By The Social Network Show
Originally published March 16, 2015
Part of the Show Recap
The Social Network Show welcomes Dr. John Gavazzi to the March 16, 2015 episode.
If you are a healthcare professional or a professional in any other field, one thing you have to pay attention to is your online reputation. Something to remember, there is no difference in your professional and your personal online presence and patients, clients and customers can find you.
Dr. Gavazzi, a clinical psychologist and named Ethics Educator of the Year by the Pennsylvania Psychological Association in 2013, talks about the issues to consider when building an online presence. In this episode you will hear about what ethical issues to consider; the importance of setting boundaries; what is included in informed consent; the limitations of technology; what constitutes a violation of privacy; and what are the advantages of being online for professionals.
(I was also named Ethics Educator of the Year by the American Psychological Association in 2014.)
The podcast is here.
Wednesday, April 8, 2015
Tuesday, April 7, 2015
Premera Blue Cross Breach May Have Exposed 11 Million Customers' Medical And Financial Data
By Kate Vinton
Forbes
Originally published March 17, 2015
Medical and financial data belonging to as many as 11 million Premera Blue Cross customers may have been exposed in a breach discovered on the same day as the Anthem breach, the health insurance company announced Tuesday.
Premera discovered the breach on January 29, 2015. Working with both Mandiant and the FBI to investigate the attack, the company discovered that the initial attack occurred on May 5, 2014. Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska were both impacted, in addition to affiliate brands Vivacity and Connexion Insurance Solutions. Additionally, other Blue Cross Blue Shield customers in Washington and Alaska may have been affected by the breach.
The entire article is here.
Forbes
Originally published March 17, 2015
Medical and financial data belonging to as many as 11 million Premera Blue Cross customers may have been exposed in a breach discovered on the same day as the Anthem breach, the health insurance company announced Tuesday.
Premera discovered the breach on January 29, 2015. Working with both Mandiant and the FBI to investigate the attack, the company discovered that the initial attack occurred on May 5, 2014. Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska were both impacted, in addition to affiliate brands Vivacity and Connexion Insurance Solutions. Additionally, other Blue Cross Blue Shield customers in Washington and Alaska may have been affected by the breach.
The entire article is here.
Healthcare Accounted For Almost Half Of 2014 Client Breaches
By Christine Kern
Health IT Outcomes
Originally published March 12, 2015
A Kroll study has found the healthcare industry accounted for 49 percent of the company’s “client events” during 2014, followed by business services (retail, insurance, and financial services) at 26 percent, and higher education at 11 percent. The study further found malicious intent breach events increased while those caused by human error declined.
Monday, April 6, 2015
Evolutionary Moral Realism
By John Collier and Michael Stingl
Biological Theory
March 2013, Volume 7, Issue 3, pp 218-226
Abstract
Evolutionary moral realism is the view that there are moral values with roots in evolution that are both specifically moral and exist independently of human belief systems. In beginning to sketch the outlines of such a view, we examine moral goods like fairness and empathetic caring as valuable and real aspects of the environments of species that are intelligent and social, or at least developing along an evolutionary trajectory that could lead to a level of intelligence that would enable individual members of the species to recognize and respond to such things as the moral goods they in fact are. We suggest that what is most morally interesting and important from a biological perspective is the existence and development of such trajectories, rather than the position of one particular species, such as our own, on one particular trajectory.
The entire article is here.
Biological Theory
March 2013, Volume 7, Issue 3, pp 218-226
Abstract
Evolutionary moral realism is the view that there are moral values with roots in evolution that are both specifically moral and exist independently of human belief systems. In beginning to sketch the outlines of such a view, we examine moral goods like fairness and empathetic caring as valuable and real aspects of the environments of species that are intelligent and social, or at least developing along an evolutionary trajectory that could lead to a level of intelligence that would enable individual members of the species to recognize and respond to such things as the moral goods they in fact are. We suggest that what is most morally interesting and important from a biological perspective is the existence and development of such trajectories, rather than the position of one particular species, such as our own, on one particular trajectory.
The entire article is here.
How (Un)ethical Are You?
Mahzarin R. Banaji, Max H. Bazerman, & Dolly Chugh
Harvard Business Review
Originally published in 2003
Here is an excerpt:
Bias That Emerges from Unconscious Beliefs
Most fair-minded people strive to judge others according to their merits, but our research shows how often people instead judge according to unconscious stereotypes and attitudes, or “implicit prejudice.” What makes implicit prejudice so common and persistent is that it is rooted in the fundamental mechanics of thought. Early on, we learn to associate things that commonly go together and expect them to inevitably coexist: thunder and rain, for instance, or gray hair and old age. This skill—to perceive and learn from associations—often serves us well.
