By Wes Fisher
Dr.KevinMD Blog
Originally posted on May 28, 2013
The position paper from the American College of Physicians and the Federation of State Medical Boards, is a humbling reminder of the challenges that today’s physicians face when entering the online space.
Their recommendations for online medical professionalism, written by ethics committees for the two organizations, “provides recommendations about the influence of social media on the patient–physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician–physician communication that preserve confidentiality while best using these technologies” — no small amount of territory to summarize.
But given the tenure of their document, I should probably hang up this blog right now. After all, why risk being vulnerable in the online world? While well-meaning on one hand, we should appreciate that physicians have officially been put on notice on how to behave online.
To be fair, I agree with most of what they say. All the things about patient confidentiality are appropriate. All the things about respect for persons, better still.
But to me, the part of the document that wanders off into the “influence of social media on the patient-physician relationship” and the influence of social media on the “public perception of physician behaviors,” is more difficult to gauge in its benefit or detriment to the public discourse.
The entire article is here.
Sunday, June 9, 2013
Saturday, June 8, 2013
Needed: New approaches to defuse 'suicide contagion' among teens
How should we talk about suicide? Mental health experts have some ideas
By Andre Mayer
CBC News
Posted: May 23, 2013
Experts on adolescent behaviour say the apparent susceptibility of Canadian teens to the idea of suicide shows the need to change public discussion about this sensitive topic.
Among the suggestions being put forward are finding new ways to refer to the act, to put it in a more appropriate context and training crisis-intervention teams to be more aware of how young people can respond to a suicide in their midst.
A study published May 21 in the Canadian Medical Association Journal reported that teens who knew of schoolmates who took their own lives were more likely to consider it or attempt it themselves — a phenomenon the authors call "suicide contagion."
The entire article is here.
By Andre Mayer
CBC News
Posted: May 23, 2013
Experts on adolescent behaviour say the apparent susceptibility of Canadian teens to the idea of suicide shows the need to change public discussion about this sensitive topic.
Among the suggestions being put forward are finding new ways to refer to the act, to put it in a more appropriate context and training crisis-intervention teams to be more aware of how young people can respond to a suicide in their midst.
A study published May 21 in the Canadian Medical Association Journal reported that teens who knew of schoolmates who took their own lives were more likely to consider it or attempt it themselves — a phenomenon the authors call "suicide contagion."
The entire article is here.
Ethics Without Borders
By Cynthia Schoeman
The Ethics Monitor
For organisations that strive to be ethical, there are two important criteria for earning and maintaining an ethical status: the continual, consistent application of their values to all their stakeholders and their on-going adherence to all applicable laws and regulations. If a company’s commitment to their values or their compliance with regulations is intermittent or applied selectively, it erodes their ethical standing. The constancy of ethical behaviour reflects the practice of “ethics without borders”.
Borderless ethics necessitates that the organisation has a very inclusive ethical boundary, whereby ethics is exercised beyond self-interest and includes all stakeholders affected by the company’s operations. By contrast, an exclusive ethical boundary, which implies that ethics is exercised only for the organisation’s own benefit and relative to a select few stakeholders (typically shareholders), totally contradicts an approach of ethics without borders. While the exclusion of other stakeholders does not necessarily mean that the company is behaving unethically, it does highlight the fact that the company prioritises their own goals and needs above others’ or that they don’t give equal priority to their various stakeholders – such as communities who are impacted by the company’s operations. Added to that, organisations are rarely obliged - for example, by law - to include all stakeholder groups formally within their ethical boundary. So, although such companies may not be technically behaving unethically or illegally, their limited application of ethics means that they would rarely be regarded as an ethical organisation.
There is a further challenge to following an approach of ethics without borders. This emanates from the recurring discourse in workplace ethics that ethics differs for different people, cultures, countries and situations. This view needs to be addressed not only because it appears to invalidate the possibility for ethics without borders, but also because it undermines the pursuit of common and shared organisational ethics. The globalised nature of the world of work particularly makes for a multitude of differences in the workplace. Yet, ironically, globalisation makes the practice of ethics without borders all the more valuable, not least for the clarity it offers all affected parties and the fairness it embodies by operating in terms of the same ethics globally.
