By David Alfrandre and John Henning Schumann
JAMA
First published November 11, 2013
Here is an excerpt:
It is time to rethink the approach to this issue. For a profession accountable to the public and committed to patient-centered care, continued use of the discharged against medical advice designation is clinically and ethically problematic. Designating a discharge as against medical advice is a clinical practice without standards, legal requirements, or demonstrated benefits to patients, and there is evidence of its harm. The more relevant and pressing question should be, “Why would you discharge a patient against medical advice?” Without a compelling answer to that question, continued use of the practice does not seem justified. Taking leadership on this problem through enhanced research, teaching, and quality patient care ensures that the profession will honor its commitment to providing patient-centered care and improving clinical outcomes.
The entire article is here.
Thanks to Gary Schoener for this information.
Saturday, November 30, 2013
No Faith in Science
By Jerry A. Coyne
Slate.com
Originally published November 14, 2013
A common tactic of those who claim that science and religion are compatible is to argue that science, like religion, rests on faith: faith in the accuracy of what we observe, in the laws of nature, or in the value of reason. Daniel Sarewitz, director of a science policy center at Arizona State University and an occasional Slate contributor, wrote this about the Higgs boson in the pages of Nature, one of the world’s most prestigious science journals: “For those who cannot follow the mathematics, belief in the Higgs is an act of faith, not of rationality.”
Such statements imply that science and religion are not that different because both seek the truth and use faith to find it. Indeed, science is often described as a kind of religion.
But that’s wrong, for the “faith” we have in science is completely different from the faith believers have in God and the dogmas of their creed.
The entire article is here.
Slate.com
Originally published November 14, 2013
A common tactic of those who claim that science and religion are compatible is to argue that science, like religion, rests on faith: faith in the accuracy of what we observe, in the laws of nature, or in the value of reason. Daniel Sarewitz, director of a science policy center at Arizona State University and an occasional Slate contributor, wrote this about the Higgs boson in the pages of Nature, one of the world’s most prestigious science journals: “For those who cannot follow the mathematics, belief in the Higgs is an act of faith, not of rationality.”
Such statements imply that science and religion are not that different because both seek the truth and use faith to find it. Indeed, science is often described as a kind of religion.
But that’s wrong, for the “faith” we have in science is completely different from the faith believers have in God and the dogmas of their creed.
The entire article is here.
Friday, November 29, 2013
Gruesome case videos became too much for top psychiatrist
Chris Cobb, Postmedia News | Originally published 11/11/13
Dr. John Bradford’s mental breakdown hit without warning less than half an hour after he watched Canadian Air Force colonel Russell Williams sexually assaulting two young women whom he would later kill.
During his long and distinguished career as a doctor and teacher, the internationally renowned forensic psychiatrist had become skilled at emotionally detaching himself from all manner of horrendous images.
He was relatively comfortable sitting across a table from the likes of notorious sex killers Paul Bernardo, Robert (Willie) Pickton and Williams.
And like all professionals in his line of work, Dr. Bradford was trained to focus on the killer, not the crime. His job is to get inside a killer’s mind, not to pass judgment on the severity or brutality of the killer’s actions.
The entire article is here.
Thanks to Gary Schoener for this article.
Dr. John Bradford’s mental breakdown hit without warning less than half an hour after he watched Canadian Air Force colonel Russell Williams sexually assaulting two young women whom he would later kill.
During his long and distinguished career as a doctor and teacher, the internationally renowned forensic psychiatrist had become skilled at emotionally detaching himself from all manner of horrendous images.
He was relatively comfortable sitting across a table from the likes of notorious sex killers Paul Bernardo, Robert (Willie) Pickton and Williams.
And like all professionals in his line of work, Dr. Bradford was trained to focus on the killer, not the crime. His job is to get inside a killer’s mind, not to pass judgment on the severity or brutality of the killer’s actions.
The entire article is here.
Thanks to Gary Schoener for this article.
So much for Hippocrates: Why docs won’t reveal each other’s mistakes
Research suggests physicians are concerned about becoming known as a tattler and losing referrals
By Marshall Allen
Propublica
Originally published November 12, 2013
Patients don’t always know when their doctor has made a medical error. But other doctors do.
A few years ago I called a Las Vegas surgeon because I had hospital data showing which of his peers had high rates of surgical injuries – things like removing a healthy kidney, accidentally puncturing a young girl’s aorta during an appendectomy and mistakenly removing part of a woman’s pancreas.
I wanted to see if he could help me investigate what happened. But the surgeon surprised me.
Before I could get a question out, he started rattling off the names of surgeons he considered the worst in town. He and his partners often had to correct their mistakes — “cleanup” surgeries, he said. He didn’t need a database to tell him which surgeons made the most mistakes.
The entire story is here.
Thanks to Gary Schoener for this article.
