In medical market, shoppers lack savvy

By Peter Ubel
The News and Observer
Originally posted April 6, 2016

Even before Obamacare became the law of the land, the U.S. health care system was undergoing a dramatic transformation. Millions of people were shifting from generous health insurance plans to consumer-directed ones that pair low monthly premiums with high out-of-pocket costs.

This shift has been encouraged by employers, eager to reduce the cost of employee benefits. It has also been encouraged by market enthusiasts who contend that the U.S. health care system needs to be more like the traditional consumer economy.

In theory, a family with a high deductible plan – on the hook for, say, the first $5,000 of health care expenses each year – will scrutinize the cost and quality of health care alternatives before deciding whether to receive them. In practice, health care consumerism doesn’t always play out at the bedside in ways that promote savvy medical decisions.

The article is here.

Highlights:

• A shift from generous health insurance plans to consumer-directed plans has not helped people

• Most patients, or doctors, do not know how to discuss out-of-pocket health care costs

• Frustration with our system often distracts physicians from dealing with patients’ financial concerns

No, You Can’t Feel Sorry for Everyone

BY Adam Waytz
Nautilus
Originally posted April 14, 2015

Here is an excerpt:

Morality can’t be everywhere at once—we humans have trouble extending equal compassion to foreign earthquake victims and hurricane victims in our own country. Our capacity to feel and act prosocially toward another person is finite. And one moral principle can constrain another. Even political liberals who prize universalism recoil when it distracts from a targeted focus on socially disadvantaged groups. Empathy draws our attention toward particular targets, and whether that target represents the underprivileged, blood relatives, refugees from a distant country, or players on a sports team, those targets obscure our attention from other equally (or more) deserving ones.

That means we need to abandon an idealized cultural sensitivity that gives all moral values equal importance. We must instead focus our limited moral resources on a few values, and make tough choices about which ones are more important than others. Collectively, we must decide that these actions affect human happiness more than those actions, and therefore the first set must be deemed more moral than the second set.

The article is here.

How We Feel about Human Cloning

Guest post by Joshua May
BMJ Blogs
Originally posted April 7, 2016

Here is an excerpt:

How would you feel about cloning?  Take the nucleus of a cell from yourself or a loved one, then put it into an egg that will eventually develop into a baby that shares nearly all the genes of the donor cell.  The resulting baby will simply be a kind of ‘delayed twin’ of the donor.

Most people believe this is immoral.  There’s a bit more support for therapeutic uses that merely create new tissue, for example.  But, at least in the US and UK, people overwhelmingly condemn cloning for the purposes of creating new human lives.  In fact, a recent poll suggests there is little disagreement in America over this issue, where human cloning is among the most widely condemned topics (alongside polygamy and infidelity).

That’s what people think, but how do they feel?  Controversial bioethical issues often generate intense feelings.  Some bioethicists treat cloning in particular as a line in the sand that we mustn’t cross, for fear of sliding down a slippery slope to a dystopia.

The blog post is here.

Canadian Prime Minister Seeks to Legalize Physician-Assisted Suicide

By Ian Austen
The New York Times
Originally posted April 14, 2016

The government of Prime Minister Justin Trudeau introduced legislation on Thursday to legalize physician-assisted suicide for Canadians with serious medical conditions.

The proposed law limits physician-assisted suicides to Canadians and residents, who are eligible to participate in the national health care system, preventing a surge in medical tourism among the dying from other countries. Assisted suicide is legal in only a few American states, including Oregon and Vermont.

Under Canada’s proposed law, people who want to die will be able to either commit suicide with medication provided by their doctors or have the doctors administer the dose. Family members will be allowed to assist patients with their death.

The article is here.

