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

Wednesday, September 17, 2014

Navy Nurse Faces Discipline for Actions at Guantanomo

By Kevin Gosztola
Firedoglake Blog
Originally published August 27, 2014

The first and only officer on the medical staff at Guantanamo Bay to conscientiously object to force-feeding prisoners on hunger strike has reportedly had his assignment ended. He has been sent back to Naval Health Clinic New England, his “parent command,” while an investigation is completed, which may result in discipline or a court-martial.

The Associated Press reported on August 26 that Navy Captain Maureen Pennington, who is “his commander at the network clinics, indicated, “An investigation has been conducted into his conduct while stationed at Guantanamo but it has not yet been determined if he will face any discipline.” He is “now on leave and military officials declined to provide details about him or any allegations he may face.”

The entire story is here.

Expansion of Mental Health Care Hits Obstacles

By Abby Goodnough
The New York Times
Originally published August 28, 2014

Here is an excerpt:

The new law is a big opportunity for mental health providers to reach more people of all income levels. But in Kentucky and the 25 other states that chose to expand Medicaid, the biggest expansion of mental health care has been for poor people who may have never had such treatment before.

Still, private providers face considerable headaches in taking on Medicaid patients, beyond the long-term deterrent of low reimbursement. Ms. Wright, for instance, is still waiting to be approved by some of the managed care companies that provide benefits to Medicaid recipients. Eager to build her client base, Ms. Wright has taken on a handful of new Medicaid enrollees for free while she waits for those companies to approve her paperwork.

“It’s been months and months,” she said. “It’s always there in my mind: Am I going to make it?”

The entire article is here.

Tuesday, September 16, 2014

Rethinking Hospital Restraints

Thousands of patients are physically restrained every day for their own safety—but evidence suggests that the practice may be ineffective and even harmful.

By Ravi Parikh
The Atlantic
Originally published August 18, 2014

Here is an excerpt:

Most of us who have been hospitalized have never seen physical restraints, as they are rarely used outside the ICU. Examples include wrist and ankle belts, vests, mitts, and full-length side rails attached to the bed. According to Medicare guidelines, restraints should only be used to ensure the safety of patients and staff and should be removed as early as possible. There are only a handful of situations where Medicare and other physician groups recommend using restraints, including patient violence towards himself or others and a threat of a patient disrupting his or her life-saving therapy, such as a breathing tube.

The entire article is here.

The status of NeuroLaw: A plea for current modesty and future cautious optimism

By Stephen J. Morse
Journal of Psychiatry and Law
39/Winter 2011

Abstract

Legislators, jurists, and advocates often turn to science to solve complicated normative problems addressed by the law.  This article addresses what motivates these parties, surveys the psychology of law and its concepts of the person and responsibility, and describes the general relation of neuroscience to law in terms of the issue of “translation.”  Numerous distractions have clouded our understanding of the relationship between scientific, causal accounts of behavior and responsibility. The notion of “NeuroLaw” is examined here in detail, with the conclusion that a cautious optimism regarding the contributions of neuroscience to the law is warranted.

The entire article is here.

Monday, September 15, 2014

Episode 15: Ethics and Telepsychology (Part 1)

Ethics and Telepsychology involves the rise of technology in the healthcare sector.  There are about 21 states that mandate insurance companies cover telehealth services.  John is joined by Dr. Marlene Maheu, trainer, author, researcher, and the Executive Director of the TeleMental Health Institute, Inc., where she has overseen the delivery of professional training in telemental health to more than 5000 professionals in 39 countries since 2010.  John and Marlene discuss the supporting research for telepsychology and its limitations; practitioner competencies; reimbursable, evidence-based models for telepsychology; and limitations with telepsychology.

At the end of this podcast, the listener will be able to:

1. Outline the general research findings on the usefulness of telepsychology,
2. Describe requirements of competent telepsychology practice,
3. List at least four reimbursable, evidence-based models for legal and ethical telepractice.

Click here to earn one APA-approved CE credit


Or listen directly below



Resources for Episode 15



by Marlene Maheu, Myron L. Pulier, Frank H. Wilhelm and Joseph P. McMenamin 

Bibliography from TeleMental Health Institute, Inc.

