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 Qualifications. Show all posts
Showing posts with label Qualifications. Show all posts

Friday, February 2, 2024

Young people turning to AI therapist bots

Joe Tidy
BBC.com
Originally posted 4 Jan 24

Here is an excerpt:

Sam has been so surprised by the success of the bot that he is working on a post-graduate research project about the emerging trend of AI therapy and why it appeals to young people. Character.ai is dominated by users aged 16 to 30.

"So many people who've messaged me say they access it when their thoughts get hard, like at 2am when they can't really talk to any friends or a real therapist,"
Sam also guesses that the text format is one with which young people are most comfortable.
"Talking by text is potentially less daunting than picking up the phone or having a face-to-face conversation," he theorises.

Theresa Plewman is a professional psychotherapist and has tried out Psychologist. She says she is not surprised this type of therapy is popular with younger generations, but questions its effectiveness.

"The bot has a lot to say and quickly makes assumptions, like giving me advice about depression when I said I was feeling sad. That's not how a human would respond," she said.

Theresa says the bot fails to gather all the information a human would and is not a competent therapist. But she says its immediate and spontaneous nature might be useful to people who need help.
She says the number of people using the bot is worrying and could point to high levels of mental ill health and a lack of public resources.


Here are some important points-

Reasons for appeal:
  • Cost: Traditional therapy's expense and limited availability drive some towards bots, seen as cheaper and readily accessible.
  • Stigma: Stigma associated with mental health might make bots a less intimidating first step compared to human therapists.
  • Technology familiarity: Young people, comfortable with technology, find text-based interaction with bots familiar and less daunting than face-to-face sessions.
Concerns and considerations:
  • Bias: Bots trained on potentially biased data might offer inaccurate or harmful advice, reinforcing existing prejudices.
  • Qualifications: Lack of professional mental health credentials and oversight raises concerns about the quality of support provided.
  • Limitations: Bots aren't replacements for human therapists. Complex issues or severe cases require professional intervention.

Tuesday, January 30, 2024

Lawsuit Challenges New Jersey’s Out-of-State Telehealth Licensing Law

A. Vaidya
mhealthintelligence.com
Originally posted 18 DEC 23

Here is an excerpt:

The lawsuit states that J.A. was diagnosed with pineoblastoma, an aggressive brain tumor, at 18 months old. His physicians referred him to MacDonald in Boston. The treatment enabled J.A. to beat his cancer. However, he must continue to undergo scans once a year for the rest of his life to monitor the cancer’s return.

New Jersey’s current telehealth licensing law requires patients seeking specialty care out of state to decide whether to incur the cost of traveling to meet with the specialist for initial or follow-up consultations.

“Without telemedicine, patients suffering from rare cancers and diseases like J.A. must either forego lifesaving treatment or suffer by traveling out of state every time an appointment with a national specialist like Dr. MacDonald is needed,” the suit states. “Many cannot bear the burdens of frequent travel.”

Without the option of telehealth, J.A. and his family would not have been able to consult with all the specialists they needed due to “financial and time constraints,” the lawsuit further states. Even more recently, telehealth enabled J.A. to consult with MacDonald when an anomaly appeared on one of his scans.

Maintaining multiple licenses in different states places an administrative and financial burden on physicians, especially for specialists like MacDonald and Gardner, “who have national practices and only occasionally consult with or treat patients from New Jersey,” the suit notes.

Thus, the lawsuit argues that the licensing law violates the Dormant Commerce Clause and Privileges and Immunities Clause, which prohibits states from enacting laws that excessively burden interstate commerce in relation to local benefits. It also violates the First Amendment, which prevents the government from restricting conversations between patients and their providers, and the 14th Amendment’s Due Process Clause, which bans the government from limiting the ability of parents to direct their children’s medical care.

“Plaintiffs, who are New Jersey citizens and out-of-state specialists with patients in New Jersey, seek to vindicate their constitutional rights — and ensure they can continue to provide and receive — lifesaving care,” the lawsuit states.

Tuesday, August 13, 2019

UNRWA Leaders Accused of Sexual Misconduct, Ethics’ Violations

Image result for unrwa logojns.org
Originally published July 29, 2019

An internal ethics report sent to the UN secretary-general in December alleges that the commissioner-general of the United Nations Relief and Works Agency (UNRWA) and other officials at the highest levels of the UN agency have committed a series of serious ethics violations, AFP has reported.

According to AFP, Commissioner-General Pierre Krähenbühl and other top officials at the UN agency are being accused of abuses including “sexual misconduct, nepotism, retaliation, discrimination and other abuses of authority, for personal gain, to suppress legitimate dissent, and to otherwise achieve their personal objectives.”

The allegations are currently being probed by UN investigators.

