By Susan Gubar
The New York Times - Well
Originally posted May 19, 2016
Here is an excerpt:
None of us were eased by communication strategies that have evolved since 2000 when Dr. Walter F. Baile and his associates published their paradigm for delivering bad news in The Oncologist. This article advocates a program called Spikes: S stands for finding the appropriate setting; P for gauging the perceptions of the patient; I for obtaining the patient’s invitation to hear bad news; K for providing the knowledge that the patient needs to receive; E for dealing with the emotional reactions of the patient with empathy; S for concluding with a needed summary.
Despite such a thoughtful template, miscommunication does not taint only diagnosis, as I.M. realized when she went on to confide about a more recent exchange. At her last meeting with her oncologist, they had discussed the sorry fact that the current cycle of chemotherapy had not inhibited tumor growth. The doctor gave her three choices: returning to the drug used in her first cycle, trying a clinical trial or “opting to do nothing.” Alarmed and shaken by this last proposal, she felt as if he were throwing up his hands or she had somehow been fired.
The article is here.
Thursday, June 9, 2016
Ethics and the Eye of the Beholder
Thomas Pogge, one of the world’s most prominent ethicists, stands accused of manipulating students to gain sexual advantage. Did the fierce champion of the world's disempowered abuse his own power?
Katie J.M. Baker
BuzzFeed News
Originally posted May 20, 2016
Here is an excerpt:
But a recent federal civil rights complaint describes a distinction unlikely to appear on any curriculum vitae: It claims Pogge uses his fame and influence to manipulate much younger women in his field into sexual relationships. One former student said she was punished professionally after resisting his advances.
Pogge did not respond to more than a dozen emails and phone calls from BuzzFeed News, nor to a detailed letter laying out all the claims that were likely to appear in this article. Yale’s spokesperson, Thomas Conroy, declined to comment.
Editor's note: Research shows that those who teach ethics do not act more ethically than the rest of the population.
Wednesday, June 8, 2016
Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals
Neil Levy, Thomas Douglas, Guy Kahane, Sylvia Terbeck, Philip J. Cowen, Miles
Hewstone, and Julian Savulescu
Philos Psychiatr Psychol. 2014 June 1; 21(2): 111–125.
doi:10.1353/ppp.2014.0023.
Abstract
A number of concerns have been raised about the possible future use of pharmaceuticals designed
to enhance cognitive, affective, and motivational processes, particularly where the aim is to
produce morally better decisions or behavior. In this article, we draw attention to what is arguably
a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are
already having unintended effects on these processes, and thus on moral decision making and
morally significant behavior. We review current evidence on the moral effects of three widely
used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii)
drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision
making and behavior caused by these agents may have important and difficult-to-evaluate
consequences, at least at the population level. We argue that the moral effects of these and other
widely used pharmaceuticals warrant further empirical research and ethical analysis.
The paper is here.
Hewstone, and Julian Savulescu
Philos Psychiatr Psychol. 2014 June 1; 21(2): 111–125.
doi:10.1353/ppp.2014.0023.
Abstract
A number of concerns have been raised about the possible future use of pharmaceuticals designed
to enhance cognitive, affective, and motivational processes, particularly where the aim is to
produce morally better decisions or behavior. In this article, we draw attention to what is arguably
a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are
already having unintended effects on these processes, and thus on moral decision making and
morally significant behavior. We review current evidence on the moral effects of three widely
used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii)
drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision
making and behavior caused by these agents may have important and difficult-to-evaluate
consequences, at least at the population level. We argue that the moral effects of these and other
widely used pharmaceuticals warrant further empirical research and ethical analysis.
The paper is here.
Soon we’ll use science to make people more moral
By James J. Hughes
The Washington Post
Originally posted May 19, 2016
Here is an excerpt:
he emerging debate over the use of drugs and devices for moral enhancement has had three principal viewpoints: those who focus on boosting moral sentiments such as empathy; those who would just boost moral reasoning; and the skeptics. While the former two groups accept the goal of moral enhancement — and differ over the best method — the skeptics reject the project. They argue that moral enhancement therapies are overhyped, and that even if morality drugs were effective, they would be bad for our character to rely on them.
