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, February 15, 2016

If You’re Loyal to a Group, Does It Compromise Your Ethics?

By Francesca Gino
Harvard Business Review
Originally posted January 06, 2016

Here are two excerpts:

Most of us feel loyalty, whether to our clan, our comrades, an organization, or a cause. These loyalties are often important aspects of our social identity. Once a necessity for survival and propagation of the species, loyalty to one’s in-group is deeply rooted in human evolution.

But the incidents of wrongdoing that capture the headlines make it seem like loyalty is all too often a bad thing, corrupting many aspects of our personal and professional lives. My recent research, conducted in collaboration with Angus Hildreth of the University of California, Berkeley and Max Bazerman of Harvard Business School, suggests that this concern about loyalty is largely misplaced. In fact, we found loyalty to a group can increase, rather than decrease, honest behavior.

(cut)

As our research shows, loyalty can be a driver of good behavior, but when competition among groups is high, it can lead us to behave unethically. When we are part of a group of loyal members, traits associated with loyalty — such as honor, honesty, and integrity — are very salient in our minds. But when loyalty seems to demand a different type of goal, such as competing with other groups and winning at any cost, behaving ethically becomes a less important goal.

The article is here.

When Deliberation Isn’t Smart

By Adam Bear and David Rand
Evonomics
Originally published January 25, 2016

Cooperation is essential for successful organizations. But cooperating often requires people to put others’ welfare ahead of their own. In this post, we discuss recent research on cooperation that applies the “Thinking, fast and slow” logic of intuition versus deliberation. We explain why people sometimes (but not always) cooperate in situations where it’s not in their self-interest to do so, and show how properly designed policies can build “habits of virtue” that create a culture of cooperation. TL;DR summary: intuition favors behaviors that are typically optimal, so institutions that make cooperation typically advantageous lead people to adopt cooperation as their intuitive default; this default then “spills over” into settings where it’s not actually individually advantageous to cooperate.

Life is full of opportunities to make personal sacrifices on behalf others, and we often rise to the occasion. We do favors for co-workers and friends, give money to charity, donate blood, and engage in a host of other cooperative endeavors. Sometimes, these nice deeds are reciprocated (like when we help out a friend, and she helps us with something in return). Other times, however, we pay a cost and get little in return (like when we give money to a homeless person whom we’ll never encounter again).

Although you might not realize it, nowhere is the importance of cooperation more apparent than in the workplace. If your boss is watching you, you’d probably be wise to be a team player and cooperate with your co-workers, since doing so will enhance your reputation and might even get you a promotion down the road. In other instances, though, you might get no recognition from, say, helping out a fellow employee who needs assistance meeting a deadline, or who calls out sick.

The article is here.

Sunday, February 14, 2016

Why people fall for pseudoscience

By Sian Townson
The Guardian
Originally published January 26, 2016

Pseudoscience is everywhere – on the back of your shampoo bottle, on the ads that pop up in your Facebook feed, and most of all in the Daily Mail. Bold statements in multi-syllabic scientific jargon give the false impression that they’re supported by laboratory research and hard facts.

Magnetic wristbands improve your sporting performance, carbs make you fat, and just about everything gives you cancer.

Of course, we scientists accept that sometimes people believe things we don’t agree with. That’s fine. Science is full of people who disagree with one another . If we all thought exactly the same way, we could retire and call the status quo truth.

But when people think snake oil is backed up by science, we have to challenge that. So why is it so hard?

The article is here.

Saturday, February 13, 2016

Pentagon Wants Psychologists to End Ban on Interrogation Role

By James Risen
The New York Times
Originally posted on January 24, 2016

The Pentagon has asked the American Psychological Association to reconsider its ban on the involvement of psychologists in national security interrogations at the Guantánamo Bay prison and other facilities.

The Defense Department reduced its use of psychologists at Guantánamo in late 2015 in response to the policy approved by the association last summer.

But in a letter and accompanying memo to association officials this month, Brad Carson, the acting principal deputy secretary of defense for personnel and readiness, asked that the group, the nation’s largest professional organization for psychologists, revisit its “blanket prohibition.”

Although “the Department of Defense understands the desire of the American psychology profession to make a strong statement regarding reports about the role of former military psychologists more than a dozen years ago, the issue now is to apply the lessons learned to guide future conduct,” Mr. Carson wrote.

The article is here.