By Marshall Allen
Propublica
Originally published November 12, 2013
Patients don’t always know when their doctor has made a medical error. But other doctors do.
A few years ago I called a Las Vegas surgeon because I had hospital data showing which of his peers had high rates of surgical injuries – things like removing a healthy kidney, accidentally puncturing a young girl’s aorta during an appendectomy and mistakenly removing part of a woman’s pancreas.
I wanted to see if he could help me investigate what happened. But the surgeon surprised me.
Before I could get a question out, he started rattling off the names of surgeons he considered the worst in town. He and his partners often had to correct their mistakes — “cleanup” surgeries, he said. He didn’t need a database to tell him which surgeons made the most mistakes.
The entire story is here.
Thanks to Gary Schoener for this article.
Thursday, November 28, 2013
When Healers Get Too Friendly
By Abigail Zuger
The New York Times - Well
Originally published November 11, 2013
Here is an excerpt:
The incident that it set it off: Dr. Schiff (now 63, an experienced senior clinician) had tangled with an insurer on the phone for two hours before he gave up and handed an impoverished patient $30 to pay for her pain pills. A resident observed the transaction and turned him in. But Dr. Schiff is a proud repeat offender, whose past infractions include helping patients get jobs, giving them jobs himself, offering them rides home, extending the occasional dinner invitation and, yes, once handing over a computer.
He was told physicians should stay away from “random acts of kindness” — an activity that may sound harmless but is quite distinct from the practice of medicine, and has its risks. Patients might get too familiar, expect too much.
The entire story is here.
The New York Times - Well
Originally published November 11, 2013
Here is an excerpt:
The incident that it set it off: Dr. Schiff (now 63, an experienced senior clinician) had tangled with an insurer on the phone for two hours before he gave up and handed an impoverished patient $30 to pay for her pain pills. A resident observed the transaction and turned him in. But Dr. Schiff is a proud repeat offender, whose past infractions include helping patients get jobs, giving them jobs himself, offering them rides home, extending the occasional dinner invitation and, yes, once handing over a computer.
He was told physicians should stay away from “random acts of kindness” — an activity that may sound harmless but is quite distinct from the practice of medicine, and has its risks. Patients might get too familiar, expect too much.
The entire story is here.
Robert Wright's Interview with Paul Bloom
Originally published November 13, 2013
Just Babies: The Origins of Good and Evil
BloggingHeadsTV
Just Babies: The Origins of Good and Evil
BloggingHeadsTV
Wednesday, November 27, 2013
US courts see rise in defendants blaming their brains for criminal acts
By Ian Sample, Science Correspondent in San Diego
The Guardian, Sunday 10 November 2013
Criminal courts in the United States are facing a surge in the number of defendants arguing that their brains were to blame for their crimes and relying on questionable scans and other controversial, unproven neuroscience, a legal expert who has advised the president has warned.
Nita Farahany, a professor of law who sits on Barack Obama's bioethics advisory panel, told a Society for Neuroscience meeting in San Diego that those on trial were mounting ever more sophisticated defences that drew on neurological evidence in an effort to show they were not fully responsible for murderous or other criminal actions.
Lawyers typically drew on brain scans and neuropsychological tests to reduce defendants' sentences, but in a substantial number of cases the evidence was used to try to clear defendants of all culpability.
The entire story is here.
The Guardian, Sunday 10 November 2013
Criminal courts in the United States are facing a surge in the number of defendants arguing that their brains were to blame for their crimes and relying on questionable scans and other controversial, unproven neuroscience, a legal expert who has advised the president has warned.
Nita Farahany, a professor of law who sits on Barack Obama's bioethics advisory panel, told a Society for Neuroscience meeting in San Diego that those on trial were mounting ever more sophisticated defences that drew on neurological evidence in an effort to show they were not fully responsible for murderous or other criminal actions.
Lawyers typically drew on brain scans and neuropsychological tests to reduce defendants' sentences, but in a substantial number of cases the evidence was used to try to clear defendants of all culpability.
The entire story is here.
Superhero Comics as Moral Pornography
By David Pizarro and Roy Baumeister
Superhero Comics as Moral Pornography.
In R. Rosenberg (Ed.) Our Superheroes, Ourselves. Oxford University Press.
Here is an excerpt:
Modern superhero comics (and the films they’ve inspired) are moral tales on steroids. While they present variations on the theme of good versus evil, these stories describe individuals who commit moral deeds of global (and often cosmic) significance on a weekly basis. In this chapter we will argue that superhero comics, like other moralistic tales, are popular in part because they satisfy a basic human motivation: the motivation to divide the social world into good people and bad, and to morally praise and condemn them accordingly. In their modern superhero comic incarnation, however, these tales depict an exaggerated morality that has been stripped of its real-world subtlety. In tales of superhero versus supervillain, moral good and moral bad are always the actions of easily identifiable moral agents with unambiguous intentions and actions. And it is these very qualities that make these stories so enjoyable. Much like the appeal of the exaggerated, caricatured sexuality found in pornography, superhero comics offer the appeal of an exaggerated and caricatured morality that satisfies the natural human inclination toward moralization. In short, the modern superhero comic is a form of “moral pornography”— built to satisfy our moralistic urges, but ultimately unrealistic and, in the end, potentially misleading.
