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

Friday, June 27, 2014

Psychology Can Make the Country Healthier

Insights can improve public health campaigns — and keep them from backfiring

By Crystal Hoyt and Jeni Burnette
Scientific American
Originally published June 10, 2014

Public health communications are designed to tackle significant medical issues such as obesity, AIDS, and cancer. For example, what message can best combat the growing obesity epidemic? Are educational messages effective at increasing condom use? Should cancer prevention messages stress the health risks of too much sun exposure? These are not just medical problems. These are fundamentally questions about perception, beliefs, and behavior. Psychologists bring a unique expertise to these questions and are finding consequential, and often non-intuitive, answers.

The entire article is here.

Thursday, June 19, 2014

Messy Morals

By Anthony Painter
The RSA Blog
Originally posted on May 29, 2014

David Marquand wants a new public philosophy. This philosophy will be based on ethics – a morality of social justice beyond the market. He sees that we are in a ‘moral crisis’. Markets, individualism and greed have taken over. The public good has been in retreat since Margaret Thatcher came to power.

He has found unlikely allies this week. Mark Carney, Governor of the Bank of England, and a group of capitalists gathering under an ‘inclusive capitalism’ banner have also suggested a different moral economy – though they would not necessarily express it that way. Smart business people and financiers see that the legitimacy of their activities relies on a different alignment between ethics and business. It is more about self-interest than morality. Nonetheless, the crossovers with David Marquand are intriguing.

The entire article is here.

Saturday, May 17, 2014

U.S. Should Significantly Reduce Rate of Incarceration

Unprecedented Rise in Prison Population ‘Not Serving the Country Well,’ Says New Report

Press Release from the National Academy of Sciences
Released April 30, 2014

Given the minimal impact of long prison sentences on crime prevention and the negative social consequences and burdensome financial costs of U.S. incarceration rates, which have more than quadrupled in the last four decades, the nation should revise current criminal justice policies to significantly reduce imprisonment rates, says a new report from the National Research Council.

A comprehensive review of data led the committee that wrote the report to conclude that the costs of the current rate of incarceration outweigh the benefits.  The committee recommended that federal and state policymakers re-examine policies requiring mandatory and long sentences, as well as take steps to improve prison conditions and to reduce unnecessary harm to the families and communities of those incarcerated.  In addition, it recommended a reconsideration of drug crime policy, given the apparently low effectiveness of a heightened enforcement strategy that resulted in a tenfold increase in the incarceration rate for drug offenses from 1980 to 2010 — twice the rate for other crimes.

“We are concerned that the United States is past the point where the number of people in prison can be justified by social benefits,” said committee chair Jeremy Travis, president of John Jay College of Criminal Justice in New York City.  “We need to embark on a national conversation to rethink the role of prison in society.  A criminal justice system that makes less use of incarceration can better achieve its aims than a harsher, more punitive system. There are common-sense, practical steps we can take to move in this direction.”

The rest of the press release is here.

Sunday, April 27, 2014

With Guns, Suicide Is the Biggest Problem

By Sarah Wickline
MedPage Today
Originally posted April 11, 2014

Every day, 88 people die from firearm-related injury; two-thirds of those deaths are suicides, a high proportion of which are committed by seniors and individuals living in rural areas, researchers reported here.

"Mass shooting episodes are obviously horrible," Molly Cooke, MD, president of the American College of Physicians (ACP), told reporters in a press briefing. "But one of the points we make in the paper is that every day there are 88 firearms-related deaths."

The entire article is here.

Friday, April 25, 2014

U.S. Prisons Becoming De Facto Home of the Mentally Ill

A new study reveals that prisons in America house ten times as many mentally ill as the state-run psychiatric wards that could actually treat them.

By Abby Haglage
The Daily Beast
Originally published April 10, 2014

Here is an excerpt:

While TAC’s study—titled The Treatment of Persons With Mental Illness in Prisons and Jails—isn’t the first of its kind, it’s notable for two reasons: it’s the first to analyze the data by state, and it’s the most recent illustration that the problem is growing more acute. One of the worst offenders is New York, where the law mandates mentally ill inmates be sent to psychiatric hospitals (which—given the lack of available beds—is mostly useless). A 2011 study estimated that of the 12,200 inmates at Riker’s Island, ⅓ of the men and ⅔ of the women are mentally ill.

The entire article is here.