The entire story is here.
Editor's Note: This article has direct connections to individual psychologists in private practice, businesses in general, state psychological associations, and the American Psychological Association.
The Ethics Monitor
For organisations that strive to be ethical, there are two important criteria for earning and maintaining an ethical status: the continual, consistent application of their values to all their stakeholders and their on-going adherence to all applicable laws and regulations. If a company’s commitment to their values or their compliance with regulations is intermittent or applied selectively, it erodes their ethical standing. The constancy of ethical behaviour reflects the practice of “ethics without borders”.
Borderless ethics necessitates that the organisation has a very inclusive ethical boundary, whereby ethics is exercised beyond self-interest and includes all stakeholders affected by the company’s operations. By contrast, an exclusive ethical boundary, which implies that ethics is exercised only for the organisation’s own benefit and relative to a select few stakeholders (typically shareholders), totally contradicts an approach of ethics without borders. While the exclusion of other stakeholders does not necessarily mean that the company is behaving unethically, it does highlight the fact that the company prioritises their own goals and needs above others’ or that they don’t give equal priority to their various stakeholders – such as communities who are impacted by the company’s operations. Added to that, organisations are rarely obliged - for example, by law - to include all stakeholder groups formally within their ethical boundary. So, although such companies may not be technically behaving unethically or illegally, their limited application of ethics means that they would rarely be regarded as an ethical organisation.
There is a further challenge to following an approach of ethics without borders. This emanates from the recurring discourse in workplace ethics that ethics differs for different people, cultures, countries and situations. This view needs to be addressed not only because it appears to invalidate the possibility for ethics without borders, but also because it undermines the pursuit of common and shared organisational ethics. The globalised nature of the world of work particularly makes for a multitude of differences in the workplace. Yet, ironically, globalisation makes the practice of ethics without borders all the more valuable, not least for the clarity it offers all affected parties and the fairness it embodies by operating in terms of the same ethics globally.
The entire story is here.
Editor's Note: This article has direct connections to individual psychologists in private practice, businesses in general, state psychological associations, and the American Psychological Association.
Friday, June 7, 2013
Vignette 26: A Political Donation
Dr. Fair performs child custody evaluations. She is well known in both the legal and psychological communities. Recently, Dr. Fair received solicitations for contributions from a candidate for judge in her county, Deloris True. She has worked with Attorney True on numerous occasions and believes that she would be a real asset as a judge in her community. She clearly wants this individual to be elected as a judge.
However, if Attorney True is elected as judge, Dr. Fair will likely appear before her in court as an expert witness. Will contributing to the campaign of the judicial candidate be contraindicated because it could lead to a perception of bias in future court cases? Is the contribution warranted because Dr. Fair believes that Attorney True is highly qualified for that position?
In her state, political contributions over $50 are in the public domain and anyone could see that Dr. Fair made the contribution. Dr. Fair would like to show her financial support by contributing more than $50. (Dr. Fair has already ruled out giving 10 checks for $49.95.). Concerned about ethics and reputation, Dr. Fair contacts you for a consult.
What are the potential ethical issues involved in the situation?
What are the competing ethical principles?
What are your suggestions for Dr. Fair?
However, if Attorney True is elected as judge, Dr. Fair will likely appear before her in court as an expert witness. Will contributing to the campaign of the judicial candidate be contraindicated because it could lead to a perception of bias in future court cases? Is the contribution warranted because Dr. Fair believes that Attorney True is highly qualified for that position?
In her state, political contributions over $50 are in the public domain and anyone could see that Dr. Fair made the contribution. Dr. Fair would like to show her financial support by contributing more than $50. (Dr. Fair has already ruled out giving 10 checks for $49.95.). Concerned about ethics and reputation, Dr. Fair contacts you for a consult.
What are the potential ethical issues involved in the situation?
What are the competing ethical principles?
What are your suggestions for Dr. Fair?
