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

Wednesday, February 27, 2013

House Republican aims to repeal Medicare doctor pay cuts

Reuters
Originally published on February 13, 2013

Republicans in the House of Representatives will seek a permanent solution to scheduled steep cuts in physician payments from the federal Medicare health insurance plan for retirees and disabled people, a House committee chairman said on Wednesday.

Rep. Fred Upton, chairman of the House Energy and Commerce Committee, told doctors he hopes to send so-called "Doc Fix" legislation to the House floor this summer that would repeal payment reductions enacted in 1997 as part of a law to balance the federal budget.

The 16-year-old "sustainable growth rate" (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.


The entire article is here.

Tuesday, February 26, 2013

The Shredder Ate My Culture Report: Five Questions the Barclays Board Should Have Asked

By Donna Boehme
Corporate Compliance Insights
Originally published on February 13, 2013


It’s been a terrible, horrible, no good, very bad few weeks for Barclays.   Despite tough talk last month by new CEO Antony Jenkins about “Five New Values” (inviting any of its 140,000 employees who don’t want to sign up to head for the exits), the bad news just keeps on coming for the embattled firm.  And the latest round involves a shredder.

Last week’s headlines of “Shreddergate” and “Qatargate” spelled out the bank’s latest troubles.  In the former, Andrew Tinney, the chief operating officer of the bank’s high-end investment division, commissioned a “workplace culture report” from an outside consultancy, but was so horrified by its contents that he shredded the report on the spot at his Surrey estate and then, according to media reports,  “denied all knowledge of it ever having existed.” Neat trick, until an anonymous internal whistleblower emailed Jenkins a hint about the mysterious culture report.   Add to this the latest revelations about a Qatari cash injection at the height of the financial crisis that may have been funded by the bank itself, which means the bank may have lied to UK regulators.

Mind you, this is after an annus horribilis in which Barclays was hit by a half a billion dollar fine for its part in manipulating LIBOR, lost its Chairman, CEO and COO in quick succession, and saw its credit rating lowered by Moody’s from “stable” to “negative.”  The scandal ripples from that debacle continues, as the firm has just announced the exit of two more top execs: its finance chief and general counsel.

The entire article is here.

The Ethics of Innovation

By Chris MacDonald
The Business Ethics Blog
Originally published February 21, 2013


Innovation is a hot topic these days. It’s been the subject of studies and reports and news reports. In fact, I spent the entire day this past Monday at the Conference Board of Canada’s “Business Innovation Summit,” listening to business leaders and civil servants talk about how Canada is lagging on innovation, and how much is left to be done to promote and manage innovation. And certainly technological innovations like Google’s new glasses and 3D printing make for compelling headlines.

So sure, hot topic. But how is it connected to ethics? What is an ethics professor like me doing at an event dedicated to innovation?

If you understand the domain of ethics properly, the connection is clear. In point of fact, innovation is an ethical matter through and through, because ethics is fundamentally concerned with anything that can promote or hinder human wellbeing. So ethics is relevant to assessing the goals of innovation, to the process by which it is carried out, and to evaluating its outcomes.

Let’s start with goals. Innovation is generally a good thing, ethically, because it is aimed at allowing us to do new and desirable things. Most typically, that gets expressed in the painfully vague ambition to ‘raise productivity.’ Accelerating our rate of innovation is a worthy policy objective because we want to be more productive as a society, to increase our social ‘wealth’ in the broadest sense.

The entire blog post is here.

Monday, February 25, 2013

New Federal Rule Requires Insurers to Offer Mental Health Coverage

By ROBERT PEAR
The New York Times
Published: February 20, 2013

The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.

The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.

Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.

White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.

The entire story is here.

U.S. proposes scrapping some obsolete Medicare regulations

By Reuters
Originally published February 13, 2013

The Obama administration on Monday proposed eliminating certain obsolete Medicare regulations, a move it said would save hospitals and other healthcare providers an estimated $676 million a year, or $3.4 billion over five years.

The Department of Health and Human Services described the targeted regulations as unnecessary or excessively burdensome and said their proposed elimination would allow greater efficiency without jeopardizing safety for the Medicare program's elderly and disabled beneficiaries.

"We are committed to cutting the red tape for healthcare facilities, including rural providers," Health and Human Services Secretary Kathleen Sebelius said in a statement.

"By eliminating outdated or overly burdensome requirements, hospitals and health care professionals can focus on treating patients," she added.

Industry representatives largely welcomed the changes, saying the proposed rule would help hospitals free up more resources for patient care.

"There are a number of particularly meaningful provisions in the proposed rule," said Chip Kahn of the Federation of American Hospitals.

The American Hospital Association, though, said it was disappointed the administration did not allow "hospitals in multi-hospital systems" to have single integrated medical staff structures.

"Hospitals are delivering more coordinated, patient-centered care and (the administration) should not let antiquated organizational structures stand in the way," AHA President Rich Umbdenstock said in a statement.

The entire article is here.