Wednesday, April 9, 2014

Behavioural economics and public policy

By Tim Harford
The Financial Times
Originally published March 17, 2014

Here is an excerpt:

Behavioural economics is one of the hottest ideas in public policy. The UK government’s Behavioural Insights Team (BIT) uses the discipline to craft better policies, and in February was part-privatised with a mission to advise governments around the world. The White House announced its own behavioural insights team last summer.

So popular is the field that behavioural economics is now often misapplied as a catch-all term to refer to almost anything that’s cool in popular social science, from the storycraft of Malcolm Gladwell, author of The Tipping Point (2000), to the empirical investigations of Steven Levitt, co-author of Freakonomics (2005).

Yet, as with any success story, the backlash has begun. Critics argue that the field is overhyped, trivial, unreliable, a smokescreen for bad policy, an intellectual dead-end – or possibly all of the above.

The entire article is here.

Saturday, January 4, 2014

Nanoethics as a Discipline?

By Adam Keiper
The New Atlantis: A Journal of Technology and Society
Originally published in 2007, but still relevant today

Here is an excerpt:

The growing interest among academics and activists in the implications of nanotechnology is surely, in some ways, to be welcomed. Serious scholarship and responsible advocacy can serve to enlighten and invigorate policy disputes and thereby play an important role in democratic self-rule. After all, as anyone who follows nanotech policy debates even from a distance can tell you, those debates are awash in spin and misinformation. Environmental groups exaggerate the known dangers of nanoparticles. Firms involved in nanotech investment vie with one another in hyping their projections of how many trillions of dollars the “nanotechnology market,” defined as expansively as possible, will be worth in a few years’ time. Some analysts are ludicrously credulous, while others are just plain confused — like the panelist at a conference in Washington in April 2006 who fretted about Pentagon-funded research on nanosatellites. (Nanosatellites are just small satellites; they have even less to do with nanotechnology than Apple’s “iPod nano” does.) Commentators who are ill-informed or disingenuous or just “shooting from the lip” may, in time, cede the sound bites and the airwaves to the growing ranks of better-informed and more responsible scholars — or at least that’s the theory.

Indeed, that theory seems itself to be the core of nanoethics at the moment. A recurring theme in much of the social-science writing about nanotechnology is the importance of social-science writing about nanotechnology. When you sift through the growing piles of scholarship about media coverage of nanotechnology, about the public understanding of and attitudes toward nanotechnology, about whether there are multiple “publics” who need to be “engaged” in nanotech policy, one sentiment in particular becomes clear — social scientists’ sense of self-importance.

The entire article is here.

Tuesday, November 5, 2013

Economics as a moral science

by INGRID ROBEYNS on OCTOBER 31, 2013
The Crooked Timber

Here are some excerpts:

Why is it relevant now? In the lively discussion on what kind of science (or something else) economics is which is currently raging on the blogs, we should also consider the view of those who have argued that economics is a moral science. This, in Tony Atkinson’s words means that “Economists need to be more explicit about the relation between the welfare criteria and the objectives of government, policymakers and individual citizens”. Atkinson traces the expression back to Keynes, who had written in a letter that ‘economics is essentially a moral science’. More recent defenders of that view include Kenneth Boulding in his 1968 AEA presidential address, who defended the strong view that economics inherently depends on the acceptance of some values, and thus inherently has an ethical component.

(cut)

My view is this: economics shouldn’t aspire to be a value-free science, but an intellectual enterprise that combines elements from the sciences with elements from ‘the arts’ done in a manner that makes it value-commitments explicit. Values in economics have many sources. There are values involved in the choice of questions that are asked (and not asked). Value judgements are embedded in the normative principles (such as the Pareto-criterion) that are endorsed. Value judgments flow from the choices in how basic categories and notions are conceptualized (is ‘labour’ only what we do for pay, or also what we do to reproduce the human species?).

The entire post is here.

Sunday, July 7, 2013

Why politicians should have backgrounds in clinical psychology

By Alex Lickerman
KevinMD.com
Originally published May 14, 2013

Of all the different criteria people use when deciding for whom to vote in presidential elections, I’ve never heard anyone talk about the importance of a background in clinical psychology—but it’s always struck me as important for a president to have as for a clinical psychologist. Certainly, foreign policy experience, a firm grasp of the principles of economics, a bold and confident leadership style, and the ability to get people to work together are all critically important—but a moment of reflection is all it takes to realize that all of these abilities spring from an understanding of and ability to leverage the principles of human psychology.

