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 Guidelines. Show all posts
Showing posts with label Guidelines. Show all posts

Tuesday, April 16, 2024

As A.I.-Controlled Killer Drones Become Reality, Nations Debate Limits

Eric Lipton
The New York Times
Originally posted 21 Nov 23

Here is an excerpt:

Rapid advances in artificial intelligence and the intense use of drones in conflicts in Ukraine and the Middle East have combined to make the issue that much more urgent. So far, drones generally rely on human operators to carry out lethal missions, but software is being developed that soon will allow them to find and select targets more on their own.

The intense jamming of radio communications and GPS in Ukraine has only accelerated the shift, as autonomous drones can often keep operating even when communications are cut off.

“This isn’t the plot of a dystopian novel, but a looming reality,” Gaston Browne, the prime minister of Antigua and Barbuda, told officials at a recent U.N. meeting.

Pentagon officials have made it clear that they are preparing to deploy autonomous weapons in a big way.

Deputy Defense Secretary Kathleen Hicks announced this summer that the U.S. military would “field attritable, autonomous systems at scale of multiple thousands” in the coming two years, saying that the push to compete with China’s own investment in advanced weapons necessitated that the United States “leverage platforms that are small, smart, cheap and many.”

The concept of an autonomous weapon is not entirely new. Land mines — which detonate automatically — have been used since the Civil War. The United States has missile systems that rely on radar sensors to autonomously lock on to and hit targets.

What is changing is the introduction of artificial intelligence that could give weapons systems the capability to make decisions themselves after taking in and processing information.

Here is a summary:

This article discusses the debate at the UN regarding Lethal Autonomous Weapons (LAW) - essentially autonomous drones with AI that can choose and attack targets without human intervention. There are concerns that this technology could lead to unintended casualties, make wars more likely, and remove the human element from the decision to take a life.
  • Many countries are worried about the development and deployment of LAWs.
  • Austria and other countries are proposing a total ban on LAWs or at least strict regulations requiring human control and limitations on how they can be used.
  • The US, Russia, and China are opposed to a ban and argue that LAWs could potentially reduce civilian casualties in wars.
  • The US prefers non-binding guidelines over new international laws.
  • The UN is currently deadlocked on the issue with no clear path forward for creating regulations.

Monday, January 22, 2024

Deciding for Patients Who Have Lost Decision-Making Capacity — Finding Common Ground in Medical Ethics

Bernard Lo
The New England Journal of Medicine
Originally published 16 Dec 23

Here is an excerpt:

Empirical studies...show that advance directives do not work as was hoped.2 Only a minority of patients complete them. Directives commonly are not well informed, because patients have serious misconceptions about life-sustaining interventions and about their own prognoses. Designated surrogates are often inaccurate in stating patients’ preferences in specific scenarios. Patient preferences commonly change over time. Patients often want surrogates to have leeway to override their prior statements. And when making decisions, surrogates frequently consider aspects of patient well-being to be more important than the patient’s previously stated preferences.

Conceptually, relying completely on an incompetent patient’s prior directives may be unsound. Often surrogates must extrapolate from the patient’s previous directives and statements to a situation that the patient did not foresee. Patients generally underestimate how well they can cope with and adapt to new situations.

So the standard approach shifted to advance care planning, a process for helping adults understand and communicate their values, goals, and preferences regarding future care. Advance care planning improves satisfaction with communication and reduces the risk of post-traumatic stress disorder, depression, or anxiety among surrogate decision makers.3 However, its use neither increases the likelihood that decisions are concordant with patients’ values and goals nor improves patients’ quality of life.3

Studies show that patients are less concerned about specific medical interventions than about clinical outcomes, burdens, and quality of life. Such evidence led advocates of advance care planning to begin focusing on preparing for in-the-moment decisions rather than documenting directives for medical interventions.

Many state legislatures rejected the strict requirements for surrogate decision making that Cruzan allowed. By 2004, 10 states allowed patients to appoint a health care proxy in a conversation with a physician as well as in formal documents. By 2016, 41 states — both conservative and liberal — had enacted laws allowing family members to act as health care surrogates for patients who lacked decision-making capacity and had not designated a health care proxy. Seven states included domestic partners or close friends on the list of acceptable surrogates.