But, of course, our associations only reflect approximations of the truth; they are rarely applicable to every encounter. Rain doesn’t always accompany thunder, and the young can also go gray. Nonetheless, because we automatically make such associations to help us organize our world, we grow to trust them, and they can blind us to those instances in which the associations are not accurate—when they don’t align with our expectations.
Because implicit prejudice arises from the ordinary and unconscious tendency to make associations, it is distinct from conscious forms of prejudice, such as overt racism or sexism. This distinction explains why people who are free from conscious prejudice may still harbor biases and act accordingly.
The entire article is here.
Harvard Business Review
Originally published in 2003
Here is an excerpt:
Bias That Emerges from Unconscious Beliefs
Most fair-minded people strive to judge others according to their merits, but our research shows how often people instead judge according to unconscious stereotypes and attitudes, or “implicit prejudice.” What makes implicit prejudice so common and persistent is that it is rooted in the fundamental mechanics of thought. Early on, we learn to associate things that commonly go together and expect them to inevitably coexist: thunder and rain, for instance, or gray hair and old age. This skill—to perceive and learn from associations—often serves us well.
But, of course, our associations only reflect approximations of the truth; they are rarely applicable to every encounter. Rain doesn’t always accompany thunder, and the young can also go gray. Nonetheless, because we automatically make such associations to help us organize our world, we grow to trust them, and they can blind us to those instances in which the associations are not accurate—when they don’t align with our expectations.
Because implicit prejudice arises from the ordinary and unconscious tendency to make associations, it is distinct from conscious forms of prejudice, such as overt racism or sexism. This distinction explains why people who are free from conscious prejudice may still harbor biases and act accordingly.
The entire article is here.
Sunday, April 5, 2015
Compliance with Results Reporting at ClinicalTrials.gov
By Monique L. Anderson and others
N Engl J Med 2015; 372:1031-1039
March 12, 2015
DOI: 10.1056/NEJMsa1409364
Here are two excerpts:
The human experimentation that is conducted in clinical trials creates ethical obligations to make research findings publicly available. However, there are numerous historical examples of potentially harmful data being withheld from public scrutiny and selective publication of trial results. In 2000, Congress authorized the creation of the ClinicalTrials.gov registry to provide information about and access to clinical trials for persons with serious medical conditions. In 2007, Section 801 of the Food and Drug Administration Amendments Act (FDAAA) expanded this mandate by requiring sponsors of applicable clinical trials to register and report basic summary results at ClinicalTrials.gov. Such trials generally include all non–phase 1 interventional trials of drugs, medical devices, or biologics that were initiated after September 27, 2007, or before that date but that were still ongoing as of December 26, 2007, have at least one U.S. research site, or are conducted under an investigational-new-drug application or an investigational-device exemption. The FDAAA also mandates that trial results be reported by the sponsor within 1 year after the completion of data collection for the prespecified primary outcome (primary completion date) or within 1 year after the date of early termination, unless legally acceptable reasons for the delay are evident.
(cut)
In conclusion, despite ethical mandates, statutory obligations, and considerable societal pressure, most trials that were funded by the NIH or other government or academic institutions and were subject to FDAAA provisions have yet to report results at ClinicalTrials.gov, whereas the medical-products industry has been more responsive to the legal mandate of the FDAAA. However, industry, the NIH, and other government and academic institutions all performed poorly with respect to ethical obligations for transparency.
The entire article is here.
N Engl J Med 2015; 372:1031-1039
March 12, 2015
DOI: 10.1056/NEJMsa1409364
Here are two excerpts:
The human experimentation that is conducted in clinical trials creates ethical obligations to make research findings publicly available. However, there are numerous historical examples of potentially harmful data being withheld from public scrutiny and selective publication of trial results. In 2000, Congress authorized the creation of the ClinicalTrials.gov registry to provide information about and access to clinical trials for persons with serious medical conditions. In 2007, Section 801 of the Food and Drug Administration Amendments Act (FDAAA) expanded this mandate by requiring sponsors of applicable clinical trials to register and report basic summary results at ClinicalTrials.gov. Such trials generally include all non–phase 1 interventional trials of drugs, medical devices, or biologics that were initiated after September 27, 2007, or before that date but that were still ongoing as of December 26, 2007, have at least one U.S. research site, or are conducted under an investigational-new-drug application or an investigational-device exemption. The FDAAA also mandates that trial results be reported by the sponsor within 1 year after the completion of data collection for the prespecified primary outcome (primary completion date) or within 1 year after the date of early termination, unless legally acceptable reasons for the delay are evident.
