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 Public Policy. Show all posts
Showing posts with label Public Policy. Show all posts

Sunday, September 17, 2023

The Plunging Number of Primary Care Physicians Reaches a Tipping Point.

Elisabeth Rosenthal
KFF Health News
Originally posted 8 September 23

Here are two excerpts:

The percentage of U.S. doctors in adult primary care has been declining for years and is now about 25% — a tipping point beyond which many Americans won’t be able to find a family doctor at all.

Already, more than 100 million Americans don’t have usual access to primary care, a number that has nearly doubled since 2014. One reason our coronavirus vaccination rates were low compared with those in countries such as China, France, and Japan could be because so many of us no longer regularly see a familiar doctor we trust.

Another telling statistic: In 1980, 62% of doctor’s visits for adults 65 and older were for primary care and 38% were for specialists, according to Michael L. Barnett, a health systems researcher and primary care doctor in the Harvard Medical School system. By 2013, that ratio had exactly flipped and has likely “only gotten worse,” he said, noting sadly: “We have a specialty-driven system. Primary care is seen as a thankless, undesirable backwater.” That’s “tragic,” in his words — studies show that a strong foundation of primary care yields better health outcomes overall, greater equity in health care access, and lower per capita health costs.

One explanation for the disappearing primary care doctor is financial. The payment structure in the U.S. health system has long rewarded surgeries and procedures while shortchanging the diagnostic, prescriptive, and preventive work that is the province of primary care. Furthermore, the traditionally independent doctors in this field have little power to negotiate sustainable payments with the mammoth insurers in the U.S. market.

Faced with this situation, many independent primary care doctors have sold their practices to health systems or commercial management chains (some private equity-owned) so that, today, three-quarters of doctors are now employees of those outfits.


Some relatively simple solutions are available, if we care enough about supporting this foundational part of a good medical system. Hospitals and commercial groups could invest some of the money they earn by replacing hips and knees to support primary care staffing; giving these doctors more face time with their patients would be good for their customers’ health and loyalty if not (always) the bottom line.

Reimbursement for primary care visits could be increased to reflect their value — perhaps by enacting a national primary care fee schedule, so these doctors won’t have to butt heads with insurers. And policymakers could consider forgiving the medical school debt of doctors who choose primary care as a profession.

They deserve support that allows them to do what they were trained to do: diagnosing, treating, and getting to know their patients.

Here is my warning:

The number of primary care physicians in the US is declining, and this trend is reaching a tipping point. More than 100 million Americans don't have usual access to primary care, and this number has nearly doubled since 2014. This shortage of primary care physicians could have a negative impact on public health, as people without access to primary care are more likely to delay or forgo needed care.

Thursday, July 20, 2023

Big tech is bad. Big A.I. will be worse.

Daron Acemoglu and Simon Johnson
The New York Times
Originally posted 15 June 23

Here is an excerpt:

Today, those countervailing forces either don’t exist or are greatly weakened. Generative A.I. requires even deeper pockets than textile factories and steel mills. As a result, most of its obvious opportunities have already fallen into the hands of Microsoft, with its market capitalization of $2.4 trillion, and Alphabet, worth $1.6 trillion.

At the same time, powers like trade unions have been weakened by 40 years of deregulation ideology (Ronald Reagan, Margaret Thatcher, two Bushes and even Bill Clinton). For the same reason, the U.S. government’s ability to regulate anything larger than a kitten has withered. Extreme polarization, fear of killing the golden (donor) goose or undermining national security means that most members of Congress would still rather look away.

To prevent data monopolies from ruining our lives, we need to mobilize effective countervailing power — and fast.

Congress needs to assert individual ownership rights over underlying data that is relied on to build A.I. systems. If Big A.I. wants to use our data, we want something in return to address problems that communities define and to raise the true productivity of workers. Rather than machine intelligence, what we need is “machine usefulness,” which emphasizes the ability of computers to augment human capabilities. This would be a much more fruitful direction for increasing productivity. By empowering workers and reinforcing human decision making in the production process, it also would strengthen social forces that can stand up to big tech companies. It would also require a greater diversity of approaches to new technology, thus making another dent in the monopoly of Big A.I.

