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 23, 2015

Microaggression and Moral Cultures

By Bradley Campbell and Jason Manning
Comparative Sociology 13 (2014) 692–726

Here is an except:

A culture of victimhood is one characterized by concern with status and sensitivity to slight combined with a heavy reliance on third parties. People are intolerant of insults, even if unintentional, and react by bringing them to the attention of authorities or to the public at large. Domination is the main form of deviance, and victimization a way of attracting sympathy, so rather than emphasize either their strength or inner worth, the aggrieved emphasize their oppression and social marginalization. This culture shares some characteristics and conditions with the culture of dignity out of which it evolved, and it may even be viewed as a variant of this culture. It emerges in contemporary settings, such as college campuses, that increasingly lack the intimacy and cultural homogeneity that once characterized towns and suburbs, but in which organized authority and public opinion remain as powerful sanctions. Under such conditions complaint to third parties has supplanted both toleration
and negotiation. People increasingly demand help from others, and advertise their oppression as evidence that they deserve respect and assistance. Thus we might call this moral culture a culture of victimhood because the moral status of the victim, at its nadir in honor cultures, has risen to new heights.

The culture of victimhood is currently most entrenched on college campuses, where microaggression complaints are most prevalent. Other ways of campaigning for support from third parties and emphasizing one’s own oppression – from protest demonstrations to the invented victimization of
hate-crime hoaxes – are prevalent in this setting as well.

The entire article is here.

Microaggression and Changing Moral Cultures

By Bradley Campbell and Jason Manning
The Chronicle of Higher Education
Originally posted July 9, 2015

Here is an excerpt:

We can better understand complaints about microaggression and the reactions to them if we understand that each side of the debate draws from a different moral culture. Those calling attention to microaggressions have rejected the morality dominant among middle-class Americans during the 20th century — what sociologists and historians have sometimes called a dignity culture, which abhors private vengeance and encourages people to go to the police or use the courts when they are seriously harmed. Less serious offenses might be ignored, and certainly any merely verbal offense should be. Parents thus teach their children to say, "Sticks and stones may break my bones, but words can never hurt me."

Microaggression complaints make clear that this is no longer settled morality. Those who see microaggressions as a serious problem and who bring up minor and unintentional slights reject the idea that words can’t hurt, that slights should be brushed off, that even overt insults should be ignored. This attitude reveals the emergence of a new moral culture, one we call victimhood culture, since it valorizes victimhood.

Microaggression complaints are just one manifestation; from the same circles of campus activists also come calls for trigger warnings to alert sensitive students to course material that might disturb them, and the creation of "safe spaces" to shield students from offensive ideas.

The entire blog post is here.

Tuesday, September 22, 2015

Anomalies: The Endowment Effect, Loss Aversion, and Status Quo Bias

Daniel Kahneman, Jack L. Knetsch, Richard H. Thaler
The Journal of Economic Perspectives, 5(1), pp. 193-206, Winter 1991

A wine-loving economist we know purchased some nice Bordeaux wines years ago at low prices. The wines have greatly appreciated in value, so that a bottle that cost only $10 when purchased would now fetch $200 at auction. This economist now drinks some of this wine occasionally, but would neither be willing to sell the wine at the auction price nor buy an additional bottle at that price. Thaler (1980) called this pattern—the fact that people often demand much more to give up an object than they would be willing to pay to acquire it—the endowment effect. The example also illustrates what Samuelson and Zeckhauser (1988) call a status quo bias, a preference for the current state that biases the economist against both buying and selling his wine. These anomalies are a manifestation of an asymmetry of value that Kahneman and Tversky (1984) call loss aversion—the disutility of giving up an object is greater that the utility associated with acquiring it. This column documents the evidence supporting endowment effects and status quo biases, and discusses their relation to loss aversion.

The entire article is here.

Re-engineering shared decision-making

By Muriel R Gillick
J Med Ethics 2015;41:785-788
doi:10.1136/medethics-2014-102618

Abstract

Shared decision-making is widely accepted as the gold standard of clinical care. Numerous obstacles to achieving shared decision-making have been identified, including patient factors, physician factors and systemic factors. Until now, the paradigm is seldom successfully implemented in clinical practice, raising questions about the practicality of the process recommended for its use. A re-engineered model is proposed in which physicians elicit and prioritise patients’ goals of care and then help translate those goals into treatment options, after clarifying the patient's underlying health status. Preliminary evidence suggests that each step of this revised process is feasible and that patients and physicians are comfortable with this strategy. Adoption of this model, after further testing, would allow the goal of shared decision-making to be realised.

The entire article is here.

Monday, September 21, 2015

Public trust has dwindled in America with rise in income inequality

Association for Psychological Science
Originally published September 4, 2015

Here is an excerpt:

Trust in others and confidence in societal institutions are at their lowest point in over three decades, analyses of national survey data reveal. The findings are forthcoming in Psychological Science, a journal of the Association for Psychological Science.

"Compared to Americans in the 1970s-2000s, Americans in the last few years are less likely to say they can trust others, and are less likely to believe that institutions such as government, the press, religious organizations, schools, and large corporations are 'doing a good job,'" explains psychological scientist and lead researcher Jean M. Twenge of San Diego State University.

The entire article is here.

Moral Perception

By Ana P. Gantman and Jay J. Van Bavel
Trends in Cognitive Sciences. Forthcoming

Abstract

Based on emerging research, we propose that human perception is preferentially attuned to moral content. We describe how moral concerns enhance detection of morally relevant stimuli, and both command and direct attention. These perceptual processes, in turn, have important consequences for moral judgment and behavior.

The entire paper isis here.

Sunday, September 20, 2015

Saturday, September 19, 2015

When Bad Doctors Happen to Good Patients

By Thomas Moore and Steve Cohen
The New York Times
Originally published August 31, 2015

Here is an excerpt:

That Lavern’s Law wasn’t allowed to come up for a final vote is Albany’s shame. The greater shame is that hospitals don’t put more emphasis on patient safety. As the Lavern’s Law travesty makes clear, we need better solutions. Don’t limit what injured people may collect, and don’t make it more difficult for victims to get their cases heard. Even better for all concerned, keep the negligent act from ever happening in the first place. And there are practical ways to do that.

Doctors and hospitals must do a better job of policing themselves. Six percent of all doctors were estimated to be responsible for 58 percent of all malpractice payments between 1991 and 2005. State licensing agencies must do a much better job of keeping those worst of the worst out of hospitals. The threshold for state medical licensing agencies to initiate reviews should be reduced; in New York it takes six malpractice judgments or settlements. It should be three at most.

The entire article is here.

Friday, September 18, 2015

The Devil is in the Details: How Patients' Mental Health Data is at Risk

By Farai Chideya
The Intercept
Aug. 21 2015

Here is an excerpt:

If the effort to blend the efficiency of technology with patients’ privacy needs has backfired in general health care (see “Medical Privacy Under Threat”), it is causing particular emotional and financial wounds in the world of mental health, where even a well-managed diagnosis can become a job-threatening stigma. HIPAA laws, long assumed by patients to protect their privacy, only apply in certain circumstances to certain entities. There’s a raging debate over how to regulate the new privacy issues around employee assistance plans and workplace wellness incentives. And the issue of how and when to track mental health patients has even become an issue at the U.S.-Canada border. Citing the high numbers of Americans who have experienced sexual abuse, major depression, or substance abuse, Dr. Deborah Peel, a psychiatrist who founded Patient Privacy Rights, a research and advocacy group, says, “You cannot force people to cough up information when it’s not private. They will hide it. How can we accept an electronic records system that drives people away from being open and honest?”

The entire article is here.