It is certainly true that the initial enthusiasm for certain moral enhancement therapies has been tempered by subsequent research. Dozens of studies have suggested that genes that regulate oxytocin, the “cuddle hormone,” affect trust and empathy, and that empathy is boosted when subjects snort oxytocin. But it now appears that the effects of boosting oxytocin were over-reported and that some of the hormone’s effects are less than cuddly — oxytocin tends to boost empathy only for people like us, increasing ethnocentric “in-group bias.”
The article is here.
The Washington Post
Originally posted May 19, 2016
Here is an excerpt:
he emerging debate over the use of drugs and devices for moral enhancement has had three principal viewpoints: those who focus on boosting moral sentiments such as empathy; those who would just boost moral reasoning; and the skeptics. While the former two groups accept the goal of moral enhancement — and differ over the best method — the skeptics reject the project. They argue that moral enhancement therapies are overhyped, and that even if morality drugs were effective, they would be bad for our character to rely on them.
It is certainly true that the initial enthusiasm for certain moral enhancement therapies has been tempered by subsequent research. Dozens of studies have suggested that genes that regulate oxytocin, the “cuddle hormone,” affect trust and empathy, and that empathy is boosted when subjects snort oxytocin. But it now appears that the effects of boosting oxytocin were over-reported and that some of the hormone’s effects are less than cuddly — oxytocin tends to boost empathy only for people like us, increasing ethnocentric “in-group bias.”
The article is here.
Tuesday, June 7, 2016
The empty brain
by Robert Epstein
Aeon Magazine
Originally published May 18, 2016
Here are two excerpts:
Forgive me for this introduction to computing, but I need to be clear: computers really do operate on symbolic representations of the world. They really store and retrieve. They really process. They really have physical memories. They really are guided in everything they do, without exception, by algorithms.
Humans, on the other hand, do not – never did, never will. Given this reality, why do so many scientists talk about our mental life as if we were computers?
(cut)
Misleading headlines notwithstanding, no one really has the slightest idea how the brain changes after we have learned to sing a song or recite a poem. But neither the song nor the poem has been ‘stored’ in it. The brain has simply changed in an orderly way that now allows us to sing the song or recite the poem under certain conditions. When called on to perform, neither the song nor the poem is in any sense ‘retrieved’ from anywhere in the brain, any more than my finger movements are ‘retrieved’ when I tap my finger on my desk. We simply sing or recite – no retrieval necessary.
The article is here.
Editor's note: This article may help clinician's reflect on the way we discuss memories and change with our patients. Our understanding of how the brain works is quite limited. And, the brain is not like a computer.
Aeon Magazine
Originally published May 18, 2016
Here are two excerpts:
Forgive me for this introduction to computing, but I need to be clear: computers really do operate on symbolic representations of the world. They really store and retrieve. They really process. They really have physical memories. They really are guided in everything they do, without exception, by algorithms.
Humans, on the other hand, do not – never did, never will. Given this reality, why do so many scientists talk about our mental life as if we were computers?
(cut)
Misleading headlines notwithstanding, no one really has the slightest idea how the brain changes after we have learned to sing a song or recite a poem. But neither the song nor the poem has been ‘stored’ in it. The brain has simply changed in an orderly way that now allows us to sing the song or recite the poem under certain conditions. When called on to perform, neither the song nor the poem is in any sense ‘retrieved’ from anywhere in the brain, any more than my finger movements are ‘retrieved’ when I tap my finger on my desk. We simply sing or recite – no retrieval necessary.
The article is here.
Editor's note: This article may help clinician's reflect on the way we discuss memories and change with our patients. Our understanding of how the brain works is quite limited. And, the brain is not like a computer.