We also need regulation that protects privacy and pushes back against surveillance capitalism, or the pervasive use of technology to monitor what we do — including whether we are in compliance with “acceptable” behavior, as defined by employers and how the police interpret the law, and which can now be assessed in real time by A.I. There is a real danger that A.I. will be used to manipulate our choices and distort lives.

Finally, we need a graduated system for corporate taxes, so that tax rates are higher for companies when they make more profit in dollar terms. Such a tax system would put shareholder pressure on tech titans to break themselves up, thus lowering their effective tax rate. More competition would help by creating a diversity of ideas and more opportunities to develop a pro-human direction for digital technologies.

The article argues that big tech companies, such as Google, Amazon, and Facebook, have already accumulated too much power and control. I concur that if these companies are allowed to continue their unchecked growth, they will eventually become too powerful and oppressive because of strength of AI compared to the limited thinking and reasoning of human beings.

Tuesday, April 5, 2022

The Emerging Science of Suicide Prevention

Kim Armstong
Originally published 28 FEB 22

The decisions leading up to a person’s death by suicide are made under conditions unlike almost any other. Although we may spend weeks or even months considering whether to purchase a home, change jobs, or get married, the decision to attempt suicide is often made in the spur of the moment amid a crush of emotions, according to Brian W. Bauer and Daniel W. Capron (University of Southern Mississippi). A person may live with suicidal thoughts for years, yet anywhere from 25% to 40% of suicide attempts may take place less than 5 minutes after the individual decides to take their life, Bauer and Capron wrote in a 2020 Perspectives on Psychological Science article. 

These circumstances make people experiencing suicidal ideation uniquely vulnerable to common cognitive biases that can result in irrational decision-making, causing them to act against their own self-interest. We are particularly bad at predicting how our emotional state may change in the future and tend to value short-term relief over long-term outcomes, Bauer and Capron noted. Both of these tendencies can contribute to the decision to end severe psychological pain through suicide despite the strong possibility that those feelings will change given time. 

Nudges could offer some hope to people in crisis. Based in behavioral economics, these microinterventions are designed to push people toward making choices that align with their own self-interest, such as conserving energy or getting vaccinated, by providing easily digestible information about the benefits of those choices (e.g., stickers on washing machines reading “Fuller laundry loads save water”) or even removing barriers to making those choices (e.g., offering walk-in vaccinations instead of requiring appointments). 

Nudges have been used in mental health contexts to help people cut back on their drinking and enroll in treatment programs. In the case of suicide prevention, pre-crisis interventions can occur at several levels, Bauer said in an interview with the Observer.  

Public safety campaigns, for example, might advise gun owners to store their firearms and ammunition separately, creating a barrier to impulsive self-harm, and encourage them to save the number for a local crisis hotline in their phone. In clinical care settings, reframing education on coping skills as a way to assist peers, rather than oneself, may increase patients’ willingness to complete safety plans and participate in suicide prevention workshops. And for individual patients, smartphones may offer an avenue for effective “just-in-time” interventions. 

Unfortunately, no nudge is a one-size-fits-all solution, Bauer said. 

Thursday, December 2, 2021

The globalizability of temporal discounting

Ruggeri, K., Panin, A., et al. (2021, October 1). 


Economic inequality is associated with extreme rates of temporal discounting, which is a behavioral pattern where individuals choose smaller, immediate financial gains over larger, delayed gains. Such patterns may feed into rising global inequality, yet it is unclear if they are a function of choice preferences or norms, or rather absence of sufficient resources to meet immediate needs. It is also not clear if these reflect true differences in choice patterns between income groups. We test temporal discounting and five intertemporal choice anomalies using local currencies and value standards in 61 countries. Across a diverse sample of 13,629 participants, we found highly consistent rates of choice anomalies. Individuals with lower incomes were not significantly different, but economic inequality and broader financial circumstances impact population choice patterns.

Technical Abstract

Economic inequality is associated with extreme rates of temporal discounting, which is a behavioral pattern  where  individuals  choose  smaller,  immediate  financial  gains  over larger, delayed gains. Such patterns may feed into rising global inequality, yet it is unclear if  they are a function of choice preferences or norms, or rather absence of sufficient resources to meet immediate needs. It is also not clear if these reflect true differences in choice  patterns  between  income  groups.  We  test  temporal  discounting and  five intertemporal choice anomalies using local currencies and value standards in 61 countries. Across a diverse sample of 13,629 participants, we found highly consistent rates choice anomalies. Individuals with lower incomes were not significantly different, but economic inequality and broader financial circumstances impact population choice patterns.

