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 Vulnerability. Show all posts
Showing posts with label Vulnerability. Show all posts

Monday, September 19, 2022

The impact of economic inequality on conspiracy beliefs

Salvador Casara, B. G., Suitner, C., & Jetten, J.
(2022). Journal of Experimental Social 
Psychology, 98, 104245.
https://doi.org/10.1016/j.jesp.2021.104245

Abstract

Previous literature highlights the crucial role of economic inequality in triggering a range of negative societal outcomes. However, the relationship between economic inequality and the proliferation of conspiracy beliefs remains unexplored. Here, we explore the endorsement of conspiracy beliefs as an outcome of objective country-level (Study 1a, 1b, 1c), perceived (Study 2), and manipulated economic inequality (Studies 3a, 3b, 4a, 4b). In the correlational studies, both objective and perceived economic inequality were associated with greater conspiracy beliefs. In the experiments, participants in the high (compared to the low) inequality condition were more likely to endorse conspiratorial narratives. This effect was fully mediated by anomie (Studies 3a, 3b) suggesting that inequality enhances the perception that society is breaking down (anomie), which in turn increases conspiratorial thinking, possibly in an attempt to regain some sense of order and control. Furthermore, the link between economic inequality and conspiracy beliefs was stronger when participants endorsed a conspiracy worldview (Studies 4a, 4b). Moreover, conspiracy beliefs mediated the effect of the economic inequality manipulation on willingness to engage in collective action aimed at addressing economic inequality. The results show that economic inequality and conspiracy beliefs go hand in hand: economic inequality can cause conspiratorial thinking and conspiracy beliefs can motivate collective action against economic inequality.

From the General Discussion

It is also important to consider whether economic inequality triggers the endorsement of general or more specific conspiracy beliefs. Data from Studies 3a and 3b showed that the manipulation of economic inequality affects the endorsement of a wide range of conspiracy beliefs— general conspiracy beliefs as well as conspiracies that relate to the specific fictional society. In Studies 4a and 4b, we found that inequality enhanced the belief in conspiracies perpetrated by different groups in the specific fictional society (i.e., politicians, scientists, multinational companies, and pharmaceutical industries) while it did not affect participants’ conspiracy worldview. Future research should focus on the impact of economic inequality on the endorsement of specific versus more general conspiracy theories. It may well be the case that the relation between economic inequality and conspiracy belief endorsement is stronger when participants consider specific conspiracy beliefs that blame an outgroup for heightened anomie that results from economic inequality. Such conspiracy beliefs best serve the function of mobilizing collective ingroup action that might hold the promise of providing people with a sense of collective agency (or control; see Bukowski et al., 2017).

These results have important implications. First, those who are prone to believe in conspiracy theories are sometimes viewed as driven by irrationality — a vision that is indeed supported by a vast literature about the negative consequences of conspiracy beliefs (e.g., Jolley & Douglas, 2014; Lewandowsky et al., 2013; Van der Linden, 2015). Other findings show that conspiracy beliefs are associated with dispositional constructs that are prodromal of mental disease, such as schizotypy and delusional thinking (Barron et al., 2018; Darwin et al., 2011). However, factors that trigger conspiracy beliefs are not always irrational and they may be driven by anomie-prompted socio-structural perceptions about societies, such as economic inequality. 

Monday, August 16, 2021

Therapist Targeted Googling: Characteristics and Consequences for the Therapeutic Relationship

Cox, K. E., Simonds, L. M., & Moulton-Perkins, A. 
(2021).  Professional Psychology: 
Research and Practice. Advance online publication. 

Abstract

Therapist-targeted googling (TTG) refers to a patient searching online to find information about their therapist. The present study investigated TTG prevalence and characteristics in a sample of adult psychotherapy clients. Participants (n = 266) who had attended at least one session with a therapist completed an anonymous online survey about TTG prevalence, motivations, and perceived impact on the therapeutic relationship. Two-thirds of the sample had conducted TTG. Those participants who were having therapy privately had worked with more than one therapist, or were having sessions more often than weekly were significantly more likely to conduct TTG; this profile was particularly common among patients who were having psychodynamic psychotherapy. Motivations included wanting to see if the therapist is qualified, curiosity, missing the therapist, and wanting to know them better. Nearly a quarter who undertook TTG thought the findings impacted the therapeutic relationship but only one in five had disclosed TTG to the therapist. TTG beyond common sense consumerism can be conceptualized as a patient’s attempt to attain closeness to the therapist but may result in impacts on trust and ability to be open. Disclosures of TTG may constitute important therapeutic material. 

Impact Statement

This study suggests that there are multiple motivations for clients searching online for information about their therapist. It highlights the need for practitioners to carefully consider the information available about them online and the importance of client searching to the therapeutic relationship.

