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

Friday, February 28, 2014

Technical Problems and Apology

The host for Ethics and Psychology, Enom.com, has been experiencing technical problems throughout the day.

This is the first time in almost three years that this site has had such extensive hosting difficulties.

I apologize to those who have struggled to access Ethics and Psychology since early this morning. Accessing the site has been spotty at best, especially for Comcast customers.

I appreciate the email feedback regarding these problems.

Ethics and Psychology typically has between 500 and 700 page views per day.  Today's number is well below this average.

My hope is that readers, followers, and users will continue to visit Ethics and Psychology in spite of this technical glitch.  Enom.com assures me that they are working diligently to resolve the issues completely.

Again, my sincerest apologies.

John Gavazzi

Broadening Bioethics: Clinical Ethics, Public Health and Global Health

By Onora O'Neill
Nuffield Council on Bioethics

Medical ethics is the most discussed field of bioethics, and has been mainly concerned with clinical ethics.  It has often marginalized ethical questions about public health.  A focus on the treatment of individuals has highlighted patient choice and informed consent.  It can be widened to discuss the just distribution of health care, but is useless for considering many other interventions and policies that matter for public health.  Many public health interventions are non-distributable goods, so cannot be allocated to individuals or subjected to individual choice requirements.  In marginalizing public health, work in medical ethics also often marginalized questions about global health issues, where public health interventions matter hugely, and entrenched a deep separation of medical from environmental ethics.

Work that takes public and global health seriously needs to be anchored in political philosophy, to look beyond informed consent and individual choice, and to ask which interventions are permissible without the consent of those who they may affect, and which are not.  Public health encompasses more than health 'promotion' and 'nudges' - and these too require justification - and even clinical interventions that are directed to individuals presuppose standards, technologies, and structures that cannot be matters of choice.

The entire article is here.

The Ethics of an Ordinary Doctor

William T. Branch Jr.
Article first published online: 9 JAN 2014

DOI: 10.1002/hast.250

Here is an excerpt:

Bioethicists have proposed that an emphasis on autonomy and justice constitutes the important turn in contemporary medical ethics. As an ordinary doctor involved in the care of sick patients, I experienced a different turn: the shift from scientific hubris toward more compassionate care.

The future will likely bring an emphasis on limiting the costs of health care, related in ethics to distributive justice. But what do we learn about justice from being at the patient's bedside? We will not learn to abandon being our individual patients’ advocates. As in the case above, we witness their suffering. We participate. Our responsibility is to care for them.

The entire article is here.

Thursday, February 27, 2014

Did God Make These Babies Moral?

By Paul Bloom
New Republic
Originally posted January 13, 2014

Here is an excerpt:

As someone who studies morality, I hear this argument a lot. People can be selfish and amoral and appallingly cruel, but we are also capable of transcendent kindness, of great sacrifice and deep moral insight. Isn’t this evidence for God? This version of “intelligent design” is convincing to many people—including scientists who are otherwise unsympathetic to creationism—and it’s worth taking seriously. Like other intelligent design arguments, it doesn’t work, but its failure is an interesting one, touching on findings about evolution, moral psychology, and the minds of babies and young children.

For most of human history, it was easy enough to believe in a loving and all-powerful God. The natural world appears to teem with careful and complex design, and, as scholars from Cicero to Paley have argued, design implies a designer. This is a powerful argument: The evolutionary theorist and well-known atheist Richard Dawkins notes at the start of The Blind Watchmaker that he would certainly have been a believer before 1859—any observant and intellectual person would have to be. But Darwin changed everything, as he proposed a mechanistic account of where this complexity could come from. The theory of natural selection has been supported by abundant evidence from paleontology, genetics, physiology, and other fields of science, and denying it now is as intellectually disgraceful as denying that the Earth orbits the Sun.

The entire article is here.

Does NIH Head Francis Collins Believe in Intelligent Design?