Bottom line: This research refutes the perspective that low-income individuals are poor decision-makers.

Sunday, April 18, 2021

The Antiscience Movement Is Escalating, Going Global and Killing Thousands

Peter J. Hotez
Scientific American
Originally posted 29 MAR 21

Antiscience has emerged as a dominant and highly lethal force, and one that threatens global security, as much as do terrorism and nuclear proliferation. We must mount a counteroffensive and build new infrastructure to combat antiscience, just as we have for these other more widely recognized and established threats.

Antiscience is the rejection of mainstream scientific views and methods or their replacement with unproven or deliberately misleading theories, often for nefarious and political gains. It targets prominent scientists and attempts to discredit them. The destructive potential of antiscience was fully realized in the U.S.S.R. under Joseph Stalin. Millions of Russian peasants died from starvation and famine during the 1930s and 1940s because Stalin embraced the pseudoscientific views of Trofim Lysenko that promoted catastrophic wheat and other harvest failures. Soviet scientists who did not share Lysenko’s “vernalization” theories lost their positions or, like the plant geneticist, Nikolai Vavilov, starved to death in a gulag.

Now antiscience is causing mass deaths once again in this COVID-19 pandemic. Beginning in the spring of 2020, the Trump White House launched a coordinated disinformation campaign that dismissed the severity of the epidemic in the United States, attributed COVID deaths to other causes, claimed hospital admissions were due to a catch-up in elective surgeries, and asserted that ultimately that the epidemic would spontaneously evaporate. It also promoted hydroxychloroquine as a spectacular cure, while downplaying the importance of masks. Other authoritarian or populist regimes in Brazil, Mexico, Nicaragua, Philippines and Tanzania adopted some or all of these elements.   

As both a vaccine scientist and a parent of an adult daughter with autism and intellectual disabilities, I have years of experience going up against the antivaccine lobby, which claims vaccines cause autism or other chronic conditions. This prepared me to quickly recognize the outrageous claims made by members of the Trump White House staff, and to connect the dots to label them as antiscience disinformation. Despite my best efforts to sound the alarm and call it out, the antiscience disinformation created mass havoc in the red states. 

Monday, August 10, 2020

An approach for combining ethical principles with public opinion to guide public policy

E. Awad and others.
Artificial Intelligence
Volume 287, October 2020, 103349


We propose a framework for incorporating public opinion into policy making in situations where values are in conflict. This framework advocates creating vignettes representing value choices, eliciting the public's opinion on these choices, and using machine learning to extract principles that can serve as succinct statements of the policies implied by these choices and rules to guide the behavior of autonomous systems.

From the Discussion

In the general case, we would strongly recommend input from experts (including ethicists, legal scholars, policymakers among others). Still, two facts remain: (1) views on life and death are emotionally driven, so it’s hard for people to accept some authority figure telling them how they should behave; (2) Even from an ethical perspective, it’s not always clear which view is the correct one. In such cases, when policy experts cannot reach a consensus, they may use citizens’ preferences as a tie-breaker. Doing so, helps reach a conclusive decision, it promotes values of democracy, it increases public acceptance of this technology (especially when it provides much better safety), and it promotes their sense of involvement and citizenship.  On the other hand, a full dependence on public input would always have the possibility for tyranny of the majority, among other issues raised above. This is why our proposed method provides a suitable approach that combines the utilization of citizen’s input with the responsible oversight by experts.

In this paper, we propose a framework that can help resolve conflicting moral values. In so doing, we exploit two decades of research in the representation and abstraction of values from cases in the service of abstracting and representing the values expressed in crowd-sourced data to the end of informing public policy. As a results, the resolution of competing values is produced in two forms: one that can be implemented in autonomous systems to guide their behavior, and a human-readable representation (policy) of these rules. At the core of this framework, is the collection of data from the

Wednesday, May 13, 2020

America's Mental Health Crisis Hidden Behind Bars

Eric Westervelt & Liz Baker
Originally posted 25 Feb 20

Here is an excerpt:

It's a culmination of decades of policies affecting those with a mental illness. Many of the nation's asylums and hospitals were closed over the past 60-plus years — some horrific places that needed to be shuttered, others emptied to cut costs.