Here is a quick summary:

Following the 1990 Supreme Court's Cruzan ruling, which emphasized clear evidence for life-sustaining treatment withdrawal, practices shifted. Advance directives like living wills gained popularity, but studies revealed their limitations. Advance care planning, focusing on communication and values, took hold. POLST forms were introduced for specific interventions, but studies show inconsistency with actual situations.

The emphasis is now on family decision-making and flexible guidelines. Rigid legal formalities have decreased, and surrogates consider not just past directives but also current situations and evolving values. Discussions involving patients, surrogates, and physicians are crucial. Different approaches like past commitments, current well-being, and "life story continuation" may be appropriate depending on the context.

The Cruzan framework is no longer the basis for medical ethics and law. Family decisions, flexible standards, and evolving values now guide care. This shift showcases how medical ethics can adapt through discussions, research, and legal changes. Finding common ground on critical issues in today's divided society remains a challenge, but it's more important than ever.

Saturday, June 19, 2021

Preparing for the Next Generation of Ethical Challenges Concerning Heritable Human Genome Editing

Robert Klitzman
The American Journal of Bioethics
(2021) Volume 21 (6), 1-4.

Here is the conclusion

Moving Forward

Policymakers will thus need to make complex and nuanced risk/benefit calculations regarding costs and extents of treatments, ages of onset, severity of symptoms, degrees of genetic penetrance, disease prevalence, future scientific benefits, research costs, appropriate allocations of limited resources, and questions of who should pay.

Future efforts should thus consider examining scientific and ethical challenges in closer conjunction, not separated off, and bring together the respective strengths of the Commission’s and of the WHO Committee’s approaches. The WHO Committee includes broader stakeholders, but does not yet appear to have drawn conclusions regarding such specific medical and scientific scenarios (WHO 2020). These two groups’ respective memberships also differ in instructive ways that can mutually inform future deliberations. Among the Commission’s 18 chairs and members, only two appear to work primarily in ethics or policy; the majority are scientists (National Academy of Medicine, the National Academies of Sciences and the Royal Society 2020). In contrast, the WHO Committee includes two chairs and 16 members, with both chairs and the majority of members working primarily in ethics, policy or law (WHO 2020). ASRM and other countries’ relevant professional organizations should also stipulate that physicians and healthcare professionals should not be involved in any way in the care of patients using germline editing abroad.

The Commission’s Report thus provides valuable insights and guidelines, but multiple stakeholders will likely soon confront additional, complex dilemmas involving interplays of both science and ethics that also need urgent attention.

Thursday, June 3, 2021

Scientific panel loosens ’14-day rule’ limiting how long human embryos can be grown in the lab

Andrew Joseph
Originally posted 26 May 2021

An influential scientific panel cracked open the door on Wednesday to growing human embryos in the lab for longer periods of time than currently allowed, a step that could enable the plumbing of developmental mysteries but that also raises thorny questions about whether research that can be pursued should be.

For decades, scientists around the world have followed the “14-day rule,” which stipulates that they should let human embryos develop in the lab for only up to two weeks after fertilization. The rule — which some countries (though not the United States) have codified into law — was meant to allow researchers to conduct inquiries into the early days of embryonic development, but not without limits. And for years, researchers didn’t push that boundary, not just for legal and ethical reasons, but for technical ones as well: They couldn’t keep the embryos growing in lab dishes that long.

More recently, however, scientists have refined their cell-culture techniques, finding ways to sustain embryos up to that deadline. Those advances — along with other leaps in the world of stem cell research, with scientists now transmogrifying cells into blobs that resemble early embryos or injecting human cells into animals — have complicated ethical debates about how far biomedical research should go in its quest for knowledge and potential treatments.

Now, in the latest updates to its guidelines, the International Society for Stem Cell Research has revised its view on studies that would take human embryos beyond 14 days, moving such experiments from the “absolutely not” category to a “maybe” — but only if lots of conditions are first met.

“We’ve relaxed the guidelines in that respect, we haven’t abandoned them,” developmental biologist Robin Lovell-Badge of the Francis Crick Institute, who chaired the ISSCR’s guidelines task force, said at a press briefing.