Thursday, June 6, 2013
Gag Orders on Sexuality
By Allie Grasgreen
Inside Higher Ed
Originally posted on May 23, 2013
When Brittney Griner, Baylor University’s star basketball player and one of the most celebrated athletes in the history of the sport, came out publicly as gay last month, she was rather nonchalant about it. She didn’t write a Sports Illustrated cover story – à la professional basketball player Jason Collins, a few weeks later – she just sort of mentioned it in media interviews. Griner is “someone who’s always been open,” she said, with family, friends and teammates.
But, as Griner revealed a few weeks later, she wasn’t allowed to be open as much as she might have liked. That’s because Baylor head coach Kim Mulkey told her and her teammates not to talk publicly about their sexuality.
“It was a recruiting thing,” Griner told ESPN. “The coaches thought that if it seemed like they condoned it, people wouldn’t let their kids come play for Baylor.”
Griner's account followed on the heels of speculation that her coming out signaled a new age at Baylor – a private Christian university whose nondiscrimination policy does not cover sexual orientation and whose student handbook entry for “sexual misconduct” includes as examples of inappropriate actions "homosexual behavior" and participation in “advocacy groups which promote understanding of sexuality that are contrary to biblical teaching.”
City Seeking to Diversify Foster System
By Mara Gay
The Wall Street Journal
Originally posted on June 2, 2013
New York City is launching a campaign to recruit gay and lesbian foster parents, part of a major push to expand the kinds of families who consider fostering and to find more welcoming homes for children who identify as lesbian, gay, bisexual, transgender or queer.
The public ad campaign, set to roll out this week, features images of an interracial gay couple spending time with a young child. "Be the reason she has hope," one of the ads reads. In another, a black woman is pictured alone with a white teenage boy. "Be the reason it gets better," the message says.
How many of the nearly 13,000 children in New York City's foster-care system identify as LGBTQ is unclear because the city does not keep such data. But, citing anecdotal evidence, researchers, child advocates and city officials insist that the children are disproportionately represented in the foster care system and say the need to find them supportive homes is great.
"When we decided to do this campaign we knew that LGBTQ young people are disproportionately represented in our foster care population, especially among our teens," said Ronald Richter, commissioner of the Administration for Children's Services, the city's child welfare agency.
Mr. Richter, citing a study the city commissioned last year, said the data show that adults who identify as LGBTQ are more likely to want to foster a child who may also identify that way.
The entire story is here.
The Wall Street Journal
Originally posted on June 2, 2013
New York City is launching a campaign to recruit gay and lesbian foster parents, part of a major push to expand the kinds of families who consider fostering and to find more welcoming homes for children who identify as lesbian, gay, bisexual, transgender or queer.
The public ad campaign, set to roll out this week, features images of an interracial gay couple spending time with a young child. "Be the reason she has hope," one of the ads reads. In another, a black woman is pictured alone with a white teenage boy. "Be the reason it gets better," the message says.
How many of the nearly 13,000 children in New York City's foster-care system identify as LGBTQ is unclear because the city does not keep such data. But, citing anecdotal evidence, researchers, child advocates and city officials insist that the children are disproportionately represented in the foster care system and say the need to find them supportive homes is great.
"When we decided to do this campaign we knew that LGBTQ young people are disproportionately represented in our foster care population, especially among our teens," said Ronald Richter, commissioner of the Administration for Children's Services, the city's child welfare agency.
Mr. Richter, citing a study the city commissioned last year, said the data show that adults who identify as LGBTQ are more likely to want to foster a child who may also identify that way.
The entire story is here.
Wednesday, June 5, 2013
Empathy Plays a Key Role in Moral Judgments
Science Daily
Originally published May 22, 2013
Is it permissible to harm one to save many? Those who tend to say "yes" when faced with this classic dilemma are likely to be deficient in a specific kind of empathy, according to a report published in the scientific journal PLOS ONE.
Philosophers and psychologists have long argued about whether there is one "right" answer to such moral questions, be it utilitarian ethics, which advocates saving as many as possible, even if it requires personally harming an individual, or non-utilitarian principles, which mandate strict adherence to rules like "don't kill" that are rooted in the value of human life and dignity.