The entire chapter is here.
Superhero Comics as Moral Pornography.
In R. Rosenberg (Ed.) Our Superheroes, Ourselves. Oxford University Press.
Here is an excerpt:
Modern superhero comics (and the films they’ve inspired) are moral tales on steroids. While they present variations on the theme of good versus evil, these stories describe individuals who commit moral deeds of global (and often cosmic) significance on a weekly basis. In this chapter we will argue that superhero comics, like other moralistic tales, are popular in part because they satisfy a basic human motivation: the motivation to divide the social world into good people and bad, and to morally praise and condemn them accordingly. In their modern superhero comic incarnation, however, these tales depict an exaggerated morality that has been stripped of its real-world subtlety. In tales of superhero versus supervillain, moral good and moral bad are always the actions of easily identifiable moral agents with unambiguous intentions and actions. And it is these very qualities that make these stories so enjoyable. Much like the appeal of the exaggerated, caricatured sexuality found in pornography, superhero comics offer the appeal of an exaggerated and caricatured morality that satisfies the natural human inclination toward moralization. In short, the modern superhero comic is a form of “moral pornography”— built to satisfy our moralistic urges, but ultimately unrealistic and, in the end, potentially misleading.
The entire chapter is here.
Tuesday, November 26, 2013
The Roots of Good and Evil: An Interview with Paul Bloom
By Sam Harris
Sam Harris Blog
Originally published November 12, 2013
Here is one excerpt:
Harris: What are the greatest misconceptions people have about the origins of morality?
Bloom: The most common misconception is that morality is a human invention. It’s like agriculture and writing, something that humans invented at some point in history. From this perspective, babies start off as entirely self-interested beings—little psychopaths—and only gradually come to appreciate, through exposure to parents and schools and church and television, moral notions such as the wrongness of harming another person.
Now, this perspective is not entirely wrong. Certainly some morality is learned; this has to be the case because moral ideals differ across societies. Nobody is born with the belief that sexism is wrong (a moral belief that you and I share) or that blasphemy should be punished by death (a moral belief that you and I reject). Such views are the product of culture and society. They aren’t in the genes.
But the argument I make in Just Babies is that there also exist hardwired moral universals—moral principles that we all possess. And even those aspects of morality—such as the evils of sexism—that vary across cultures are ultimately grounded in these moral foundations.
A very different misconception sometimes arises, often stemming from a religious or spiritual outlook. It’s that we start off as Noble Savages, as fundamentally good and moral beings. From this perspective, society and government and culture are corrupting influences, blotting out and overriding our natural and innate kindness.
This, too, is mistaken. We do have a moral core, but it is limited—Hobbes was closer to the truth than Rousseau. Relative to an adult, your typical toddler is selfish, parochial, and bigoted. I like the way Kingsley Amis once put it: “It was no wonder that people were so horrible when they started life as children.” Morality begins with the genes, but it doesn’t end there.
The entire interview is here.
Sam Harris Blog
Originally published November 12, 2013
Here is one excerpt:
Harris: What are the greatest misconceptions people have about the origins of morality?
Bloom: The most common misconception is that morality is a human invention. It’s like agriculture and writing, something that humans invented at some point in history. From this perspective, babies start off as entirely self-interested beings—little psychopaths—and only gradually come to appreciate, through exposure to parents and schools and church and television, moral notions such as the wrongness of harming another person.
Now, this perspective is not entirely wrong. Certainly some morality is learned; this has to be the case because moral ideals differ across societies. Nobody is born with the belief that sexism is wrong (a moral belief that you and I share) or that blasphemy should be punished by death (a moral belief that you and I reject). Such views are the product of culture and society. They aren’t in the genes.
But the argument I make in Just Babies is that there also exist hardwired moral universals—moral principles that we all possess. And even those aspects of morality—such as the evils of sexism—that vary across cultures are ultimately grounded in these moral foundations.
A very different misconception sometimes arises, often stemming from a religious or spiritual outlook. It’s that we start off as Noble Savages, as fundamentally good and moral beings. From this perspective, society and government and culture are corrupting influences, blotting out and overriding our natural and innate kindness.
This, too, is mistaken. We do have a moral core, but it is limited—Hobbes was closer to the truth than Rousseau. Relative to an adult, your typical toddler is selfish, parochial, and bigoted. I like the way Kingsley Amis once put it: “It was no wonder that people were so horrible when they started life as children.” Morality begins with the genes, but it doesn’t end there.
The entire interview is here.
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