Thursday, April 16, 2020

How To Move From Data Privacy To Data Ethics

Photo:Thomas Walle
Originally posted 11 March 20

Here is an excerpt:

Data Ethics Is Up To Each And Every Company

Data ethics, however, is more nuanced and complicated. It's up to each company to decide what use cases their collected data should support or not. There are no federal or state laws related to data ethics, and there are no government-owned bodies that will penalize the ones that cross the ethical boundaries of how data should and should not be used.

However, in the growing data industry, which is composed of those helping companies and individuals to make better decisions, there’s a constant influx of new data being generated and collected, such as health data, car driving data and location data, to name a few. These data sets and insights are new to the market, and I believe we will start to see the first wave of forward-looking data companies taking a clear stance and drawing their own ethical guidelines.

These are companies that acknowledge the responsibility they have when holding such information and want to see it be used for the right use cases -- to make people’s lives better, easier and safer. So, if you agree that data ethics is important and want to be ahead of the curve, what is there to do?

Creating A Set Of Ethical Guidelines

My recommendation for any data company is to define a set of core ethical guidelines your company should adhere to. To accomplish this, follow these steps:

1. Define Your Guidelines

The guidelines should be created by inviting different parts of your organization to get a balanced and mixed view of what the company sees as acceptable use cases for its insights and data. In my experience, including different departments, such as commercial and engineering, people from different nationalities and all geographies, if your companies operate in multiple markets, is crucial in getting a nuanced and healthy view of what the company, its employees and stakeholders see as ethically acceptable.

The info is here.

Saturday, March 28, 2020

Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Ariana Eunjung Cha
The Washington Post
Originally posted 25 March 20

Hospitals on the front lines of the pandemic are engaged in a heated private debate over a calculation few have encountered in their lifetimes — how to weigh the “save at all costs” approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of coronavirus.

The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment — such as masks, gowns and gloves — may be too great to justify the conventional response when a patient “codes,” and their heart or breathing stops.

Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.

Richard Wunderink, one of Northwestern’s intensive-care medical directors, said hospital administrators would have to ask Illinois Gov. J.B. Pritzker for help in clarifying state law and whether it permits the policy shift.

“It’s a major concern for everyone,” he said. “This is something about which we have had lots of communication with families, and I think they are very aware of the grave circumstances.”

Officials at George Washington University Hospital in the District say they have had similar conversations, but for now will continue to resuscitate covid-19 patients using modified procedures, such as putting plastic sheeting over the patient to create a barrier. The University of Washington Medical Center in Seattle, one of the country’s major hot spots for infections, is dealing with the problem by severely limiting the number of responders to a contagious patient in cardiac or respiratory arrest.

The info is here.

Saturday, March 7, 2020

Ethical guidelines for social justice in psychology

Hailes, H. and others
Professional Psychology:
Research and Practice


As the field of psychology increasingly recognizes the importance of engaging in work that advances social justice and as social justice-focused training and practice in the field grows, psychologists need ethical guidelines for this work. The American Psychological Association’s ethical principles include “justice” as a core principle but do not expand extensively upon its implications. This article provides a proposed set of ethical guidelines for social justice work in psychology. Within the framework of 3 domains of justice—interactional (about relational dynamics), distributive (about provision for all), and procedural (about just processes) justice—this article outlines 7 guidelines for social justice ethics: (1) reflecting critically on relational power dynamics; (2) mitigating relational power dynamics; (3) focusing on empowerment and strengths-based approaches; (4) focusing energy and resources on the priorities of marginalized communities; (5) contributing time, funding, and effort to preventive work; (6) engaging with social systems; and (7) raising awareness about system impacts on individual and community well-being. Vignettes of relevant ethical dilemmas are presented and implications for practice are discussed.

This article explores the need for a set of ethical standards to guide psychologists’ social justice-oriented work. It conceptualizes social justice as having three components, focused on relational dynamics, provision for all, and just processes. Additionally, it outlines and provides examples of seven proposed standards for social justice ethics in psychology.

The article is here.

Wednesday, January 8, 2020

Can expert bias be reduced in medical guidelines?