In their new report, co-authors Liane Young, an assistant professor of psychology at Boston College, and Ezequiel Gleichgerrcht of the Institute of Cognitive Neurology and Favaloro University in Argentina, address two key questions related to moral decision-making: First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarian respondents or enhanced in non-utilitarians?
The entire story is here.
The entire article is here.
Abstract
Is it permissible to harm one to save many? Classic moral dilemmas are often defined by the conflict between a putatively rational response to maximize aggregate welfare (i.e., the utilitarian judgment) and an emotional aversion to harm (i.e., the non-utilitarian judgment). Here, we address two questions. First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarians or enhanced in non-utilitarians? The results reveal a key relationship between moral judgment and empathic concern in particular (i.e., feelings of warmth and compassion in response to someone in distress). Utilitarian participants showed significantly reduced empathic concern on an independent empathy measure. These findings therefore reveal diminished empathic concern in utilitarian moral judges.
Citation: Gleichgerrcht E, Young L (2013) Low Levels of Empathic Concern Predict Utilitarian Moral Judgment. PLoS ONE 8(4): e60418. doi:10.1371/journal.pone.0060418
Originally published May 22, 2013
Is it permissible to harm one to save many? Those who tend to say "yes" when faced with this classic dilemma are likely to be deficient in a specific kind of empathy, according to a report published in the scientific journal PLOS ONE.
Philosophers and psychologists have long argued about whether there is one "right" answer to such moral questions, be it utilitarian ethics, which advocates saving as many as possible, even if it requires personally harming an individual, or non-utilitarian principles, which mandate strict adherence to rules like "don't kill" that are rooted in the value of human life and dignity.
In their new report, co-authors Liane Young, an assistant professor of psychology at Boston College, and Ezequiel Gleichgerrcht of the Institute of Cognitive Neurology and Favaloro University in Argentina, address two key questions related to moral decision-making: First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarian respondents or enhanced in non-utilitarians?
The entire story is here.
The entire article is here.
Abstract
Is it permissible to harm one to save many? Classic moral dilemmas are often defined by the conflict between a putatively rational response to maximize aggregate welfare (i.e., the utilitarian judgment) and an emotional aversion to harm (i.e., the non-utilitarian judgment). Here, we address two questions. First, what specific aspect of emotional responding is relevant for these judgments? Second, is this aspect of emotional responding selectively reduced in utilitarians or enhanced in non-utilitarians? The results reveal a key relationship between moral judgment and empathic concern in particular (i.e., feelings of warmth and compassion in response to someone in distress). Utilitarian participants showed significantly reduced empathic concern on an independent empathy measure. These findings therefore reveal diminished empathic concern in utilitarian moral judges.
Citation: Gleichgerrcht E, Young L (2013) Low Levels of Empathic Concern Predict Utilitarian Moral Judgment. PLoS ONE 8(4): e60418. doi:10.1371/journal.pone.0060418
Silencing the Whistle-Blowers
By EYAL PRESS
The New York Times - OpEd
Published: May 27, 2013
LAST week Pfc. Bradley Manning returned to court for his final pretrial hearing in the WikiLeaks case, an appearance that has renewed debate about how to balance the imperatives of national security against the rights of whistle-blowers.
But while Private Manning’s ordeal has received exhaustive news coverage, it may ultimately have a less profound bearing on this tension than a barely noticed memo quietly released by the Obama administration earlier this year.
Issued on Jan. 25, the memo instructs the director of national intelligence and the Office of Personnel Management to establish standards that would give federal agencies the power to fire employees, without appeal, deemed ineligible to hold “noncritical sensitive” jobs. It means giving them immense power to bypass civil service law, which is the foundation for all whistle-blower rights.
The administration claims that the order will simply enable these agencies to determine which jobs qualify as “sensitive.” But the proposed rules are exceptionally vague, defining such jobs as any that could have “a material adverse impact” on national security — including police, customs and immigration positions.