The idea was that they'd be replaced with community-based mental health care and supportive services. That didn't happen. Ensuing decades saw tougher sentencing under aggressive "war on drugs and crime" policies as well as cuts to subsidized housing and mental health. It all created a perfect storm of failed policies driving more of the mentally ill into the nation's jails and prisons.

Many were left to fend for themselves. Substance abuse and homelessness sometimes followed, as did encounters with police, who often are called first to help deal with the effects of or related to mental crises.

It has put the jails in an awkward position. Today the three biggest mental health centers in America are jails: LA County, Cook County, Ill. (Chicago) and New York City's Rikers Island jail. Without the support needed, conditions have created new asylums, advocates say, that can resemble the very places they vowed to shut down.

"Local jails and prisons have become the de facto mental health institutions," says Elizabeth Hancq, director of research at the Treatment Advocacy Center, a national nonprofit that works to eliminate barriers to treatment for people with severe mental illness. "It's really a humanitarian crisis that if you suffer from a severe mental illness in this country, you almost need to commit a crime in order to get into the system."

The info is here.

Wednesday, March 18, 2020

How Salesforce Makes Decisions on Ethics and Social Issues

Kristin Broughton
The Wall Street Journal
Originally published 17 Feb 20

After facing public backlash in 2018 for doing business with U.S. immigration authorities amid the separation of migrant families at the southern U.S. border, Salesforce.com Inc., a company known for speaking up on social issues, hired a resident ethicist.

Paula Goldman joined the business software company early last year as chief ethical and humane use officer, a new role tasked with developing a framework for making decisions on complicated political issues.

Although the company’s contract with U.S. Customs and Border Protection remains in place, Salesforce has tackled other controversial issues. In her first year on the job, Ms. Goldman supervised the development of a corporate policy that prohibits customers from using Salesforce’s software to sell military-style firearms to private citizens.

She also is responsible for ensuring Salesforce’s products are developed with ethics in mind, particularly those involving artificial intelligence. One way she has done that is by introducing a process known as “consequence scanning,” an exercise that requires employees to document the potential unintended outcomes of releasing a new function, she said.

“We’re in this moment of correction where it’s like, ‘Oh yeah, this is our responsibility to integrate this question into the way we do business,’” Ms. Goldman said.

The info is here.

Wednesday, March 11, 2020

The Polarization of Reality

A. Alesina, A. Miano, and S. Stantcheva
American Economic Review Papers and Proceedings

Evidence is growing that Americans are polarized not only in their views on policy issues and attitudes towards government and society, but also in their perceptions of the same, factual reality.

In this paper we conceptualize how to think about the polarization of reality and review recent papers that show that Republican and Democrats as well as Trump and non-Trump voters since 2016) view the same reality through a different lens. Perhaps as a result, they hold different views about policies and what should be done to address different economic and social issues.

The direction of causality is unclear: On the one hand, individuals could select into political affiliation based on their perceptions of reality. On the other hand, political affiliation affects the information one receives, the groups one interacts with, and the media one is exposed to, which in turn can shape perceptions of reality.

Regardless of the direction of causality though, this is not about having different attitudes about economic or social phenomena or policies that could justifiably be viewed differently from different angles.

What is striking is rather to have different perceptions of realities that can be factually checked.

We highlight evidence about differences in perceptions across the political spectrum on social mobility, inequality, immigration, and public policies.

We also show that providing information leads to different reassessments of reality and different responses along the policy support margin, depending on one’s political leanings.

The paper can be downloaded here.

Tuesday, February 25, 2020

The Morality of Taking From the Rich and Giving to the Poor

Noah Smith
Originally posted 11 Feb 20

Here is an excerpt:

Instead, economists can help by trying to translate people’s preferences for fairness, equality and other moral goals into actionable policy. This requires getting a handle on what amount and types of redistribution people actually want. Some researchers now are attempting to do this.

For example, in a new paper, economists Alain Cohn, Lasse Jessen, Marko Klasnja and Paul Smeets, reasoning that richer people have an outsized impact on the political process, use an online survey to measure how wealthy individuals think about redistribution. Their findings were not particularly surprising; people in the top 5% of the income and wealth distributions supported lower taxes and tended to vote Republican.