Sheldon Greenfield
BMJ 2019; 367

Here are two excerpts:

Despite robust study designs, even double blind randomised controlled trials can be subject to subtle forms of bias. This can be because of the financial conflicts of interest of the authors, intellectual or disciplinary based opinions, pressure on researchers from sponsors, or conflicting values. For example, some researchers may favour mortality over quality of life as a primary outcome, demonstrating a value conflict. The quality of evidence is often uneven and can include underappreciated sources of bias. This makes interpreting the evidence difficult, which results in guideline developers turning to “experts” to translate it into clinical practice recommendations.

Can we be confident that these experts are objective and free of bias? A 2011 Institute of Medicine (now known as the National Academy of Medicine) report1 challenged the assumption of objectivity among guideline development experts.


The science that supports clinical medicine is constantly evolving. The pace of that evolution is increasing.

There is an urgent imperative to generate and update accurate, unbiased, clinical practice guidelines. So, what can we do now? I have two suggestions.

Firstly, the public, which may include physicians, nurses, and other healthcare providers dependent on guidelines, should advocate for organisations like the ECRI Institute and its international counterparts to be supported and looked to for setting standards.

Secondly, we should continue to examine the details and principles of “shared decision making” and other initiatives like it, so that doctors and patients can be as clear as possible in the face of uncertain evidence about medical treatments and recommendations.

It is an uphill battle, but one worth fighting.

Wednesday, October 23, 2019

Supreme Court Ethics Reform

Johanna Kalb and Alicia Bannon
Brennan Center for Justice
Originally published September 24, 2019

Today, the nine justices on the Supreme Court are the only U.S. judges — state or federal — not governed by a code of ethical conduct. But that may be about to change. Justice Elena Kagan recently testified during a congressional budget hearing that Chief Justice John Roberts is exploring whether to develop an ethical code for the Court. This was big news, given that the chief justice has previously rejected the need for a Supreme Court ethics code.

In fact, however, the Supreme Court regularly faces challenging ethical questions, and because of their crucial and prominent role, the justices receive intense public scrutiny for their choices. Over the last two decades, almost all members of the Supreme Court have been criticized for engaging in behaviors that are forbidden to other federal court judges, including participating in partisan convenings or fundraisers, accepting expensive gifts or travel, making partisan comments at public events or in the media, or failing to recuse themselves from cases involving apparent conflicts of interest, either financial or personal. Congress has also taken notice of the problem. The For the People Act, which was passed in March 2019 by the House of Representatives, included the latest of a series of proposals by both Republican and Democratic legislators to clarify the ethical standards that apply to the justices’ behavior.

The info is here.

Saturday, June 15, 2019

Legal questions surround police use of facial recognition tech

Alexander J Martin, Technology Reporter and Tom Cheshire
Originally posted August 23, 2017

Here is an excerpt:

He noted that despite this threat to privacy "this new database is subject to none of the governance controls or other protections which apply as regards the DNA and fingerprint databases" - and that it "has been put into operation without public or parliamentary consultation or debate."

Similar concerns were raised by Parliament's science and technology committee, which also complained to the Government that it was running two years late on its planned publication date for the joint forensics and biometrics strategy.

Although a separate forensics strategy has since been published, the biometrics strategy - which will set out how police can use technologies such as facial recognition - has still not been released by the Home Office, and it is now four years overdue.

The committee also noted that facial biometrics were currently not covered by strict rules that govern the police's collection of DNA profiles and fingerprints, and recommended the biometrics commissioner's role be expanded to include them.

The info is here.

Wednesday, June 12, 2019

'Ethics Bots' and Other Ways to Move Your Code of Business Conduct Beyond Puffery

Michael Blanding
Harvard Business Week
Originally posted May 14, 2019

Here is an excerpt:

Even if not ready to develop or deploy such technologically advanced solutions, companies can still make their ethics codes more intuitive, interactive, and practical for day-to-day decision-making, Soltes says. That may mean reducing the number of broad-brush value statements and uninspired clip-art, instead making the document more concise in describing practical guidelines for the company’s employees.

He also recommends thinking beyond the legal department to bring in other areas of the company, such as marketing, communications, or consumer behavior specialists, to help design a code that will be understandable to employees. Uber, for example, rolled out a mobile app-focused version of its ethics code to better serve its employees, who are younger and more tech savvy.

Lastly, Soltes advises that firms not be afraid to experiment. An ethics code shouldn’t be a monolith, but rather a living document that can be adapted to the expanding needs of a firm and its employees. After rolling out a policy to a subgroup of employees, for example, companies should evaluate how the code is actually being used in practice and how it can be further refined and improved.