Marlene Maheu SlideShare

Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42, 276-283. 
doi: 10.1016/j.beth.2010.07.005

Harris, E., & Younggren, J. N. (2011). Risk management in the digital world.
Professional Psychology: Research and Practice, 42, 412-418.
doi: 10.1037/a0025139

Sunday, September 14, 2014

On Rage As a Moral Emotion

By Antti Kauppinen
PEA Soup Blog
Originally posted August 25, 2014

It is not rare to see groups of enraged people engaged in destructive behavior when you turn on the news these days. Such behavior is puzzling when we think of the agents as rational choosers, since it is often obviously counterproductive. The agents end up in many respects worse off – the neighborhoods that get damaged in riots tend to be the ones rioters live or work in, above all, and violent resistance often invites a brutal response from those who hold the power and control the drones. So what’s the deal with rage? Does it make sense to act out of rage? Can rage be warranted? In this tentative exploration of the issue (I haven’t come across any philosophical literature on it), I’ll argue that it can be, and that when it is, much of the moral responsibility for the wrongful harm that results from acting out of rage belongs to those who have created the rage-warranting situation.

The entire blog post is here.

Saturday, September 13, 2014

Oxford professor thinks artificial intelligence will destroy us all

By Dylan Matthews
Interview on Vox
Updated August 19, 2014

Here is an excerpt:

The basic argument is simple. At some point, many experts believe that artificial intelligence will advance to a point where it not only exceeds human intelligence, but is capable of expanding its own intelligence, setting off an exponential "intelligence explosion." In theory, these hyper-intelligent machines could be used to serve human ends. They could cure diseases and resolve intractable scientific quandaries. In an extreme case, they could wholly replace human workers, enabling humankind to quit working and live comfortably off the robots' labor.

But the problem is that, Bostrom argues, superintelligent machines will be so much more intelligent than humans that they most likely won't remain tools. They'll become goal-driven actors in their own right, and their goals may not be compatible with those of humans. Indeed, they might not be compatible with the continued existence of humans. Please consult the Terminator franchise for more on how that situation plays out.

The entire article and interview is here.

Friday, September 12, 2014

Against Empathy

By Paul Bloom
Boston Review
Originally published August 26, 2014

Here is an excerpt:

Most people see the benefits of empathy as akin to the evils of racism: too obvious to require justification. I think this is a mistake. I have argued elsewhere that certain features of empathy make it a poor guide to social policy. Empathy is biased; we are more prone to feel empathy for attractive people and for those who look like us or share our ethnic or national background. And empathy is narrow; it connects us to particular individuals, real or imagined, but is insensitive to numerical differences and statistical data. As Mother Teresa put it, “If I look at the mass I will never act. If I look at the one, I will.” Laboratory studies find that we really do care more about the one than about the mass, so long as we have personal information about the one.

In light of these features, our public decisions will be fairer and more moral once we put empathy aside. Our policies are improved when we appreciate that a hundred deaths are worse than one, even if we know the name of the one, and when we acknowledge that the life of someone in a faraway country is worth as much as the life a neighbor, even if our emotions pull us in a different direction. Without empathy, we are better able to grasp the importance of vaccinating children and responding to climate change. These acts impose costs on real people in the here and now for the sake of abstract future benefits, so tackling them may require overriding empathetic responses that favor the comfort and well being of individuals today. We can rethink humanitarian aid and the criminal justice system, choosing to draw on a reasoned, even counter-empathetic, analysis of moral obligation and likely consequences.

The entire article is here.

Who Can Consent to Neuroscience Research?

By Nick Seaver
blog.bioethics.org
Originally posted on August 20, 2014

Here is an excerpt:

“Generally, a researcher has to obtain a legally effective informed consent of the subject or the subject’s legally authorized representative,” said Menikoff. However, he went on to explain that while the definition does not sound complicated, its implementation can be.

“If you conclude that they did have the capacity and it’s correct, you’re pretty good,” continued Menikoff. “Once you’ve concluded they do not have the capacity, we are now in the area, as you all know, where the rules are very unclear.”

The entire article is here.