Student Resistance to Thought Experiments
Regina A. Rini
APA Newsletter - Teaching Philosophy
Spring 2016, Volume 15 (2)
Introduction
From Swampmen to runaway trolleys, philosophers make routine use of thought experiments. But our students are not always so enthusiastic. Most teachers of introductory philosophy will be familiar with the problem: students push back against the use of thought experiments, and not for the reasons that philosophers are likely to accept. Rather than challenge whether the thought experiments actually
support particular conclusions, students instead challenge their realism or their relevance.
In this article I will look at these sorts of challenges, with two goals in mind. First, there is a practical pedagogical goal: How do we guide students to overcome their resistance to a useful method? Second, there is something I will call “pedagogical bad faith.” Many of us actually do have sincere doubts, as professional philosophers, about the value of thought experiment methodology. Some of
these doubts in fact correspond to our students’ naïve resistance. But we often decide, for pedagogical reasons, to avoid mentioning our own doubts to students. Is this practice defensible?
The article is here.
Editor's Note: I agree with this article in many ways. After I have read a philosophy article and a podcast using a thought experiment, I provided critiques regarding how the thought experiments were limited to the author. My criticisms were dismissed with a more ad hominem attack of my lack of understanding of philosophy or how philosophers work. I was told I should read more philosophy, especially Derek Parfit. I wish I had this article several years ago.
APA Newsletter - Teaching Philosophy
Spring 2016, Volume 15 (2)
Introduction
From Swampmen to runaway trolleys, philosophers make routine use of thought experiments. But our students are not always so enthusiastic. Most teachers of introductory philosophy will be familiar with the problem: students push back against the use of thought experiments, and not for the reasons that philosophers are likely to accept. Rather than challenge whether the thought experiments actually
support particular conclusions, students instead challenge their realism or their relevance.
In this article I will look at these sorts of challenges, with two goals in mind. First, there is a practical pedagogical goal: How do we guide students to overcome their resistance to a useful method? Second, there is something I will call “pedagogical bad faith.” Many of us actually do have sincere doubts, as professional philosophers, about the value of thought experiment methodology. Some of
these doubts in fact correspond to our students’ naïve resistance. But we often decide, for pedagogical reasons, to avoid mentioning our own doubts to students. Is this practice defensible?
The article is here.
Editor's Note: I agree with this article in many ways. After I have read a philosophy article and a podcast using a thought experiment, I provided critiques regarding how the thought experiments were limited to the author. My criticisms were dismissed with a more ad hominem attack of my lack of understanding of philosophy or how philosophers work. I was told I should read more philosophy, especially Derek Parfit. I wish I had this article several years ago.
Monday, June 6, 2016
Stopping the revolving prison door for the mentally ill
by Courtenay Harris Bond
Phillie.com
Originally posted May 10, 2016
Here is an excerpt:
But the unfortunate reality right now is that many people with serious mental illness who commit even minor infractions are locked up, making over-crowded prisons and jails responsible for mental health services they are ill equipped to deal with.
“The police are called on to do too much, and the health care system is not doing enough,” Sisti said. “The whole idea that the police are now front-line mental health workers shows that we’ve abdicated our responsibilities as health care professionals.”
“The police in their best efforts aren’t equipped with the tools”—psychiatric medications, for example, that only physicians and nurses can administer—“to de-escalate some of these situations,” added Cyndi Rickards, an assistant professor in the Department of Criminology and Justice Studies at Drexel.
Dr. Philip Candilis, director of the forensic psychiatry fellowship at St. Elizabeth’s Hospital in Washington, described a jail diversion program in Arlington, Va., where courts work with social service agencies to aid people struggling with mental illness who find themselves in trouble with the law. Mental health courts in Philadelphia and Washington function in a similar way.
The article is here.
