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

Thursday, September 10, 2015

Law and Ethics

Richard Marshall interviews Matthew Kramer
3:AM Magazine
Originally published on August 22, 2015

Here is an excerpt:

3:AM: If capital punishment is a central contemporary issue so is the use of torture. Why do you argue that torture is always wrong?

MK: There is no single answer to that question, because there are many different types of torture, and the explanation of the wrongness of torture is not uniform across those types. (When I refer to the sundry types of torture, I am not differentiating among them on the basis of the techniques employed; rather, I am differentiating among them with regard to the chief purposes for which torture is undertaken.) Let me say a bit here about the most frequently discussed type, interrogational torture. My 2014 book Torture and Moral Integrity maintains that such torture is always and everywhere morally wrong. The gravity of the wrong varies, but the wrongness itself does not. Hence, it should be apparent that that book is as robustly deontological as any of my previous volumes. (“Robustly deontological” is definitely not equivalent to “robustly Kantian.” My book on torture contains numerous objections to Kantianism as well as to consequentialism.)

Interrogational torture involves the deliberate infliction of severe pain for the purpose of extracting information from someone (either from the person on whom the pain is directly inflicted or from someone who is likely to care deeply about that person). The deliberate infliction of severe pain for that purpose is always morally wrong because of the overweeningness of the control exerted both through the infliction itself and through the aim which it is undertaken to achieve. The overweeningness of the control exerted by the infliction itself has been brought out especially incisively in recent years by David Sussman, and the overweeningness of the aim pursued has been brought out especially incisively in recent years by David Luban. Hence, I draw upon their writings as well as those of many other philosophers in my ruminations on torture.

The entire interview is here.

A tale of vigilante justice

Adulterers, hackers, and the Ashley Madison affair

By Russell Blackford
The Conversation
Originally published on August 23, 2015

Here is an excerpt:

Whatever you think about adulterous liaisons – even if you regard them as outrageous, destructive, morally wicked breaches of trust – this sort of vigilante justice is unacceptable. When vigilantes set out to punish sinners or wrongdoers, the results can be perverse, disproportionate, sometimes extreme and often irreversible. Even the supposed victims of wrongdoers may end up worse off.

It is difficult enough to judge the wisdom of revealing an adulterous affair to an affected individual when the facts are fairly clear and the consequences are possibly manageable. Indiscriminately letting loose this kind of data, affecting millions of personal situations, is atrociously arrogant and callous.

I’m sure that customers signed up to Ashley Madison for a wide range of reasons. Some may have done little or nothing wrong, even by conventional standards of sexual morality, but will now be held up for public shaming. Some may have been sufficiently interested in a phenomenon such as Ashley Madison to want to research it from the inside. Many may simply have been curious.

Others may have toyed with the idea of an affair, but not in a serious way – they may have been driven by their curiosity and other emotions to browse the site, but gone no further. Some may have been in open relationships of one kind or another: but even so, they could be embarrassed, shamed and otherwise harmed by revelations about their memberships.

The entire article is here.

Wednesday, September 9, 2015

How can healthcare professionals better manage their unconscious racial bias?

By April Dembosky
MedCity News
Originally published August 21, 2015

Here is an excerpt:

Racial Disparity In Medical Treatment Persists

Even as the health of Americans has improved, the disparities in treatment and outcomes between white patients and black and Latino patients are almost as big as they were 50 years ago.

A growing body of research suggests that doctors’ unconscious behavior plays a role in these statistics, and the Institute of Medicine of the National Academy of Sciences has called for more studies looking at discrimination and prejudice in health care.

For example, several studies show that African-American patients are often prescribed less pain medication than white patients with the same complaints. Black patients with chest pain are referred for advanced cardiac care less often than white patients with identical symptoms.

Doctors, nurses and other health workers don’t mean to treat people differently, says Howard Ross, founder of management consulting firm Cook Ross, who has worked with many groups on diversity issues. But all these professionals harbor stereotypes that they’re not aware they have, he says. Everybody does.

The entire article is here.

Can generosity go too far?

By Julian Baggini
The New Statesman
Originally published on August 21, 2015

Here is an excerpt:

We have heard so many stories of misguided projects and misspent money over the years that surely the time has come to demand evidence that the charities we ­support are effective. But how do you measure whether a charity is effective? One answer would be to apply two tests: does it achieve its stated goal and does it do so as cost-efficiently as it can? A charity such as Guide Dogs might pass this test. But for effective altruists, in deciding whether to give to Guide Dogs, you ought to ask another question: could you get more altruistic bang for your buck by giving to something completely different instead?