That kind of creativity can help companies stay away from the scrutiny of regulators and avoid negative headlines. “Ultimately, the goal should not simply be to just create a legal document, but instead a valuable tool that helps cultivate the kind of behavior and culture the firm wants to support on a day-to-day basis,” Soltes says.

The info is here.

Saturday, April 6, 2019

Wit et al. vs. United Behavioral Health and Alexander et al. vs. United Behavioral Health

U.S. Federal Court Finds United Healthcare Affiliate Illegally Denied Mental Health and Substance Use Coverage in Nationwide Class Action

  • Landmark Case Challenges the Nation’s Largest Mental Health Insurance Company for Unlawful, Systematic Claims Denials – and Wins
  • Groundbreaking Ruling Affects Certified Classes of Tens of Thousands of Patients, Including Thousands of Children and Teenagers 
  • Judge Rules, “At every level of care that is at issue in this case, there is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions.”

In a landmark mental health ruling, a federal court held today that health insurance giant United Behavioral Health (UBH), which serves over 60 million members and is owned by UnitedHealth Group, used flawed internal guidelines to unlawfully deny mental health and substance use treatment for its insureds across the United States. The historic class action was filed by Psych-Appeal, Inc. and Zuckerman Spaeder LLP, and litigated in the U.S. District Court for the Northern District of California.

The federal court found that, to promote its own bottom line, UBH denied claims based on internally developed medical necessity criteria that were far more restrictive than generally accepted standards for behavioral health care. Specifically, the court found that UBH’s criteria were skewed to cover “acute” treatment, which is short-term or crisis-focused, and disregarded chronic or complex mental health conditions that often require ongoing care.

The court was particularly troubled by UBH’s lack of coverage criteria for children and adolescents, estimated to number in the thousands in the certified classes.

“For far too long, patients and their families have been stretched to the breaking point, both financially and emotionally, as they battle with insurers for the mental health coverage promised by their health plans,” said Meiram Bendat of Psych-Appeal, Inc. and co-counsel for the plaintiffs who uncovered the guideline flaws. “Now a court has ruled that denying coverage based on defective medical necessity criteria is illegal.”

In its decision, the court also held that UBH misled regulators about its guidelines being consistent with the American Society of Addiction Medicine (ASAM) criteria, which insurers must use in Connecticut, Illinois and Rhode Island. Additionally, the court found that UBH failed to apply Texas-mandated substance use criteria for at least a portion of the class period.

The legal opinion is here.

Monday, January 28, 2019

Second woman carrying gene-edited baby, Chinese authorities confirm

Zhou Xiaoqin, left, loads Cas9 protein and PCSK9 sgRNA molecules into a fine glass pipette as Qin Jinzhou watches at a laboratory in Shenzhen in southern ChinaAgence France-Presse
Originally posted January 21, 2019

A second woman became pregnant during the experiment to create the world’s first genetically edited babies, Chinese authorities have confirmed, as the researcher behind the claim faces a police investigation.

He Jiankui shocked the scientific community last year after announcing he had successfully altered the genes of twin girls born in November to prevent them contracting HIV.

He had told a human genome forum in Hong Kong there had been “another potential pregnancy” involving a second couple.

A provincial government investigation has since confirmed the existence of the second mother and that the woman was still pregnant, the official Xinhua news agency reported.

The expectant mother and the twin girls from the first pregnancy will be put under medical observation, an investigator told Xinhua.

The info is here.

Thursday, March 15, 2018

Apple’s Move to Share Health Care Records Is a Game-Changer

Aneesh Chopra and Safiq Rab
Originally posted February 19, 2018

Here is an excerpt:

Naysayers point out the fact that Apple is currently displaying only a sliver of a consumer’s entire electronic health record. That is true, but it's largely on account of the limited information available via the open API standard. As with all standards efforts, the FHIR API will add more content, like scheduling slots and clinical notes, over time. Some of that work will be motivated by proposed federal government voluntary framework to expand the types of data that must be shared over time by certified systems, as noted in this draft approach out for public comment.

Imagine if Apple further opens up Apple Health so it no longer serves as the destination, but a conduit for a patient's longitudinal health record to a growing marketplace of applications that can help guide consumers through decisions to better manage their health.