Our scientific understanding of these principles has finally advanced far enough—and in many cases has been found to be counterintuitive enough—that, as wise as any one of us may be in our personal lives, compared to trained clinical and research psychologists, we’re all a bunch of amateurs. As a result of our politicians’ distinct lack of psychological expertise, we’ve experienced—and will continue to experience—a number of significant policy failures. Why? Because at its core, public policy achieves societal improvements by changing the behavior of its citizens. How can a policy be expected to achieve its purpose if it’s not then grounded in a correct understanding of human psychology?

The entire article is here.

Thanks for Ed Zuckerman for this blog.

Monday, June 17, 2013

Treatment of Mental Illness Lowers Arrest Rates, Saves Money

Science Daily
Originally published June 10, 2013

Research from North Carolina State University, the Research Triangle Institute (RTI) and the University of South Florida shows that outpatient treatment of mental illness significantly reduces arrest rates for people with mental health problems and saves taxpayers money.

"This study shows that providing mental health care is not only in the best interest of people with mental illness, but in the best interests of society," says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and co-author of a paper describing the research.

The researchers wanted to determine the extent to which treating mental illness can keep people with mental health problems out of trouble with the law. It is well established that people with mental health problems, such as schizophrenia or bipolar disorder, make up a disproportionate percentage of defendants, inmates and others who come into contact with the criminal justice system.

The entire story is here.

Tuesday, May 7, 2013

An Imperative for Change: Access to Psychological Services for Canada

Canadian Psychological Association
Press Release
May 2013

To mark the one year anniversary of Canada’s first mental health strategy next week, the Canadian Psychological Association (CPA) is releasing an independent report by a group of health economists. The report ‘An Imperative for Change’ states that the delivery of mental health services can be characterized as a silent crisis and provides a business case, and proposes models, for improved access to psychological services.

“One of the great challenges when it comes to caring for the mental health of Canadians is the significant barriers to accessing mental health services. Despite the fact that one in five Canadians will experience a mental health problem in a given year, only one-third will receive the help they need. We have psychological treatments that work, and experts trained to deliver them. Yet the services of psychologists are not funded by provincial health insurance plans, which make them inaccessible to many with modest incomes or no insurance. Publically funded services, when available, are often in short supply and wait lists are long. The cost of mental illness in Canada is estimated at 51 billion dollars annually so we need to act now and be innovative in our approach,” said Dr. Jennifer Frain, President of the CPA.

“Last year we were very pleased that Canada’s national mental health strategy called for increased access to evidence-based psychotherapies by service providers qualified to deliver them. In response, we commissioned a report to look at how this can be achieved. The report proposes and costs out four models that could be implemented and adapted here,” said Dr. Karen Cohen, Chief Executive Officer of the CPA.

“Canada has fallen behind other countries such as the United Kingdom, Australia, the Netherlands, and Finland who have launched mental health initiatives which include covering the services of psychologists through public health systems. These initiatives are proving both cost and clinically effective. Analysis of research in the United Kingdom found that substantial returns on investments could be achieved in the early detection and treatment of common mental health conditions such as depression. These models respond to the recommendations of the mental health strategy. By implementing them, we can move from conversation to action,” added Dr. Cohen.

Models for Canada

Adapt the United Kingdom’s publicly funded model for Improved Access to Psychological Therapies (IAPT) in the provinces and territories. Under this program psychologists and low intensity therapists deliver care for people with the most common mental health problems:

  • depression and anxiety.
  • Integrate psychologists on primary care teams so that mental health problems are addressed at the right time, in the right place, by the right provider.
  • Include psychologists on specialist care teams in secondary and tertiary care facilities for health and mental health conditions.
  • Expand private insurance coverage and promote employer support for psychological services
  • Canadian employers could expect to recover $6 to $7 billion annually with attention to prevention, early identification and treatment of mental health problems among their workforces.


Read “An Imperative for Change: Access to Psychological Services for Canada” here


Tuesday, March 12, 2013

Ethics of Admission, Pt. II: Undergraduates and the Brass Ring

By Jane Robbins
Inside Higher Ed
Originally posted February 26, 2013

Here are some excerpts:

But what about students? Is it worth the chance at the brass ring? One could say there is no choice but get on the merry-go-round—and that is certainly what they are being told. But if we know that many will not get a shot because of where they are placed or when they got on or whether, metaphorically, they lack the height compared to the one behind them to reach the ring, is the current approach wrong—in both the incorrect and immoral senses of the word?

