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

Monday, September 1, 2014

5 Ethical Responsibilities of Corporate Boards

By Kirk O. Hanson
Markkula Center for Applied Ethics Blog
Originally published August 14, 2014

Most corporate boards have learned to act quickly when a scandal breaks. General Motors’ board is moving much more quickly to clean up the fallout from its vehicles’ ignition failures than Toyota’s board did to address its rapid acceleration problems of several years ago. It is now the rare board that doesn’t launch an independent investigation quickly when misbehavior is reported.

But the responsibility of the board to prevent scandals is more important than the responsibility to clean up the mess once it has emerged. Here most boards are still at the starting gate. Recent legislation and guidance embodied in the Federal Sentencing Guidelines clearly require the board to take a key role in preventing ethics failures before they happened. This is more complicated than calling in the outside lawyers once disaster happens.

The entire article is here.

Thought Experiments

Stanford Encyclopedia of Philosophy
Substantive revision on August 12, 2014

Thought experiments are devices of the imagination used to investigate the nature of things. They are used for diverse reasons in a variety of areas, including economics, history, mathematics, philosophy, and the sciences, especially physics. Most often thought experiments are communicated in narrative form, frequently with diagrams. Thought experiments should be distinguished from thinking about experiments, from merely imagining any experiments to be conducted outside the imagination, and from psychological experiments with thoughts. They should also be distinguished from counterfactual reasoning in general, as they seem to require an experimental element, which seems to explain the impression that something is experienced in a thought experiment. In other words, though many call any counter-factual or hypothetical situation a thought experiment, this seems too encompassing. It seems right to demand that they also be visualized (or perhaps smelled, tasted, heard, touched); there should be something experimental about a thought experiment.

The primary philosophical challenge of thought experiments is simple: How can we learn about reality (if we can at all), just by thinking? More precisely, are there thought experiments that enable us to acquire new knowledge about the intended realm of investigation without new empirical data? If so, where does the new information come from if not from contact with the realm of investigation under consideration? Finally, how can we distinguish good from bad instances of thought experiments? These questions seem urgent with respect to scientific thought experiments, because most philosophers and historians of science “recognize them as an occasionally potent tool for increasing our understanding of nature. […] Historically their role is very close to the double one played by actual laboratory experiments and observations. First, thought experiments can disclose nature's failure to conform to a previously held set of expectations. Second, they can suggest particular ways in which both expectation and theory must henceforth be revised.” (Kuhn, 1977, p. 241 and 261) The questions are urgent regarding philosophical thought experiments, because they play an important role in philosophical discourse. Philosophy without thought experiments seems almost hopeless.

There is widespread agreement that thought experiments play a central role both in philosophy and in the natural sciences. General acceptance of the importance of some of the well-known thought experiments in the natural sciences, like Maxwell's demon, Einstein's elevator or Schrödinger's cat. Probably more often than not, these, and many other thought experiments have led the careful analysis of their epistemic powers to the conclusion that we should not portray science as an exclusively empirical activity (see Winchester, 1990, p. 79).

The entire entry is here.

Sunday, August 31, 2014

Medicare considers funding end-of-life talks

By Pam Belluck
The New York Times
Originally published August 31, 2014

Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.

Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans.

The entire article is here.

Editorial note: Politics will continue to affect health care delivery in the United States.  It is critical that healthcare providers cite foundational ethical principles when advocating for changes in our healthcare system, and not become immersed in sloganeering or bumper sticker politics to support one political party or the other.  High quality health care and informed patient choice are paramount.

Fast, Frugal, and (Sometimes) Wrong

Cass R. Sunstein
University of Chicago Law School and Department of Political Science
Originally published in 2005

Abstract

Do moral heuristics operate in the moral domain? If so, do they lead to moral errors? This brief essay offers an affirmative answer to both questions. In so doing, it responds to an essay by Gerd Gigerenzer on the nature of heuristics, moral and otherwise. While focused on morality, the discussion bears on the general debate between those who emphasize cognitive errors, sometimes produced by heuristics, and those who emphasize the frequent success of heuristics in producing sensible judgments in the real world. General claims are that it is contentious to see moral problems as ones of arithmetic, and that arguments about moral heuristics will often do well to steer clear of contentious arguments about what morality requires.

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But no one should deny that in many contexts, moral and other heuristics, in the form of simple rules of thumb, lead to moral error on any plausible view of morality. Consider, for example, the idea, emphasized by Gigerenzer, that one ought to do as the majority does, a source of massive moral blunders (see Sunstein, 2003). Or consider the fast and frugal idea that one ought not to distort the truth—a heuristic that generally works well, but that also leads (in my view) to moral error when, for example, the distortion is necessary to avoid significant numbers of deaths. Or consider the act- omission distinction, which makes moral sense in many domains, but which can lead to unsupportable moral judgments as well (Baron, 2004).