They say you can. Guide Dogs UK says it costs £32,400 to train a guide dog and its owner and then another £12,800 “to support the working partnership”. In contrast, Singer says you can save someone from going blind in the developing world for between $20 and $100. “If you do the maths,” he writes, “you will see that the choice we face is to provide one person with a guide dog or prevent anywhere between 400 and 2,000 cases of blindness.”

The entire article is here.

Tuesday, September 8, 2015

Doctors Behaving Badly

By Roni Caryn Rabin
The New York Times - Well
Originally published

Here is an excerpt:

Nancy Berlinger, a scholar at The Hastings Center who writes about ethical challenges in health care as well as issues of power between junior and senior clinicians, disagrees. “Doctors must be respectful even if a patient is sedated,” she said. And in these cases, she said, the supervising physicians also did harm to the medical students they were responsible for training and mentoring.

“This is the worst thing a role model can do: to suggest that wrong behavior is acceptable, to nudge junior people to be callous and to misuse power,” Dr. Berlinger said. In both cases, the senior doctors made a trainee student complicit in their abuse and “made them feel dirty at an early stage of their careers.”

The entire article is here.

Feds oppose UO for releasing alleged gang-rape victim's therapy records

By Richard Read
The Oregonian
Originally published August 20, 2015

A federal official advised universities this week to not share a student's medical records without written consent, contradicting the University of Oregon's release of an alleged gang-rape victim's therapy records to the school's lawyers.

The six-page draft letter from Kathleen Styles, the U.S. Education Department's chief privacy officer, was issued this week after repeated inquiries by The Oregonian/Oregonlive and members of Oregon's congressional delegation.

In effect, the letter steamrolls a UO Counseling Center confidentiality policy weakened in March by center director Shelly Kerr, clinical director Joseph DeWitz and university associate general counsel Samantha Hill. The Oregon Board of Psychologist Examiners is investigating four UO psychologists, including the two center managers, after Kerr secretly gave the woman's records to university attorneys in December without seeking her permission or notifying her therapist, Jennifer Morlok.

The entire article is here.

Monday, September 7, 2015

Science Isn’t Broken

By Christine Aschwanden
FivethirtyeightScience
Originally published August 19, 2015

If you follow the headlines, your confidence in science may have taken a hit lately.

Peer review? More like self-review. An investigation in November uncovered a scam in which researchers were rubber-stamping their own work, circumventing peer review at five high-profile publishers.

Scientific journals? Not exactly a badge of legitimacy, given that the International Journal of Advanced Computer Technology recently accepted for publication a paper titled “Get Me Off Your Fucking Mailing List,” whose text was nothing more than those seven words, repeated over and over for 10 pages. Two other journals allowed an engineer posing as Maggie Simpson and Edna Krabappel to publish a paper, “Fuzzy, Homogeneous Configurations.”

The entire article is here.

How to Know Whether to Believe a Health Study

By Austin Frakt
The New York Times - The Upshot
Originally posted on August 17, 2015

Here is an excerpt:

Unfortunately, there’s no substitute for careful examination of studies by experts. Yet, if you’re not an expert, you can do a few simple things to become a more savvy consumer of research. First, if the study examined the effects of a therapy only on animals or in a test tube, we have very limited insight into how it will actually work in humans. You should take any claims about effects on people with more than a grain of salt. Next, for studies involving humans, ask yourself: What method did the researchers use? How similar am I to the people it examined?

Sure, there are many other important questions to ask about a study — for instance, did it examine harms as well as benefits? But just assessing the basis for what researchers call “causal claims” — X leads to or causes Y — and how similar you are to study subjects will go a long way toward unlocking its credibility and relevance to you.

The entire article is here.

Sunday, September 6, 2015

How to influence the right corporate culture in your business (and why it matters)

By Rick Spence
Financial Post
Originally published on August 17

Here is an excerpt:

A culture not built on authenticity is an illusion. But there are many things a good boss can do to influence development of the right culture:

  • Live the values you set for the company. If you want honesty, courage, creativity and collaboration, demonstrate those traits every day. Make sure your entire leadership team follows suit. Employees will sense – and resent – hypocrisy.
  • Make sure HR and/or your hiring managers understand and reinforce the culture you’re trying to create. Develop interview tools that identify candidates with desired characteristics. Weed out employees who don’t share these values. When employees see you tolerating people who don’t honor the culture, they will conclude that it’s not that important to you.
  • Identify other organizations with cultures similar to the culture you wish to build (e.g., Design = Apple; Innovation = Google, Happiness = Zappos). Communicate regularly with your staff to show how those companies build, maintain and benefit from their unique cultures.
  • Take every opportunity to restate your company’s values. If your employees can’t explain their culture using the same words you do, you’re not there yet.
  • Conduct regular satisfaction surveys to measure how engaged your employees feel with the culture.