(cut)
In conclusion, despite ethical mandates, statutory obligations, and considerable societal pressure, most trials that were funded by the NIH or other government or academic institutions and were subject to FDAAA provisions have yet to report results at ClinicalTrials.gov, whereas the medical-products industry has been more responsive to the legal mandate of the FDAAA. However, industry, the NIH, and other government and academic institutions all performed poorly with respect to ethical obligations for transparency.
The entire article is here.
Saturday, April 4, 2015
Teaching doctors how to engage more and lecture less
By Sandra G. Boodman
The Washington Post
Originally posted March 9, 2015
Here is an excerpt:
“Doctors are explainaholics,” Tulsky said. “Our answer to distress is more information, that if a patient just understood it better, they would come around.” In reality, bombarding a patient with information does little to alleviate the underlying worry.
The “Empathetics” program teaches doctors “how to show up, not what to say,” said Riess. “We do a lot of training in emotional recognition and self-monitoring.” That includes learning to identify seven universal facial expressions — using research pioneered by psychologist Paul Ekman — and to take stock of one’s own emotional responses to patients or situations.
The entire article is here.
The Washington Post
Originally posted March 9, 2015
Here is an excerpt:
“Doctors are explainaholics,” Tulsky said. “Our answer to distress is more information, that if a patient just understood it better, they would come around.” In reality, bombarding a patient with information does little to alleviate the underlying worry.
The “Empathetics” program teaches doctors “how to show up, not what to say,” said Riess. “We do a lot of training in emotional recognition and self-monitoring.” That includes learning to identify seven universal facial expressions — using research pioneered by psychologist Paul Ekman — and to take stock of one’s own emotional responses to patients or situations.
The entire article is here.
Friday, April 3, 2015
Ethical Implications of Patients and Families Secretly Recording Conversations With Physicians
By Michelle Rodriguez, Jason Morrow, and Ali Seifi
JAMA.
Published online March 12, 2015. doi:10.1001/jama.2015.2424
Here are two excerpts:
Recording conversations could be beneficial for patients. Patients do not always understand or recall all the information provided during visits to physicians. Recordings could potentially improve accuracy, adherence, and personal engagement by providing opportunities to review conversations at other times, from the comfort of home, and in conjunction with other family members or caregivers.
(cut)
Not all possible uses of these recorded conversations are beneficial to patients and physicians. Patients or family members who disagree with the advice of their physicians or who are upset with their physicians for whatever reason can easily take comments from these recordings out of context and, with a few keystrokes, disseminate them via social media. Patients can conceivably record conversations with the specific intent of establishing the grounds for a lawsuit or gathering material with which to manipulate a physician.
The entire article is here.
JAMA.
Published online March 12, 2015. doi:10.1001/jama.2015.2424
Here are two excerpts:
Recording conversations could be beneficial for patients. Patients do not always understand or recall all the information provided during visits to physicians. Recordings could potentially improve accuracy, adherence, and personal engagement by providing opportunities to review conversations at other times, from the comfort of home, and in conjunction with other family members or caregivers.
(cut)
Not all possible uses of these recorded conversations are beneficial to patients and physicians. Patients or family members who disagree with the advice of their physicians or who are upset with their physicians for whatever reason can easily take comments from these recordings out of context and, with a few keystrokes, disseminate them via social media. Patients can conceivably record conversations with the specific intent of establishing the grounds for a lawsuit or gathering material with which to manipulate a physician.
The entire article is here.
Ethical Breakdowns
Max H. Bazerman and Ann E. Tenbrunsel
Harvard Business Review
Originally published in April 2011
Here is an excerpt:
Motivated Blindness
It’s well documented that people see what they want to see and easily miss contradictory information when it’s in their interest to remain ignorant—a psychological phenomenon known as motivated blindness. This bias applies dramatically with respect to unethical behavior. At Ford the senior-most executives involved in the decision to rush the flawed Pinto into production not only seemed unable to clearly see the ethical dimensions of their own decision but failed to recognize the unethical behavior of the subordinates who implemented it.
Let’s return to the 2008 financial collapse, in which motivated blindness contributed to some bad decision making. The “independent” credit rating agencies that famously gave AAA ratings to collateralized mortgage securities of demonstrably low quality helped build a house of cards that ultimately came crashing down, driving a wave of foreclosures that pushed thousands of people out of their homes. Why did the agencies vouch for those risky securities?
Part of the answer lies in powerful conflicts of interest that helped blind them to their own unethical behavior and that of the companies they rated. The agencies’ purpose is to provide stakeholders with an objective determination of the creditworthiness of financial institutions and the debt instruments they sell.
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