The authors also performed an online experiment in which some people were allowed to choose to redistribute winnings among other experimental subjects who completed an online task. No matter whether the winnings were awarded based on merit or luck, rich subjects chose less redistribution.

But not all rich subjects. Cohn and his co-authors found that people who grew up wealthy favored redistribution about as much as average Americans. But those with self-made fortunes favored more inequality. Apparently, many people who make it big out of poverty or the middle class believe that everyone should do the same.

This suggests that the U.S. has a dilemma. A dynamic economy creates lots of new companies, which bring great fortunes to the founders. But if Cohn and his co-authors are right, those founders are likely to support less redistribution as a result. So if the self-made entrepreneurs wield political power, as the authors believe, there could be a political trade-off between economic dynamism and redistribution.

The info is here.

Friday, June 21, 2019

It's not biology bro: Torture and the Misuse of Science

Shane O'Mara and John Schiemann
PsyArXiv Preprints
Last edited on December 24, 2018


Contrary to the (in)famous line in the film Zero Dark Thirty, the CIA's torture program was not based on biology or any other science. Instead, the Bush administration and the CIA decided to use coercion immediately after the 9/11 terrorist attacks and then veneered the program's justification with a patina of pseudoscience, ignoring the actual biology of torturing human brains. We reconstruct the Bush administration’s decision-making process from released government documents, independent investigations, journalistic accounts, and memoirs to establish that the policy decision to use torture took place in the immediate aftermath of the 9/11 attacks without any investigation into its efficacy. We then present the pseudo-scientific model of torture sold to the CIA based on a loose amalgamation of methods from the old KUBARK manual, reverse-engineering of SERE training techniques, and learned helplessness theory, show why this ad hoc model amounted to pseudoscience, and then catalog what the actual science of torturing human brains – available in 2001 – reveals about the practice. We conclude with a discussion of how process of policy-making might incorporate countervailing evidence to ensure that policy problems are forestalled, via the concept of an evidence-based policy brake, which is deliberately instituted to prevent a policy going forward that is contrary to law, ethics and evidence.

The info is here.

Thursday, November 29, 2018

Does AI Ethics Need to be More Inclusive?

Patrick Lin
Originally posted October 29, 2018

Here is an excerpt:

Ethics is more than a survey of opinions

First, as the study’s authors allude to in their Nature paper and elsewhere, public attitudes don’t dictate what’s ethical or not.  People believe all kinds of crazy things—such as that slavery should be permitted—but that doesn’t mean those ethical beliefs are true or have any weight.  So, capturing responses of more people doesn’t necessarily help figure out what’s ethical or not.  Sometimes, more is just more, not better or even helpful.

This is the difference between descriptive ethics and normative ethics.  The former is more like sociology that simply seeks to describe what people believe, while the latter is more like philosophy that seeks reasons for why a belief may be justified (or not) and how things ought to be.

Dr. Edmond Awad, lead author of the Nature paper, cautioned, “What we are trying to show here is descriptive ethics: peoples’ preferences in ethical decisions.  But when it comes to normative ethics, which is how things should be done, that should be left to experts.”

Nonetheless, public attitudes are a necessary ingredient in practical policymaking, which should aim at the ethical but doesn’t always hit that mark.  If expert judgments in ethics diverge too much from public attitudes—asking more from a population than what they’re willing to agree to—that’s a problem for implementing the policy, and a resolution is needed.

The info is here.

Thursday, April 12, 2018

CA’s Tax On Millionaires Yields Big Benefits For People With Mental Illness

Anna Gorman
Kaiser Health News
Originally published March 14, 2018

A statewide tax on the wealthy has significantly boosted mental health programs in California’s largest county, helping to reduce homelessness, incarceration and hospitalization, according to a report released Tuesday.

Revenue from the tax, the result of a statewide initiative passed in 2004, also expanded access to therapy and case management to almost 130,000 people up to age 25 in Los Angeles County, according to the report by the Rand Corp. Many were poor and from minority communities, the researchers said.

“Our results are encouraging about the impact these programs are having,” said Scott Ashwood, one of the authors and an associate policy researcher at Rand. “Overall we are seeing that these services are reaching a vulnerable population that needs them.”