Here is the conclusion:

In this study, most participants searched for information about their therapist. Curiosity and commonsense consumerism might explain much of this activity. We argue that there is evidence that some of this might be motivated by moments of vulnerability between sessions to regain a connection with the therapist. We also suggest that the discovery of challenging information during vulnerability might represent difficulties for the patient that are not disclosed to the therapist due to feelings of guilt and shame. Further work is needed to understand TTG, the implications on the therapeutic relationship, and how therapists work with disclosures of TTG in a way that does not provoke more shame in the patient, but which also allows therapists to effectively manage therapeutic closeness and their own vulnerability.

Sunday, June 21, 2020

Downloading COVID-19 contact tracing apps is a moral obligation

G. Owen Schaefer and Angela Ballantyne
BMJ Blogs
Originally posted 4 May 20

Should you download an app that could notify you if you had been in contact with someone who contracted COVID-19? Such apps are already available in countries such as Israel, Singapore, and Australia, with other countries like the UK and US soon to follow. Here, we explain why you might have an ethical obligation to use a tracing app during the COVID-19 pandemic, even in the face of privacy concerns.

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Vulnerability and unequal distribution of risk

Marginalized populations are both hardest hit by pandemics and often have the greatest reason to be sceptical of supposedly benign State surveillance. COVID-19 is a jarring reminder of global inequality, structural racism, gender inequity, entrenched ableism, and many other social divisions. During the SARS outbreak, Toronto struggled to adequately respond to the distinctive vulnerabilities of people who were homeless. In America, people of colour are at greatest risk in several dimensions – less able to act on public health advice such as social distancing, more likely to contract the virus, and more likely to die from severe COVID if they do get infected. When public health advice switched to recommending (or in some cases requiring) masks, some African Americans argued it was unsafe for them to cover their faces in public. People of colour in the US are at increased risk of state surveillance and police violence, in part because they are perceived to be threatening and violent. In New York City, black and Latino patients are dying from COVID-19 at twice the rate of non-Hispanic white people.

Marginalized populations have historically been harmed by State health surveillance. For example, indigenous populations have been the victims of State data collection to inform and implement segregation, dispossession of land, forced migration, as well as removal and ‘re‐education’ of their children. Stigma and discrimination have impeded the public health response to HIV/AIDS, as many countries still have HIV-specific laws that prosecute people living with HIV for a range of offences.  Surveillance is an important tool for implementing these laws. Marginalized populations therefore have good reasons to be sceptical of health related surveillance.

Monday, April 27, 2015

Do You Google Your Shrink?

By Ana Fels
The New York Times - Opinionator
Originally published April 4, 2015

Here are two excerpts:

Patients’ access to huge amounts of information about therapists’ lives can’t help but change both members of the therapeutic dyad. It can have, for instance, a chilling effect on the therapist’s work outside the office. As a psychiatrist who occasionally writes and speaks, I now have to think about the impact of these activities on prospective patients. If I write a feminist article, will I end up with only female patients?

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The blurring of boundaries between the personal and professional can get quite creepy. A patient told me, in greater detail than I wished to know, about her Match.com date with a psychoanalyst with whom I’ve had professional dealings. It was an encounter that almost certainly would not have occurred in the pre-Internet-dating era, and it will be hard ever to think of him in quite the same way.

The entire article is here.

Monday, January 5, 2015

Ethics is for human subjects too: Participant perspectives on responsibility in health research

By Susan Cox and Michael McDonald
Social Science & Medicine
Volume 98, December 2013, Pages 224–231

Abstract

Despite the significant literature as well as energy devoted to ethical review of research involving human subjects, little attention has been given to understanding the experiences of those who volunteer as human subjects. Why and how do they decide to participate in research? Is research participation viewed as a form of social responsibility or as a way of obtaining individual benefits? What if anything do research subjects feel they are owed for participation? And what do they feel that they owe the researcher? Drawing on in-depth individual interviews conducted in 2006 and 2007 with 41 subjects who participated in a variety of types of health research in Canada, this paper focuses on subject perspectives on responsibility in research. Highlighting the range of ways that subjects describe their involvement in research and commitments to being a ‘good’ subject, we present a typology of narratives that sheds new light on the diverse meanings of research participation. These narratives are not mutually exclusive or prescriptive but are presented as ideal types typifying a set of circumstances and values. As such, they collectively illuminate a range of motivations expressed by human subjects as well as potential sources of vulnerability. The typology adds a new dimension to the literature in this area and has significant implications for researchers seeking more human-subject centred approaches to research recruitment and retention, as well as research ethics boards trying to better anticipate the perspectives of prospective participants.