The inevitable is, of course, happening: people are beginning to question the value of a college degree for them as individuals. This is why, counterintutively, the push for the current wage data approach to value is completely wrong-headed and also, I think unethical. It is the individual that has been lost in the wholesale approach to commodity credentials and wage comparison, a particularly perverse kind of educational “channeling.” In the service of whose interests is, for example, the tireless emphasis on STEM and the disparagement of arts? Who will care when large percentages with STEM credentials can’t find jobs, experience depressed wages because there are so many of them, and find themselves with no transferable skills or habits of mind when technology moves on? If it is going to be difficult to find a job anyway, one should at least have followed one’s own interests. Education should allow you to choose your work, not vice versa.

On the constant merry-go-round, we seem to have forgotten that college, or any other education at any level except technical and some forms of professional education, is not to get a job, and certainly not to get a particular job. That is what trade school is for. We should be encouraging students who want a particular job -- a vocation -- to train elsewhere, perhaps with the idea of getting more and broader education at a later time.

The rest of the blog post is here.

Tuesday, January 29, 2013

Warning Signs of Violent Acts Often Unclear

By BENEDICT CAREY and ANEMONA HARTOCOLLIS
The New York Times
Published: January 15, 2013

No one but a deeply disturbed individual marches into an elementary school or a movie theater and guns down random, innocent people.

That hard fact drives the public longing for a mental health system that produces clear warning signals and can somehow stop the violence. And it is now fueling a surge in legislative activity, in Washington and New York.

But these proposed changes and others like them may backfire and only reveal how broken the system is, experts said.

“Anytime you have one of these tragic cases like Newtown, it’s going to expose deficiencies in the mental health system, and provide some opportunity for reform,” said Richard J. Bonnie, a professor of public policy at the University of Virginia’s law school who led a state commission that overhauled policies after the 2007 Virginia Tech shootings that left 33 people dead. “But you have to be very careful not to overreact.”

The entire story is here.

Tuesday, October 9, 2012

President Obama Unveils Landmark Actions To Fight Human Trafficking


The president said it was time to call human trafficking by its real name: "modern slavery."

By ELIZABETH FLOCK
US News and World Report
Originally published September 26, 2012


President Barack Obama unveiled major actions to fight human trafficking at home and abroad in a speech at the Clinton Global Initiative's annual meeting Tuesday, a problem the U.S. has long sought to control.

Just hours after his Republican challenger Mitt Romney spoke to the same audience, arguing broadly that free trade and aid were the key to a better world, Obama chose to focus his speech on the single issue of trafficking, and what the U.S. can do to stop it. Obama told the assembled audience it was time to turn the focus on fighting trafficking within American borders.

"The ugly truth is that this goes on right here," he said. "It's the migrant worker unable to pay off the debt to his trafficker... The teenage girl—beaten, forced to walk the streets. This should not be happening in America."

The president also said it was time to call human trafficking by its real name: "modern slavery." Obama's speech came just days after the 150th anniversary of the Emancipation Proclamation, the executive order issued by President Abraham Lincoln in 1863 that freed millions of slaves across the United States.

The entire story is here.

Friday, September 28, 2012

Government Can Play Important Role in Obesity Epidemic, Expert Argues

ScienceDaily
Originally published September 18, 2012

Addressing the obesity epidemic by preventing excess calorie consumption with government regulation of portion sizes is justifiable and could be an effective measure to help prevent obesity-related health problems and deaths, according to a Viewpoint in the September 19 issue of JAMA, and theme issue on obesity.

Thomas A. Farley, M.D., M.P.H., Commissioner of the New York City Department of Health and Mental Hygiene, presented the article at a JAMA media briefing.

"Americans consume many more calories than needed, and the excess is leading to diabetes, cardiovascular disease, and premature mortality. Since the 1970s, caloric intake has increased by some 200 to 600 calories per person per day. Although it is unclear how important changes in physical activity are to the surge in obesity prevalence, it is quite clear that this increase in calorie consumption is the major cause of the obesity epidemic—an epidemic that each year is responsible for the deaths of more than 100,000 Americans and accounts for nearly $150 billion in health care costs," writes Dr. Farley.