The positive findings came just a few weeks after a critical state audit accused California counties of hoarding the mental health money — and the state of failing to ensure that the money was being spent. The February audit said that the California Department of Health Care Services allowed local mental health departments to accumulate $231 million in unspent funds by the end of the 2015-16 fiscal year — which should have been returned to the state because it was not spent in the allowed time frame.

Proposition 63, now known as the Mental Health Services Act, imposed a 1 percent tax on people who earn more than $1 million annually to pay for expanded mental health care in California. The measure raises about $2 billion each year for such services, such as preventing mental illness from progressing, reducing stigma and improving treatment. Altogether, counties have received $16.53 billion.

The information is here.

Sunday, February 11, 2018

Trump shifts meaning of 'Drain the Swamp' from ethics to anything he objects to

Noah Bierman
The Los Angeles Times
Originally posted February 9, 2018

Donald Trump long thought the phrase "Drain the Swamp" was a little hokey, he has confessed to crowds. Yet it stayed. If Frank Sinatra had to croon "My Way," even when he tired of it, Trump reasoned aloud, Trump could belt out his crowd-pleasing catchphrase.

More than a year into his presidency, Trump mouths the words a little less often. But rather than completely kill off a slogan that once rivaled "Build the Wall" in the Trump repertoire, he has done something more subversive: He has drained it of its meaning.

The motto no longer refers to Trump's promises of ethics and lobbying reforms — many of which have dropped by the wayside or been watered down — or to vows about stopping members of his administration from profiting from their service.

In recent months, Trump has rebranded the "swamp" to mean almost anything he objects to: reporters, opponents of his immigration plan, free traders, phonies, bureaucrats, politicians who vote against tax cuts.

The article is here.

Friday, January 19, 2018

Why banning autonomous killer robots wouldn’t solve anything

Susanne Burri and Michael Robillard
Originally published December 19, 2017

Here is an excerpt:

For another thing, it is naive to assume that we can enjoy the benefits of the recent advances in artificial intelligence (AI) without being exposed to at least some downsides as well. Suppose the UN were to implement a preventive ban on the further development of all autonomous weapons technology. Further suppose – quite optimistically, already – that all armies around the world were to respect the ban, and abort their autonomous-weapons research programmes. Even with both of these assumptions in place, we would still have to worry about autonomous weapons. A self-driving car can be easily re-programmed into an autonomous weapons system: instead of instructing it to swerve when it sees a pedestrian, just teach it to run over the pedestrian.

To put the point more generally, AI technology is tremendously useful, and it already permeates our lives in ways we don’t always notice, and aren’t always able to comprehend fully. Given its pervasive presence, it is shortsighted to think that the technology’s abuse can be prevented if only the further development of autonomous weapons is halted. In fact, it might well take the sophisticated and discriminate autonomous-weapons systems that armies around the world are currently in the process of developing if we are to effectively counter the much cruder autonomous weapons that are quite easily constructed through the reprogramming of seemingly benign AI technology such as the self-driving car.

The article is here.

Tuesday, January 16, 2018

Should Governments Invest More in Nudging?

Shlomo Benartzi, John Beshears, Katherine L. Milkman, and others
Psychological Science 
Vol 28, Issue 8, pp. 1041 - 1055
First Published June 5, 2017


Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes to economic incentives. We calculated ratios of impact to cost for nudge interventions and for traditional policy tools, such as tax incentives and other financial inducements, and we found that nudge interventions often compare favorably with traditional interventions. We conclude that nudging is a valuable approach that should be used more often in conjunction with traditional policies, but more calculations are needed to
determine the relative effectiveness of nudging.

The article is here.

Thursday, September 7, 2017

Harm to self outweighs benefit to others in moral decision making

Lukas J. Volz, B. Locke Welborn, Matthias S. Gobel, Michael S. Gazzaniga, and Scott T. Grafton
PNAS 2017 ; published ahead of print July 10, 2017


How we make decisions that have direct consequences for ourselves and others forms the moral foundation of our society. Whereas economic theory contends that humans aim at maximizing their own gains, recent seminal psychological work suggests that our behavior is instead hyperaltruistic: We are more willing to sacrifice gains to spare others from harm than to spare ourselves from harm. To investigate how such egoistic and hyperaltruistic tendencies influence moral decision making, we investigated trade-off decisions combining monetary rewards and painful electric shocks, administered to the participants themselves or an anonymous other. Whereas we replicated the notion of hyperaltruism (i.e., the willingness to forego reward to spare others from harm), we observed strongly egoistic tendencies in participants’ unwillingness to harm themselves for others’ benefit. The moral principle guiding intersubject trade-off decision making observed in our study is best described as egoistically biased altruism, with important implications for our understanding of economic and social interactions in our society.


