Considerations Regarding Health Databases and Biobanks, was determined to be the lack of overt recognition of patient autonomy, despite references to the physician’s obligation to exercise respect, beneficence, and medical confidentiality toward his or her patient(s). To address this difference, the workgroup, informed by other WMA members, ethical advisors, and other experts, recommended adding the following clause: “I WILL RESPECT the autonomy and dignity of my patient.” In addition, to highlight the importance of patient self-determination as one of the key cornerstones of medical ethics, the workgroup also recommended shifting all new and existing paragraphs focused on patients’ rights to the beginning of the document, followed by clauses relating to other professional obligations.

To more explicitly invoke the standards of ethical and professional conduct expected of physicians by their patients and peers, the clause “I WILL PRACTISE my profession with conscience and dignity” was augmented to include the wording “and in accordance with good medical practice.”

The article and the Declaration can be found here.

Monday, February 26, 2018

How Doctors Deal With Racist Patients

Sumathi Reddy
The Wall Street Journal
Originally published January 22, 2018

Her is an excerpt:

Patient discrimination against physicians and other health-care providers is an oft-ignored topic in a high-stress job where care always comes first. Experts say patients request another physician based on race, religion, gender, age and sexual orientation.

No government entity keeps track of such incidents. Neither do most hospitals. But more trainees and physicians are coming forward with stories and more hospitals and academic institutions are trying to address the issue with new guidelines and policies.

The examples span race and religion. A Korean-American doctor’s tweet about white nationalists refusing treatment in the emergency room went viral in August.

A trauma surgeon at a hospital in Charlotte, N.C., published a piece on KevinMD, a website for physicians, last year detailing his own experiences with discrimination given his Middle Eastern heritage.

Penn State College of Medicine adopted language into its patient rights policy in May that says patient requests for providers based on gender, race, ethnicity or sexual orientation won’t be honored. It adds that some requests based on gender will be evaluated on a case-by-case basis.

The article is here.