In one instance, Krähenbühl, a married father of three from Switzerland, is accused of having a lover appointed to a newly-created role of senior adviser to the commissioner-general after an “extreme fast-track” process in 2015, which also entitled her to travel with him around the world with top accommodations.

The info is here.

Monday, December 10, 2018

What makes a ‘good’ clinical ethicist?

Trevor Bibler
Baylor College of Medicine Blog
Originally posted October 12, 2018

Here is an excerpt:

Some hold that the complexity of clinical ethics consultations couldn’t be reduced to multiple-choice questions based on a few sources, arguing that creating multiple-choice questions that reflect the challenges of doing clinical ethics is nearly impossible. Most of the time, the HEC-C Program is careful to emphasize that they are testing knowledge of issues in clinical ethics, not the ethicist’s ability to apply this knowledge to the practice of clinical ethics.

This is a nuanced distinction that may be lost on those outside the field. For example, an administrator might view the HEC-C Program as separating a good ethicist from an inadequate ethicist simply because they have 400 hours of experience and can pass a multiple-choice exam.

Others disagree with the source material (called “core references”) that serves as the basis for exam questions. I believe the core references, if repetitious, are important works in the field. My concern is that these works do not pay sufficient attention to some of the most pressing and challenging issues in clinical ethics today: income inequality, care for non-citizens, drug abuse, race, religion, sex and gender, to name a few areas.

Also, it’s feasible that inadequate ethicists will become certified. I can imagine an ethicist might meet the requirements, but fall short of being a good ethicist because in practice they are poor communicators, lack empathy, are authoritarian when analyzing ethics issues, or have an off-putting presence.

On the other hand, I know some ethicists I would consider experts in the field who are not going to undergo the certification process because they disagree with it. Both of these scenarios show that HEC certification should not be the single requirement that separates a good ethicist from an inadequate ethicist.

The info is here.

Thursday, February 22, 2018

James Comey isn’t qualified for his new gig teaching ethics, experts explain

Olivia Goldhill
Quartz
Originally published January 27, 2018

Here is an excerpt:

“My entire professional life has been dedicated to ethics education. I’m disheartened by the fact that educational institutions hire people to teach ethics who really don’t have a background in ethics,” says Aine Donovan, director of the ethics institute at Dartmouth University.

Certainly, Comey’s own behavior as FBI director would make the basis of a strong case study, says Donovan. But Comey’s experience navigating a moral quandary is not sufficient qualification. “I’d rather have moral exemplars teaching an ethical leadership class than somebody who has even a whiff of controversy associated with them,” Donovan says. In addition, Donovan adds, it seems Comey did not make the right moral choice at every stage. For example, Comey leaked documents about his conversations with Trump. “I’m highly skeptical that that would ever pass ethical muster,” adds Donovan.

A “puzzling” choice

“There is much to be learned about [ethics from] studying Mr. Comey’s own conduct, but most of it is not positive,” Howard Prince II, who holds the Loyd Hackler Endowed Chair in Ethical Leadership at University of Texas-Austin, writes in an email. Overall, Comey is “a puzzling choice” to teach ethical leadership, he adds.

The article is here.

Tuesday, August 22, 2017

Informed-consent ruling may have “far-reaching, negative impact”

Andis Robeznieks
AMA Wire
Originally published August 8, 2017

Here are two excerpts:

A lawsuit alleging Dr. Toms had not obtained informed consent was initiated by Shinal and her husband on Dec. 17, 2009. The brief notes that Shinal “did not assert that the harm was the result of negligence” and that “there is no contention” that Dr. Toms’ staff provided inaccurate information during the informed consent process.

A jury found for Dr. Toms. Shinal appealed and the Pennsylvania Superior Court affirmed the decision. The case was heard before the Pennsylvania Supreme Court in November 2016. The case was decided June 20.

According to Wecht, a key issue is “whether the trial court misapplied the common law and the MCARE Act when it instructed the jury that it could consider information provided to Mrs. Shinal by Dr. Toms' ‘qualified staff’ in deciding whether Dr. Toms obtained Mrs. Shinal's informed consent to aggressive brain surgery.”

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PAMED General Counsel Angela Boateng also weighed in.

“It was not uncommon for other qualified staff to assist a physician in providing the requisite information or answering follow-up questions a patient may have had. The Medical Practice Act and other professional regulations permitted this level of assistance,” she commented. “The patient’s ability to follow up with the physician or his qualified staff was usually aimed at promoting a patient’s understanding of the treatment or procedure to be completed. The court’s decision, however, has put an end to this practice.”

The article is here.

Tuesday, April 11, 2017

Welcker v. Georgia Board of Examiners of Psychologists

Legal Decision

Synopsis: Georgia State Board of Psychology is permitted to deny a license to an applicant, when the applicant's doctoral program does not meet the residency requirement, and, without substantial hardship.