Thankfully, the consumer data-sharing movement—placing the longitudinal health record in the hands of the patient and the applications they trust—is taking hold, albeit quietly. In just the past few weeks, a number of health systems that were initially slow to turn on the required APIs suddenly found the motivation to meet Apple's requirement.

The article is here.

Wednesday, February 28, 2018

Can scientists agree on a code of ethics?

David Ryan Polgar
Originally published January 30, 2018

Here is an excerpt:

Regarding the motivation for developing this Code of Ethics, Hug mentioned the threat of reduced credibility of research if the standards seem to loose. She mentioned the pressure that many young scientists face in being prolific with research, insinuating the tension with quantity versus quality. "We want research to remain credible because we want it to have an impact on policymakers, research being turned into action." One of the goals of Hug presenting about the Code of Ethics, she said, was to start having various research institutions endorse the document, and have those institutions start distributing the Code of Ethics within their network.

“All these goals will conflict with each other," said Jodi Halpern, referring to the issues that may get in the way of adopting a code of ethics for scientists. "People need rigorous education in ethical reasoning, which is just as rigorous as science education...what I’d rather have as a requirement, if I’d like to put teeth anywhere. I’d like to have every doctoral student not just have one of those superficial IRB fake compliance courses, but I’d like to have them have to pass a rigorous exam showing how they would deal with certain ethical dilemmas. And everybody who will be the head of a lab someday will have really learned how to do that type of thinking.”

The article is here.

Thursday, February 22, 2018

NIH adopts new rules on human research, worrying behavioral scientists

William Wan
The Washington Post
Originally posted January 24, 2018

Last year, the National Institutes of Health announced plans to tighten its rules for all research involving humans — including new requirements for scientists studying human behavior — and touched off a panic.

Some of the country’s biggest scientific associations, including the American Psychological Association and Federation of Associations in Behavioral and Brain Sciences, penned impassioned letters over the summer warning that the new policies could slow scientific progress, increase red tape and present obstacles for researchers working in smaller labs with less financial and administrative resources to deal with the added requirements. More than 3,500 scientists signed an open letter to NIH director Francis Collins.

The new rules are scheduled to take effect Thursday. They will have a big impact on how research is conducted, especially in fields like psychology and neuroscience. NIH distributes more than $32 billion each year, making it the largest public funder of biomedical and health research in the world, and the rules apply to any NIH-supported work that studies human subjects and is evaluating the effects of interventions on health or behavior.

The article is here.

Sunday, February 4, 2018

Goldwater Rule: Red Line or Guideline?

Scott O. Lilienfeld, , Joshua D. Miller, Donald R. Lynam
Perspectives on Psychological Science 
Vol 13, Issue 1, pp. 33 - 35
First Published October 13, 2017

The decades following Miller’s (1969) call for psychological scientists to “give psychology away” have witnessed a growing recognition that we need to do more to communicate our knowledge to the general public (Kaslow, 2015; Lilienfeld, 2012). But should there be limits on the nature of this communication? The Goldwater Rule, which expressly forbids psychiatrists from commenting on the mental health of public figures whom they have not directly examined, answers this query in the affirmative; as we observed in our article (Lilienfeld, Miller, & Lynam, 2017), this rule has been de facto adopted by psychology.

We appreciate the opportunity to respond to two commentators who raise thoughtful qualifications and objections to our thesis, which holds that the Goldwater Rule is antiquated and premised on dubious scientific assumptions.  We are pleased that both scholars concur with us that the direct interview assumption—the principal empirical linchpin of the Goldwater Rule—is contradicted by large bodies of psychological research.

(cut to the conclusion)

Psychologists should typically refrain from proffering diagnostic judgments regarding public figures. Such judgments boost the risk of inaccurate ‘arm chair' diagnoses and of damaging the reputation of public figures and the profession at large.  At the same time, there is scant justification for a categorical ban on this practice, especially because psychologists can at times offer diagnostic information that bears to some degree on the question of individuals’ suitability for high public office.  We therefore recommend reformulating the 'Goldwater Rule” as the 'Goldwater Guideline.’  Such a change would underscore the wisdom of discretion with respect to statements concerning the diagnostic status of public figures but remind psychologists that such statements can be useful and even advisable within limits.