Friday, February 12, 2016

Harm is all you need? Best interests and disputes about parental decision-making

by Giles Birchley
J Med Ethics 2016;42:111-115
doi:10.1136/medethics-2015-102893

Abstract

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema's seminal paper as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests.

The article is here.

Growing use of neurobiological evidence in criminal trials, new study finds

By Emily Underwood
Science
Originally posted January 21, 2016

Here is an excerpt:

Overall, the new study suggests that neurobiological evidence has improved the U.S. criminal justice system “through better determinations of competence and considerations about the role of punishment,” says Judy Illes, a neuroscientist at the University of British Columbia, Vancouver, in Canada. That is not Farahany’s interpretation, however. With a few notable exceptions, use of neurobiological evidence in courtrooms “continues to be haphazard, ad hoc, and often ill conceived,” she and her colleagues write. Lawyers rarely heed scientists’ cautions “that the neurobiological evidence at issue is weak, particularly for making claims about individuals rather than studying between-group differences,” they add.

The article is here.

Thursday, February 11, 2016

An American Psychiatric Horror Story

By Todd Essig
Forbes
Originally posted January 24, 2016

Here is an excerpt:

In order to say denying care is a good thing Bennett has to denigrate the value of the care provided. He wants readers to believe weekly psychotherapy, or whatever frequency and duration a patient and therapist determine is in the patient’s best interests, has “limited potential to heal and protect.” He concludes this because, as he writes, “Objectively, there’s little evidence that the treatment relationship is as healing, powerful or anchoring as we and our patients wish it would be…”

That is such an absurd pretzel I have to resist the urge to turn on my caps lock. Of course treatment is NEVER as amazing as people wish it would be. That’s what makes them wishes and not plans. His is a meaningless statement because not gratifying wishes for transcendent change is not an outcome measure. It is an inevitability. But that’s the reason he says therapy has limited potential.

And I should point out, every (EVERY!) medical intervention has limits. Remember the old joke about the patient who gets an unequivocal yes after asking his surgeon if he’ll be able to play the piano after the life-saving operation only to say “that’s great, I can’t play now!” Well, according to Bennett that would be reason enough for an insurance company to deny coverage for the life-saving operation.

The article is here.

‘Is this knowledge mine and nobody else's? I don't feel that.’

Patient views about consent, confidentiality and information-sharing in genetic medicine

Sandi Dheensa, Angela Fenwick, and Anneke Lucassen
J Med Ethics doi:10.1136/medethics-2015-102781

Abstract

In genetic medicine, a patient's diagnosis can mean their family members are also at risk, raising a question about how consent and confidentiality should function in clinical genetics. This question is particularly pressing when it is unclear whether a patient has shared information. Conventionally, healthcare professionals view confidentiality at an individual level and ‘disclosure without consent’ as the exception, not the rule. The relational joint account model, by contrast, conceptualises genetic information as confidential at the familial level and encourages professionals to take disclosure as the default position. In this study, we interviewed 33 patients about consent and confidentiality and analysed data thematically. Our first theme showed that although participants thought of certain aspects of genetic conditions—for example, the way they affect day-to-day health—as somewhat personal, they perceived genetic information—for example, the mutation in isolation—as familial. Most thought these elements were separable and thought family members had a right to know the latter, identifying a broad range of harms that would justify disclosure. Our second theme illustrated that participants nonetheless had some concerns about what, if any, implications there would be of professionals treating such information as familial and they emphasised the importance of being informed about the way their information would be shared. Based on these results, we recommend that professionals take disclosure as the default position, but make clear that they will treat genetic information as familial during initial consultations and address any concerns therein.

The article is here.

Wednesday, February 10, 2016

End-of-life care in U.S. not as costly as in Canada

By Jessica McDonald
newsworks.org
Originally posted January 10, 2016

The United States has a reputation for providing costly -- and often unwanted -- end-of-life care. But the first study to do an international comparison finds it's not as egregious as we thought.

Compared with patients in other developed nations, Americans diagnosed with cancer spend more time in the intensive care unit and get more chemotherapy in the last months of their lives.

But fewer patients are in the hospital when they die. And the overall bill, while high, isn't the steepest. That honor goes to Canada.

"We found that end-of-life care in the United States is not the worst in the world, and I think that surprises a lot of people," said Dr. Ezekiel Emanuel, a medical ethicist at the University of Pennsylvania.

The article is here.