The entire article is here.

Saturday, August 30, 2014

The New Scientism

We can value scientific inquiry without viewing the natural sciences as free of politics.

By Kamil Ahsan
Jacobin Magazine
Originally published August 5, 2014

Here is an excerpt:

Ever since its coining by conservatives, “scientism” has been used pejoratively, most commonly by the same people who deny evolution and climate change. Consequently, leftists have historically renounced the word, signaling that that they fall on the side of scientific truth and not religion or spirituality.

This is a false dichotomy. One can value scientific inquiry without viewing the natural sciences as unimpeachable truth. And one can assail purported scientific progress without assailing science itself.

But try telling that to Michael Shermer, who, writing in Scientific American, sees in every critique of corporate behavior an anti-science temper tantrum: “Try having a conversation with a liberal progressive about GMOs…in which the words “Monsanto’ and ‘profit’ are not dropped like syllogistic bombs… The fact is that we’ve been genetically modifying organisms for 10,000 years through breeding and selection.”

The tunnel vision brought on by scientism resolves itself in a kind of social apathy, a dismissiveness of “real” problems, for which scientific data is the only antidote. This “just the facts, ma’am” approach excises ethics from the discussion and frames science as an appropriately depoliticized sphere. And in the process, it completely disregards what the humanities or the social sciences are able to tell us.

The entire article is here.

Free Will & Moral Responsibility in a Secular Society

By Michael Shermer
TAM 2014
Originally posted August 10, 2014

Michael Shermer, PhD presents theory and research on understanding the concepts of free will, moral responsibility and agency in current American society.  He draws from neuroscience, social psychology, and comparative psychology to develop ideas about how moral emotions play a part in understanding moral responsibility and culpability.

 

Friday, August 29, 2014

Artificial Wombs Are Coming, but the Controversy Is Already Here

By Zoltan Istvan
MotherBoard
Originally posted August 4, 2014

Of all the transhumanist technologies coming in the near future, one stands out that both fascinates and perplexes people. It's called ectogenesis: raising a fetus outside the human body in an artificial womb.

It has the possibility to change one of the most fundamental acts that most humans experience: the way people go about having children. It also has the possibility to change the way we view the female body and the field of reproductive rights.

Naturally, it's a social and political minefield.

The entire article is here.

Ethical Dilemmas of Confidentiality with Adolescent Clients: Case Studies from Psychologists

Rony E. Duncan, Annette C. Hall, Ann Knowles
Ethics & Behavior 
DOI:10.1080/10508422.2014.923314

Abstract

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analysed using interpretive content and thematic analysis. Three key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices (breach/don’t breach) because psychologists described five distinct options. These can be conceptualised on a spectrum of varying degrees of client autonomy, ranging from ‘no disclosure’ (highest client autonomy) to ‘disclosure without the client’s knowledge or consent’ (lowest client autonomy). Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimise potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development.

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1. It is of little use to conceptualise confidentiality as a binary choice.

2. Reaching a final decision about confidentiality dilemmas often entails balancing multiple and conflicting risks.

3. Participants demonstrated significant practice wisdom about how to negotiate confidentiality with adolescents in a manner that minimises harm.

The entire article is here.

Thursday, August 28, 2014

Punishment or therapy? The ethics of sexual offending treatment

Tony Ward
Journal of Sexual Aggression 
Vol. 16, Iss. 3, 2010
DOI:10.1080/13552600.2010.483822

Abstract

The claim that sex offender treatment is a form of punishment and as such cannot be covered by traditional ethical codes is a controversial one. It challenges the ethical basis of current practice and compels clinicians to rethink the work they do with sex offenders. In this paper I comment on Bill Glaser's defence of that idea in a challenging and timely paper and David Prescott and Jill Leveson's rejection of his claims. First, I consider briefly the nature of both punishment and treatment and outline Glaser's argument and Prescott and Levenson's rejoinder. I then investigate what a comprehensive argument for either position should look like and finish with a few comments on each paper.

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The Core Argument

The ethical problem concerning treatment and punishment is straightforward and can be outlined in terms of two broad possibilities, with some suboptions. First, do actions associated with punishment and treatment coexist within a sex offender treatment programme? And should they? Secondly, if not, is this because (a) they are functionally separate with punishment occurring outside the therapeutic orbit or (b) because only (or primarily) punishment is actually apparent within the therapy context? Prescott and Levenson argue for (a) and Glaser opts for (b). My own preference is for the rather messier option of coexistence, namely the first possibility.

The entire article is here.