If the new rules are put in place, national security could soon be invoked to deny civil servants like Franz Gayl the right to defend themselves when subjected to retaliation. Back in 2010, Mr. Gayl was accused of engaging in a pattern of “intentional misconduct” and suspended from his job. A Marine Corps adviser who had been deployed to Iraq in 2006, Mr. Gayl claimed he was being punished for publicly disclosing that Pentagon bureaucrats had ignored battlefield requests for mine-resistant armored vehicles, at a time when roadside bombs were killing and maiming soldiers.
The entire story is here.
The New York Times - OpEd
Published: May 27, 2013
LAST week Pfc. Bradley Manning returned to court for his final pretrial hearing in the WikiLeaks case, an appearance that has renewed debate about how to balance the imperatives of national security against the rights of whistle-blowers.
But while Private Manning’s ordeal has received exhaustive news coverage, it may ultimately have a less profound bearing on this tension than a barely noticed memo quietly released by the Obama administration earlier this year.
Issued on Jan. 25, the memo instructs the director of national intelligence and the Office of Personnel Management to establish standards that would give federal agencies the power to fire employees, without appeal, deemed ineligible to hold “noncritical sensitive” jobs. It means giving them immense power to bypass civil service law, which is the foundation for all whistle-blower rights.
The administration claims that the order will simply enable these agencies to determine which jobs qualify as “sensitive.” But the proposed rules are exceptionally vague, defining such jobs as any that could have “a material adverse impact” on national security — including police, customs and immigration positions.
If the new rules are put in place, national security could soon be invoked to deny civil servants like Franz Gayl the right to defend themselves when subjected to retaliation. Back in 2010, Mr. Gayl was accused of engaging in a pattern of “intentional misconduct” and suspended from his job. A Marine Corps adviser who had been deployed to Iraq in 2006, Mr. Gayl claimed he was being punished for publicly disclosing that Pentagon bureaucrats had ignored battlefield requests for mine-resistant armored vehicles, at a time when roadside bombs were killing and maiming soldiers.
The entire story is here.
Tuesday, June 4, 2013
Scholars call for new ethical guidelines to direct research on social networking
By Jennifer Sereno
University of Wisconsin-Madison News
Originally published January 2013
The unique data collection capabilities of social networking and online gaming websites require new ethical guidance from federal regulators concerning online research involving adolescent subjects, an ethics scholar from the Morgridge Institute for Research and a computer and learning sciences expert from Tufts University argue in the journal Science.
Increasingly, academics are designing and implementing research interventions on social network sites such as Facebook to learn how these interventions may affect user behavior, knowledge, attitudes and psychological health. Online games are being used as research interventions. However, the ability to mine user data (including information about Facebook "friends"), sensitive personal information and behavior raises concerns that deserve closer ethical scrutiny, say Pilar Ossorio and R. Benjamin Shapiro.
Ossorio is a bioethics scholar-in-residence at the Morgridge Institute, a private, nonprofit biomedical research institute on the University of Wisconsin-Madison campus. She also holds joint appointments as a professor of law and bioethics at the University of Wisconsin Law School and the School of Medicine and Public Health. Shapiro is an assistant professor in computer science and education at Tufts, where he is a member of the Center for Engineering Education and Outreach. He previously held appointments in educational research at Morgridge and the Wisconsin Institute for Discovery.
"Given the unprecedented ability of online research using social network sites to identify sensitive personal information concerning the research subject and the subject's online acquaintances, researchers need clarification concerning applicable ethical and regulatory standards," Ossorio says. "Regulators need greater insights into the possible benefits and harms of online social network research, and researchers need to better understand the relevant ethical and regulatory universe so they can design technical strategies for minimizing harm and complying with legal requirements."
For instance, Ossorio says, researchers may be able to design game features that detect player distress and respond by modifying the game environment, and marry those features to data collection technologies that maximally protect users' privacy while still offering useful data to researchers.
Consent for online research is tricky, particularly when it involves minors. Under Shapiro and Ossorio's analysis, current law does not require that researchers obtain parental permission to conduct studies of adolescents on social networking sites. Parental permission is required for younger children, while adolescents and adults provide their own consent. Of course, parents can prohibit their adolescents from any online activity, including research participation, regardless of legal limits on researchers. Parents have the same amount of control over their adolescents' online research participation as they do over any other online activity in which their teens engage.