Phillie.com
Originally posted May 10, 2016
Here is an excerpt:
But the unfortunate reality right now is that many people with serious mental illness who commit even minor infractions are locked up, making over-crowded prisons and jails responsible for mental health services they are ill equipped to deal with.
“The police are called on to do too much, and the health care system is not doing enough,” Sisti said. “The whole idea that the police are now front-line mental health workers shows that we’ve abdicated our responsibilities as health care professionals.”
“The police in their best efforts aren’t equipped with the tools”—psychiatric medications, for example, that only physicians and nurses can administer—“to de-escalate some of these situations,” added Cyndi Rickards, an assistant professor in the Department of Criminology and Justice Studies at Drexel.
Dr. Philip Candilis, director of the forensic psychiatry fellowship at St. Elizabeth’s Hospital in Washington, described a jail diversion program in Arlington, Va., where courts work with social service agencies to aid people struggling with mental illness who find themselves in trouble with the law. Mental health courts in Philadelphia and Washington function in a similar way.
The article is here.
Freedom of patient-physician conversations hinges on court case
AMA Wire
Originally posted May 16, 2016
A federal court will be hearing a case about the constitutionality of a state law that represses free discussion between physicians and patients regarding health and safety issues.
In a friend-of-the-court brief filed April 26, the AMA and eight other medical societies urged the Court of Appeals for the 11th Circuit to overturn a Florida law that restricts physicians from discussing firearm safety with patients and their families.
The brief argues that the Firearm Owners’ Privacy Act is unconstitutional and intrudes on the practice of medicine. The law will inevitably affect other aspects of patient care, the brief says.
The press release is here.
Originally posted May 16, 2016
A federal court will be hearing a case about the constitutionality of a state law that represses free discussion between physicians and patients regarding health and safety issues.
In a friend-of-the-court brief filed April 26, the AMA and eight other medical societies urged the Court of Appeals for the 11th Circuit to overturn a Florida law that restricts physicians from discussing firearm safety with patients and their families.
The brief argues that the Firearm Owners’ Privacy Act is unconstitutional and intrudes on the practice of medicine. The law will inevitably affect other aspects of patient care, the brief says.
The press release is here.
Sunday, June 5, 2016
Memories of unethical actions become obfuscated over time
Maryam Kouchakia and Francesca Gino
PNAS 2016 ; published ahead of print May 16, 2016
doi:10.1073/pnas.1523586113
Abstract
Despite our optimistic belief that we would behave honestly when facing the temptation to act unethically, we often cross ethical boundaries. This paper explores one possibility of why people engage in unethical behavior over time by suggesting that their memory for their past unethical actions is impaired. We propose that, after engaging in unethical behavior, individuals’ memories of their actions become more obfuscated over time because of the psychological distress and discomfort such misdeeds cause. In nine studies (n = 2,109), we show that engaging in unethical behavior produces changes in memory so that memories of unethical actions gradually become less clear and vivid than memories of ethical actions or other types of actions that are either positive or negative in valence. We term this memory obfuscation of one’s unethical acts over time “unethical amnesia.” Because of unethical amnesia, people are more likely to act dishonestly repeatedly over time.
The article is here.
PNAS 2016 ; published ahead of print May 16, 2016
doi:10.1073/pnas.1523586113
Abstract
Despite our optimistic belief that we would behave honestly when facing the temptation to act unethically, we often cross ethical boundaries. This paper explores one possibility of why people engage in unethical behavior over time by suggesting that their memory for their past unethical actions is impaired. We propose that, after engaging in unethical behavior, individuals’ memories of their actions become more obfuscated over time because of the psychological distress and discomfort such misdeeds cause. In nine studies (n = 2,109), we show that engaging in unethical behavior produces changes in memory so that memories of unethical actions gradually become less clear and vivid than memories of ethical actions or other types of actions that are either positive or negative in valence. We term this memory obfuscation of one’s unethical acts over time “unethical amnesia.” Because of unethical amnesia, people are more likely to act dishonestly repeatedly over time.
The article is here.
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