Highlights

• Participant responsibility is a neglected aspect of research ethics.
• Responsibility can be conceptualized according to degree of agency and altruism.
• Participants' narrative accounts yield four main orientations to responsibility.
• These reveal differing motivations and sources of vulnerability.

The entire article is here.

Sunday, October 2, 2011

In Deal, Hundreds of Mentally Ill People Will Leave Confinement of Nursing Home

By Anemona Hartcollis
The New York Times
Published September 12, 2011

Hundreds of mentally ill people who have been confined to nursing homes, sometimes in prisonlike conditions, would move to apartments or other housing within three years under a legal settlement with New York State.

The settlement resolved a case that was filed in Brooklyn federal court in 2006 and that accused the state of violating the spirit of its own longstanding rules for housing mentally ill people.

In researching the case, the plaintiffs found that psychiatric centers and nursing homes had developed “turnaround agreements, which essentially were written agreements to transfer patients back and forth,” Veronica S. Jung, senior staff attorney for New York Lawyers for the Public Interest, which helped to represent plaintiffs, said Monday.

“This certainly raises broader, troubling questions about the role of nursing homes, and their financial stakes, within the mental health care system,” Ms. Jung said.

The settlement came as the judge in the case, Brian M. Cogan, set a trial date for early October, Ms. Jung said.

“It did seem pretty clear that the specter of going to trial in the next few days probably motivated the state to move more quickly in negotiations,” Ms. Jung said. The state has agreed to pay $2.5 million in legal fees and costs to the plaintiffs’ counsel.

Andrew J. Zambelli, counselor to Gov. Andrew M. Cuomo, said the state had settled the case because “it just jibed with our kind of policy viewpoint — care for the vulnerable, into the community, using money appropriately.”

Under longstanding legal principle in New York and elsewhere, the mentally ill cannot be confined unless they are considered a threat to themselves or others, and should be housed in the least restrictive setting appropriate for their needs.

Under the terms of the settlement, the Cuomo administration has agreed to reform the process used to assess whether patients are capable of living in the community and want to live there. The state has also promised to hire independent contractors who would be trained to make the assessments.

The entire story can be found here.

Friday, September 16, 2011

Patient Data Posted Online in Major Breach of Privacy

By Kevin Sack
The New York Times
Published September 9, 2011

A medical privacy breach led to the public posting on a commercial Web site of data for 20,000 emergency room patients at Stanford Hospital in Palo Alto, Calif., including names and diagnosis codes, the hospital has confirmed. The information stayed online for nearly a year.

Since discovering the breach last month, the hospital has been investigating how a detailed spreadsheet made its way from one of its vendors, a billing contractor identified as Multi-Specialty Collection Services, to a Web site called Student of Fortune, which allows students to solicit paid assistance with their schoolwork.
Gary Migdol, a spokesman for Stanford Hospital and Clinics, said the spreadsheet first appeared on the site on Sept. 9, 2010, as an attachment to a question about how to convert the data into a bar graph.
Although medical security breaches are not uncommon, the Stanford breach was notable for the length of time that the data remained publicly available without detection.
Even as government regulators strengthen oversight by requiring public reporting of breaches and imposing heavy fines, experts on medical security said the Stanford breach spotlighted the persistent vulnerability posed by legions of outside contractors that gain access to private data.
The spreadsheet included names, diagnosis codes, account numbers, admission and discharge dates, and billing charges for patients seen at Stanford Hospital’s emergency room during a six-month period in 2009, Mr. Migdol said. It did not include Social Security numbers, birth dates, credit-card numbers or other information used to perpetrate identity theft, he said, but the hospital is offering free identity protection services to affected patients.
The breach was discovered by a patient and reported to the hospital on Aug. 22, according to a letter written four days later to affected patients by Diane Meyer, Stanford Hospital’s chief privacy officer. The hospital took “aggressive steps,” and the Web site removed the post the next day, Ms. Meyer wrote. It also notified state and federal agencies, Mr. Migdol said.
“It is clearly disturbing when this information gets public,” he said. “It is our intent 100 percent of the time to keep this information confidential and private, and we work hard every day to ensure that.”
Diane Dobson, of Santa Clara, Calif., said her “jaw dropped” on Saturday when she intercepted the letter from Ms. Meyer addressed to her 21-year-old son, who she said had received emergency psychiatric treatment at Stanford in 2009. Ms. Dobson said it could have been disastrous if her son, who lives at home, had learned that his name was linked to a mental health diagnosis.
“My son, I can tell you, is fragile and confused enough that this would have sent him over the edge,” Ms. Dobson said, saying she decided to speak publicly now because of her frustration with the breach. “Everyone with an electronic medical record is at risk, and that means everyone.”

The entire story can be read here.