"Researchers should use the online environment to deliver innovative, informative consent processes that help participants understand the dimensions of the research and the accompanying data collection," Shapiro says. "This is especially important given the general public's ignorance about the ability to collect massive amounts of personal data over the Internet."
If traditional approaches to consent are of limited value for protecting online subjects, Ossorio says, then researchers and regulators should emphasize other aspects of research ethics, such as using all reasonable approaches to minimize research risks. Also, researchers should seek innovative methods for generating transparency around the research enterprise.
Writing in the Policy Forum section of the Jan. 11 edition of Science, Shapiro and Ossorio conclude by emphasizing that the richness of online information should not become the sole domain of commercial marketing interests but should be used to advance understanding of human behavior and inspire positive social outcomes. Elucidating ethical and legal guidelines for design research on social media will create new opportunities for researchers to understand and improve society.
The news release is here.
University of Wisconsin-Madison News
Originally published January 2013
The unique data collection capabilities of social networking and online gaming websites require new ethical guidance from federal regulators concerning online research involving adolescent subjects, an ethics scholar from the Morgridge Institute for Research and a computer and learning sciences expert from Tufts University argue in the journal Science.
Increasingly, academics are designing and implementing research interventions on social network sites such as Facebook to learn how these interventions may affect user behavior, knowledge, attitudes and psychological health. Online games are being used as research interventions. However, the ability to mine user data (including information about Facebook "friends"), sensitive personal information and behavior raises concerns that deserve closer ethical scrutiny, say Pilar Ossorio and R. Benjamin Shapiro.
Ossorio is a bioethics scholar-in-residence at the Morgridge Institute, a private, nonprofit biomedical research institute on the University of Wisconsin-Madison campus. She also holds joint appointments as a professor of law and bioethics at the University of Wisconsin Law School and the School of Medicine and Public Health. Shapiro is an assistant professor in computer science and education at Tufts, where he is a member of the Center for Engineering Education and Outreach. He previously held appointments in educational research at Morgridge and the Wisconsin Institute for Discovery.
"Given the unprecedented ability of online research using social network sites to identify sensitive personal information concerning the research subject and the subject's online acquaintances, researchers need clarification concerning applicable ethical and regulatory standards," Ossorio says. "Regulators need greater insights into the possible benefits and harms of online social network research, and researchers need to better understand the relevant ethical and regulatory universe so they can design technical strategies for minimizing harm and complying with legal requirements."
For instance, Ossorio says, researchers may be able to design game features that detect player distress and respond by modifying the game environment, and marry those features to data collection technologies that maximally protect users' privacy while still offering useful data to researchers.
Consent for online research is tricky, particularly when it involves minors. Under Shapiro and Ossorio's analysis, current law does not require that researchers obtain parental permission to conduct studies of adolescents on social networking sites. Parental permission is required for younger children, while adolescents and adults provide their own consent. Of course, parents can prohibit their adolescents from any online activity, including research participation, regardless of legal limits on researchers. Parents have the same amount of control over their adolescents' online research participation as they do over any other online activity in which their teens engage.
"Researchers should use the online environment to deliver innovative, informative consent processes that help participants understand the dimensions of the research and the accompanying data collection," Shapiro says. "This is especially important given the general public's ignorance about the ability to collect massive amounts of personal data over the Internet."
If traditional approaches to consent are of limited value for protecting online subjects, Ossorio says, then researchers and regulators should emphasize other aspects of research ethics, such as using all reasonable approaches to minimize research risks. Also, researchers should seek innovative methods for generating transparency around the research enterprise.
Writing in the Policy Forum section of the Jan. 11 edition of Science, Shapiro and Ossorio conclude by emphasizing that the richness of online information should not become the sole domain of commercial marketing interests but should be used to advance understanding of human behavior and inspire positive social outcomes. Elucidating ethical and legal guidelines for design research on social media will create new opportunities for researchers to understand and improve society.
The news release is here.
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