Here are two excerpts:

Neither the Board's decision to deny Welcker a license nor their denial of her petition for waiver can be considered a contested case. Georgia law allows the denial of a license without a hearing where an applicant fails to show that she has met all the qualifications for that license. OCGA § 43-1-19 (a). Therefore, because no hearing was required by law before the denial of Welcker's license, the Board's denial of Welcker's license application does not present a contested case subject to judicial review.

The Board's decision to deny a petition for waiver also cannot be considered a contested case. OCGA § 43-1-19 (j) explicitly states that the "refusal to issue a previously denied license" shall not be considered a contested case under the Administrative Procedure Act and "notice and hearing with the meaning of the [Act] shall not be required"; however, the applicant "shall be allowed to appear before the board if he or she so requests." Nevertheless, such rulings are expressly made subject to judicial review under OCGA § 50-13-9.1 (f), which provides that "[t]he agency's decision to deny a petition for variance or waiver shall be subject to judicial review in accordance with Code Section 50-13-19."

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The Board denied Welcker's petition for waiver on two grounds: (1) her failure to meet the appropriate residency requirements "as per the Board rules in effect in 2007" and (2) her failure to prove a substantial hardship resulting from strict application of the rule.

The ruling is here.

Wednesday, October 28, 2015

Exploring Accountability of Clinical Ethics Consultants: Practice and Training Implications

Kathryn L. Weise & Barbara J. Daly
The American Journal of Bioethics
Volume 14, Issue 6, 2014

Abstract

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

The entire article is here.

Thursday, February 5, 2015

Women and Leadership

Public Says Women are Equally Qualified, but Barriers Persist

Pew Research
Originally published January 14, 2015

According to the majority of Americans, women are every bit as capable of being good political leaders as men. The same can be said of their ability to dominate the corporate boardroom. And according to a new Pew Research Center survey on women and leadership, most Americans find women indistinguishable from men on key leadership traits such as intelligence and capacity for innovation, with many saying they’re stronger than men in terms of being compassionate and organized leaders.

So why, then, are women in short supply at the top of government and business in the United States? According to the public, at least, it’s not that they lack toughness, management chops or proper skill sets.

The entire article is here.

Sunday, February 10, 2013

Ethical Framework for the Use of Technology in Supervision


By LoriAnn S. Stretch, DeeAnna Nagel and Kate Anthony

Ethical and Statutory Considerations

Supervisors must demonstrate and promote good practice by the supervisee to ensure supervisees acquire the attitudes, skills, and knowledge necessary to protect clients. Supervisors and supervisees must research and abide by all applicable legal, ethical, and customary requirements of the jurisdiction in which the supervisor and supervisee practice.   The supervisor and supervisee must document relevant requirements in the respective record(s).  Supervisors and supervisees need to review and abide by requirements and restrictions of liability insurance and accrediting bodies as well.

Informed Consent

Supervisors will review the purposes, goals, procedures, limitations, potential risks, and benefits of distance services and techniques. All policies and procedures will be provided in writing and reviewed verbally before or during the initial session. Documentation of understanding by all parties will be maintained in the respective record(s).

Supervisor Qualifications

Supervisors will only provide services for which the supervisor is qualified.  The supervisor will provide copies of licensure, credentialing, and training upon request.  The supervisor will have a minimum of 15 hours of training in distance clinical supervision as well as an active license and authorization to provide supervision within the jurisdiction for which supervision will be provided. Supervisors providing distance supervision should participate in professional organizations related to distance services and develop a network of professional colleagues for peer and supervisory support.

Supervisee and Client Considerations

Supervisors will screen supervisees for appropriateness to receive services via distance methods. The supervisor will document objective reasons for the supervisee’s appropriateness in the respective record(s).  Supervisors will ensure that supervisees screen clients seeking distance services for appropriateness to receive services via distance methods. Supervisors will ensure that the supervisee utilizes objective methods for screening clients and maintains appropriate documentation in the respective record(s).

Supervisors will ensure that supervisees inform clients of the supervisory relationship and that all clients have written information on how to contact the supervisor.  Written documentation of the client acknowledging the supervisory relationship and receipt of the supervisor’s contact information should be maintained in the respective record(s). Supervisors will only advise the supervisee to provide services for which the supervisee is qualified to provide.
Clients and supervisees must be informed of potential hazards of distance communications, including warnings about sharing private information when using a public access or computer that is on a shared network.  Clients and supervisees should be discouraged, in writing, from saving passwords and user names when prompted by the computer.  Clients and supervisees should be encouraged to review employer’s policies regarding using work computers for distance services.

The entire story is here.