The article is here.

Thursday, January 11, 2018

The IEEE Global Initiative on Ethics of Autonomous and Intelligent Systems

Aligned Design: A Vision for Prioritizing Human Well-being with Autonomous and Intelligent Systems, Version 2. 
IEEE, 2017.


As the use and impact of autonomous and intelligent systems (A/IS) become pervasive, we need to establish societal and policy guidelines in order for such systems to remain human-centric, serving humanity’s values and ethical principles. These systems have to behave in a way that is beneficial to people beyond reaching functional goals and addressing technical problems. This will allow for an elevated level of trust between people and technology that is needed for its fruitful, pervasive use in our daily lives.

To be able to contribute in a positive, non-dogmatic way, we, the techno-scientific communities, need to enhance our self-reflection, we need to have an open and honest debate around our imaginary, our sets of explicit or implicit values, our institutions, symbols and representations.

Eudaimonia, as elucidated by Aristotle, is a practice that defines human well-being as the highest virtue for a society. Translated roughly as “flourishing,” the benefits of eudaimonia begin by conscious contemplation, where ethical considerations help us define how we wish to live.

Whether our ethical practices are Western (Aristotelian, Kantian), Eastern (Shinto, Confucian), African (Ubuntu), or from a different tradition, by creating autonomous and intelligent systems that explicitly honor inalienable human rights and the beneficial values of their users, we can prioritize the increase of human well-being as our metric for progress in the algorithmic age. Measuring and honoring the potential of holistic economic prosperity should become more important than pursuing one-dimensional goals like productivity increase or GDP growth.

The guidelines are here.

Monday, January 1, 2018

Leaders Don't Make Deals About Ethics

John Baldoni
Originally published December 8, 2017

Here is an excerpt:

Partisanship abides in darker recesses of our human nature; it’s about winning at all costs. Partisans comfort themselves that their side is in the right, and therefore, whatever they do to promote it is correct. To them I quote Abraham Lincoln: “my concern is not whether God is on our side; my greatest concern is to be on God's side, for God is always right."

Human values do not need to be sanctioned through religious faith. Human values as they relate to morality, equality and dignity are bedrock principles that when cast aside allow aberrant and abhorrent behaviors to flourish. The least among us become the most preyed-upon among us.

Ethics therefore knows no party. The Me Too movement is apolitical; it gives voice to women who have been abused. The preyed upon are beginning to take back what they never should have lost in the first place – their dignity. To argue about which party – or which industry – has the most sexual harassers is a fool’s errand. Sexual harassers exist within every social strata as well as every political persuasion.

Living by a moral code is putting into practice what you believe is right. That is, you call out men who abuse women – as well as all those who give the abusers sanctuary. Right now, men in powerful positions in the media, business and politics are tumbling like dominoes.

But make no mistake — there are bosses in organizations of every kind who are guilty of sexual harassment and worse. A moral code demands that such men be exposed for their predatory behaviors. It also demands protection for their accusers.

The article is here.

Friday, December 1, 2017

Selling Bad Therapy to Trauma Victims

Jonathan Shedler
Psychology Today
Originally published November 19, 2017

Here is the conclusion:

First, do no harm

Many health insurance companies discriminate against psychotherapy. Congress has passed laws mandating mental health “parity” (equal coverage for medical and mental health conditions) but health insurers circumvent them. This has led to class action lawsuits against health insurance companies, but discrimination continues.

One way that health insurers circumvent parity laws is by shunting patients to the briefest and cheapest therapies — just the kind of therapies recommended by the APA’s treatment guidelines. Another way is by making therapy so impersonal and dehumanizing that patients drop out. Health insurers do not publicly say the treatment decisions are driven by economic self-interest. They say the treatments are scientifically proven — and point to treatment guidelines like those just issued by the APA.

It’s bad enough that most Americans don’t have adequate mental health coverage, without also being gaslighted and told that inadequate therapy is the best therapy.

The APA’s ethics code begins, “Psychologists strive to benefit those with whom they work and take care to do no harm.” APA has an honorable history of fighting for patients’ access to good care and against health insurance company abuses.

Blinded by RCT ideology, APA inadvertently handed a trump card to the worst apples in the health insurance industry.

The article is here.