Introducing deprescribing into culture of medication

By Catherine Cross
Canadian Medical Association
Originally published August 12, 2013

An Ontario pharmacist has received a government grant to develop clinical guidelines to help doctors determine whether patients are on medications they no longer need or that should be reduced.

"We don't normally test drugs in the elderly, but they are taking many drugs. As they get older and get more chronic conditions, the number of medications increases," says Barbara Farrell, a clinical scientist with the Bruyère Research Institute in Ottawa, Ontario.

Sometimes when medications are deprescribed or reduced, "confusion will clear, or they'll stop falling, and a lot of literature supports that," says Farrell, who received the $430 000 grant from the Ontario Ministry of Health and Long-Term Care.

The entire story is here.

When Doctors Discriminate

By JULIANN GAREY
The New York Times - Opinion
Published: August 10, 2013

Here is an excerpt:

If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.

I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”

I never knew it until I started poking around, but this particular kind of discriminatory doctoring has a name. It’s called “diagnostic overshadowing.”

According to a review of studies done by the Institute of Psychiatry at King’s College, London, it happens a lot. As a result, people with a serious mental illness — including bipolar disorder, major depression, schizophrenia and schizoaffective disorder — end up with wrong diagnoses and are under-treated.

The entire sad story is here.

Quiet No Longer, Rape Survivors Put Pressure on Colleges

By Libby Sander
The Chronicle of Higher Education
Originally published August 12, 2013

In February, writing on her blog, Tucker Reed identified a classmate at the University of Southern California as the man who raped her.

Ms. Reed, then a junior, included his name, three photos of him, and a detailed account of their troubled relationship.

The post went viral.

Within two weeks, Ms. Reed's apartment became a haven for fellow students who also identified as survivors of rape.

They baked cookies, killed zombies on Xbox, and began writing letters to the university, expressing their dissatisfaction with how it had treated them.

Before long they had formed a group, the Student Coalition Against Rape, or SCAR.

As the Southern California students were finding one another, so were survivors across the country.

Throughout the spring, they exchanged a hail of Facebook messages and tweets, swapping stories, giving advice, and, before long, mobilizing.

The entire story is here, behind a paywall.

Thanks to Ken Pope for this story.

What Spinoza Knew and Neuroscience Is Discovering: ‘Free Will’ Doesn’t Exist

Vox Tablet
Published July 1, 2013

Questions of character shape public discourse. From Paula Deen to Edward Snowden—the choices people make and actions people take raise questions about free will, personal responsibility, and morality. And yet, researchers in sociology, psychology, and neuroscience are increasingly asserting that the independent self that we are all so attached to doesn’t really exist. What’s more, there are philosophical traditions dating back to Aristotle, Maimonides, and Spinoza that may offer more useful ways of thinking about how to foster ethical behavior and moral societies.

In The Self Beyond Itself: An Alternative History of Ethics, the New Brain Sciences, and the Myth of Free Will, Heidi Ravven, a professor of religious studies at Hamilton College, examines these questions. She joins Vox Tablet host Sara Ivry on the podcast to discuss how the myth of free will took hold, what Spinoza had to say about it, and why if you want to be a moral person, the last thing you should do is surround yourself with like-minded people.

The audio file is here [Running time: 24:52.]

Science Is Not Your Enemy

An impassioned plea to neglected novelists, embattled professors, and tenure-less historians

By Steven Pinker

The New Republic

Originally published August 6, 2013

Here is an excerpt:

Scientism, in this good sense, is not the belief that members of the occupational guild called “science” are particularly wise or noble. On the contrary, the defining practices of science, including open debate, peer review, and double-blind methods, are explicitly designed to circumvent the errors and sins to which scientists, being human, are vulnerable. Scientism does not mean that all current scientific hypotheses are true; most new ones are not, since the cycle of conjecture and refutation is the lifeblood of science. It is not an imperialistic drive to occupy the humanities; the promise of science is to enrich and diversify the intellectual tools of humanistic scholarship, not to obliterate them. And it is not the dogma that physical stuff is the only thing that exists. Scientists themselves are immersed in the ethereal medium of information, including the truths of mathematics, the logic of their theories, and the values that guide their enterprise. In this conception, science is of a piece with philosophy, reason, and Enlightenment humanism. It is distinguished by an explicit commitment to two ideals, and it is these that scientism seeks to export to the rest of intellectual life.

The entire story is here.

The Concept of “Conduct Unbecoming” as Applied to a Physician’s Extra-Medical Behavior

By THOMAS G. GUTHEIL, M.D., HOWARD E. BOOK, M.D., and ARCHIE BRODSKY, B.A.
Journal of Psychiatry & Law 39/Summer 2011

An approach analogous to the military concept of “conduct unbecoming an officer” is increasingly evident in the attempted management of physicians’ personal behavior by medical licensing entities—even when such behavior bears little or no relation to medical practice. This article surveys the genesis
of this approach, the social and professional forces that have encouraged attempts to regulate extra-medical activities, and the current status of pertinent guild rules and other professional guidelines. Two reported case examples are reviewed with critical commentary.

The entire article is here.

Thanks to Gary Schoener for this information.

Empathy as a choice

By Jamil Zaki
Scientific American
July 29, 2013

Here is an excerpt:

Evidence from across the social and natural sciences suggests that we take on others’ facial expressions, postures, moods, and even patterns of brain activity.  This type of empathy is largely automatic.  For instance, people imitate others’ facial expressions after just a fraction of a second, often without realizing they’re doing so. Mood contagion likewise operates under the surface.  Therapists often report that, despite their best efforts, they take on patients’ moods, consistent with evidence from a number of studies.

(cut)

Together, these studies suggest that instead of automatically taking on others’ emotions, people make choices about whether and how much to engage in empathy.

The entire story is here.

'Selfish' Genes Create Cooperative Organisms

Rosa Rubicondior
June 9, 2013

Here are some excerpts:

One of the criticisms of Richard Dawkins' seminal work, and the work which initially made him famous as an evolutionary biologist, The Selfish Gene, is that it portrayed life itself as essentially selfish, so undermining any claim Atheists might have to be moral, empathetic and considerate people. This was of course always nonsense and is an example of attacking a scientific theory based on its consequences not on its validity, as though truth is subject to a human convenience test - rather like claiming nuclear fission doesn't work because atom bombs are destructive or that the Big Bang can't have been an uncaused event because that would shut god(s) out of the picture.

But the consequences of 'selfish' genes are not as is claimed anyway. In fact, anything more than a cursory glance at biology will reveal how cooperation, at all levels of organisation, has almost always been the key to long-term success.

(cut)

Cooperative alliances are the single greatest achievement of selfish genes. The entire web of mutually interdependent life on Earth owes its existence to these alliances, even the mutual interdependence of plant and animal life as animals provide the carbon dioxide for plants to use to make the sugars for animals to eat.

The entire blog post is here.

Motivated Moral Reasoning

By Peter H. Ditto, David A. Pizarro, and David Tannenbaum

Abstract

Moral judgments are important, intuitive, and complex. These factors make moral judgment particularly fertile ground for motivated reasoning. This chapter reviews research (both our own and that of others) examining two general pathways by which motivational forces can alter the moral implications of an act: by affecting perceptions of an actor’s moral accountability for the act, and by influencing the normative moral principles people rely on to evaluate the morality of the act. We conclude by discussing the implications of research on motivated moral reasoning for both classic and contemporary views of the moral thinker.

The entire chapter is here.

Thanks to Dave Pizarro for making this available.