The Visual Guide to Morality: Vision as an Integrative Analogy for Moral Experience, Variability and Mechanism

Chelsea Schein, Neil Hester and Kurt Gray
Social and Personality Psychology Compass 10/4 (2016): 231–251

Abstract

Analogies help organize, communicate and reveal scientific phenomena. Vision may be the best analogy for understanding moral judgment. Although moral psychology has long noted similarities between seeing and judging, we systematically review the “morality is like vision” analogy through
three elements: experience, variability and mechanism. Both vision and morality are experienced as automatic, durable and objective. However, despite feelings of objectivity, both vision and morality show substantial variability across biology, culture and situation. The paradox of objective experience and cultural subjectivity is best understood through constructionism, as both vision and morality involve the flexible combination of more basic ingredients. Specifically, both vision and morality involve a mechanism that demonstrates Gestalt, combination and coherence. The “morality is like vision” analogy not only provides intuitive organization and compelling communication for moral psychology but also speaks to debates in the field, such as intuition versus reason, pluralism versus universalism and modularity versus constructionism.

The article is here.

Are moral foundations heritable? Probably

by Jonathan Haidt
The Righteous Mind Blog
Originally posted April 11, 2016

Are moral foundation scores heritable? A new paper by Kevin Smith et al. has tested moral foundations theory in a sample of Australian twins and found that moral foundations are neither heritable nor stable over time. The authors summarized MFT fairly, and they used a research design that is appropriate for the questions they asked, but with one major flaw: They improvised an ultra-short measure of moral foundations (around 2008) that was so poor that they essentially have no measure of moral foundations at time 1. Then at time 2 (around 2010) they used a better measure, the MFQ20. As I show below, nothing can be concluded about heritability or stability from their data.

The blog post is here.

Intuitive Ethics and Political Orientations: Testing Moral Foundations as a Theory of Political Ideology

Kevin B. Smith, John R. Alford, John R. Hibbing, Nicholas G. Martin, Peter K. Hatemi
American Journal of Political Science. 
doi:10.1111/ajps.12255

Abstract

Originally developed to explain cultural variation in moral judgments, moral foundations theory (MFT) has become widely adopted as a theory of political ideology. MFT posits that political attitudes are rooted in instinctual evaluations generated by innate psychological modules evolved to solve social dilemmas. If this is correct, moral foundations must be relatively stable dispositional traits, changes in moral foundations should systematically predict consequent changes in political orientations, and, at least in part, moral foundations must be heritable. We test these hypotheses and find substantial variability in individual-level moral foundations across time, and little evidence that these changes account for changes in political attitudes. We also find little evidence that moral foundations are heritable. These findings raise questions about the future of MFT as a theory of ideology.

The article is here.

Doctors often overestimate promise of newly approved drugs

By Dennis Thompson
HealthDay News
Originally posted April 12, 2016

Here is an excerpt:

The U.S. Congress in 2012 gave FDA the power to designate a drug as a "breakthrough therapy" if preliminary clinical evidence suggests an advantage over existing medications.

But a survey of nearly 700 doctors revealed that many tended to misinterpret "breakthrough." Doctors often believed the drugs were supported by stronger evidence than the law requires to achieve that designation, said lead author Dr. Aaron Kesselheim. He is a faculty member at Brigham and Women's Hospital in Boston.

"When people hear 'breakthrough,' it gives them an inappropriately elevated sense of what the drug might do," Kesselheim said. "It may give physicians false reassurance about the outcomes they might expect to receive when they prescribe it."

The article is here.

Inference of Trustworthiness from Intuitive Moral Judgments

Jim A. C. Everett, David A. Pizarro, M. J. Crockett.
Journal of Experimental Psychology: General, 2016
DOI: 10.1037/xge0000165

Abstract

Moral judgments play a critical role in motivating and enforcing human cooperation. Research on the proximate mechanisms of moral judgments highlights the importance of intuitive, automatic processes in forming such judgments. Intuitive moral judgments often share characteristics with deontological theories in normative ethics, which argue that certain acts (such as killing) are absolutely wrong, regardless of their consequences. Why do moral intuitions typically follow deontological prescriptions, as opposed to those of other ethical theories? Here we test a functional explanation for this phenomenon by investigating whether agents who express deontological moral judgments are more valued as social partners. Across five studies we show that people who make characteristically deontological judgments (as opposed to judgments that align with other ethical traditions) are preferred as social partners, perceived as more moral and trustworthy, and trusted more in economic games. These findings provide empirical support for a partner choice account for why intuitive moral judgments often align with deontological theories.

The article can be downloaded here.