Principles guiding decisions that affect both ourselves and others are of prominent importance for human societies. Previous accounts in economics and psychological science have often described decision making as either categorically egoistic or altruistic. Instead, the present work shows that genuine altruism is embedded in context-specific egoistic bias. Participants were willing to both forgo monetary reward to spare the other from painful electric shocks and also to suffer painful electric shocks to secure monetary reward for the other. However, across all trials and conditions, participants accrued more reward and less harm for the self than for the other person. These results characterize human decision makers as egoistically biased altruists, with important implications for psychology, economics, and public policy.

The article is here.

Wednesday, March 22, 2017

Act versus Impact: Conservatives and Liberals Exhibit Different Structural Emphases in Moral Judgment

Ivar R. Hannikainen, Ryan M. Miller, & Fiery A. Cushman
Ratio: Special Issue on ‘Experimental Philosophy as Applied Philosophy’

Conservatives and liberals disagree sharply on matters of morality and public policy. We propose a
novel account of the psychological basis of these differences. Specifically, we find that conservatives
tend to emphasize the intrinsic value of actions during moral judgment, in part by mentally simulating themselves performing those actions, while liberals instead emphasize the value of the expected outcomes of the action. We then demonstrate that a structural emphasis on actions is linked to the condemnation of victimless crimes, a distinctive feature of conservative morality. Next, we find that the conservative and liberal structural approaches to moral judgment are associated with their corresponding patterns of reliance on distinct moral foundations. In addition, the structural approach uniquely predicts that conservatives will be more opposed to harm in circumstances like the wellknown trolley problem, a result which we replicate. Finally, we show that the structural approaches of conservatives and liberals are partly linked to underlying cognitive styles (intuitive versus deliberative).  Collectively, these findings forge a link between two important yet previously independent lines of research in political psychology: cognitive style and moral foundations theory.

The article is here.

Saturday, October 8, 2016

The Irrational Idea That Humans Are Mostly Irrational

Paul Bloom
The Atlantic
Originally posted September 16, 2016

Last summer I was at a moral psychology conference in Chile, listening to speaker after speaker discuss research into how people think about sexuality, crime, taxation, and other politically and socially fraught issues. The consensus was that human moral reasoning is a mess—irrational, contradictory, and incoherent.

And how could it be otherwise? The evolutionary psychologists in the room argued that our propensity to reason about right and wrong arises through social adaptations calibrated to enhance our survival and reproduction, not to arrive at consistent or objective truth. And according to the social psychologists, we are continually swayed by irrelevant factors, by gut feelings and unconscious motivations. As the primatologist Frans de Waal once put it, summing up the psychological consensus: “We celebrate rationality, but when push comes to shove we assign it little weight.”

I think that this is mistaken. Yes, our moral capacities are far from perfect. But—as I’ve argued elsewhere, including in my forthcoming book on empathy—we are often capable of objective moral reasoning. And so we can arrive at novel, sometimes uncomfortable, moral positions, as when men appreciate the wrongness of sexism or when people who really like the taste of meat decide that it’s better to go without.

The article is here.

Tuesday, May 31, 2016

South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says

By Matt Apuzzomay
The New York Times
Originally posted May 2, 2016

When patients in South Dakota seek help for serious but manageable disabilities such as severe diabetes, blindness or mental illness, the answer is often the same: With few alternatives available, they end up in nursing homes or long-term care facilities, whether they need such care or not.

In a scathing rebuke of the state’s health care system, the Justice Department said on Monday that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago.

The Obama administration has opened more than 50 such investigations and reached settlements with eight states. One investigation, into Florida’s treatment of children with disabilities, ended in a lawsuit over policies that placed those children in nursing homes. With its report Monday, the Justice Department signaled that it might also sue South Dakota.

The article is here.