Sunday, February 24, 2013

Situationism and Confucian Virtue Ethics

By Deborah S. Mower

Ethical Theory and Moral Practice
February 2013, Volume 16, Issue 1, pp 113-137

Abstract

Situationist research in social psychology focuses on the situational factors that influence behavior. Doris and Harman argue that this research has powerful implications for ethics, and virtue ethics in particular. First, they claim that situationist research presents an empirical challenge to the moral psychology presumed within virtue ethics. Second, they argue that situationist research supports a theoretical challenge to virtue ethics as a foundation for ethical behavior and moral development. I offer a response from moral psychology using an interpretation of Xunzi—a Confucian virtue ethicist from the Classical period. This Confucian account serves as a foil to the situationist critique in that it uncovers many problematic ontological and normative assumptions at work in this debate regarding the prediction and explanation of behavior, psychological posits, moral development, and moral education. Xunzi’s account of virtue ethics not only responds to the situationist empirical challenge by uncovering problematic assumptions about moral psychology, but also demonstrates that it is not a separate empirical hypothesis. Further, Xunzi’s virtue ethic responds to the theoretical challenge by offering a new account of moral development and a ground for ethical norms that fully attends to situational features while upholding robust character traits.

The entire article is here.

The Ethics of Admissions, Part I: Graduate and Professional School


By Jane Robbings
Inside HigherEd - Sounding Board Blog
Originally posted February 13, 2013

I’ve been wanting to write a series of posts on the ethics of admissions and its connection to operating models since I began this blog a few months ago.  While there is lots of talk about one or the other, they are rarely brought together in the sense of recognizing how embedded the ethical choices of institutions—and their consequences—are in the construction of their program and college business models. Acknowledging the ethics of a business model—yes, business models are ethics-laden—implies a stakeholder, or corporate social responsibility (CSR) view.

For a long time, though, institutions of higher education have made their operational decisions largely on the basis of internal interests. We could argue about whether what is going on now in terms of business model collapse is essentially chickens coming home to roost—the inevitable outcome of blindedness and self-interest.  And maybe warn about what is yet to come in other areas such as medical research. But for now I’m most interested in looking at recent movements—some coerced, some bravely self-initiated, to consider the ethical connection between admissions and business models. So far, the most explicit has been going on in graduate and professional education.

In the “coerced” category, the poster child is law schools. One could say this is a case of the market, and in response the government, saying “enough” and forcing change. While it can seem sudden, like most sources of change the problems did not arise overnight, but are the cumulative effect of a gradual process. Law schools, like business schools, underwent a “Flexnorization”—a specific effort to become more scientific and empirical as a strategy to drive out lower, practitioner-driven forms—in the late 60s on; the reports from the middle decades of the 20th century, such as the 1968 Rutgers “Law School of Tomorrow,” reflect contentious debate and an awareness of what might be the negative outcomes; by the time of the 2007 Carnegie report with its meaningful title (Educating Lawyers: Preparation for the Practice), many concerns had become a reality. And a funny thing happened along the way: the lower-tier schools were not driven out—indeed, like their business school counterparts they thrived by the promise of credentials and high earnings—and the upper tier schools have lost much of their market in the recession—a market that may never return, in part because the narrow tasks performed by even highly paid associates can be performed more cheaply overseas or through an agency (and, increasingly, by a computer), and because firms themselves are restructuring the way they practice.

The entire blog post is here.

Saturday, February 23, 2013

MU halts administrator search after torture controversy

By Catherine Martin
The Columbia Daily Tribune
Originally posted on February 15, 2013

The University of Missouri is holding off on filling an administrative position that attracted a controversial candidate.

Larry James, who served as the director of behavioral science division at Guantanamo Bay and Abu Ghraib, was one of two finalists being considered for the job of division executive director at the MU College of Education.

His past experiences, including allegations of involvement in torture, drew criticism from staff and sparked a protest on campus. An on-campus interview last week was open to the public, and questions from community members centered on James' alleged connections to torture.

The entire story is here.

From Guantanamo to Mizzou?

By Colleen Flaherty
Inside HigherEd
Originally published February 12, 2013

Retired Col. Larry James, a former Army psychologist, went into both Abu Ghraib prison in Iraq and the military detention center at Guantanamo Bay, Cuba, to address and correct known human rights violations – hence the name of his 2008 book, Fixing Hell: An Army Psychologist Confronts Abu Ghraib.

“This is very, very important conversation to have in a variety of venues, and it’s very important to understand what went wrong at these awful places,” said James – now dean of the School of Professional Psychology at Wright State University – of why he wrote the memoir. “If we keep things in secret we’re destined to repeat it again.”

But some of the revelations in Fixing Hell are being levied against him as he tries to secure an administrative post at at the University of Missouri at Columbia. An on-campus protest was held earlier this month as James’s name surfaced as one of two finalists for the position, division executive director in the College of Education. As such, he’d oversee 60 faculty and 29 staff members in three units, including the Department of Educational, School and Counseling Psychology.

Aamer Trambu, a business graduate student and member of the Muslim Student Organization, attended the protest, along with members of the St. Louis Chapter of the Council on American-Islamic Relations and the Mid-Missouri Fellowship of Reconciliation, an interfaith peace group. He also attended a Mizzou forum last week at which James answered questions for more than an hour. A petition against James’s candidacy with at least 60 names was turned over to university administrators. (The American-Islamic relations council chapter also launched an online petition. Leaders did not respond to requests for comment.)

The entire article is here.