The entire story is here.

Friday, August 17, 2012

Doctors target gun violence as a social disease

By Marilynn Marchione
Seattle Post-Intelligencer
Originally published on August 13, 2012

Is a gun like a virus, a car, tobacco or alcohol? Yes say public health experts, who in the wake of recent mass shootings are calling for a fresh look at gun violence as a social disease.

What we need, they say, is a public health approach to the problem, like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago, even as the number of vehicles on the road rose.

One example: Guardrails are now curved to the ground instead of having sharp metal ends that stick out and pose a hazard in a crash.

"People used to spear themselves and we blamed the drivers for that," said Dr. Garen Wintemute, an emergency medicine professor who directs the Violence Prevention Research Program at the University of California, Davis.

It wasn't enough back then to curb deaths just by trying to make people better drivers, and it isn't enough now to tackle gun violence by focusing solely on the people doing the shooting, he and other doctors say.

They want a science-based, pragmatic approach based on the reality of a society saturated with guns and seek better ways of preventing harm from them.

Saturday, July 21, 2012

Mental health disorders among troops increased 65 percent since 2000

By Rebecca Ruiz
msnbc.com
Originally published July 12, 2012

Mental health disorders in active-duty troops increased 65 percent since 2000, according to a report released this week by the Armed Forces Health Surveillance Center.

The report looked at a 12-year period between 2000 and 2011 and found that more than 936,000 service members had been diagnosed with at least one mental disorder. Of those diagnoses, about 85 percent were cases of adjustment disorders, depression, alcohol abuse and anxiety, among other conditions.

Between 2003 and 2008, the rate of post-traumatic stress disorder (PTSD) increased nearly sixfold; by 2011, there were more than 100,000 diagnoses. The report, however, did not evaluate mental disorders in relationship to deployments.

The entire story is here.

Friday, July 20, 2012

Aging Boomers' Mental Health Woes Will Swamp Health System

By Amanda Gardner
HealthDay Reporter
Originally published July 10, 2012

The United States faces an unprecedented number of aging baby boomers with mental health or substance use issues, a number so great it could overwhelm the existing health care system, a new report warned Tuesday.

"The report is sufficiently alarmist," said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "I think [the report authors] are right."

Kennedy was not involved with the report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? It was mandated by Congress and issued by The Institute of Medicine in light of a "silver tsunami" of health care needs expected to accompany a senior population that will reach 72.1 million by 2030.

The "silver tsunami" is the result of simple supply-and-demand forces gone awry, the report authors explained.

The entire story is here.

Read the report online for free

Wednesday, July 18, 2012

Free access to British scientific research to be available within two years

Radical shakeup of academic publishing will allow papers to be put online and be accessed by universities, firms and individuals

By Ian Sample
The Guardian
Originally published July 15, 2012

The government is to unveil controversial plans to make publicly funded scientific research immediately available for anyone to read for free by 2014, in the most radical shakeup of academic publishing since the invention of the internet.

Under the scheme, research papers that describe work paid for by the British taxpayer will be free online for universities, companies and individuals to use for any purpose, wherever they are in the world.

In an interview with the Guardian before Monday's announcement David Willetts, the universities and science minister, said he expected a full transformation to the open approach over the next two years.

The move reflects a groundswell of support for "open access" publishing among academics who have long protested that journal publishers make large profits by locking research behind online paywalls. "If the taxpayer has paid for this research to happen, that work shouldn't be put behind a paywall before a British citizen can read it," Willetts said.

Tuesday, July 17, 2012

Appeals Court Rejects Student's Lawsuit Over Alleged Harassment by Professor

By Libby Sander
The Chronicle of Higher Education
Originally published July 10, 2012

Student workers who are sexually harassed on the job do not enjoy a higher standard of protection under federal employment law than do workers in other employment settings, a federal appeals court ruled on Tuesday.

The case involves Southern Illinois University at Carbondale, which the U.S. Court of Appeals for the Seventh Circuit concluded is not liable for an undergraduate student's claims of sexual harassment by a prominent emeritus faculty member who was also a major donor.

In a 2-to-1 opinion, a three-judge panel of the appeals court rejected claims by the student, Samuel Milligan, under federal employment law that Southern Illinois created a hostile work and educational environment.

The entire story is here.