By Eric Reitan
Religious Dispatches
Originally published February 4, 2014

Here is an excerpt:

The implications of Bloom’s essay go beyond critiquing a specific argument for God. Collins—a devout evangelical Christian and a prominent geneticist who headed up the human genome project—is viewed by many as a kind of poster child for the thesis that you really can be a top-notch scientist and a person of faith. Collins has done more than just about anyone to bring the case for accepting evolutionary theory to a skeptical evangelical community and has argued rigorously for the compatibility of science and faith.

In addition to that he’s been a strong critic of Intelligent Design, consistently urging his evangelical brothers and sisters not to hitch their faith to the fortunes of an approach that rests the credibility of theism on the supposed inadequacies of reputable science.

The entire article is here.

Wednesday, February 26, 2014

Digital and Social Media for Psychologist: Current Issues and Ethical Dilemmas

By Keely Kolmes, PsyD

Psychologists, whether they are in independent practice, working in an agency setting, or are teaching and supervision, are struggling more and more with issues related to their own, their trainees', and their clients' online access and availability.  Zur and Donner (2009) wrote about the accessibility of online information.  the compared unintentional vs. intentional disclosures clinicians may make during the psychotherapy hour and then compared these with the unintentional disclosures that psychotherapists might make available on the Internet when clients seek out information about providers.  They noted that the motivations could range from mild curiosity to criminal stalking, and they encouraged clinicians to maintain awareness of what information is made available about them.

The entire article is here.

Theory of Mind: Did Evolution Fool Us?

By Marie Devaine, Guillaume Hollard, and Jean Daunizeau
PLOS One
Published: February 05, 2014 DOI: 10.1371/journal.pone.0087619

Abstract

Theory of Mind (ToM) is the ability to attribute mental states (e.g., beliefs and desires) to other people in order to understand and predict their behaviour. If others are rewarded to compete or cooperate with you, then what they will do depends upon what they believe about you. This is the reason why social interaction induces recursive ToM, of the sort “I think that you think that I think, etc.”. Critically, recursion is the common notion behind the definition of sophistication of human language, strategic thinking in games, and, arguably, ToM. Although sophisticated ToM is believed to have high adaptive fitness, broad experimental evidence from behavioural economics, experimental psychology and linguistics point towards limited recursivity in representing other’s beliefs. In this work, we test whether such apparent limitation may not in fact be proven to be adaptive, i.e. optimal in an evolutionary sense. First, we propose a meta-Bayesian approach that can predict the behaviour of ToM sophistication phenotypes who engage in social interactions. Second, we measure their adaptive fitness using evolutionary game theory. Our main contribution is to show that one does not have to appeal to biological costs to explain our limited ToM sophistication. In fact, the evolutionary cost/benefit ratio of ToM sophistication is non trivial. This is partly because an informational cost prevents highly sophisticated ToM phenotypes to fully exploit less sophisticated ones (in a competitive context). In addition, cooperation surprisingly favours lower levels of ToM sophistication. Taken together, these quantitative corollaries of the “social Bayesian brain” hypothesis provide an evolutionary account for both the limitation of ToM sophistication in humans as well as the persistence of low ToM sophistication levels.

The entire article is here.

Tuesday, February 25, 2014

Mental Health: Parity Yes, Providers No

By Ben Hartman
Contributing Writer, MedPage Today
Originally published February 7, 2014

Demand -- for both facilities and providers -- has long outpaced supply in the field of mental health, but recent moves to increase funding for mental health services combined with innovative delivery systems may reverse that trend.

(cut)

But money is not the only issue: many PCPs lack the needed psychiatric training, according to Jaseu Han, MD, residency director of the combined family medicine/psychiatry program at the University of California Davis Health System.

"There has to be a behavioral component to all residencies. There is a ton of talk about the value of patient-physician interactions, but the residents are not receiving psychiatric training. If you look at internal medicine, Ob/Gyn, pediatrics, and family medicine, they don't get anything. There is no requirement during residency to get any mental health experience."

The entire story is here.

Editorial note: This article points out another reason psychologists with advanced training and supervision in psychopharmacology can bridge the gap as prescribing psychologists.

Please listen the Psychologists and Prescriptive Authority: Where are we now? podcast

The N-Word "Double Standard"